Partner Spotlight Series: Callen-Lorde Community Health Center
Finn Brigham and Anthony Fortenberry both sit on MSPPS Projects and Workgroups.
Callen-Lorde Community Health Center’s serves the LGBT community within New York City and provides a voice for these individuals to improve the quality of care they receive.
In 2015 New York State fee-for-service Medicaid and Medicaid Managed Care began covering “transition-related care and services for persons diagnosed with gender dysphoria.”* Gender dysphoria is a diagnosis given to an individual whose gender assignment at birth does not match the gender they identify with. These services include counseling, hormone therapy, and gender reassignment surgery.
For an organization like Callen-Lorde Community Health Center, this was monumental. Callen-Lorde is a health center that provides supportive services to New York’s lesbian, gay, bisexual, and transgender communities. These services include dental, primary care, health outreach for teens, pharmacy, sexual health clinic, and transgender health services. The Transgender Health Services Program serves 3,000 to 4,000 patients who identify as either transgender or gender non-conforming. Services specific to the Transgender Health Services include primary care, hormone care, sexually transmitted infection screenings & treatment, care coordination, and harm reduction counseling. The coverage of transgender services from Medicaid provides patients with opportunities to receive these services that they were previously unable to afford. According to Finn Brigham, Director of Project Management, “This has been a wonderful development for our patients who would have to pay out of pocket for these services.”
While this is a step in the right direction, Finn is aware that those who identify as transgender or gender non-conforming are still uncomfortable in medical settings and specifically some are afraid to go to the emergency room. He feels that the implementation of DSRIP will help alleviate these fears among Callen-Lorde’s patients. Finn said, “DSRIP is a great opportunity to solidify best practices around trans care and essentially train other healthcare providers.”
Callen-Lorde opened up a new space in the South Bronx this past July and they are already surpassing its predicated numbers. In fact, they hope to open up a new facility in Brooklyn in the coming years. Anthony Fortenberry, Director of Nursing, said, “We have certainly shown that there is a greater need for more LGBT care in NYC.”
Callen-Lorde is aware that DSRIP could assist with its capacity issues. By interacting with other organizations through the workgroups and projects, Finn is hoping to share and combine practices among other organizations within the Mount Sinai PPS. He said, “We all refer to one another. Callen-Lorde doesn’t do a lot of specialty services (preventative services) so when our patients need these things; we want to recommend them to a place we know has been properly trained. Even to have a name of a person that I can email makes the whole process a lot more personal.”
The Effects of DSRIP within Callen-Lorde
Callen-Lorde provides a variety of services to its patients. Pictured above is a room utilized for dentistry services.
Callen-Lorde is heavily involved with DSRIP even presenting at the September Cultural Competency and Health Literacy (CC/HL) Kickoff Event where Finn shared with partners concerns and fears faced by the LGBT community and discussed strategies for culturally competent trainings for staff to support LGBT patients.
Callen-Lorde is also involved with Projects 2.c.i., 3.a.i., and 4.c.ii and has tried to implement these projects’ strategies to improve its services. For example, Anthony explains that within the LGBT population there are higher rates of depression and suicide. Being involved with Project 3.a.i, Integration of Primary Care and Behavioral Health Services, has allowed them to utilize depression screenings. In fact, Callen-Lorde has even hired mental health professionals to conduct these assessments. If a patient tests positive for depression, a warm hand-off will be conducted in the moment to these mental health professionals to determine if this is an urgent need. Depression screenings have increased in Callen-Lorde by 30% in one year and it’s hoping to expand. In fact, Anthony credits the success of this implementation to those involved within the 3.a.i workgroup. He said, “It has been a great opportunity for us to learn from organizations who have integrated similar types of models.”
DSRIP has also helped Callen-Lorde restructure its data collection strategy. Anthony shares that Callen-Lorde has had its own electronic medical records (EMRs) for the past 20 years. He said, “We had to create a really customized electronic medical record to ensure we could record more information on gender than just sex assigned at birth. It’s limiting for us. We want to bridge the gap, but it’s been a particular struggle for our organization in regards to the data we’re collecting. The data we’re collecting is actually much more robust than the system allows for.”
Due to DSRIP, Callen-Lorde has enhanced its population health team to really focus and analyze its data. The organization is now able to pull out data by demographics such as income, gender identity, and race which allows the organization to target its quality improvement around the specific data. Finn shares, “When determining who from the population is affected by certain issues, it feels much more data driven which is something we needed to work on and we have been.” Due to the extraction of data, Callen-Lorde now has an eagle-eye view of its practice and can share the feedback to its staff to focus on specific issues.
Health Homes and VBP Implementation
Health Outreach to Teens (HOTT) provides medical services to teens.
Along with the involvement within workgroups and projects, Anthony and Finn are also optimistic about other improvements implemented by the state. For example, the implementation of the Health Home Program and Value-Based Payment fits right in at Callen-Lorde. Callen-Lorde had coincidentally started a small case management program for patients who have mental health issues, but did not have the resources to support the program. Finn shares, “When the Health Homes Program was implemented, we were already trying to work with these folks and now there is a program created to supporting them with the same goals we had.”
Finn said of DSRIP, “The fact that VBPs and health homes are meeting needs and in-line with things we wanted to accomplish anyway is positive. When DSRIP started it seemed like a big leap of faith and overwhelming. But the deeper we get into it and being in the workgroups I’ve become fully invested and can see how helpful it can be.”
For more information on Callen-Lorde please visit here.
*”Department of Health.” Medicaid Update. Web. 17 Oct. 2016.