What is Integrated Healthcare?
It is the systematic coordination of integrating mental health, substance
abuse, and primary care services when caring for people with multiple
People with mental and substance abuse disorders may die decades earlier
than the average person — mostly from untreated and preventable
chronic illnesses like hypertension, diabetes, obesity, and cardiovascular
disease that are aggravated by poor health habits such as inadequate physical
activity, poor nutrition, smoking, and substance abuse. Barriers to
primary care, coupled with challenges in navigating complex healthcare systems have
been a major obstacle to care.
At the same time,
primary care settings have become the gateway to the behavioral health system, and
primary care providers need support and resources to screen and treat
individuals with behavioral and general healthcare needs.
Working with Maricopa Integrated Health System (MIHS), JFCS is working
to build a health information exchange. This partnership will allow JFCS
to determine if a client is in the MIHS system for his or her physical
health needs and exchange information. This helps treat the whole person
and better understand their needs.
Integrated Health at JFCS
JFCS is one of three local agencies selected to receive a grant from Magellan
Health Services to implement an integrated health program. The program's
main focus is on clients with chronic obstructive pulmonary disease, high
blood pressure, diabetes and obesity. To enroll in the program, JFCS clients
must opt in. Every new behavioral health client fills out a health risk
assessment (HRA), which requests information about their physical activity
levels, social activities, cholesterol and glucose levels, and other health
information. After reviewing a client's HRA, a peer navigator is assigned
to work with the client to establish health goals and act as a support
system. Goals may be a simple as focusing on eating breakfast three times
a week or increasing physical activity. We start small and meet the client
where they're at. Depending on the client's needs peer navigators
also help connect clients to community resources, talk them through medical
procedures, find them a doctor or dentist, go to appointments with them,
help them stay on AHCCCS, and even provide food boxes.
A final aspect of the program is education. Many clients are stuck in what
is called the symptom cycle. If they suffer from depression, the may struggle
to focus on eating well and exercising to reduce symptoms of diabetes.
And an inability to control a chronic condition like diabetes can feed
a person's depression. In addition to working with doctors to treat
the client's physical and mental health needs, JFCS has implemented
a six-week chronic disease self-management class that helps people manage
their particular condition. These 6-week classes are taught in a supportive
group setting and focus on nutrition, exercise, health management, decision
making, and goal setting.
The Integrated Health Program is FREE to all current JFCS clients.
Available at all 4 of our clinics, call the customer service & referral
center at (602) 256-0528 to make an appointment.
Program is funded by Magellan Health Services of Arizona community reinvestment
grant; in collaboration with Maricopa Integrated Health Systems.
JFCS Peer Navigator, Kelly Purnell (left) pictured here with a program