OneWorld Community Health Centers | EXCHANGE Issue 2, 2024
Paving a path for PROGRESS Page 4
FROM OUR CEO
Physical, mental and behavioral health interact to shape a person’s overall well-being. By offering behavioral health services
CONTENT
integrated within primary care, OneWorld ensures patients receive timely, coordinated care that improves outcomes, enhances dignity and reduces barriers. OneWorld’s integrated care model includes warm handoffs between a primary care provider and a therapist, to connect patients to behavioral health services during a medical appointment, and collaborative care, an evidence-based approach that brings together the primary care provider, a psychiatrist and a behavioral health therapist. Our unique Medication-Assisted Treatment (MAT) program is a comprehensive approach to treating substance use disorders. Structured conversations to address emotional and psychological challenges, known as traditional therapy, expand OneWorld’s capacity to care for patients. The need for quality, culturally- appropriate health care is only increasing. One way we are answering the call is by expanding our services with the construction of a new facility on our South Omaha Campus. With you as our partner, we can make a lasting impact on our community’s health. Our mission is simple, “Care for All People,” especially the underserved—because everyone deserves access to comprehensive, integrated care.
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Closing health care gaps
Paving a path for progress
Seeing the bigger picture
Rising to the occasion
16 Excellence at work 18 Community Matters
Happy 50th Anniversary!
Happy 50th anniversary to the Special Nutrition Program for Women, Infants and Children, also known as WIC! Widely regarded as one of the most successful nutrition programs in
the United States, WIC is linked to healthier pregnancies, improved birth outcomes, and enhanced child development. OneWorld’s WIC clinic is the largest in Nebraska, and its team members proudly serve nearly 5,000 people each month. With regular breastfeeding classes and trained Community Breastfeeding Educators, OneWorld’s WIC staff are ready to educate, encourage and embrace mothers on their feeding journeys.
Andrea M. Skolkin Chief Executive Officer
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By building the new facility, OneWorld aims to address significant health care challenges facing South Omaha and beyond.
OneWorld to close health care gaps with new building
A new OneWorld building, slated for construction at OneWorld’s South Omaha headquarters, will help close gaps in the community’s health care needs. The facility will house a healthcare workforce training center, expanded behavioral health services, a child development center and a micro-unit for epidemic or pandemic responses. Groundbreaking is expected this fall, just east of the trio of buildings that now make up the main OneWorld campus. The three-story, 29,000-square- foot building will be funded by a state South Omaha Economic Development Grant, local foundations and national donors. “We are anxiously awaiting the day we break ground, given the demand across the community and in South Omaha,” said OneWorld CEO Andrea Skolkin. “We envision the new building will deepen the breadth and depth of our services and our commitment to the community.” By building the new facility, OneWorld aims to address significant health care access challenges facing South Omaha and beyond. The challenges are amplified by a shortage of health care professionals, particularly Spanish-speaking providers; compassion fatigue; and insufficient training resources. There are also critical shortages of childcare facilities.
Here’s how expanded services inside the facility will address these challenges: • The Healthcare Workforce Training Center will focus on training, upskilling, and retaining OneWorld’s workforce, particularly Hispanic team members, and creating a pipeline to high- paying health care jobs for local residents. This will help address the recruitment challenges in the health care sector and ensure a workforce that reflects patient diversity. • The new building will have capacity for eight to 10 new behavioral health therapists, each managing a caseload of 20-30 clients weekly. This expansion will significantly enhance OneWorld’s capacity to meet the growing demand for bilingual behavioral health services. • A child development center, offered in partnership with a local organization, will provide childcare and early childhood development services for OneWorld’s employees, patients and community members. Access to reliable childcare will both support early childhood development and allow parents to work. By responding to the community’s needs, OneWorld will make a powerful impact on patient health, the healthcare workforce and early childhood education.
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Paving a path for PROGRESS
Psychiatrist Shannon Kinnan, MD, sees patients at the OneWorld Livestock Exchange Health Campus.
Behavioral health care transforms lives
About a year ago Jacob* began behavioral health treatment at OneWorld, following a pattern of impulsive behaviors and unhealthy relationships. Sometimes the behaviors were hostile or violent, leading to interactions with the police. Fortunately, thanks to caring interventions from
Jacob as a patient, said he wasn’t so fond of therapy at first. But over time, he became more willing to engage in therapy as he built a relationship with Swain and psychiatrist Shannon Kinnan, MD. Diagnosed with autism as well as a mood disorder, Jacob has noticed a difference in how he feels these days. “He said, in his own words, that therapy and medication have helped him be less angry and less violent,” Swain said, sharing with Jacob’s permission. “It’s allowed him to push himself to be around people and to not feel so anxious.” For Swain, it’s important to reiterate that help is available for people
OneWorld providers, Jacob’s life has taken a turn for the better. Traditional Behavioral Health Therapist Brittney Swain, LIMHP, CPC, LADC, who sees
Brittany Swain, LIMHP, CPC, LADC Traditional Behavioral Health Therapist
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with mental and behavioral health concerns. That help may be provided in different ways, depending on the patient’s needs, but there are a few main pathways for care at OneWorld. Briefly, those paths are as follows: • Warm hand-offs happen when patients visiting a primary care provider are connected with a behavioral health therapist for a brief session on the same day. • Psychiatric care covers assessment and evaluation, diagnosis, medication management and therapeutic services. • Traditional behavioral health therapy helps patients to identify and address issues affecting their mental health. • Medication-Assisted Treatment is a personalized program for people with substance use disorders that, at OneWorld, combines group therapy and medication management. • In the Advanced Integrative Mental Health Services program (AIMS), otherwise known as the Collaborative Care Model, medical and behavioral health clinicians integrate care with psychiatric clinicians to treat patients. Dr. Kinnan, a national leader for her work in implementing AIMS, said the model helps track patient outcomes and centers cultural fit for patients. “The value is access to care,” said Dr. Kinnan. “It’s quicker access to high quality care that allows patients to stay in their medical homes.”
Dr. Kinnan is the Associate Medical Director of Behavioral Health.
Regardless of the type of services a patient needs, meeting them where they are in their own personal journey is important, said Longfellow Marquez, LIMHP, LMHP, LADC, Behavioral Health Therapist and Licensed Alcohol and Drug Counselor Trainer. Marquez, who often sees patients with substance use disorders, said not all patients are at the same level for change, but care is still available for them. And that care – from behavioral health and medical providers alike – makes a difference. “I feel this type of population, they are very appreciative because usually they come to you as the last resource,” Marquez said. “That’s a great satisfaction, being able to provide some help when they are in need.”
What is behavioral health? What do we mean when we say behavioral health? One way to think of behavioral health is as an umbrella term that includes mental health and behaviors that affect well-being. At OneWorld, behavioral health services cover conditions and circumstances including, but not limited to: ADHD, anxiety, child and adolescent well-being, chronic diseases, depression, family concerns, family violence, risky behaviors, substance use and abuse and trauma.
Traditional Behavioral Health Therapist Brittney Swain, LIMHP, CPC, LADC, sees patients at the OneWorld Livestock Exchange Health Campus.
Family Medicine and Psychiatry Nurse Practitioner Ian Mitchell, APRN, who sees patients for primary care and mental health diagnoses, also notices demand for services – and progress within his patients. He said he likes being able to follow his pediatric and adult patients over
use disorder,” Mitchell said. “We provide treatment and suddenly they are able to maintain a job, have a home and form stable relationships.” Quality of care is paramount at OneWorld. Chief Medical Officer William Ostdiek, MD, praised the staff for their dedication. He said that patients, who are historically underserved often have complex needs or financial
Ian Mitchell, APRN Family Medicine and Psychiatry Nurse Practitioner
time. With young patients, he enjoys the development that occurs from one grade level to the next. “At the same time, I like helping adult patients who struggle with a substance
barriers to care – and OneWorld health care providers work hard to do right by everyone.
William Ostdiek, MD Chief Medical Officer
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Dr. Kinnan works with behavioral health therapists to provide care for patients.
“What excites me is the connection to the community, and the respect within the community, that has been “
in the world to patients like Jacob.
Swain, his Behavioral Health Therapist, said Jacob’s mom couldn’t share enough praise for
What excites me is ... the respect within the
community that has been earned by OneWorld by providing quality of care that, frankly, I would stack up against anybody.”
earned by OneWorld by providing quality of care that, frankly, I would stack up against anybody,” Dr. Ostdiek said.
the services he has received at
OneWorld. His mom has noticed his new ability to regulate emotions – evidence that a patient’s improvements can help the whole family. Swain shared: “It’s changed his life.”
Chief Medical Officer William Ostdiek, MD
Receiving that quality of care makes all the difference
*The patient’s name has been changed to protect his privacy. Photos do not depict the patient referenced in the story.
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Seeing the BIGGER PICTURE
Social Worker Jair Alverez and Behavioral Health Therapist Karla Deacon.
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OneWorld teams address drivers of health
Sometimes helping a patient requires digging a little deeper into their inner and outer worlds. Take, for example, a patient who visits her primary care provider for support managing her diabetes. After learning she’ll need to take insulin, the patient
behavioral health needs that otherwise wouldn’t be presenting in the way they are in that appointment,” Ramirez said. This is just one example of how a patient’s current economic situation could stand in the way of ongoing medical treatment, while heightening the need for behavioral health care. As Social Services staff members work to address the patient’s resource barriers, a Behavioral Health Therapist could also be called to provide mental health support. The therapist might help the patient with coping mechanisms for her stress and anxiety, or provide a safe space to talk about what is going on. Social drivers of health attempt to describe the big picture affecting an individual’s well-being: the socioeconomic conditions, environmental conditions, institutional power and social networks, according to the National Association of Community Health Centers’ PRAPARE toolkit. For example, the assessment explores personal characteristics like race, ethnicity, language and work status, taking into consideration systemic racism and inequality. It also delves into housing status and neighborhood; money and other resources; social connection and stress; and safety.
becomes stressed. Insulin needs to be refrigerated, and her utilities are about to be shut off due to lack of funds. She’ll have no
way to keep the insulin cold. Her anxiety rises. The interdisciplinary teams of OneWorld are prepared. In this hypothetical scenario shared by Associate Director of Operations Idania Ramirez, the primary care provider would contact the Social Services team to assess the patient’s living, working and other conditions, sometimes referred to as social drivers of health. The assessment could reveal other needs, like food insecurity or lack of transportation, that are also affecting the patient. “That physical representation of unmet needs looks like a patient who is very overwhelmed, who is presenting a lot of symptoms of anxiety, depression and maybe even triggering other Idania Ramirez Associate Director of Operations
“
The physical representation of unmet needs looks like a patient who is very overwhelmed, who is presenting a lot of symptoms of anxiety and depression...”
Associate Director of Operations, Idania Ramirez
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It’s the role of the Social Services team to get to the heart of a patient’s specific social drivers of health, acting as a third pillar of support along with medical and behavioral health staff. Social Services support is available to established patients who have seen a provider in the past year and are otherwise eligible for OneWorld Services. Sometimes Social Services staff begin providing support while meeting with the patient, as in the above example. At other times, they may work behind the scenes to identify community resources and follow up with a call. Depending on the situation, Behavioral Health staff might arrange to work with a patient over time – or may only have a brief session with them alongside a primary care visit. Behavioral Health Therapist Karla Deacon, LMHP, LADC, said these brief sessions can include discussions about the mind-body connection, or how current stressors might be expressed physically. For example, a patient who has been suffering from headaches might share that their spouse has lost a job, which opens a discussion on managing anxiety. But sometimes patients are living with ongoing effects of systemic or political realities – those “upstream” social drivers of health that lead to the worst outcomes for the least powerful. Deacon said many OneWorld patients experience the complexity of having been forced to leave their home country in order to survive, while enduring the separation from loved ones who remain. They may send money back to support family members, while living in poverty here.
Social Worker Jair Alvarez speaks with patients to learn about their social determinants of health.
Understanding that big picture helps a patient’s care team provide the right resources. “Many patients are depressed because the finance, because the food,
because the housing, and many external factors that are related with resources in the community,” said Longfellow Marquez, LIMHP, LMHP, LADC, Behavioral Health Therapist and Licensed Alcohol and Drug Counselor Trainer. “That’s also the component for the holistic treatment that we can provide to the patient.”
Longfellow Marquez, LIMHP, LMHP, LADC
Behavioral Health Therapist and Licensed Alcohol and Drug Counselor Trainer
Social determinants of health Many areas of life can impact health and well-being, including access to health care, housing, healthy food and transportation and other conditions present where a person lives or was born. These areas may be referred to as social determinants of health or social drivers of health. The National Association of Community Health Centers uses the term “drivers” rather than “determinants,” as a reminder that inequitable conditions do not have to stay that way - reflecting the “ability for policy-makers, communities, and individuals to affect change on the factors negatively impacting health and well-being.
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Social Worker Jair Alvarez and Behavioral Health Therapist Karla Deacon discuss patients’ social determinants of health.
“And so there’s no easy answer because there’s systems in place that make it difficult for them to overcome some of the barriers to their happiness,” Deacon said. “So it is unique here. We’re dealing with the depression, anxiety and the trauma that looks different. It feels systemic.” OneWorld’s providers understand that a person’s needs – medical, behavioral and social – are all connected. And even if there isn’t a quick fix for all the social drivers of health that impact a patient, there is a team is very important.” “
committed to their overall well-being. Social Worker Jair Alvarez said that’s part of what makes OneWorld unique. “I think it’s very special that you can see your primary care physician, see behavioral health and see social work all in the same visits,” Alvarez said. He added: “We want to make sure we meet basic needs, so that they understand their mental health is very important, and [we] want them to continue seeing their doctor and therapist here so that overall, they can have a better, healthier life.”
We want to make sure we meet basic needs, so that they understand their mental health
Social Worker, Jair Alvarez
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Mindee Swanson, DNP, PMHS, APRN, works at OneWorld’s School-Based Health Centers.
Youth behavioral health needs soar Rising to the occasion
Back-to-school season can be a time for big dreams and fresh starts for the year ahead. It can also be a time when student struggles emerge. Each fall, providers at OneWorld’s School- Based Health Centers catch behavioral health concerns during routine school and sports physicals for children and adolescents. Fortunately, when such problems come to light, OneWorld’s providers are there to help. Mindee Swanson, DNP, PMHS, APRN, said a recent school physical helped a teenaged student who had been absent for over half of the previous school year, and whose mom was really worried.
“Even though [the student] was here for the sports physical and making sure their heart’s OK, we took time to ask, ‘What was going on last year?’” Swanson said. After talking with the student and parent, Swanson suspected undiagnosed attention deficit disorder. That conversation allowed Swanson to create a path for additional mental and behavioral screening – and a treatment plan to help the teen return to school. Mental health is the No. 1 health issue facing adolescents ages 12 to 17, according to parents who responded to the 2021 Child & Adolescent Health Needs Assessment of Omaha metro
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Swanson discusses patients with OneWorld behavioral health therapists.
area counties. Thirty percent of responses mentioned mental health as the top health issue for this age group. For children ages 11 and under, mental health was mentioned in 12.5% of responses. In Swanson’s example, a sports physical created opportunity to delve into a student’s repeated absences. In other cases, mental health screenings – routinely included in each physical - detect underlying problems. The screeners look for signs of depression, self-harm and other behavioral health concerns. Checking in with young people about their behavioral health is critical. Associate Tania Murrell, BSN, RN, AMB-BC Associate Director of Nursing
Director of Nursing Tania Murrell, BSN, RN, AMB-BC, has noticed a steep incline in adolescent and pediatric mental health issues, particularly in the past few years. While she isn’t sure of the exact reasons for the increase – whether due to the COVID-19 pandemic, screen use or other characteristics of this generation – she does know young people are struggling. “We’ve just noticed that our kids are more isolated,” Murrell said. “They don’t have those strong relationships with friends, they don’t have those strong relationships with parents. A lot of times they’re technology dependent. And so it becomes really, really hard for them to have coping skills that are healthy.” OneWorld specifically works to support young people and their unique needs. That’s one reason why OneWorld has
We’ve just noticed that our kids are more isolated ... And so it becomes really, really hard for them to have coping skills that are healthy.” “ Associate Director of Nursing, Tania Murrell, BSN, RN, AMB-BC
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OneWorld works with Omaha Public Schools to provide medical and behavioral health services at our School-Based Health Centers.
worked with Omaha Public Schools (OPS) to establish School-Based Health Centers inside five OPS schools. Medical and behavioral health services at these centers are available to all OPS students, regardless of which school they attend. Pediatric and adolescent health care doesn’t stop there. To reach more students, OneWorld’s Medical Mobile Clinic rotates between Ralston Public Schools, Bellevue, Public Schools and Westside Community Schools and includes behavioral health counseling and other health care. In addition, OneWorld’s two Teen and Young
Adult Health Centers provide services for youth up to age 25. “If I could, if I had my way, every single school would have a School-Based Health Center because it makes that much of an impact to our community when we have the kids right there,” Murrell said. Among the concerns Murrell shared about young people’s mental health are anxiety, self-harm and thoughts of suicide. Indeed, the Child & Adolescent Health Needs Assessment showed an increase in anxiety diagnoses among metro-area children ages 5-17, from 10.1% in 2015 to 15.7% in
Suicide Prevention Month September is National Suicide Prevention Month – an opportunity to focus on preventing suicide, and to remember those whose lives have been lost and the impact on families and communities. The 988 Suicide & Crisis Lifeline is available for anyone facing mental health struggles, emotional distress, alcohol or drug use concerns, or who just needs to talk. The 988 Lifeline can be reached by calling or texting 988.
Traditional Behavioral Health Therapist Brittney Swain, LIMHP, CPC, LADC, sees a patient.
2021. According to the Nebraska Department of Education’s Adolescent Health Report 2023, 25% of girls had considered suicide, compared with 14% of boys; conversely, boys were nearly four times as likely to die by suicide. Behavioral Health Therapist Kevin Heeb, PLMHP, sees patients at Millard South and West High Schools and at OneWorld Teen and Young Adult Health Center West. He said having appointments at school is good for students and convenient for parents. Millard schools are the first locations where students accessing behavioral health services don’t have to see a medical provider first. The Teen and Young Adult Health Centers work a little differently. At those, Heeb may collaborate with a patient’s other health care providers, like a OneWorld psychiatrist or psychiatric nurse practitioner who prescribes medication. Still, some young people need an extra level of psychiatric care, some of which is provided through a contracted psychiatrist. Murrell said
this service makes a huge impact for children who would not otherwise be able to get the psychiatric care they deserve. She said that while resources are sometimes stretched thin to meet increasing demand, OneWorld’s providers know the community needs their care. “The one thing about OneWorld that I think we do really well is we’re willing to help anyone,” Heeb said. “It doesn’t matter where they come from, doesn’t matter what language they speak. We have open arms and we’re willing to bring them in, help them, give them support, make them feel like we care. Because we do.” For Swanson, school physicals season offers an important chance for teens to share problems that may have been hidden under the surface – and begin the process of getting the individualized help they need. “Just having that five minutes to talk through, what to an adult could look like a simple problem, can make a world of difference,” Swanson said.
At OneWorld, care is for all people – of every age.
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Awards & Recognitions
EXCELLENCE AT WORK
Brian Penly, DDS, Dental Director 2024 Clinical Excellence Award – Health Center Association
Rochelle Loseke-Wray, BSN, RN, Clinical Services Manager Omaha World-Herald, Nurses – Heart of Healthcare
OneWorld Women, Infants and Children (WIC) team The WIC team is proud to be part of the Douglas County Health Department’s (DCHD) effort to promote a culture of breastfeeding. DCHD, which supports WIC teams in the county, recently earned a regional Breastfeeding Award for Excellence.
Amari Ware, MSN/MBA, RN, Clinical Education & Regulatory Quality Manager/ BLS Nebraska Nurses Association, 2024 Positive Image of Nursing Award
Solving problems with skill
EXCELLENCE IN CARE
Excellence in care requires meeting the particular needs of the patient - even when multiple obstacles stand in the way. Emily Lingelbach, Medical Assistant V, recently demonstrated persistence, dedication and compassion to help a young patient. According to Associate Director of Nursing Tania Murrell, Lingelbach encountered a patient who had twice tested positive for a sexually transmitted infection. The patient had not disclosed her sexual activity to her parents - making accessing care somewhat delicate.
Taking a proactive approach, Lingelbach coordinated with the patient and the OneWorld sexual health outreach team to deliver medication directly to the patient. “Emily’s dedication to our mission and values shines brightly through her actions, and I believe it is essential to acknowledge and celebrate her exemplary service,” Murrell said. “Her initiative, problem-solving skills, and genuine concern for the well-being of our patients embody the spirit of our organization.” Going above and beyond is excellence in action.
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CHANGE STARTS WITH US
CHANGE STARTS WITH US
Milagro Awards Dinner and Silent Auction Milagro Awards Dinner & Silent Auction
Milagro Awards Dinner and Silent Auction OCTOBER 24, 2024 | 5 P.M. MARRIOTT CAPITOL DISTRICT
OCTOBER 24, 2024 | 5 P.M. MARRIOTT CAPITOL DISTRICT
COMMUNITY MATTERS
In 2022, OneWorld partnered with the Stephen Center to open a clinic at the shelter to address the unique needs of the individuals it serves. OneWorld Stephen Center Clinic originally opened one day a week for primary care services including diagnosis and treatment of acute and chronic diseases, behavioral health referrals, laboratory services and vaccines. Since then, OneWorld has added regular psychiatry and women’s health services. This approach allows patients to receive holistic support in their everyday environment. Physician Assistant Cody Thorson, PA-C, who shares time between OneWorld’s Stephen Center and main campus clinics, said being on site at Stephen Center helps patients build relationships with health care providers they might not have had before. As a primary care provider, Thorson
Physician Assistant Cody Thorson, PA-C
“Over time, I learned there is no way to do that without addressing the social and behavioral health needs of patients,” Thorson said. “That is what makes the collaboration between medical, behavioral health and social work so important, in order to fully address our patients’ needs.”
is often the first clinician a patient will see for evaluating and diagnosing behavioral health and other concerns. Then, together with the patient, he’ll develop an individualized course of action. For Thorson, like so many OneWorld providers, it’s all about making a difference in patients’ lives.
Because Community Matters.
VOLUNTEER AT ONEWORLD
ABOUT THE STEPHEN CENTER
Stephen Center’s mission is to partner with individuals, families and the community to overcome homelessness, addiction and mental health challenges. Founded 40 years ago, Stephen Center provides emergency shelter for men, women and families; addiction recovery services; permanent supportive housing; and a donation center.
OneWorld volunteers help bring our mission to life. Join people from diverse cultures and make a positive impact in the health and well-being of OneWorld patients. For more information, visit oneworldomaha.org.
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Erik Servellon Development and Communications Director eservellon@oneworldomaha.org If you no longer wish to receive information about OneWorld Community Health Centers, please contact Erik Servellon, Development and Communications Director.
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