CELEBRATING 40 YEARS • QUALITY HEALTHCARE • ACCESS for ALL
OPEN DOOR
Community Health Centers
A Tale for Our Times Jay Molofsky, Site Administrator
In these troubled and troubling times, I am often reminded of a tale I heard as a young man. I offer it here for your consideration. here was once a very wise and curious Rabbi, Ari Benjamin. He wanted to understand more about what our souls might encounter after our physical deaths. “ Would you show me heaven and show me hell,” he asked his Guiding Spirit. And his Spirit responded, “Which do you want to see first?” Ari thought about it and said, “Let’s have the bad news first. Show me hell.” His Guiding Spirit led him to hell. Ari saw a group of people and noticed that they were all starving, filthy, weeping, covered in sores and scars. Then Ari noticed a strange thing. None of the people could bend their arms. Ari thought about this and realized that the
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Jesse Vos, PA-C greets patient Carl Schwartz
Heaven Porter gets a quick check-up from medical assistant Jen Busseau.
Del Norte Community Health Center
Mission Driven
he desire to work in an underserved area can be the factor that attracts talented health care providers to a rural community. Dr. Christian Holland, physician and medical director at the Del Norte Community Health Center in Crescent City felt that desire. “Providing services that would otherwise be out of reach for some of our patients is truly meaningful to me. Engaging the community in its healthcare is an essential part of what I do. All of us work hard to respond to the demand for service. It is satisfying to know that no one is being turned away.” Jesse Vos, physician assistant, agrees. “Many of our patients face barriers to accessing quality care. Maybe they don’t have insurance or can’t
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Ted Humphrey, MD with patient Addison White
McKinleyville Community Health Center
Makynna
akynna Lynne White. It may sound like just another name to you, but it means so much more to me, her family and to the community she affected profoundly. Makynna, my third child, was born on October 16, 2005. She was six months old when I first noticed something different. At Makynna’s eight-month well child visit with Dr. Humphry I discussed my concerns. Dr. Humphry had noticed something too. He believed it could be Hurler Syndrome and after running some tests, he confirmed his suspicions. At eight months old, Makynna was diagnosed with a rare birth defect known as mucupolysaccharidoses (MPS); insufficient or missing critical body enzymes. The most severe form of MPS is Hurler’s
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OPEN DOOR COMMUNITY HEALTH CENTERS SPECIAL SECTION • THURSDAY, SEPT. 22, 2011
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Del Norte Community Health Center continued from page 1
The pediatrics staff, (from left) Deb Riley, MA, Alex Wade, MD, Alisha Quast, RN, Sherrie Lynch, MA, and Laura Lyons, FNP”
travel due to financial or physical limitations. We are Open Door. We do everything in our power to open doors for all who need medical care.” While access to care is of utmost importance, the type of care is essential. Dr. Alexander Wade has been the clinic’s pediatrician for five years. He understands the importance of comprehensive care. “I work with children. I know that social barriers, family support, personal security and mental health concerns are extremely important to the well-being of our children. These issues are a part of a child’s development and physical health. I strive to provide comprehensive and compassionate care for the total person.” Dr. Holland elaborates, “I practice internal medicine, mostly for adults. I provide my patients with a full scope of care for primary health needs. We want the community to know that if you are experiencing any type of physi-
cal, emotional or mental health concern, we want health and wellness to be your goals. We are here to assist you.” “We are dedicated to partnering with our patients. I believe that patients should be active participants in their health care,” says Dr. Holland. Jesse Vos furthers this idea, “My primary objective is to assist patients in managing their own care. I’m here to help patients understand the elements of health and their health care plans. Our goal is to achieve wellness. It is up to our patients, through their decisions and actions, to be as healthy as possible. We are here to encourage and support that process.”
Serving the Entire County
“Our patients are working professionals, homeless individuals, retirees, children and everyone else in the area,” says Hilda YepesContreras, site administrator at the Del Norte clinic. “I think there was
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moved into a brand-new home: a a misconception that we only saw well-designed facility with enough Medi-Cal patients, but that isn’t space to meet the increasing detrue. We offer high quality care and mand for healthcare in the area. the community recognizes that.” With The clinic over 60 accepts employees, virtually including every form 10 mediof public cal, dental and private and behavinsurance ioral health and proproviders, vides large the clinic discounts sees an to those average who are of almost uninsured; 700 pano one will tients each be turned week. Hilda away benotes, cause of “Del Norte finances or County is insurance. considered “We care Christian Holland, DO, with patient Rita Moore a medifor and cally unabout our derserved and health professionals patients.” shortage area. As a team, we work Working closely with Cheyenne hard to create enough access so Spetzler, Chief Operations Officer that our patients, our neighbors, for Open Door Community Health our friends, can get the quality Centers, Hilda was with the clinic care they deserve. The staff is part when it opened its doors in downof this community. We are deeply town Crescent City in 1990. “I affected by the lives and health of remember Cheyenne living here for those we serve.” months to make this clinic a realDr. Katrina Groves concurs with ity. She didn’t always get home to Hilda, “This is my community too. I Arcata on the weekends because want it to be the best community there was so much to do.” recalls it can be. If I can help someone Hilda. Since then, the clinic has with even one little problem, I’m moved several times, always to doing my job. As a community, we larger quarters. After a multi-year are only as healthy as our sickest effort, the Del Norte Healthcare people. If we do not work to imDistrict completed the Del Norte prove the health and well-being of Wellness Center at the corner of our most struggling citizens, the Northcrest Drive and East Washingcommunity as a whole suffers.” ton Boulevard. In 2007, Open Door
The Del Norte clinic is a vital part Mission in Action of the health care system in Del Dr. Katrina Groves works to Norte County. “If we aren’t here inspire patients to be proactive in delivering this care, who will?” asks their health care. Instead of tradiDr. Groves. tional fam“We are about ily practice, people’s lives. Dr. Groves It’s the person focuses who is imporprimarily on tant.” women’s Hilda exhealth isplains that the sues, serves staff takes it as the main upon themprovider for selves to go Teen Clinic the extra mile and facilito serve their tates the neighbors. “We suboxone do what we treatment can to meet program. the needs of In women’s our patients.” health, the Sometimes focus is on this goes beprevention Katrina Groves, MD yond peoof cervical ple’s medical and breast needs. We cancers have an aramong moire in the other isThe staff is part of this clinic lobby sues unique full of gently to women. community. We are deeply used clothGood affected by those we serve. ing. Patients health habare welcome its are im- Hilda Yepes-Contreras to help portant for themselves preventing to what they certain need. It’s a problems small effort, but we know it can and regular screening can lead to make a huge difference.” The clinic early detection and treatment. also provides assistance in applying Health screening has been proven for benefits and connects people to save lives. with other community resources. Teen Clinic is about providing “Health and wellness are much education to help young people more than medical care,” notes make healthy choices and providHilda. ing the care and services they
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Most of the DNCHC staff
need to maintain their health. “In Teen Clinic we provide patients with information on abstinence, body image, self esteem and preventing disease and pregnancy. We have two teen advocates, trained teens who serve as peer educators, who can talk with our teen patients” Teen Clinics are offered every Monday afternoon but, Katrina notes, “It’s important for teens to know that they can come to the clinic anytime – just let the front desk know that you need to be seen.” Dr. Groves also leads the suboxone treatment program for opiate dependency. Suboxone is an effective outpatient program for people dependent on heroin and prescription medications such as methadone, Vicodin and Oxycodone. The group that Dr. Groves has established focuses on the overall well-being of patients. “My medical assistant, Susan Hintz, and I have worked with the suboxone group from the ground up. There
is a huge need for this program in Del Norte County,” explains Dr. Groves. “The program isn’t about passing out prescriptions. This is a structured program where we help patients realize and make progress toward their health and personal goals.” There are currently 25 people enrolled in the program. “If someone falls out, we work with them so they learn the steps to stay clean. We are helping people get their lives back together. We’ve helped people get clean and some have gotten their kids, their houses and their jobs back. This is the sort of impact we strive for. If you are serious about treating your addiction and getting clean, we want you to come here.” So that the clinic can address all of a patient’s medical needs, someone interested in the suboxone program must first become an established patient with a primary care provider at the clinic. “Then continued on next page ➤
OPEN DOOR COMMUNITY HEALTH CENTERS SPECIAL SECTION • THURSDAY, SEPT. 22, 2011
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Del Norte Community Health Center continued from page 3
Growing Your Own
Clinic staff members who are active gardeners at the Wellness Center garden
2000. “I really liked the mission of the organization.” Carolyn quickly began to feel the need to do more. “So I completed my prerequisites at CR and enrolled in the Physician Assistant program at UC Davis. My husband came out of retirement and worked as a medical assistant at the clinic while I was in the PA program.” GraduDNCHC also has a comprehensive dental clinic open to ating in 2009, Carolyn children and adults. Above: Susan Wellman, DSD with a patient. The October 27th North Coast Journal Special returned to work in Del Section will highlight Open Door dental services Norte. Her work covers a broad scope of services: family practice, HIV care and anyone here can help arrange reTeen Clinic. “My goal is to educate ferral into the suboxone program,” patients to be self-sufficient. Our notes Dr. Groves. staff is committed to helping patients be as healthy as possible.” Growing Our Own What patients do outside the Carolyn Dikes was an EMT before clinic and the choices they make becoming a medical assistant. Her are essential to their health. The interest in healthcare came natuchallenge to patients and to the rally, growing up with a mother who community is to make health a worked as a nurse. Carolyn began real priority, and to support that working at the Del Norte clinic in
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priority with action and resources. “We want you just as committed to your health as we are,” says Carolyn. Carolyn is not the only clinic employee inspired to further their career and give more to their community. Christina Fosdick started work as a medical assistant at the clinic shortly after graduating from high school, participating in the clinic’s on-the-job training program. “I absolutely fell in love with the work. I am committed to the clinic and the care we provide. I enrolled in CR’s nursing program and after that I want to become a nurse practitioner. I’ll return to the Open Door clinic. I was raised in this community. I married my sweetheart from junior high. We are committed to giving back to this community. Providers are needed here, particularly those who want to stay in the area. I want to help fill that need. I’ve been inspired to push my career and my service to the community further than I ever imagined.”
“The Wellness Center is surrounded by open land,” says Cheyenne Spetzler. “We always thought of that space for a playground and other outdoor activities.” Thanks to a grant from Community Clinics Initiative of Tides and The California Endowment, this vision is becoming reality. In collaboration with Community Assistance Network and the Del Norte Healthcare District, a community garden is taking root. Hilda Contreras notes, “Everyone is so thankful that the garden is here. Many of our patients and staff participate. We love taking a walk through the garden. People who never gardened before now grow vegetables for their families.” A true community effort involving scores of volunteers, the area will soon be expanded to include a greenhouse, more planting beds, a children’s play area, walking paths and exercise stations. Jesse Vos remarks, “I encourage patients to become involved. I tell them ‘your body builds itself from what you put in it every day’. The garden allows people to grow and eat healthy food.” Dr. Groves agrees, “The garden gets people outdoors, learning to grow things for themselves. Fresh air, healthy food and self-sufficiency can help on many levels. The activities of gardening, opportunities to meet new people, learning to work together – these all help ease depression, anxiety and contribute to the health of the whole community. The garden is a symbol of health in action. People with diabetes, obesity, and hypertension improve with healthier diets. Chronic pain and arthritis eases if people are moving around. The very existence of the garden allows nature to provide a profound healing experience.” ❖
McKinleyville Community Health Center continued from page 1
Syndrome. Dr. Humphry told us that if untreated, Makynna would pass away between five and eight years of age. As a team we acted fast. Makynna was admitted to Stanford Medical Center on December 10, 2006 and began her first course of needed chemotherapy the following morning. Thankfully, Makynna was diagnosed extremely early. Hurler’s Syndrome is often detected when the child is between two and eight. Makynna was only 14 months old when she received her bone marrow transplant. I’ll never forget walking through the first door to the isolation room where Makynna was staying. Whenever I looked through the window her face would light up, her smile melting my heart and any sadness. Because of her light and love I was able to support her and give her the extra love she needed to get better. Makynna is progressing toward a happy, normal life, well on her way to recovery.
Without the trust of Dr. Humphry and the medical insight he provided our family, we would not have been able to see the light at the end of the tunnel. Dr. Humphry was my pediatrician when I was a child, and now all my children go to him. I am so thankful that he listened to my concerns, trusted me, and acted quickly. I have met my fair share of doctors and I only trust a few: Dr. Humphry is one of them. I’ve found that it’s the little things in life that are the best learning experiences. I cherish every day with my family. It has made every breath a little sweeter and every laugh a little longer. Tasha White, a mother of five, lives in McKinleyville. Makynna, who just started kindergarten, will celebrate her sixth birthday next month.
One Roof – One Mission – Many Generations The McKinleyville Community
Dr. Bill Carlson with patient, Lyle Ocheltree
Health Center was established Through One Door some years ago to serve a mostly “I came here in 1980 to join the adult population from the area. In Humboldt Open Door Clinic in Ar2007, when Ted Humphry brought cata when it was still in the Tin Can his pediatrics practice to Open Mailman building. I was interested Door, McKinleyville had the availin family practice and obstetrics,” able space. says William With separate Carlson, MD. entrances, When Open it may seem Door opened like two clinthe McKinIt has made every breath ics, but they leyville Comshare much in munity Health a little sweeter and every common. This Center, Dr. site offers a Carlson, now laugh a little longer. comprehenthe site’s medisive array of cal director, - Tasha White pediatric and moved to the primary care new location. “I family mediwanted to work cine. It still in the commuhas the small nity I lived in. clinic feel that Dr. Carlson discusses This feels like a small clinic, but we below, and remains committed to fill a big need in this community.” its long-standing patients. As GloIn reality, the McKinleyville site has rie Williamson, RN, notes, access is always an issue. continued on next page ➤
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Some of the staff of McKinleyville Community Health Center
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Through Another Door
RNs Cynthia Graves (left) and Glorie Williamson
almost as many medical appointments each year as most other Open Door clinics. One possible explanation for the more relaxed feel: “We’ve been working with many of the same patients for several decades. They appreciate the continuity of care from being together for so long.” “Small is beautiful. We don’t have all the services right here, but we’re hooked into the other resources of Open Door and can connect patients to specialists and the bigger medical community,” continues Dr. Carlson. Like other Open Door clinics, McKinleyville uses a team concept. Dr. Carlson explains, “Two or three providers work together as a small family practice unit. We rely on our nurses quite a bit.” Team work is essential to an efficient working environment. All members of the staff help to address pa-
Teen Clinic Teen Advocate Rachel Maxwell
tients concerns, facilitate communication and create access. The McKinleyville clinic offers patient-centered care, with strong relationships between patients and providers. Glorie Williamson, RN Clinic Coordinator, explains, “Relationships are what we’re here for, what we want. Our care is about follow up, health maintenance, keeping up with our patients and protecting their health.” Glorie notes, “I came here from Sacramento , graduated from the nursing program at CR, and taught clinical nursing. I have worked at Mad River and St. Joe’s.” When Glorie explored Open Door she found, “Open Door stood for what I believed in as a nurse: access to patient-centered care.” After several years at the McKinleyville clinic, Glorie feels the collaborative effort among all Open Door clinics. “The clinics work closely with one
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another. We all work hard for our patients to be seen. And if we’re short of appointments, we’ll work to have them seen at another Open Door clinic. We’re always working to get new patients into care.” “We do our best to calm and reassure those who call us. Our job is knowing how to approach the patient and comfort their woes,” says Sarah Kohndrow, front desk lead at MCHC. Sarah knows it takes experience to understand that forming relationships with patients is both an important part of the clinic and an understated perk. “We know our patients as people. We greet them by name. That makes a big difference.” Sarah explains that the front desk is entrusted to make the first impression of the clinic and to help the patient have a successful clinic visit.
Theodore “Ted” R. Humphrey, father of seven, husband of Cindy for 30 years, and the pediatrician many families in this community have grown to trust, received his medical degree from the USC School of Medicine in 1971. He completed his pediatric residency at the University of Oregon in Portland and worked at the Los Angeles Children’s Hospital and the U.S. Indian Health Services Hospital in Alaska before settling in Arcata to open his own practice in 1977. Today Ted works full time at Open Door’s McKinleyville Community Health Center. “After 30 years of private practice I wanted a change. I couldn’t afford to pay new providers, though they wanted to be here, it was expensive. And it’s hard to ask new providers to be on call twenty-four/seven.” Open Door helped recruit two new pediatricians, Drs. Wirthlin and Heise to join Ted at the McKinleyville clinic. While Dr. Heise recently moved on, Dr. Ed Kody is filling in until a permanent replacement is found. Having three pediatricians helps share the work while bringing a variety of talent to the MCHC family. Being on call is an important in a pediatrics clinic. Parents call with all kinds of concerns. They need to know someone will listen and respond. Open Door pediatricians are also on-call to the hospitals for newborns and unusual or emergency situations involving infants and children. In the case of Makynna’s ordeal, Ted has been an important figure in the family’s support team. As Tasha White, Makynna’s mother, explains, “When something is wrong, any-
thing, I call him. Naturally I worry about Makynna, and Dr. Humphry would always calls me back. He is a laid back guy, and his calmness helps to keep me calm.” Ted has a passion about his medical practice. He also has a passion for his community. “I raised my seven children here, all graduating from local high schools.” He chose Arcata as the place to start his practice because he wanted to work and raise his family in a rural environment. “I had a list of criteria, 32 points to judge a community on,” and this community won. In what spare time he has, Ted is a volunteer for the Redwood National State Park, “I am what they call a ‘rover’, I walk around and talk to people, do trail reports, things like that. The people I meet in the park tell me I have the best job in the world. I have to smile, because although I love my volunteer work, the best job in the world is being a pediatrician. I am at the age of retirement, but I plan to work indefinitely, I just enjoy it.” The staff at the McKinleyville Pediatrics clinic echo Ted’s enthusiasm. Theresa Sawatsky, pediatrics office manager explains, “We’ve all had pregnancies, births, and our time raising children. We understand what our patients are going through.” The team has a strong connection
Dr. Tara Vu McKinleyville's Newest Team Member Tara Vu, MD, recently completed her residency at UC Davis Medical Center. So did her husband, Kelvin Vu, DO. “We have been thinking about where we would go after our residencies for quite a while. We have been looking for a place to call home. We wanted to work in a small community and just loved this area. We were lucky enough to find positions for both of us.” Tara is the newest family physician at McKinleyville Community Health Center. Kelvin is the newest family physician at Open Door’s NorthCountry Clinic in Arcata. “It seems like a huge percentage of the population uses an Open Door clinic. I’m sure I’ll be running into patients more and more. That’s a reassuring feeling. When you’re involved in people’s lives it’s a real advantage to know them well. That is definitely something I am looking forward to.” The Drs. Vu are a valuable addition to the health care community and a great addition to their respective Open Door clinics. Notes Tara, “We would like to be here for quite awhile. It seems like a great environment. I really like the small close-knit feel. It is so different from where we were.” Tara has only been in the community for a few months but she feels at home, “Everyone’s been really welcoming. I already feel part of the team.” ❖ Tara Vu, MD
to the families that step through the door. “One way or another, we have all been there.” The ultimate joy of their job? “We get to hold babies; then we get to watch them grow up.”
And Still Another Door
On Monday afternoons the usually unused south waiting room of the McKinleyville Community Health Center is abuzz with activity. Every Monday, from 3:00 to 5:00 is Teen Clinic. “Teen Clinic provides a great place to get in-
formation even if you don’t want to be seen by a health care provider,” explains Darci Ray, medical assistant and Teen Clinic Supervisor. “I want our teens to know this is an absolutely confidential service. Access to health information and care is important to maintaining well-being, whether for reproductive health or simply as support for the changes teens go through.” Darci recalls, “When I was in high school there was nothing like this. It is so neat to see kids, and hear all their questions
and all that they know. It is exciting to meet this need.” Teens can come in and pick from a display of brochures and educational materials, and they are encouraged to take as much as they want. Cynthia Johnson, nurse practitioner, is available to provide health exams and care; however, in many cases teens choose to use Teen Clinic as a place for communication. Darci explains, “While they can be seen by a provider if they wish, a lot of the time they just hangout and discuss what’s on their minds.” ❖
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suffering and horrid condition must be because these people couldn’t bend their arms to feed or clean or tend to themselves. After a few minutes, Ari had seen enough. “Please let me see heaven,” Ari asked of his Guiding Spirit. Upon reaching heaven, Ari saw another group of people. This time he noticed that all of the people were clean, well-fed, healthy and happy. Upon further observation, Ari again noticed the strange phenomenon that none of these people could bend their arms – just like the people he had seen during his vision of hell. Ari asked his Guiding Spirit, “What is this I have seen? The people in hell were all diseased, suffering and unfed. I thought it was because they couldn’t bend their arms to care for themselves. But here in heaven, everyone is happy, healthy, and well-fed, yet they can’t bend their arms either. What’s going on?” Ari’s Guiding Spirit replied, “Did you not notice, Ari? It’s simple. The people in hell are only focused on themselves. The people in heaven are focused on each other. They take care of each other, feeding the hungry, washing the dirty, clothing the ragged.” Ari thought for a long time before speaking to his Guiding Spirit, “So, while each individual may not be able to take care of his or her own needs, when we work together we can take care of each other and make life better for all, including ourselves.” His Spirit smiled.
Jay Molofsky relocated from Austin, Texas to Humboldt County in 2003. He is the site administrator at both Humboldt Open Door Clinic and NorthCountry Clinic. He is also director of the Open Door HIV Early Intervention and Treatment program.
➤ Visit northcoast journal.com/specialpublications to view past editions of Open Door Special Sections ➤ Visit www.opendoorhealth.com for e panded versions of these articles and to learn more about Open Door Community Health Centers
OPEN DOOR COMMUNITY HEALTH CENTERS
Administrative Offices: 670 Ninth Street, Suite 203 • Arcata, CA 95521 • 707-826-8633 www.opendoorhealth.com • Arcata HUMBOLDT OPEN DOOR CLINIC 770 Tenth Street, Arcata, CA 95521 707-826-8610 NORTHCOUNTRY CLINIC 785 18th Street, Arcata, CA 95521 707-822-2481 NORTHCOUNTRY PRENATAL SERVICES 3800 Janes Road, Suite 101, Arcata, CA 95521 (in the Shaw Pavilion of Mad River Community Hospital) 707-822-1385 • Crescent City DEL NORTE COMMUNITY HEALTH CENTER 550 East Washington Blvd, Crescent City, CA 95531 707-465-6925 - Medical 707-465-4636 - Dental • Eureka BURRE DENTAL CENTER 959 Myrtle Avenue, Eureka, CA 95501 707-442-7078 EUREKA COMMUNITY HEALTH CENTER 2412 Buhne Street, Eureka, CA 95501 707-441-1624 TELEHEALTH & VISITING SPECIALIST CENTER 2426 Buhne Street, Eureka, CA 95501 707-442-4038
• McKinleyville McKINLEYVILLE COMMUNITY HEALTH CENTER 1644 Central Avenue, McKinleyville, CA 95519 707-839-3068 - Medical 707-839-2677 - Pediatrics • Willow Creek WILLOW CREEK COMMUNITY HEALTH CENTER 38883 Route 299, Willow Creek, CA 95573 530-629-3111 - Medical 530-629-1941 - Dental All clinics will do their best to accommodate your immediate needs; however, there may be a waiting list at some clinics to establish care for new patients at this time. Open Door clinics offer either family practice/primary care medical services or dental services for children and adults. Several clinics offer both medical and dental services. While not available at all sites, other services provided to patients of Open Door Community Health Centers include: • • • • • • • • • • • •
Behavioral Health and Counseling Services Evening and Saturday Hours HIV/AIDS and Hepatitis C Care Nutritional Counseling Opiate Dependency Treatment Pediatric Services Psychiatry Specialty Medical Care Teen Health Clinics Transgender Health Clinic Urgent Care (Walk-In Services) Wellness and Health Maintenance
Articles by Breanne Sorrells, Development Associate, and Julianne Barnum, Advancement Assistant, Open Door Community Health Centers; editorial contributions by Christopher Peters, Chief Advancement Officer, Open Door Community Health Centers Most Photography by Paul Swenson Photography, www.paulphoto.com Layout and graphic design by Siobhan Calderwood, North Coast Journal Please visit www.opendoorhealth.com to read expanded versions of these stories and discover more about Open Door. Comments may be addressed to: editor@opendoorhealth.com.
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This health center is a Health Center Program grantee under 42 U.S.C. 254(b), and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n)