Advancing Health Equity - MetroHealth
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ADVANCING
HEALTH EQUITY

AAMOTH FAMILY PEDIATRIC WELLNESS CENTER

Through the wellness center’s hands-on nutrition and fitness classes at MetroHealth Medical Center and local schools, children, teenagers and families learn about healthier living.

  • Established seven years ago, the program teaches participants to incorporate the American Academy of Pediatrics 5-2-1-0 daily recommendation for healthier living into their lives. That is to eat five servings of fresh fruits and vegetables, spend less than two hours looking at a screen (TV, videos, computer, game console, phone), get at least one hour of vigorous physical exercise and drink zero sugar-sweetened beverages, promoting more water consumption.
  • The Aamoth Family Pediatric Wellness Center is part of MetroHealth’s Pediatric Weight Management and Wellness Program. This clinical, by-appointment program screens for obesity-related medical problems in children and helps them achieve a healthy weight.
  • In 2017, more than 1,000 children and their family members participated in a joint Aamoth Family Pediatric Wellness Center and Pediatric Weight Management and Wellness Program.
  • During the summer, nearly 100 children participated in nearly 1,000 visits to the wellness center to learn about gardening and healthy living.
  • The result has been that children in the wellness center program are improving their body mass index (BMI), a measure of body mass based on height and weight, and are acquiring healthy life skills.
  • Each school year, the wellness center offers more than 400 Cleveland Metropolitan School District students weekly “wellness days” that focus on fitness and nutrition.

ASIA-INTERNATIONAL COMMUNITY HEALTH CENTER (Asia-ICHC)

Once a month, a post-doctoral psychology fellow provides behavioral
health services including mental health assessments and counseling at
this health center.

 

  • The collaboration provides needed services to low income,
    underserved members of the community.
  • Asia-ICHC serves all patients regardless of ability to pay.

BETTER HEALTH PARTNERSHIP

Better Health Partnership is a regional health care improvement collaborative committed to the Triple Aim of better care, better health and lower costs for adults and children in Northeast Ohio with common chronic medical conditions.

  • MetroHealth is a co-founder of the organization, formerly known as Better Health Greater Cleveland, which was established in 2007.
  • Better Health Partnership members include over 1,700 health care providers from 13 health care systems including MetroHealth, plus employers, insurers, community groups and agencies.
  • Better Health leverages regionwide partnerships among primary care providers to establish common goals and uses evidence-based metrics, collaboration and sharing of best practices to improve care and outcomes and reduce disparities of primary care patients with common and costly chronic diseases. Care and outcomes for nearly 281,000 patients are measured.
  • In 2015, Better Health launched the Children’s Health Initiative whose initial focus is on nearly 256,000 children with asthma and/or obesity and efforts to help clinicians link them to resources to meet non-medical needs that impede health.

BRINGING EDUCATION, ADVOCACY AND SUPPORT TOGETHER (BREAST)/AMIGAS PROGRAM

The MetroHealth Cancer Center is a leader in the field of women’s breast health. Through its premier BREAST/Amigas Program, MetroHealth is helping uninsured, low-income women fight breast cancer.

  • The program’s mission is to reduce health disparities, especially for uninsured minority women, by providing early detection of breast cancer through screening, education, community outreach and patient navigation.
  • The program trains bilingual breast health advocates to become certified Amigas volunteers, connects women to the BREAST/Amigas Program for free mammograms and other community resources, and organizes small-group bilingual breast cancer education sessions held in homes, churches, beauty salons or community centers.
  • More than 42,000 individuals have learned about breast health, screening guidelines and where to get mammograms in their community.
  • Community health fairs offer additional tests and screenings including blood pressure, glucose, HIV, cholesterol, sickle cell, pap exams, skin checks, and health consultations for men, colorectal screening education and other screenings and education.

CARE ALLIANCE

MetroHealth has helped Care Alliance, a nonprofit community health center that serves the uninsured and underinsured of Greater Cleveland, establish an ongoing Ob/Gyn service within the community, and continues to support this program in the Central neighborhood.

  • A MetroHealth Ob/Gyn physician collaborates with Care Alliance staff to provide consultative and ongoing Ob/Gyn care to women in the Central neighborhood – a population at high risk for pregnancy complications, preterm birth, infant mortality, and who often have complex gynecologic care needs.
  • Through this relationship, our shared patients can easily access high-risk pregnancy care, obstetric and gynecologic ultrasound imaging, and other needed services. After delivery, our goal is for mother and baby to continue their health care by receiving primary care adult and children’s services close to home at Care Alliance.

CENTER FOR REDUCING HEALTH DISPARITIES

Since 2004, The MetroHealth System and Case Western Reserve University have collaborated on the mission to reduce health disparities through (a) research on root causes, mechanisms and interventions, (b) education of students, providers and policy makers and (c) partnership with community organizations and government agencies.

  • The Center’s faculty and staff are involved in several research, education and community collaboration activities designed to address health disparities in Greater Cleveland and beyond.
  • They have received more than $10 million from the National Institutes of Health, the Department of Health and Human Services And other agencies to understand and address health disparities related to hypertension, kidney disease and transplantation.
  • Center faculty also play an active role in the Community Research Partnership Core of the NIH-funded Clinical and Translational Science Collaborative, a partnership involving Case Western Reserve University, University Hospitals, Cleveland Clinic and MetroHealth.

 

COMMUNITY ADVOCACY PROGRAM (CAP)

For more than 15 years, MetroHealth has partnered with The Legal Aid Society of Cleveland to remove legal barriers to health for MetroHealth patients through CAP.

  • This medical-legal partnership integrates lawyers in the health care setting to help patients navigate the complex government and community systems that often hold solutions to many social determinants of health. For example, CAP addresses income supports for food insecure families, appropriate special education services for students with disabilities and utility shut-off protection during cold winter months.
  • By pairing legal and medical professionals, CAP improves health outcomes for low-income, vulnerable individuals and families including children, pregnant women, Spanish speakers, immigrants, the elderly and formerly incarcerated people.
  • In 2017, CAP provided legal assistance to 788 household members through brief advice or extended legal representation.
  • Also in 2017, CAP attorneys presented more than thirty trainings to MetroHealth staff on topics such as housing, utilities, bullying, school discipline, immigration and public benefits.

COMPASS SERVICES

Compass Services is a free program that guides people living with HIV/AIDS along the path to wellness.

  • Services offered include counseling and linkage to care for the newly diagnosed, support groups, peer coaching, special programming and a smartphone app called Positive Peers, created by MetroHealth to retain youth and young adults (ages 13-34) in HIV care (positivepeers.org).
  • Compass Services programs and staff are funded through generous grants and other public and private sources.
  • Since the program’s 2008 inception, every year about 100 individuals newly diagnosed with HIV receive individualized counseling, education and linkage to care.
  • In 2017, Compass Services offered more than 70 support groups for people living with HIV.
  • The multifaceted Peer Coaching Program is designed to encourage and help patients learn how to successfully live with HIV.
  • In 2017, MetroHealth once again hosted its biennial display of the AIDS Memorial Quilt. MetroHealth staff and 25 volunteers worked with local families to create seven new AIDS Quilt panels for loved ones lost to AIDS-related illness. The panels were sent to Atlanta to become part of the AIDS Memorial Quilt. The closing reception was attended by 125 guests.

COMPREHENSIVE CARE PRACTICE

This MetroHealth practice offers primary care, consultation and care coordination for people of all ages with complex medical conditions, developmental delays or disabilities – addressing their associated unique health care needs.

  • The practice has been serving the special needs population and their families with coordinated multidisciplinary care for more than 50 years.
  • Pediatric specialty clinics are offered in the areas of cerebral palsy, spina bifida/hydrocephalus, behavior assessment and craniofacial/cleft lip and palate.
  • Nutrition and social work staff are available at appointments to address specific needs.
  • As patients reach adulthood, they transition from pediatric to adult providers within the practice, remaining with providers who are familiar with them.

CORRECTIONAL HEALTH PROGRAM

Established in 2013, this partnership teams leadership and resources from MetroHealth with Cuyahoga County Corrections Center health care providers to improve the health and safety of 2,200 inmates at the Cuyahoga County Corrections Center.

  • MetroHealth provides the medical director, director of operations, nursing supervisor and primary providers including physicians, nurse practitioners, physician assistants and paramedics. County staff includes the director of nursing, licensed practical nurses, registered nurses, an obstetrics/gynecology specialist, a pharmacist and medical team assistants.
  • More comprehensive, cost-effective care is provided for the 60-70 daily patients who have an average length of stay of 45 days.
  • A family medicine chronic disease management program institutes on-site six-week diabetes self-management courses for inmates and addresses chronic hypertension.
  • MetroHealth’s real-time “virtual visit” telemedicine program enables consultation with specialty services such as cardiology, neurology, infectious disease, wound care and dermatology.
  • Digital in-house x-ray/ultrasound imaging and laboratory support and ongoing skills training (e.g., wound care, orthopaedics, suturing) improve the standard of care while reducing the need for inmate transports to MetroHealth Medical Center for services.
  • The use of electronic health records provides a key link to MetroHealth specialists system-wide.
  • Two modern dental areas with state-of-the-art equipment and professional staffing enable preventive and comprehensive dental services.
  • Family medicine behavioral health and addiction counseling provides one-on-one counseling sessions and group therapy.
  • A Medication Assisted Treatment program helps inmates struggling with opioid addiction, including incarcerated pregnant women. This includes Vivitrol for inmates identified through drug courts and Subutex (buprenorphine) for pregnant females with opioid use disorder.
  • Testing for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is followed with referrals for recovery support services.
  • The MetroHealth Center for Biomedical Ethics provides consultation services for the Correctional Health Program.
  • Medical residents perform elective rotations at the corrections center.
  • The federal 340B Discount Drug Program, requiring drug manufacturers to provide outpatient drugs to eligible health care organizations or entities at significantly reduced prices, was implemented at the Corrections Center, reducing monthly pharmacy costs by up to 50 percent.

New in 2018:

The MetroHealth Correctional Health Program is working with the MetroHealth Office of Opioid Safety to provide Naloxone along with proper training for all first responders in the jail. This includes corrections officers and medical staff.

All post-operative follow-up care for trauma patients will be completed using the InTouch Health telemedicine platform. This will reduce the number of transports for follow-up surgery and orthopaedic visits.

CUYAHOGA COUNTY HEALTH CARE COUNCIL

Organized by the Cuyahoga County Department of Health & Human Services, this is a forum for health and social service providers to keep abreast of major developments affecting low-income individuals and families.

  • The Council discusses and responds to changes involving Medicaid, behavioral health, senior services and prescription discount programs.
  • MetroHealth participates in the quarterly meetings.

CUYAHOGA COUNTY WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM

WIC is a federally funded food supplement and nutrition education program.

  • It serves pregnant and breastfeeding women, and children up to the age of 5 who are at risk due to inadequate nutrition.
  • Administered in Cuyahoga County by The MetroHealth System, the program operates in 22 sites and serves more than 25,000 participants each month throughout the county.
  • WIC provides nutrition education, breastfeeding education and support, nutritious foods, iron-fortified infant formula and referral to health care and human service programs.

CUYAHOGA HEALTH ACCESS PARTNERSHIP (CHAP)

MetroHealth welcomes patients referred by the Cuyahoga Health Access Partnership (CHAP), a non-profit organization dedicated to providing a coordinated system of health care for the county’s low-income, uninsured adults.

  • Through its coordinated network, CHAP connects patients without insurance to providers who offer discounted primary care and specialty care.
  • CHAP also provides health insurance education to its clients. If individuals qualify for Medicaid or private insurance, CHAP helps individuals complete the necessary application paperwork.
  • CHAP was founded on the principle of shared responsibility by hospital systems, community health centers, free clinics, local governments, foundations and other key organizations in Cuyahoga County.

DOCTORS ON THE STREETS (DOTS)

On Friday nights from fall through spring, doctors, nurses and medical residents from MetroHealth’s Department of Family Medicine volunteer at St. Malachi church on West 25th Street in Cleveland to provide care to the homeless.

  • Medical care is brought to some of Cleveland’s most vulnerable populations, many of whom deal with a variety of illnesses and conditions.
  • Throughout the year, MetroHealth medical residents collect necessities such as over-the-counter medications, blankets, boots, socks, foot care products, canes, reading glasses, warm clothing, sleeping bags and tarps to be distributed to men and women who are exposed to our region’s harsh weather.
  • Participants, who also include nursing, pharmacy, social work and pre-medical and medical students, discuss developing empathy, preventing burnout and overall professional development.

EASIER ACCESS FOR ALL

With locations throughout Cuyahoga County, almost all residents are less than a 10-minute drive drive to a MetroHealth location.

  • New hospitals opened in Cleveland Heights and Parma during the first week of 2018, ensuring that every Cuyahoga County resident can reach a MetroHealth hospital within 15 minutes.
  • The opening of new locations creates jobs and adds to payroll taxes collected and dollars spent in the area.
MetroHealth locations as of January 4, 2018:
West Region
    1. 1. Brooklyn Health Center
    2. 2. MetroHealth Medical Center, Main Campus*
    3. 3. MetroHealth Medical Center, Old Brooklyn
    4. 4. Rocky River Medical Offices
    5. 5. Thomas F. McCafferty Health Center**
    6. 6. West 150th Health and Surgery Center
    7. 7. West Park Health Center
    8. 8. Westlake Health Center
    9. 9. Physical Therapy at West Shore Family YMCA
East Region
    1. 10. Beachwood Health Center
    2. 11. Bedford Medical Offices
    3. 12. Broadway Health Center
    4. 13. Buckeye Health Center
    5. 14. MetroHealth Medical Center, Cleveland Heights*
    6. 15. J.Glen Smith Health Center**
    7. 16. Lyndhurst Health Center
South Region
    1. 17. Brecksville Health and Surgery Center*
    2. 18. Brunswick Health Center
    3. 19. MetroHealth at Discount Drug Mart
      • • Independence
      • • North Royalton
      • • Olmsted Falls
      • • Parma
    4. 20. Middleburg Heights November Family Health Center
    5. 21. MetroHealth Medical Center, Parma*
    6. 22. Parma Health Center
    7. 23. State Road Family Practice

*Includes an Emergency Department
**Operating in partnership with city of Cleveland

ELISABETH’S HOUSE: THE PRENTISS PEDIATRIC CRISIS NURSERY (formerly the WELLNESS NURSERY) AT PROVIDENCE HOUSE

The MetroHealth System partners with Providence House, a crisis nursery committed to child abuse prevention and family preservation, to provide medical services for all children who come to stay at Providence House.

  • The crisis nursery serves children from birth to 10 years old who have medical needs and no longer require inpatient care, but whose families are currently unable to meet their medical needs due to family crisis or unstable living environments.
  • Every child entering Providence House receives a well-child examination by a MetroHealth nurse practitioner or pediatrician. In 2017, there were 271 exams.
  • The provider then works with Providence House staff and families to develop a detailed plan of care for after the child leaves Providence House. This includes prescriptions, specialty referrals and recommendations for any necessary follow-up.
  • In 2017, approximately 60 children also were seen for sick visits for minor illnesses and health concerns.

EMPLOYEE GIVING

The MetroHealth Foundation’s annual Employee Campaign raises funds to support programs and projects of The MetroHealth System.

  • These programs address the physical, mental, social and economic health of patients and other residents of Cuyahoga County.
  • Employees contributed nearly $945,000 to MetroHealth in 2017.

ENROLLMENT VAN

An RV equipped with multiple work stations and staffed by financial representatives certified by the Centers for Medicare & Medicaid Services travels throughout Cuyahoga County to offer easy access for residents to sign up for health care.

  • The van reaches residents in their local communities, and Certified Application Counselors help individuals apply for coverage in publicly funded health care programs, and then schedule medical appointments.
  • The goals are to remove financial barriers to preventive and continuous care and to promote a healthier community through improved access.
  • MetroHealth representatives also help patients sign up for MyChart, MetroHealth’s personal electronic medical record, and explain how they can take an active role in their health care.
  • Making appointments, refilling medications, reviewing lab and radiology results and communicating with physicians are just a few benefits of MyChart.
  • In 2017, the enrollment van participated in 241 events. Staff on the RV served 1,327 patients, helped 426 patients complete applications for Medicaid and helped 285 enroll in MyChart.

HEALTH CARE AT THE JUVENILE DETENTION CENTER

MetroHealth provides daily health services at the Cuyahoga County Juvenile Detention Center for 130-180 youths, male and female, who are in the juvenile justice system.

  • Upon entering, all youths are screened by MetroHealth registered nurses and licensed practical nurses for communicable diseases, allergies and current medication use.
  • MetroHealth physicians and advance practice nurses complete comprehensive examinations every weekday morning.
  • The nursing staff responds to health issues ranging from minor to emergent 24/7/365.
  • When a youth has a medical need outside the scope of the morning clinic, an appointment is made at MetroHealth with the appropriate provider. Follow-up medical and dental appointments are scheduled as needed.

HEALTH CARE FOR RECOVERY RESOURCES

MetroHealth provides primary care for individuals at Recovery Resources, a community-based behavioral health services provider.

  • People with severe and persistent mental illness often engage in care with a psychiatrist and/or behavioral health team while neglecting to attend to their physical health.
  • Preventable and treatable health concerns such as diabetes, heart disease and hypertension, leading causes for death in the mentally ill population, often go undetected or inadequately addressed.
  • With MetroHealth’s help, the clients at Recovery Resources can seek physical health care along with mental health care.

HEALTHY CITIES CLEVELAND

In the summer of 2015, Morgan Stanley launched “Healthy Cities Cleveland,” part of a national program to encourage wellness, play and nutrition in underserved communities.

  • MetroHealth’s School Health Program joined forces with the Greater Cleveland Food Bank and other community partners to support this initiative.
  • Through the initiative, the Greater Cleveland Food Bank hosts a school-based pantry program at Cleveland Metropolitan School District schools, one or two times a month.
  • MetroHealth provided multiple health screening events for students and community members at each of these school sites through May 2017. The schools were Adlai E. Stevenson, Case, Garrett Morgan High School, Marion-Sterling and Willson.

HEALTHY EATING & ACTIVE LIVING (HEAL)

In 2010, the Center for Reducing Health Disparities at MetroHealth and the Saint Luke’s Foundation partnered to create the Healthy Eating & Active Living (HEAL) initiative to address chronic illnesses (e.g., hypertension, diabetes) in the Buckeye, Larchmere and Woodland Hills neighborhoods, using a community engagement model.

  • Fairhill Partners currently serves as the supporting organization for this initiative.
  • Together, families, friends, community groups, local organizations and businesses are working to transform their neighborhoods into places that support healthy living, where options for healthy food and exercise are widely available, affordable, accessible and desirable.
  • Guided by the leadership of the HEAL Coalition, made up of residents, local non-profits and other stakeholders, the initiative focuses on local voices to build strategies for making health and well-being a part of the everyday culture in the targeted communities.
  • HEAL efforts include Fitness Zones at three neighborhood locations, multiple free fitness classes throughout the community, community walking routes, and fun and active community events.

HIP-CUYAHOGA

The Health Improvement Partnership (HIP)-Cuyahoga is a collaborative county-wide health improvement effort with a mission to inspire, influence and advance policy as well as environmental and lifestyle changes that foster health and wellness for everyone who lives, works, learns and plays in Cuyahoga County.

  • More than 100 community partners have come together in the HIP-Cuyahoga Consortium to build opportunities for everyone in Cuyahoga County to be healthy.
  • Priority issues are: Eliminating Structural Racism, Healthy Eating and Active Living, Linking Clinical and Public Health, and Chronic Disease Management.
  • The Cuyahoga County Board of Health provides strategic and operational support. The MetroHealth System has a representative on the HIP-Cuyahoga Steering Committee and a number of employees serving on various subcommittees.

HOME-BASED PRIMARY CARE

Home visits for patients who have multiple medical problems are conducted by a family medicine attending physician and a resident or medical student.

  • Many patients are challenged with multiple illnesses including stroke and spinal cord injuries, which make access to care difficult.
  • A continuum of care is achieved through home visits, which are scheduled throughout the week.

INFANT MORTALITY

Infant mortality, defined as when a live-born baby dies before his or her first birthday, is devastating to families and our community, and is a critical concern across the country.

  • While the national infant mortality rate declined to 5.9 in every 1,000 live births in 2016 (most recent data), Ohio’s rate increased to 7.4, tied for the 41st highest rate in the country. The infant mortality rate for Ohio’s African American infants remained much higher at 15.2.
  • Though the infant mortality rate in Cuyahoga County declined from 10.4 to 8.6 per 1,000 live births in 2016, and preliminary data for 2017 is encouraging, the county rate remains higher than the rest of the state and almost the entire country.
  • Prematurity-related conditions, birth defects, sleep-related deaths, obstetric conditions (e.g. premature rupture of membranes, cervical insufficiency and placental bleeding) and injuries continue to be leading causes of infant death in Ohio.
  • MetroHealth continues to work to reduce infant mortality, with programs aimed at educating pregnant women, new moms and their families. In 2017, MetroHealth continued to offer programs such as Boot Camp for New Dads, Childbirth Preparation Classes, Sibling Classes, Teen Pregnancy Clinic and a special clinic devoted to reducing preterm births in at-risk women.
  • Cribs and clothing are provided to families that needed assistance. Cuyahoga County Women, Infants, and Children (WIC) services and home visits by nurses are also offered – all promoting awareness, parent education and better outcomes for babies.
  • In 2017, MetroHealth continued efforts to improve pregnancy and infant outcomes through:
    • Centering Pregnancy – group prenatal care to enhance participation in prenatal care and improve pregnancy outcomes
    • The Nurse-Family Partnership – home visits by nurses during pregnancy and until the child is 2 years old to identify specific family needs and provide education and counseling, and facilitate access to needed resources for first-time mothers
    • Long-Acting Reversible Contraception (LARC) – providing women with the most effective contraception on the day they request it, in MetroHealth clinics or at the time of delivery – enabling women to plan for pregnancy
  • In 2015, MetroHealth partnered with the city of Cleveland, Cuyahoga County and other stakeholders to launch the First Year Cleveland initiative to advance a community response to infant mortality. In 2017, the commitment to this program continued to improve infant mortality rates across the community.
  • MetroHealth’s High-Risk Pregnancy Service has been a leader in pregnancy care in the region for decades, improving pregnancy outcomes and preventing preterm births for over three thousand families every year.
  • In addition to providing complex pregnancy care, doctors teach the next generation of clinicians and perform the research studies that change how pregnancies are cared for locally and nationally.
  • MetroHealth’s neonatologists (specialists in the care of newborn infants) provide the highest quality care for premature babies and those with complex medical needs, in the Level III Neonatal Intensive Care Unit (NICU).

KIDZ PRIDE CLINIC

This multidisciplinary, team-based clinic offers gender-related medical and mental health services to youths and families. Our providers include specialists in pediatrics, endocrinology and behavioral health.

  • Affirming, supportive experts in transgender health care follow the latest medical guidelines for those seeking gender-related services.
  • Providing physical and mental health treatment and access to support is a major step to decreasing the health disparities that LGBTQ youths often face.
  • Established in 2008, the Kidz Pride Clinic is the first of its kind in Ohio.
  • In 2017, 154 patients came in for multiple visits including 213 endocrinology visits and 346 psychology visits.

MDA CARE CENTER

MetroHealth is home to the only Muscular Dystrophy Association (MDA) Care Center in Cleveland.

  • MDA Care Centers are designed to give individuals who are diagnosed with muscular dystrophy, amyotrophic lateral sclerosis (ALS) and other neuromuscular diseases access to an array of highly specialized, multidisciplinary care to ensure the best possible health outcomes.
  • In 2017, the MDA Care Center at MetroHealth received a 3-year certification as the Northeast Ohio regional center for neuromuscular disorders. Along with the certification, there is a grant total of $75,000 for 2017-2019.
  • The Center saw 324 patients in 2017.

MEDICAL HOME FOR CHILDREN IN FOSTER CARE

In partnership with the Cuyahoga County Division of Children and Family Services (DCFS), MetroHealth provides children in foster care with a centralized place to receive both routine and sick care including physicals, immunizations and assistance with behavioral and/or mental health concerns.

  • Cuyahoga County requires that all children receive a medical exam before they are placed in foster care or change foster homes. When a child is removed from a home, the child is first brought to MetroHealth for an examination and any immediate care that is needed. For this “triage,” a dedicated nurse practitioner is ready to welcome children 24 hours a day, seven days a week, 365 days a year. Each time a child changes homes, there is a triage visit.
  • Children receive a 30-day exam by the same medical team that they met during triage, to help build a consistent and trusting relationship with the team that they will continue to see at future appointments.
  • A social worker offers support and helps families access resources in the community.
  • The care coordinator meets with the child and foster care family and tracks compliance with appointments, how the child is adjusting and any referrals to specialists that the child may need.
  • A child psychologist is part of the team, ensuring children receive timely mental health services.
  • The MetroHealth team works closely with the DCFS health care unit and caseworkers to coordinate care and communicate recommendations.
  • All visit information is entered into the electronic medical record – EPIC, which allows MetroHealth providers to review and manage the health care plan, even if a child is seen at another health care system.
  • The Medical Home in Foster Care program began in November 2013.
  • In 2017, there were 2,085 triage visits and 826 follow-up 30-day evaluations.

MEDICATION ASSISTANCE

For more than 18 years, MetroHealth has offered a voucher program, which allows patients who qualify to receive a medication voucher once every 12 months.

  • Patients who cannot afford medication are referred to the Department of Social Work’s Medication Assistance Program.
  • In addition to the voucher, an assessment is given to understand the patient’s financial circumstance. A social worker is then able to develop a personalized plan with each individual.
  • The personalized plan often includes helping patients apply to Pharmaceutical Assistance Programs, helping patients understand which insurance option is best for them and assisting with the application process.
  • In some cases, the individual simply needs guidance on maintaining a budget to afford his/her medication(s).
  • In 2017, MetroHealth provided more than $35,000 in free medications through the voucher program.

MOTHER AND CHILD DEPENDENCY PROGRAM

Two care coordinators facilitate this program with the goal of improving the outcomes for high-risk, drug-dependent women and their babies.

  • Pregnant women and their infants are offered a non-judgmental environment to deal with the medical and emotional problems caused by addiction to drugs such as prescription opiates or heroin.
  • Whether their addictions are yet untreated or they are receiving methadone or Subutex through a community drug treatment program, the MetroHealth program provides expert care and coordinates with community agencies to optimize services.
  • Patients with opiate addiction have been seen at MetroHealth for more than a decade. In 2013, grant funding was obtained to provide a care coordinator and establish a formal program.
  • Wraparound services are provided through coordination with several community agencies.
  • In 2017, 178 mothers struggling with opiate addiction, and 126 babies who had exposure to opiates, were served.

NURSE-FAMILY PARTNERSHIP

In December 2015, MetroHealth partnered with The Mt. Sinai Health Care Foundation to develop a local site for the Nurse-Family Partnership, a community-based program in which specially trained nurses provide regular home visits to first-time moms, starting early in the pregnancy and continuing through the child’s second birthday.

  • The goal of this evidence-based intensive relationship is to help women develop the confidence and tools they need to reduce pregnancy complications, give their baby a healthy start and improve opportunities for success for both mother and baby through support, education and mentorship.
  • Now in 42 states, reported key benefits of the program have included reductions in preterm births, increased rates of breastfeeding, increased rates of childhood immunization, increased economic self-sufficiency of the family and a significant financial return on investment for communities.
  • With added support from the Sisters of Charity Foundation of Cleveland, George Gund Foundation, David and Inez Myers Foundation, Ohio Department of Health and First Year Cleveland, the MetroHealth Nurse-Family Partnership of Cuyahoga County hired staff and nurses, provided a rigorous training program and developed educational materials. It also identified community resources, established a community advisory board of regional stakeholders and in December 2016 initiated recruitment of first-time mothers from across the region.
  • To date, the MetroHealth Nurse Family Partnership has received more than 380 referrals, recruited and cared for over 190 eligible mothers before the 28th week of pregnancy and has helped bring more than 70 babies into the world. Those babies had a preterm birth rate of only 9.7 percent, and more than 90 percent of all the babies are always sleeping on their backs to help prevent SIDS. In addition, more than 200 referrals were made for government assistance, crisis intervention, health care services and other support services.
  • Grants received in early 2018 will allow for doubling the size of the program by the end of 2019, with the hiring of another nurse supervisor and eight additional nurses for home visits.

OSCAR HISPANIC CLINIC

This clinic has a bilingual staff to address the specific medical, psychological and social needs of Hispanic youth.

  • The goals are to improve the health and well-being of Hispanic children through education, prevention and intervention.
  • The clinic was opened in 2004 as the Health Services for Hispanic Children and Adolescents Clinic. In 2015, it was renamed the Oscar Hispanic Clinic in memory of Oscar Gumucio, PhD, former co-director of the clinic.

PRIDE CLINIC

Founded in 2007, the MetroHealth Pride Clinic is the first in the region devoted to serving the health needs of the lesbian, gay, bisexual, transgender and questioning (LGBTQ) community.

  • Specially trained physicians and support staff create an open and honest environment to provide care that respects unique health needs.
  • Care includes primary care and specialty services, STD and HIV screening, HIV prevention using Pre-Exposure Prophylaxis (PrEP) and treatment, and transgender health services including hormonal medical care, mental health and surgical care referrals.
  • Gender non-binary, gender-fluid and transgender children and youth are able to receive supportive and affirming care at the multidisciplinary Kidz Pride Clinic.
  • The MetroHealth Pride Clinic and the Kidz Pride Clinic are committed to removing barriers, improving access and, most importantly, providing quality health care for all LGBTQ patients in Cuyahoga County.

PROJECT DAWN

Project DAWN (Deaths Avoided with Naloxone) is an opioid overdose education and naloxone distribution program.

  • Participants are individuals who are at risk of opioid overdose – those in recovery and those actively using opioids – and individuals who know someone who is at risk for opioid overdose.
  • Program participants are educated on the risk factors of opioid overdose, how to recognize an opioid overdose and how to respond to an opioid overdose by calling 911, giving rescue breaths and administering nasal naloxone.
  • Eligible participants are given free naloxone kits containing naloxone and other educational materials.
  • Since the program was established in 2013, more than 7,900 kits have been distributed by Cuyahoga County Project DAWN, resulting in 1,315 known opiate overdose reversals.
    Community Partners include Ohio Department of Health, ADAMHS Board of Cuyahoga County, Cuyahoga County Board of Health, Circle Health Services (formerly known as The Free Medical Clinic of Greater Cleveland), Cleveland Department of Public Health’s Thomas F. McCafferty Health Center, Hispanic UMADAOP and Cleveland Emergency Medical Services.
  • Project DAWN was launched in Cuyahoga County by MetroHealth’s Dr. Joan Papp who educated lawmakers about the life-saving aspects of HB 170. The bill passed and allows for naloxone to be prescribed to individuals who may be in a position to assist someone experiencing an overdose. It also allows law enforcement to carry and administer naloxone to victims of suspected opioid overdose.

SANE

MetroHealth has a team of Sexual Assault Nurse Examiners (SANE) who are specially trained to provide timely, coordinated, comprehensive and compassionate care to pediatric and adult victims of sexual assault.

  • When an adult or child has endured a sexual assault and comes to the Emergency Department, the forensic exam can take anywhere from two to eight hours, depending on the emotional and medical needs of the patient.
  • This care is available 24 hours a day, seven days a week.
  • Three of the 41 SANE-A certified nurses in Ohio are at MetroHealth.
  • In addition to participating with the Cuyahoga County Sexual Assault Response Team and the Cuyahoga County Collaborative – a multidisciplinary team to end human trafficking, five SANE nurses are trained in the Save Our Adolescents Against Prostitution (SOAP) program. They go to local hotels and educate front desk staff on warning signs of human trafficking.
  • MetroHealth SANE coordinators educate medical residents and first responders on proper care of sexual assault patients.
  • MetroHealth also is a simulation training site for the International Association of Forensic Nursing, training new SANE nurses from all over the country with the use of gynecological teaching assistants, women who use their own bodies to teach gynecological exam techniques.
  • In 2017, MetroHealth saw 173 victimizations related to sexual assault/abuse with almost 1/3 being children and 90 percent of the total being female. Forty-three percent of the victims were White, 36 percent were African American, 17 percent were Hispanic and 4 percent were not identified.
  • The Ohio Attorney General’s office recently awarded the SANE program a $159,000 grant that will enable the team to enhance their services for victims of crime.

SCHOOL HEALTH PROGRAM

The School Health Program (SHP) mission is to improve access to health care by partnering with the community to advocate for and support the health and well-being of children in the Cleveland Metropolitan School District (CMSD). The SHP was developed in 2013 to bring MetroHealth primary care to children who are at risk of not receiving care. With parent/guardian consent, MetroHealth medical professionals care for children at school during school hours.

  • Care includes primary and preventive health such as routine check-ups and immunizations, help managing chronic diseases such as asthma and diabetes and referrals for additional services including behavioral health.
  • The program serves 13 CMSD schools in various capacities through one in-school clinic and a mobile unit that travels to different school sites, so more children can be reached.
  • During the 2016-17 school year, there were 2,067 SHP student visits for care.
  • SHP also focuses on training child health professionals across disciplines including medical residents and students, public health graduate students, and nursing, physician assistant, community health and social work students.
  • The SHP provides in-school and after-school educational programming for students, families and teachers, per each school community request. The SHP also partnered with other MetroHealth programs including the Aamoth Family Pediatric Wellness Center, Arts in Medicine and Trauma (with Safety to Go, a portable safety town), to extend their services to the school communities.
  • The SHP includes a summer component with weekly mobile clinics for physicals, immunizations/shots, urgent-care visits and other health needs.

SHOWER CLINIC

MetroHealth is running a free outpatient clinic in conjunction with the Malachi Center Shower Program, which opens its doors for homeless individuals to shower, eat, share fellowship and clean their clothes.

  • MetroHealth offers weekly blood pressure screenings and acute care visits.
  • This outreach is an effort to treat and build trust so this population will begin to take advantage of additional health care options and services to which they are entitled. A MetroHealth enrollment specialist is on site to assist in this process.
  • In addition to caring for clients, the treating physicians, residents, pharmacy residents and medical students also distribute items such as wool socks, over-the-counter medications and reading glasses to clinic patients.
  • In the past year, 450 patients were seen at the outpatient clinic.
  • In 2017, MetroHealth coordinated a free flu clinic for the patients and staff at the Malachi Center.

TUBERCULOSIS CLINIC

MetroHealth’s clinic houses the Cuyahoga County Tuberculosis Program, which is the designated clinic for the reporting, treatment and investigation of all tuberculosis cases in Cuyahoga County. In 2017, 2,271 patients were screened for TB, 294 started treatment for latent TB infection and 27 were treated for active TB disease.

  • Physician evaluation, treatment and nurse case management are provided to all residents of Cuyahoga County diagnosed with tuberculosis.
  • Medications are provided to all patients regardless of ability to pay, as required by the Ohio Revised Code.
  • Tuberculosis patients receive therapy from outreach staff as recommended by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

VOLUNTEER SERVICES

Aamoth Family Pediatric Wellness Center

Assistance with nutrition and fitness classes for children

Ambassadors

Greeting patients and visitors, and assisting by escorting patients and visitors or pushing patients in wheelchairs to their destination; offering items from the hospitality cart
Locations: Brecksville Health and Surgery Center, MetroHealth Medical Centers in Cleveland Heights and Parma

Burn Center Support

Burn survivors trained for visiting with patients and discussing the recovery process, and participating in support group for patients and families

Cancer Care

Providing comfort items to patients undergoing treatment

Child Life

Interacting with and providing activities for infants and children in a playroom and at the bedside

Clothing Distribution

Labeling and sorting clothing for distribution to patients

Critical Care Pavilion

Providing hospitality and wayfinding assistance to visitors and nonclinical support to patients on the intensive care floors

Doula

Providing emotional support and comfort measures to women during labor and delivery. Doula training offered by Doulas of North America (DONA) is required

Emergency Department

Offering non-medical assistance to patients and families in MetroHealth’s Level I Adult Trauma Center at main campus and Emergency Departments at Brecksville, Cleveland Heights and Parma

Greenhouse

Watering and misting plants

Greeters

Greeting patients and visitors, escorting patients and providing directions

Hospitality Rounds

Visiting hospitalized patients and offering comfort items such as playing cards, lip balm, puzzle books

Infant Comforter

Providing nurturing support by holding and rocking infants in the Neonatal Intensive Care Unit and Newborn Nursery

Loving Paws at MetroHealth

Bringing dogs to visit patients and families. Dogs must be certified through Therapy Dogs International or Pet Partners

New Baby Literacy Liaison

In collaboration with the Cuyahoga County Public Library, visiting new parents to promote the importance of reading to their babies, and distributing New Baby Literacy Kits and library cards

No One Dies Alone

Providing a reassuring presence at the bedside of dying patients who would otherwise be alone at the end of life

Pastoral Care

Assisting chaplains in meeting spiritual needs of patients of all faith backgrounds

Patient and Family Advisor Program

Patients and family members offering information to improve the patient experience

Patient Safety Rounding

Visiting hospitalized patients and explaining safety measures to prevent falls

Physical and Occupational Therapy – Inpatient & Outpatient

Providing non-technical assistance as directed by therapist, pushing patients in wheelchairs

Reach Out and Read

Reading to young children in pediatric waiting areas, demonstrating the importance that reading has in a child’s development

Reach Out and Read Plus

Reading aloud to children waiting for outpatient appointments, showing parents and children how to use iPads and smartphone apps to promote literacy skills

Rehabilitation Patient Activities

Assisting with activities at MetroHealth Rehabilitation Institute of Ohio under the direction of art and recreation therapists

Reiki

In MetroHealth’s Hands to Heart Reiki Clinic, qualified volunteers offering Reiki appointments to patients and employees in need of a healing touch. Training is required through the second level of Reiki and preferably Master Level

Resident Enrichment Activities

Engaging long-term care residents in a variety of activities including coffee hour, friendly visits, special events and more

Ronald McDonald Family Room at MetroHealth

Acting as the host or hostess of this special room and helping provide a friendly, relaxing and supportive environment for families who are dealing with the illness of their child

Spinal Cord Peer Support

Trained peer visitors who have successfully adapted to a spinal cord injury visiting with patients and discussing the recovery process

Spirit of Music at MetroHealth

Making music part of the healing process by sharing vocal or instrumental talent with patients and visitors

Stroke Support Group

Greeting and helping facilitate monthly support group meeting

Surgery Center

Greeting patients and visitors in ambulatory surgery center, escorting patients to changing area, checking on patients in recovery

Trauma Survivors Network

Trained peer visitors who have survived a traumatic injury visiting with newly injured patients and offering support

Wheelchair Roundup

Recovering wheelchairs from various hospital locations

Wig Salon

A program of the American Cancer Society, staffing the salon to provide free wigs to women undergoing treatment, who cannot afford them

WEIGHT LOSS SURGERY AND WEIGHT MANAGEMENT CENTER

Established more than 15 years ago, the Center offers surgical and non-surgical treatment for severe obesity and its related conditions. This multidisciplinary program improves patient outcomes and long-term success.

  • Clinical specialists at the Weight Management Center meet with patients to get a complete health and weight history and insights into the patient’s preferences and lifestyle.
  • Individualized treatment plans, with or without bariatric surgery, are designed to reach and maintain long-term improvements in fitness level and weight.
  • For bariatric surgery, the Center offers preoperative and postoperative care designed specifically for its severely obese patients.
  • Bariatric surgeons are supported by a highly trained and dedicated team that works together to provide comprehensive, individualized care. This includes nurses, obesity medicine specialists, dietitians, pulmonologists, gastroenterologists, cardiologists, endocrinologists, plastic surgeons and clinical psychologists.
  • Non-surgical treatment plans for weight management include:
    • Monthly appointments with practitioners who are board certified or have certification in obesity medicine
    • Evaluation and treatment of obesity and weight-related medical conditions
    • STRIDES (Steps To Reach Individual Diet and Exercise Solutions), a certified Diabetes Prevention Program. This weekly weight loss group program individually addresses patients’ needs and has successfully led to long-term weight loss and reduction in risk for diabetes and other chronic conditions.
    • Nutrition counseling (may include referral to Nutrition Services or the STRIDES program)
    • Activity plans
    • Behavior and systems change plans (may include referral to the STRIDES program or mental health services)
    • Medication, in addition to lifestyle efforts, to lose weight, maintain weight loss and improve medical conditions.
  • Patients must be over the age of 18, typically have a BMI greater than 30 and commonly suffer from medical conditions such as diabetes, hypertension, hyperlipidemia, polycystic ovary disease, osteoarthritis, asthma or COPD. They must be referred by a physician.
  • The Weight Loss Surgery and Weight Management Center at MetroHealth has achieved national certification: Comprehensive Center accreditation under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program®), a joint program of the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery.
  • MetroHealth’s Weight Management program is designed as a lifelong tool to obtain and maintain good health.
  • In 2017, 440 individual patients in the STRIDES program at MetroHealth’s Broadway and Middleburg Heights health centers made 3,800 visits, an average of more than eight visits per patient.
  • The Weight Management Clinic provided more than 6,500 visits to patients preparing for weight loss surgery, optimizing and maintaining weight loss after surgery, as well as those working on weight loss through medical and behavioral means.

WINDOW OF HEALTH

In a partnership with the Government of Mexico, through its consulate in Detroit, MetroHealth began the Ventanilla de Salud (Window of Health) Program in 2015.

  • The program includes bilingual, bicultural health education, enrollment in insurance programs and referrals.
  • Though it is aimed at Mexican nationals and their families, the program assists other Spanish-speaking patients as well.

YOUNG ADULT CLINIC

The Medical Home for Children in Foster Care program has expanded to help provide education, advocacy and health care for young people coming out of foster care.

  • Aging out of foster care, generally at age 18, leaves many young people adrift without adequate health care.
  • Young adults, ages 18-25, seeking care with the MetroHealth Foster Care program receive assistance in coordinating future appointments and in establishing a primary care provider.
  • They also can seek advice about resources and referrals for benefits and programs that they qualify for as a result of aging out of foster care.
  • MetroHealth staff also help to connect them to dental and eye care and other specialists they might need.
  • Many of these young adults are seeking care in a familiar place where they received care as a child in foster care.

ZUBIZARRETA HOUSE

This fully-accessible temporary home is for people with spinal cord injuries who travel to MetroHealth for research-related treatment and evaluation.

  • The 7,000-square-foot, one-story house is next to the MetroHealth Old Brooklyn Campus, the site of ongoing research on the use of functional electrical stimulation to give disabled people increased independence and improved quality of life.
  • In 2015, Kevin Kilgore, PhD, a biomedical engineer and MetroHealth researcher, submitted the idea for this living space to MetroHealth’s “Think Tank” competition. It was one of three projects chosen to receive $100,000 and received an additional $500,000 from Miguel Zubizarreta, who then purchased land and, with his wife Denise, oversaw the entire design and construction process.
  • The new house opened in 2017 and features five suites, each with a private bathroom with roll-in showers and a second bedroom for a caregiver. Motorized lifts help with transfers from the bed to the bathroom.
  • In the full kitchen, guests can practice cooking on countertops modified for wheelchair use.
  • Individuals and their caretakers stay at no cost.
  • Two innkeeper apartments are also part of the house.