Clinical Programs - MetroHealth
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CLINICAL PROGRAMS

From home visits to newborns to a bilingual Hispanic clinic, every effort is made to help our patients and community be well and stay well.

BURN MUSIC THERAPY

Music therapy at the Comprehensive Burn Care Center at MetroHealth is often used during uncomfortable bedside procedures.

  • Clinical studies conducted at MetroHealth revealed that music therapy during procedures significantly reduces pain, discomfort, anxiety and muscle tension.
  • Therapy is tailored to a patient’s needs – he or she chooses to participate in music therapy along with the type of music used.
  • MetroHealth’s music therapy program is expanding to serve trauma and rehabilitation unit patients.

CARE ALLIANCE

MetroHealth provides OB/GYN services to the patients of Care Alliance, a nonprofit community health center, which serves the uninsured and underinsured health care needs of Greater Cleveland residents.

  • A MetroHealth physician and nurse are assigned to the health care clinic and work in collaboration with Care Alliance to provide care to women in the Central neighborhood – a population that has high infant mortality rates and often complex gynecologic care needs.
  • The services offered by MetroHealth medical staff include prenatal care and consultation for gynecologic issues to provide the education and care needed for healthier women, pregnancies and babies.

CLINICS IN DISCOUNT DRUG MARTS

Patients can walk in or schedule an appointment online for same-day service for anyone who needs care, from young children to older adults.

  • The clinic is staffed by a nurse practitioner who can prescribe medications, provide sports physicals, assess a person’s basic medical needs and help with the diagnosis and treatment of illnesses such as allergies, earaches, eye conditions, rashes, skin conditions, sinus infections and sore throats.
  • In 2016, The MetroHealth System opened its fourth walk-in clinic at Discount Drug Mart in North Royalton; additional locations include Independence, Olmsted Falls and Parma Heights.
  • This is another step toward providing services where, when and how patients want them.

COMMUNITY ADVOCACY PROGRAM (CAP)

For more than 14 years, through the CAP program, MetroHealth has partnered with the Legal Aid Society of Cleveland to remove legal barriers to health for MetroHealth patients.

  • MetroHealth physicians, nurses, social workers and other providers work with four Legal Aid attorneys and one paralegal who cover several MetroHealth locations. They focus on children, pregnant women, the elderly, Spanish speakers and individuals recently released from prison.
  • When a MetroHealth provider identifies a legal issue that has an impact on a patient’s health, the provider enters a referral in MetroHealth’s electronic medical record. The provider then gives a hard copy of the referral to the patient or patient’s family so they can seek help directly from a Legal Aid professional. For example, the program can help individuals and families gain access to food, protect against utility shutoffs and get allergy-provoking mold removed from a home.
  • The medical-legal partnership has proven to greatly help patients navigate toward better health.

COMPREHENSIVE CARE PRACTICE

This MetroHealth practice offers a Primary Care Medical Home for persons 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.
  • Specialty clinics are offered in the areas of Cerebral Palsy, Spina Bifida/Hydrocephalus, Behavior Assessment and Craniofacial/Cleft Lip and Palate.
  •  As patients reach adulthood, they transition from pediatric to adult providers in the practice, remaining with a practice that is familiar with them.
  • In 2011, the Comprehensive Care Practice was the first MetroHealth practice to be awarded a National Center for Quality Assurance Level 3 (highest) Recognition for Excellence of Care as a Primary Care Medical Home.

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.

HEALTH CARE AT THE JUVENILE DETENTION CENTER

MetroHealth provides daily health services at the Cuyahoga County Juvenile Detention Center (JDC) 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.

KIDZ PRIDE CLINIC

In this clinic, specially trained physicians, psychologists and support staff provide care for lesbian, gay, bisexual, transgender, questioning (LGBTQ) youth.

  • Providing physical and mental health treatment and access to support is a major step to decreasing the health disparities that LGBTQ youths often face.
  • Kidz Pride Clinic, established in 2008, works in conjunction with MetroHealth’s Pride Clinic (for adults), the first of its kind in Ohio.
  • In 2016, 81 patients, ages 5 to 21, came in for 218 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 2016, the MDA Care Center, which was supported in part by a $36,000 grant, saw 470 patients.

MEDICAID TECHNICAL ASSISTANCE AND POLICY PROGRAM (MEDTAPP)

In 2012, the MEDTAPP Medicaid Healthcare Access Grant was awarded to MetroHealth and Case Western Reserve University to recruit, train and retain a primary care workforce to serve the Ohio Medicaid population.

  • The MEDTAPP team is comprised of medical students, physicians, registered nurses, medical assistants, psychiatry staff, psychology staff, social workers and counselors.
  • Care is often provided outside of traditional clinical settings, such as at shelters, urban housing developments, private homes and other locations in the community. The following are MEDTAPP programs.

Asia-International Community Health Center (A-ICHC)
Once a month, a post-doctoral psychology fellow provides behavioral health services including mental health assessments and counseling at the center.

  • The collaboration provides needed services to low-income, underserved members of the community.

Chronic Disease Management Groups (CDMGs)    
CDMGs provide a venue for patients with a chronic disease (e.g., diabetes, chronic obstructive pulmonary disorder, high blood pressure and chronic pain) to have extended time with their health care team in a shared environment.

  • Each CDMG is held for two hours, once a week, for six weeks.
  • Patients make action plans to increase accountability and move toward increased well-being and chronic disease management.
  • Groups are held at Cleveland Metropolitan Housing Authority (CMHA) sites and at the MetroHealth Lee-Harvard Health Center. Students participate in these groups and are invited to present on various relevant topics.
  • In fall 2016, MetroHealth held the first Wellness Group at CMHA’s Quarrytown location. The success of the first group has opened the door to other opportunities at CMHA sites.

Correctional Health Program
Special services are administered at the Cuyahoga County Corrections Center.

  • Family Medicine provides one-on-one counseling sessions and group therapy for addiction and behavioral health.
  • The Medication Assisted Treatment (MAT) program assists inmates struggling with opioid addiction. This includes Vivitrol for inmates identified through drug courts and Subutex (Buprenorphine) for pregnant females with opioid use disorder.

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.

Home Visit Program
Home visits for patients who have multiple medical problems are conducted by pairs of providers comprised of a resident and a medical student.

  • Many patients are challenged with stroke, neurological issues or terminal illness, which makes mobility difficult.
  • A continuum of care is achieved through home visits, which are scheduled throughout the week.

Renee Jones Empowerment Center    
This program provides education to teen survivors of human trafficking.

  • Groups meet twice a month.
  • There are prepared topics and the teens are free to have open conversations about their health and ask questions in a safe environment.
  • The primary focus of the group is to not only educate the survivors but to connect them with providers in their community.
  • Residents and students assist with the groups and also give presentations.

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 and clean their clothes.

  • MetroHealth offers weekly basic health screenings and monthly podiatry services.
  • 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.
  • Treating physicians also distribute much-needed items for the homeless: wool socks, over-the-counter medications and reading glasses.
  • In the past year, 450 patients were seen at the outpatient clinic.
  • In December 2016, MetroHealth coordinated a free flu clinic for the patients and staff at the Malachi Center.

Transition Program
This is a home-visit program specifically for patients who were recently discharged from the hospital and are considered at high risk for readmission due to past behavior.

  • Within 72 hours of discharge, providers visit to make sure patients are following medical directions and properly taking medications.
  • Family medicine providers bring residents and medical students on the visits, which can be valuable learning experiences.

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.

  • 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. A child psychologist is available to ensure children receive timely access to mental health services, if needed.
  • 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 see at future appointments. A social worker offers support and helps families access any needed resources. The care coordinator meets with the child and foster care family and thereafter tracks compliance with appointments, how the child is adjusting and any referrals to specialists that the child may need.
  • All visit information is entered into the electronic medical record, which allows MetroHealth providers to review the overall plan of health care and management, even if a child is seen at another health care system.
  • In 2016, a young adult clinic was established to help older children navigate as they age out of the foster care system and transition to adult medicine.
  • The Foster Care program began in November 2013. As of December 2016, the foster care team has worked with 2,907 children in 4,413 triage visits and 2,013 30-day comprehensive follow-up appointments. A child can have multiple triages, even before the 30-day appointment occurs, as it is the first step when there is a change in placement.

MEDICARE ACO, METROHEALTH CARE PARTNERS

Established in 2014, MetroHealth Care Partners is a Medicare Shared Savings Program Accountable Care Organization (ACO).

  • MetroHealth Care Partners works to ensure comprehensive care for nearly 10,000 individual members.
  • Primary care physicians, specialists and other health care providers work together to give patients high quality, more coordinated care, which results in health care savings.
  • Patients receive consistent care helping them to stay healthier and contributing to improved population health.

MEDICATION ASSISTANCE

For more than 17 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. The 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 2016, MetroHealth provided more than $30,000 in free medications through the voucher program.

MOTHER AND CHILD DEPENDENCY PROGRAM

A care coordinator facilitates 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.
  • In 2016, 162 mothers struggling with opiate addiction and 127 babies who had exposure to opiates were served.

Community Partners:

Substance Use Treatment Providers:

  • Cleveland Treatment Center
  • Community Action Against Addiction
  • Community Counseling Center in Ashtabula
  • Fortaleza
  • Hitchcock Center for Women
  • Matt Talbot for Women
  • Northern Ohio Recovery Association
  • Psych Services
  • Recovery Resources
  • Rosary Hall
  • Signature Health

Partners for Wrap-Around Services:

  • Alcohol, Drug Addiction, and Mental Health Services Board of Cuyahoga County
  • Cuyahoga County Division of Children and Family Services
  • Cuyahoga County Drug Court
  • May Dugan Center
  • Providence House
  • University Hospitals

OHIO’S ONLY EBOLA TREATMENT CENTER

In 2014, The MetroHealth System was designated an Ebola treatment center by the U.S. Centers for Disease Control and Prevention (CDC).

  • MetroHealth is the only designated Ebola treatment center in Ohio, joining only 54 others in the nation.
  • The designation recognizes that MetroHealth is prepared to provide comprehensive care to patients with an Ebola diagnosis.
  • MetroHealth was chosen because of its facility configuration and readiness, staff training and overall medical expertise when caring for an infectious disease patient.
  • MetroHealth will work closely with hospitals and health departments in the community and in the state to meet the needs of Ebola patients.
  • Community partners are the Ohio Department of Health, Cuyahoga County Board of Health and Cleveland Department of Public Health.

OSCAR  HISPANIC CLINIC

The Oscar Hispanic 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.

PRENTISS WELLNESS NURSERY AT PROVIDENCE HOUSE

The MetroHealth System provides medical services for Elisabeth’s House, the Prentiss Wellness Nursery at Providence House in Cleveland.

  • The Wellness Nursery serves children from birth to 10 years old who have medical needs and no longer require inpatient hospital care, but whose families are currently unable to meet their medical needs due to family crisis or unstable living environments.
  • MetroHealth clinicians assess patients, provide physicals, administer medication and educate parents before their children return home.

In October 2015, care was expanded to children with special health care needs and their families, as a bridge from an acute care hospital to home. A MetroHealth nurse practitioner sees all children upon admission and works with Providence House staff to develop a plan of care to support families in developing competence and confidence in caring for their child.

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 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.

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.
  • The Ohio Attorney General’s office recently awarded the SANE program with 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. 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 schools through one in-school clinic and a mobile unit that travels to different school sites, so more children can be reached.
  • During the 2015-16 school year, there were 1,108 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 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 has 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, from June through August.

SEVERAL ADDITIONAL PROGRAMS WITH CUYAHOGA COUNTY

  • Department of Children and Family Services (DCFS): Toxicology services and psychotropic medication consults
  • Court of Common Pleas: Adult probation drug testing
  • Educational affiliations with Cuyahoga Community College: Instruction and training such as the required Allied Health Program internship for med lab tech and phlebotomy students
  • County-wide health fairs: 1,275 flu shots at 11Cuyahoga County workplaces

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.

  • 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).

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, can go to an afternoon clinic that MetroHealth provides to help them with sick care, well care, mental health needs and psychosocial education.
  • 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.