A publication of OneWorld Community Health Centers Exchange THE Issue 2, 2022
NEVER LETTING GO Page 4
What does OneWorld mean to you?
What’s Inside
In a world filled with opportunities and wealth, inequality is growing. More and more people are sliding into poverty and are not able to adequately feed themselves, afford housing or health care and more people are turning to hate and violence. OneWorld was created by visionary leaders more than 50 years and has stood for equity for all people. To provide health care without considering a patient’s living, hunger or income situation, the very conditions that often determine whether a patient will have a good outcome is integral to our mission. When individuals and families experience too much stress, sadness or insecurity, health can be out of reach and hostility, anger and violence can result. Providing the best health care possible to the most people possible has driven OneWorld, our staff and board to be one of the most remarkable organizations in the community. From our grassroots and humble beginnings inside a church pantry to 17 clinical locations and five locations dedicated to prevention, outreach, literacy and our infrastructure. Ensuring that all people no matter their income, abilities, racial, ethnic, religion, gender identity or immigration status have access to quality health care and additional support is our mission, furthers our values and vision –and is our guiding light. Today we are caring for more people than ever in our history, and we are so proud, yet we know how much further we have to go until it is as easy as possible for everyone to feel welcome, connected, supported and have access to quality health care. Two things are clear. Our model works and we are grateful for your help to keep our mission moving forward.
Never Letting Go PAGE 4
No Matter What PAGE 8
Empowering Independence PAGE 10
Community Matters: Pride PAGE 14
Andrea M. Skolkin Chief Executive Officer
Expanding OneWorld School-Based Health Centers
Pictured below: Marybel Bey, Health Assistant, (left) and Mindee Swanson (right) with the Buena Vista Bison.
“I have always been drawn to working somewhere that Increases Access for All. I love working with adolescents, and I’m so glad to be a part of the School- Based Health Centers’ team at OneWorld.” –MINDEE SWANSON, DNP, FNP-BC, APRN-NP, BUENA VISTA SCHOOL-BASED HEALTH CENTER
Our brand new School-Based Health Center at Buena Vista High School, in partnership with Omaha Public Schools, is open. The clinic has two exam rooms and a behavioral health office inside the school. Well child checks, sports physicals, immunizations and behavioral and emotional health services are available on-site for students, their siblings and school faculty. This allows students to stay in school to learn while getting the care they need.
Every OneWorld clinic offers school and sports physicals. We want the youth in our community to be healthy and well, and to become advocates for their own health. Get Ready to go Back to School!
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From left to right: Ivon Aguilar-Silva, Fatima Gonzalez-Espinoza and Jesy Delgado.
OneWorld triage team use knowledge, instinct and advocacy to care for patient Never Letting Go
On May 17, 2021, a new OneWorld patient entered the Quick Sick clinic. She was 28 weeks pregnant, tested positive for Covid-19 and was experiencing shortness of breath, but her vital signs were in the “normal” range. Because the patient was pregnant, the case management and triage teams called her once a day, including the weekends, to monitor and assess her condition. The phone calls carried the weight of her health and at times, her life. With no in-person assessment, the team relied solely on the symptoms presented by the patient, medical protocols and their own medical training and knowledge. When Ivon Aguilar-Silva, BSN, RN, Covid-19 Case Manager and Nurse Lead, called the patient on May 19, the patient had a fever and her oxygen saturation dropped from 99 to 95 percent. Ivon contacted Courtney Allen, CNM, Associate Medical Director of Women’s Health, who recommended the patient go to an emergency room to be assessed. At the time, patients were typically sent to the ER if their oxygen saturation dropped to 90% or below, but because she was pregnant, the 95% saturation was concerning. “I followed up with her the next day, and she told me she was released the same day she went in because her vital signs were in the normal range,” said Ivon. “Over the course of the next few days we sent her to the ER three times. We just kept reminding her that her concerns for her health mattered until she was finally admitted.” Fatima Gonzalez-Espinoza, BSN, RN, Triage Nurse Lead, and Jesy Delgado, Triage Medical Assistant Lead, called the patient several times leading up to her admission into the hospital. “I remember the patient told me she wanted to get help, but she was worried she wouldn’t get help because the ER kept sending her home,” said Fatima. “I really had to advocate for her. The patient didn’t know a lot of English, and she was very young. You wouldn’t think she would be someone who would be so compromised from Covid-19 or get as sick as she did.”
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With no other options, the patient was intubated and had an emergency C-section. “I couldn’t imagine what she was going through when I read the case notes,” said Ivon. “When we all looked back we couldn’t help but think about what could have happened if we didn’t call her on a daily basis and advocate for her care in the ER.” Both patient and baby spent time in the Intensive Care Unit and Newborn ICU, but made full recoveries and were discharged from the hospital. “It was hard because this situation could probably have been prevented, but she didn’t receive the care she needed at the hospital, despite our efforts, until the situation became
Each time the patient went to the ER, a member of the triage team called ahead to emphasize that the patient was steadily declining and needed care. “A lot of times, our patients’ symptoms are sadly downplayed or overlooked because of language barriers and discrimination,” said Fatima. “At OneWorld, we provide care to patients who would otherwise not have access to care. We are their voice and we fight for our patients because their health matters.” The patient was finally admitted into a hospital on May 23 to be observed overnight. Her condition seemed to improve throughout the night so the hospital started the discharge process. A few hours later, her oxygen saturation deteriorated quickly and the baby went into distress.
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emergent,” said Jesy. “However, we are so thankful both mom and baby are safe and alive. It’s great to know that we played a big part of the mom being able to successfully have her baby.” Ivon, Fatima and Jesy all agreed that the patient’s strength and bravery to continue to go to the ER and advocate for her and her baby’s health, despite language barriers and being repeatedly sent home, inspires them to help as many patients as they can. As a result of this case, OneWorld created a new triage protocol for obstetrics patients with new guidelines and information to help the triage team know what signs and symptoms to look for outside of vitals that indicate an OB patient needs emergency care.
“OneWorld believes in helping those in need,” said Jesy. “We grab our patients’ hands and don’t let them go, and that makes a difference in our community every day.”
WHAT IS ONEWORLD TO YOU? “To me, OneWorld is access, stability and cultural humility. We provide access to many who would not have it otherwise, we are a stable and established entity in the community and many providers speak Spanish and understand the cultures of the patients we are caring for.” – Mark Huber, APRN, Family Medicine Nurse Practitioner
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No Matter What
Compassion and determination help patient access treatment and resources
Judy Rodriguez, Patient Care Coordinator.
“Lisa also mentioned that she recently lost her important documents, belongings and her entire home due to damage,” said Judy. “I didn’t want her to have to wait any longer than she already had to, so I recommended she apply for Medicaid to jump start the acceptance process for the assistance program.” Patients who are considered to be low-income, or are the only person in their household, oftentimes have to apply for Medicaid and be denied in order to be eligible for the assistance program for Epclusa. Without a denial letter, the wait time can increase and treatment can be delayed. Judy referred Lisa to the OneWorld Marketplace for help with her Medicaid application. A few weeks later, Judy received a phone call from Lisa.
At the OneWorld Pharmacy, Patient Care Coordinators, including Judy Rodriguez, dedicate their days to helping uninsured patients apply for programs to afford prescriptions that would be unattainable for many patients due to the high cost. Oftentimes high-cost medications are for illnesses that are life threatening without treatment. “When I first met with Lisa, she had recently been diagnosed with Hepatitis C and was prescribed Epclusa for treatment,” said Judy. Hepatitis C is an infection caused by a virus that can cause inflammation of the liver and sometimes severe liver damage. Without insurance, Epclusa costs around $30,000 per month, with the average treatment being three months long.
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With Medicaid, Lisa was able to afford the Epclusa prescription and begin the Hepatitis C treatment. “I’ve been a OneWorld patient for nearly 13 years and the staff have always been caring and kind,” said Lisa. “I have a good relationship with Dr. Donna Faber, Family Medicine Physician, and I’m very thankful for the care and help I’ve received.” Judy said she did not know if Lisa would be approved for Medicaid and was thrilled to learn that Lisa received Medicaid approval and additional support and resources as a result of applying. “OneWorld is full of people who want to help others in need,” said Judy. “No matter who it is or what help is needed, we don’t deny anyone. We will always help them get the care they need and deserve.” “I told Lisa to let me know when she got her letter from Medicaid stating her approval or denial so we could begin the application process for the Epclusa assistance program,” said Judy. “She told me she was so glad that I encouraged her to apply for Medicaid because not only did she get approved for Medicaid, but she also got approved for food stamps. She was so excited, and so was I.”
Inside of the OneWorld Pharmacy.
WHAT IS ONEWORLD TO YOU? “To me, OneWorld is caring, welcoming and exceptional. We care about each patient as a person and we welcome all people. We provide high-quality health care with leading-edge care in integrated behavioral health and care for teens and young adults, as well as Covid-19 related outpatient care.” – Donna Faber, MD, Family Medicine Physician
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Baw (left) with her brother Pray (right).
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Empowering Independence
Family and Diabetes Educator support help OneWorld patient gain control of diabetes
When Pray began losing weight, feeling extremely tired and isolating himself at home, his family knew something was wrong. Pray is a person with autism and learning disabilities, so his family advocates for him when he is unable to speak for himself. In addition to the individual barriers Pray faces, he and his family do not speak English and they had little experience with the medical system in the United States. Despite these barriers, Pray’s family knew he needed help, so they made an appointment for him at OneWorld Community Health Centers. With the help of his family and a Karenni interpreter, Melanie Menning, MD, Family Medicine Physician, learned about Pray’s symptoms and his personal health history. A blood sugar test confirmed Pray had Type 1 diabetes, a chronic condition in which the pancreas produces little or no insulin. The blood sugar test revealed that Pray’s blood sugar was very high. This meant his diabetes was considered uncontrolled and he was at risk for life-threatening health complications. Dr. Menning prescribed insulin for Pray and referred him to visit with Daisy Barragan, BSN, RN, CDCES, OneWorld Diabetes Educator. “I helped Pray and his family learn about diabetes, managing diabetes, treating high blood sugar and insulin,” said Daisy. “I also helped coordinate the delivery of insulin and blood sugar testing supplies with a local pharmacy.”
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About six months after Pray began taking insulin, his A1c (blood sugar average) went from greater than 14 percent to 6.2 percent, meaning his diabetes moved from an uncontrolled level to a controlled level. “We do blood sugar tests and control his sugar intake by limiting sweets and other things like that to give him extra help at home,” said Baw, Pray’s sister. “Pray was able to get control of his diabetes very quickly.” When Pray started his insulin treatment, he was uncomfortable with the needles and needed encouragement to take the medication. Baw helped Pray overcome his discomfort and Pray eventually learned to check his blood sugars with his glucometer and inject his insulin independently. “His family support has played an integral part of his diabetes control,” said Daisy. “Baw is very responsive to my weekly check-in calls for insulin titration for Pray. She is always prepared and has Pray’s blood sugar log ready to report his results. She asks questions and advocates for him to make sure he has enough insulin and supplies at home.”
Dr. Menning listens to Pray’s heart and lungs during a check-up.
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Daisy also connected Pray and his family to the OneWorld Marketplace to help eliminate financial barriers. “In addition to providing education in patients’ preferred language and learning style, we work with our patients to identify barriers that may be impacting their ability to focus on their diabetes or preventing them from accessing the tools they need to care for their diabetes,” said Daisy. The marketplace team helped Pray switch Medicaid plans and obtain a Continuous Glucose Monitor (CGM) through Medicaid. This technology uses a sensor to monitor blood sugar levels through the glucose found in the interstitial fluid, the fluid found between cells, eliminating the need to prick the skin with lancets multiple times each day as is required with a glucometer. CGM can be cost-prohibitive for many OneWorld patients. The OneWorld Diabetes Educators team collaborates with Diabetes Supply Center of the Midlands and other suppliers to help make this technology accessible for more patients. Pray and his sister continue to meet with Daisy each week and attend regular checkups with Dr. Menning to ensure Pray has the resources and knowledge to help him stay in control of his diabetes. ONEWORLD DIABETES PROGRAMS OneWorld offers several programs in multiple languages to support patients with diabetes. Dominate Diabetes workshops are available for OneWorld patients with Type 1 or Type 2 diabetes. Classes provide an overview on diabetes, important terminology, exercise, nutrition, medication and treatment options, coping skills and goal setting. The Diabetes Prevention Program, in partnership with the National Hispanic Alliance, is part of the National Diabetes Prevention Program, led by the CDC. This program is designed to help individuals make positive lifestyle changes to prevent Type 2 diabetes. This program is free of charge and is open to the public; participants do not have to be an OneWorld patient. To learn more visit oneworldomaha.org/get-involved/classes-programs/.
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We are excited to come to OneWorld. We get the help we need for Pray’s health issues, such as medication. From the beginning we’ve had help, and we’re happy to come to OneWorld for our care. -Baw, Pray’s sister
WHAT IS ONEWORLD TO YOU? “To me OneWorld is service, compassion and community. We provide medical, dental and mental health services with a focus on underserved populations and provide access to care to all cultures.” – Longfellow Marquez, LIMHP, LDAC, Behavioral Health Therapist
To read more inspiring stories please visit oneworldomaha.org
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COMMUNITY MATTERS
“We make a concerted, active effort to not only be there for, but to stand up with the LGBTQIA+ community because
they deserve excellent medical care.” – Dr. Alex Dworak, Associate Medical Director of Family Practice OneWorld is proud to be an ally for the LGBTQIA+ community.
No matter what your sexual orientation or gender identity may be, you will be welcomed and treated with respect at all of our clinics. As an LGBTQIA+ ally, we prioritize the following services to ensure every patient has access to the care and support they need: • Behavioral Health • Dental • Medical • Pharmacy • HIV/STD Testing and Treatment • Pre-exposure Porhpylaxis (PrEP) • Gender Affirming Hormone Therapy
Because Access Matters
C
SAVE THE DATE
MILAGRO AWARDS DINNER & SILENT AUCTION NOVEMBER 10 I 5:30 P.M. MARRIOTT CAPITOL DISTRICT
Join us Thursday, November 10 to celebrate the OneWorld medical partners, patients and volunteers who make Milagros (“miracles” in Spanish) happen for the most vulnerable children and families. Our featured speaker will be Dr. Michelle Rozen, an author and a frequent guest on media outlets such as NBC, ABC, Fox News and CNN with a Ph.D. in psychology. Dr. Rozen has found that motivation and adaptation lead to breakthroughs and every change is an opportunity rather than an obstacle when approached the right way. She promises to help us crack the code of change!
Contribution For Care
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OneWorld Community Health Centers provides culturally respectful, quality health care for our patients and the Omaha community. Access to health care continues to be a barrier for many people due to factors including cost, insurance, transportation, language and more, especially in underserved communities. To address these barriers, we go beyond care for the body- we offer whole person care to connect and empower our patients. We provide assistance in Medicaid and health insurance enrollment, and offer a sliding fee scale regardless of insurance status to ensure our patients have access to medical, dental, behavioral health and pharmacy services. Our mission is brought to life by our passion for our community, and is made possible by your dedication to help our community. Together we can create a healthier community.
Please clip & mail to: OneWorld Community Health Centers, Inc. Attn: Development 4920 S. 30th St., Ste. 103, Omaha, NE 68107
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OneWorld Community Health Centers, in partnership with the community, provides culturally respectful, quality health care with special attention to the underserved. OUR MISSION
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Jennifer Samuelson Public Relations Manager
(402) 502-8871 I jsamuelson@oneworldomaha.org If you no longer wish to receive information about OneWorld Community Health Centers, Inc., please call (402) 502-8871 or email jsamuelson@oneworldomaha.org.
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OneWorld Community Health Centers complies with applicable Federal civil rights laws and does not discriminate on the basis of race, religion, color, national origin, sexual orientation, pregnancy, age, gender identity, disability, military status, veteran status, ancestry, immigration status or ability to pay.
FTCA P SLIDING FEE SCALE
PATIENT CENTERED MEDICAL HOME
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