(bright music) (bright music continues) - Hello and welcome to "The Journal."

I'm Steve Kendall.

Over the past few years, much of our focus on health, and we talk with Health Department officials, was on navigating the pandemic.

However, there's a lot of other things going on at the Wood County Health Department, and we're joined today by the Commissioner of the Health Department, Ben Robison, and also Jerry Landers, who's the Interim CEO of the Community Health Center.

So welcome, gentlemen, both of you, for being here.

Thank you so much.

I know, even though we said we talked about COVID a lot, let's get a little COVID update and then we can kind of segue into all the other things that are going on because there's a lot to talk about the Health Department.

It's good to have something to talk about other than COVID with you, gentlemen.

So, go ahead, Commissioner.

- Well, thanks.

We are really encouraged by what we're seeing with COVID.

As you know, back in May, the national emergency was stood down, and I think there were some questions at that time as to whether the timing was appropriate, but the numbers seemed to indicate that it was.

and so we've had a substantially lower burden of severe disease with COVID over the course of this year.

We've had, to date, only 143 cases over the month of November, about 9.8 cases per day.

And while that may be a little bit higher than what we've seen, what we're not seeing is those severe outcomes.

So in total, we've had only one hospitalization through November 15th.

And over the course of the entire year, only 49, the vast majority of those were just in January and February.

So we're encouraged by these numbers, and it has allowed us to focus on things other than COVID, as you said.

- Yeah.

And I guess the good news is because we know that people are still, as you mentioned, still having some issues with it, but not nearly the levels that we were talking about before.

And I guess part of that is: Is there any confusion over vaccines?

Because I think we're gonna start now referring to the COVID as just an annual vaccine.

It's just one of many that we should get.

Is that gonna be the case?

- Yeah, I think that that's what we saw this year was an attempt to reformulate the vaccine to match what is more closely... more closely match what's circulating.

That's what we're gonna try to do every year like we do with the flu.

And really, our goal is try to get the message out to people to take the best steps to keep themselves healthy, especially people who are at increased risk for severe outcomes.

So if you have underlying health conditions that are related to those severe outcomes or if you are older, we want to encourage you to have a comprehensive approach to staying healthy.

This includes vaccination, but it also includes having a plan to get treatment if you could have illness or seeking testing so you know what the cause may be, so you can follow up with your provider appropriately.

- Yeah, and probably when you go to see your family practice physician, they're gonna say, "By the way, have you had the vaccine?

Have you had your annual COVID vaccine?"

Just like they ask you about the flu.

So that'll just become part of the normal package of routine treatment.

So now, obviously, what that allows you guys to do at the Health Department is kind of get back to what you were doing before the pandemic, all of those other services, all of those other things that you provide.

So talk a little about what it's like to get back to being a regular Health Department instead of being a pandemic, sort of focused Health Department.

- Right, so the COVID pandemic was a really significant impact.

We seek pandemics of this severity about once every 100 years.

And so as you said, this defined our activity for two of the last 100 years, but the next 98 years, we expect will be a lot different.

One of the things that we're able to turn our folks back to was our effort for accreditation.

In Ohio, local Health Departments were required to be accredited, and we had taken delay in having to do that because of COVID.

And so we were grandfathered through as we went, but we were able to complete that accreditation process.

And now we're gonna be re-accredited all the way until 2028, which really means that we are invested in having high-quality services for the residents here in Wood County.

- Yeah, now, what are some of the things when they sit down and say, "What are the accreditation criteria?

What are some of the things that you have to meet, things of that nature?"

- Yeah, so very much, like any other accreditation program, they're looking to see that we deliver the types of services across our community.

They have a huge focus on community partnerships and ensuring that we are working collaboratively beyond our walls.

We know that we can't deliver services as effectively as we need to if we're doing it only on our own.

And so they're really interested in seeing how we work with our partners, as well as the public in general.

- Yeah, and I remember when we were going through the pandemic, one of the things you emphasized was the fact that there were a lot of partners.

There were groups working together.

It wasn't just isolated silos of people doing certain things.

It had actually allowed people to work together more than maybe would've been the case in the past.

It allowed you to partner with people and for them to partner with you.

When you talk about some of the services you're getting back to, what is some of the focus now since you're not focused on that pandemic situation?

What are the things you're really aiming at right now in the department?

- Well, as we've talked before, we are focusing on the things that were identified in our community health assessment.

One of the major needs that we have here in Wood County is an increased intervention for behavioral health.

One of the ways that our Board of Health tried to get at that was by approving a renovation that added a behavioral health wing.

That renovation has recently been completed, which we commemorated last week.

And then in addition to that, our Community Health Center maintains a patient-centered medical home recognition with a distinction in behavioral health.

And so what that really means is that just like an accreditation process, they go through the additional step of demonstrating that they provide comprehensively for the patient, meeting not only their primary care needs, but their behavioral health needs as well.

- Now Jerry, you're the Interim CEO of the Community Health Center.

Talk about what the function is, what your function is there, what your focus is as the Interim CEO.

- Well, my focus is to keep things running while they do this national search to get somebody to come in and do it long term.

But I do bring in a perspective that is pretty important, especially given the need with behavioral health.

And really, the secret sauce is not that complex in traditional healthcare.

It's siloed.

You have behavioral health way over here, you have primary care way over here, and the two never talk.

And really, they should be sharing lots of time.

And that's what we do in our organization.

Behavioral health is right there integrated in real time, talking and helping that primary care physician and vice versa.

And that's the secret sauce.

- Yeah.

And I know one of the things when you go to just a routine appointment with your primary care physician, that other specialists too, they run down a checklist of things that aren't necessarily physically related, but they talk about your mental health, a lot more than maybe they would have five, 10 years ago.

And so that's part of this as well, the focus, and the partnering with that as well, the sharing of information, the working together on that.

What are some of the things... With the renovated facility, we've got a moment here in the segment, we'll revisit it later on as well.

But what are some of the things that people will see when they come into the new center now, the renovated Health Community Center?

- I didn't have an opportunity to see it before the renovation, but I can tell you it's a streamlined, very well, nice workflow.

It looks as good as any I've seen across the country.

- Yeah, yeah, and when was the last time it was renovated?

The previous one, how long had that been, basically the facility that you were working with?

- It's really been the facility since it was built.

Back in 2019, we did add a dental center, and so that was something people may remember.

But with this new money, the vast majority of this was funded by a federal grant that allowed us to make improvements.

We added a behavioral health wing, which will allow us to provide those services more broadly.

We expanded our pharmacy, which means we can not only serve more patients, but provide more of the prescriptions that our patients need.

And then we increased our waiting area and provided a check-in area in the dental center too.

So patients will have more of that direct experience of being able to come in, keep their space, settle in, and we can accommodate the number of patients we're hoping to see.

- When we come back, we can talk more about that 'cause it sounds like it's a much...

The idea, of course, is to make it as convenient for people to get all of these services, and that's obviously how it's starting to work out.

So back in just a moment, we're joined by the Commissioner of the Wood County Health Department, Ben Robison, and the Interim CEO of the Wood County Community Health Center, Jerry Landers, back in just a moment here on "The Journal."

Thanks for staying with us on "The Journal."

Our guests are Jerry Landers, the Interim CEO of the Wood County Community Health Center, and the Commissioner of the Wood County Health Department, Ben Robison.

Jerry, the new center, obviously, there's a brand new part of it that didn't exist before.

Talk about it because one of the things that people talk about is how important dental health is to your overall health, and it's something that we sort of take for granted.

But talk about that new part of the new Community Health Center.

- Oh, I love to, 'cause we have five dental suites.

They're state-of-the-art.

We do everything you would think a dentist does.

And anything that's beyond our scope, we refer out, we've got partners in the community that we work with.

And really, it's probably the busiest part of our health center.

Every time I walk through and do my rounds, they always have all those chairs full.

But the reason they have those full is because, really, Ohio Medicaid is weak when it comes to dental.

And so there's not a lot of dentists who accept Medicaid.

We're one of the exceptions and we just do a great job.

Not only that, we're integrated.

So again, healthcare is fragmented and siloed, and dentists see things and can identify things early on.

And sharing that, communicating that early intervention, early screening, it's just a great combination.

- Yeah, and we talk about the fact that yeah, when dental health is a predictor of a lot of other things, as you said, you can see things, and then instead of doing an after the fact, like fixing something, you can prevent it before it gets serious.

And that's an important thing.

And it's interesting that this is a service that is filling a gap because as you said, Ohio Medicaid was kinda leaving people on their own out there kind of on an island.

And this allows you to integrate that into the overall healthcare.

And then you've got, with the rest of the Community Health Center, to take advantage of that information and help people with those other situations.

When you looked at stuff through the improvement plan and when you ask people what was important and what wasn't, dental obviously came up because it's now become a focus of this new center.

Refresh our memory a little bit on some of the things that came out of that 'cause it's been a few months since we talked about that survey, which you do on a bi-annual basis or an annual basis.

- We do it every three years.

- Every three years, okay.

- Some communities do it every five years, but it just depends on how they're set up.

For us, one of the things that really intersected, both for dental and medical, was access to care.

We know that that encompasses a number of things, from transportation, to the ability to pay, to having access to insurance.

These are all aspects that are addressed by a federally qualified health center, like our Community Health Center.

So there are programs here in Wood County, NET Plus being one of them, that can get you transportation to a medical center for care if needed.

We also help people to navigate the insurance space.

And even if someone doesn't have insurance, we will never turn someone away for their inability to pay.

And as Jerry mentioned, we are filling a huge gap with dental.

About 2/3 of our dental patients are Medicaid recipients.

But it's not only those, I actually am a dental patient myself, and I got to sit in the chairs just a couple weeks ago.

And from my very first moment in, we saw that integrated approach to healthcare.

They did a screening of my blood pressure to see if there was something there, asked me a screening for mental health, and should I have had any issues there, they could have referred me immediately to a clinician in-house or behavioral health specialist in-house, as well as providing phenomenal care.

So our goal is to address those access to care issues, those behavioral health issues that came up in the community health assessment by doing our part, but also leveraging our partners across the community 'cause we will not be able to do it all by ourselves.

- Yeah, and I know that Jerry, one of the advantage of this is, of course, that the sooner we can interact with somebody in a health issue, whether it's dental or whatever it is, the less expensive it becomes for them and for everybody else.

And especially as you mentioned too, access.

Just getting there is has been an issue for some people.

And now they have a facility they can do and kind of do a one stop and address all of those issues.

Are you getting any feedback from people so far?

I know that you're the interim, but you said you're kind of walking around.

Are you sensing that people are good with what's going on and they like the new facility?

- Yes, the feedback's all very positive.

And just my own interaction with the staff.

We have great staff.

They really care about what they're doing.

They're very mission-oriented.

And as an FQHC, we have a competitive advantage.

Our board members are patients.

So when the people running the show are also receiving care, you get the best care possible.

And that's what it- - It speaks to the level of service and the quality of service too.

Is what we have in Wood County different than other areas do?

Are other counties as up to speed on this as we are now or not?

- Well, I think in terms of looking at the health impacts, everyone is seeing impacts on behavioral health coming out of COVID.

Access remains a major concern across Ohio.

But I think what makes our Community Health Center unique is that we're one of only six or seven public Health Departments in the state that have an FQHC under our roof.

So communities may be served by community clinics or FQHCs that are independent of Health Departments.

But by making it part of the Health Department itself, it means that we are integrating that full public health mission into its delivery of services.

So we talk about this all the time, that an FQHC really exists to have a population-level impact.

And if we do our job well, not only are we helping those patients to have a great experience, but we're making impacts of the population level, which is the goal of public health.

- Yeah, because as we know that yeah, the better the overall health of everybody in the community, that leads to better outcomes in a lot of different ways and especially behavioral health, obviously.

When you look at the other aspects of the new community center, obviously you talked about the expanded pharmacy or that sort of thing.

Was that an issue for people, too, just figuring out how to get their prescriptions and get them filled so now they can sort of take care of that while they're at the facility, correct?

- Well, it's more than that.

It's also a financial issue.

So today, even individuals with good insurance can face some pretty severe sticker shock when they're looking at pharmaceuticals.

So if you do receive services through our organization and our physicians write that script, then it does, we can run it through what's called 340B.

And that's a federal program that helps reduce the financial burden if you financially qualify.

So there's some qualifying that has to happen, but last year we assisted with over 4,000 scripts providing financial assistance.

- Yeah, and again, as we all know, better for people to be able to get access to that prescription, to treat their condition, whatever it is, because in the long run, it's simply gonna get more expensive and more dangerously impactful to them as well.

About how many people are working at the Community Health Center?

The staff levels?

- We're right around 30 people.

It can vary based on how many contractors you might be utilizing at any given point, but it is our most robust division at the health center or at the Health Department.

- Yeah, sure.

- And it's because we are trying to expand our services constantly.

And as we look ahead into this new new year, Jerry shared at our Board of Health meeting about some positions he would like to bring in that allow us to expand our behavioral health services and really looking ahead to think about what our community needs, and finding opportunities to go find funding to make those services available here in Wood County.

- Okay.

When we come back, we can talk about that too.

So obviously, you're just coming off your survey, but you're probably thinking about the next one already because as we know, things don't happen immediately.

There's a planning process of this too.

Back in just a moment with the Commissioner of the Wood County Health Department, Ben Robison, and the Interim CEO of the Wood County Community Health Center, Jerry Landers, back on "Journal" in just a moment.

Thank you for staying with us on "The Journal."

We're talking about the Wood County Health Department and its expanded and renovated Community Health Center.

One of the things we've talked about and referred to a couple of times, Jerry, is behavioral health, and that's become a huge part of what you guys do.

Maybe 30 years ago, 20 years ago, it wasn't the focus as much, but now that's one of the most important things that a Community Health Center works with.

So talk a little about the behavioral aspect, pieces of what you do.

- Well, let me talk about the need first.

- [Steve] Okay, sure.

- So, there's a national issue right now.

So this isn't just picking on Wood County.

But Wood County, in our own needs assessment, 5% of youth attempted suicide, 3% of adults.

Those are large numbers in a community.

That's what, 130, 140,000 people?

That's a lot.

So it is probably the number one issue.

I don't know the drug issue might be up there as well, but that's the one that we can address.

Health, primary healthcare and behavioral healthcare are two sides of the same coin.

If you look at the top five primary healthcare diagnosis, they're all influenced by behavior: smoking, eating, exercise.

If you look at the primary behavioral health issues, they're heavily influenced by primary care as well.

Anxiety, depression.

So ruling out organic or other issues is important process.

I use myself as an example, I'm a diabetic.

If you had looked at me before I was diagnosed as a diabetic, you would've diagnosed me as chronically depressed.

And just because I was lethargic, no energy, no appetite for anything, put me on metformin for two weeks, I'm a different person.

So, again, making sure that those two things are hand and glove and working together is incredibly important.

And that's what we're doing.

And we're certified.

We're certified as a patient centered in medical home with distinction and behavioral health, and that distinction is not easy to come by.

It was issued by the National Committee for Quality Assurance, NCOA.

And they don't just hand those out, so they make you work for them.

(indistinct) Yeah, it really is about making those two sides of the same coin work together and help each other as we're addressing that patient-centered home.

And we hope to expand our behavioral health services.

- Well, and it's interesting because something as simple as what you eat, because as we know, we use the term comfort food.

And in a way, that's good news and that's bad news because it speaks to a situation that makes you feel better, you believe, but the reality is it does impact you possibly, depending on what you're eating, creates a medical issue then that then makes you feel less enthusiastic, as you said, kind of... You have then start to develop this behavioral issue based on the eating, which was driven initially by some sort of behavioral issue.

So it's- - Very interesting.

- It's all interconnected, yeah.

And it's difficult to do that.

And I know that one of the things I was gonna ask too about that is that what we eat, obviously, drives a lot of our health issues.

And again, we tend to fall back on that's like, "Oh, I'm feeling kind of slow.

Well, I'll have somebody with a lot of caffeine in it."

Well, okay, that solves one problem, but it may create another with your physical health as well.

When you talk with people who come in, how do you work with that?

Because people obviously have set behaviors about what they like to do, whether it's good for us or not, we tend to do things that we like to, so when you have people come in, how do you work with them to maybe change their behavior or address their behavioral health issue to improve their overall physical health?

- Well, the first step is identifying it.

And a lot of primary care physicians are not doing any type of behavioral health screening.

So we do what's called a PHQ-2, which is this little mini questionnaire.

And if you hit positive on that, then we do a PSQ-9, which is more in depth.

- [Steve] Yeah.

I would drill down a little bit more.

- Yeah, and then it could lead to working with the behaviorist or the therapist.

But really, there's this concept called motivational interviewing.

Motivational interviewing is really me not telling you what to do, but convincing you that it's your... - [Steve] Idea.

- The example... - [Steve] That's a good... Well, that works.

That's good, yeah.

- The example I've always used was my father, he's a diabetic as well, but getting him to lose weight was not a really...

If a doctor told him he needed to lose weight, that'd be an argument, yeah.

- [Steve] He dug in deeper.

- Oh, yeah, dug up with... - Human nature being what it is.

- But if you told him, "Oh, dad, if you lost 15 pounds, boy, that'd really, you'd have an extra couple yards on your golf stroke."

I mean, that's a whole different conversation, right?

So it's about how you approach it.

- How you approach it.

- So motivational interviewing.

- Yeah, because as you said, telling people, "This is what you have to do," they probably know that already.

But the way you go about making, again, making it...

So here's the benefit, not just not a direct health benefit, but here's a benefit for the rest of your life.

Other things you do will benefit.

It's like, "Oh, in that case, sure."

Yeah.

Yeah.

I mean, and you probably face that with people coming in with medical issues too, besides just diabetes or something of that nature, convincing them to change their lifestyle, to improve their overall health.

And that's probably a big thing that all of your people, all the clinicians work with when people come in, whether it's through the dental clinic or whatever, to help with that, correct?

- That's right, and the mantra in public health is that an ounce of prevention is worth a pound of cure.

Unfortunately, our approach to medicine is don't do anything until it's broken.

And so we wait until things are really bad.

Many of us don't seek a dental care until our tooth hurts.

Had we been maintaining our dental health all along, we wouldn't have the tooth ache in the first place, right?

- [Steve] Wouldn't have that cavity.

Yeah.

- Yeah, so really, what we encourage people to do is to think about how to set good habits over the course of a long period of time.

Whatever health issue you're facing, particularly a chronic health issue, didn't begin over the last couple of weeks, right?

If we're talking about an infection, go get yourself checked out.

If it's an antibiotic issue, we'll get you an antibiotic, you'll be better.

But if what you've got has been years or decades in the making, it's not gonna be solved immediately overnight.

So set a goal you can maintain, build on that goal little by little, and there's that old adage of, "If you want to go fast, go alone.

If you wanna go far, go together."

So take somebody with you because anybody can die for two weeks, so what you gotta do is fit into that suit code or that outfit for that special event.

But after that event, you're gonna go back to where you were.

But if what you're trying to do is 5, 10, 15 years from now, be healthier than where you started, set up some community for yourselves, and that's what we try to do in a behavioral health approach, is build that sense of connection.

Give you a spot to really build... to tackle your health from a patient-centered medical home, and ensure that you've got the resources you need to go over the long haul.

- Yeah.

'cause I know when you talk with a family practice doctor, and obviously many people struggle with weight, that being, of course, a big determinant on your overall health affects everything with the rest of your body.

And you'll hear people say, "Well, I need to lose 30 pounds."

Well, when I talk with my family practice, doctor says, "No, you don't need to lose 30 pounds.

You need to lose five, then you can lose another five."

But to say, "You've gotta lose 30."

Yeah, ultimately, as you just said, long-term, that's where you want to be.

But you're not gonna get that 30 pounds in two weeks.

It's gonna take that five pounds or three pounds at a time sort of approach to it, which then corrects your overall way you deal with your health.

You develop better behavior versus saying... Because if you think you're gonna get rid of that situation in a week or two, you're gonna fail.

And then you're gonna feel like, "Well, then, what's the point?"

And now your behavior gets even worse.

Like, "Well, why even try?"

When you do have people who come in, I mean, it's probably difficult to be successful with everybody that comes in the door.

You probably use a team approach where people kind of work together as you've mentioned, to kind of get someone to where they at least... You think you can get them started to, down to a road to better behavioral health, and therefore better physical health.

- Yeah, I mean, and this is the whole wonderful thing about having a patient-centered medical home in our health center is that you're not having to get the best of one person.

There's a whole team.

So if what you need is behavioral health, we have that expertise in house.

If you need dental care, we have that in house.

If you need a prescription, we have that in-house.

And if you need high quality medical care, we have that too.

and these folks are working together collaboratively to ensure that not only are they delivering their best product to you, but the team is as a whole.

- Yeah.

- Yeah.

- And it's important to understand the bias and the stigma around behavioral health.

No one wants to be diagnosed with a mental health issue.

Because of that, primary care people go into primary care all the time.

Primary care docs say, "Oh, I think you've got a behavioral health.

I'm gonna refer you to somebody."

75% of the time, they never follow through.

- [Steve] They never show up, right.

But if you have somebody do what's called a warm handoff, the primary care physician is like, "I'd like you to talk with Jeff.

Jeff's a therapist."

Jeff shakes hands and introduces you, spends a few minutes.

That flips, now 75% of the time, they're gonna come back and engage.

So it's just a huge.

So making that connection, overcoming those bias, those initial fears is incredibly important, and that's what one of the things we do at the health center.

- Yeah, now, how easy for people to find out more information.

Just go to your website, you got a Facebook page, you got all those things.

So it's easy to find information, easy to get in touch with you guys.

- Yeah, and that's the best way to do it.

It'll give you our hours.

We do have extended hours on Mondays, and in an effort to try to give people a chance to visit us when they might be off of work, if they're not able to take time away.

And also gives you a chance to see what all of our services are, because we want people to come in wherever their need is.

And then from there, we'll get them connected to whatever else they might need.

But the truth is, is that, as Jerry said, this is one of the best kept secrets in Wood County.

We really want people to be aware of it because we can provide a level of care, probably different than what you know.

And for our taxpayer and for our community overall, when we make an effort in prevention like what the health center does, it aligns with what's happening community-wide.

And not only saves money for the individual, but saves money for the system overall and reduces strains so that when we really need people to seek care to hospital, those beds are available.

- HRSA says, "For every dollar invested in FQHC, it saves the health system $2.25."

- Wow, so yeah, that's incentive enough right there.

It should be for all of us then.

Well, thank you so much for being here, gentlemen.

Appreciate it very much and we'll talk again soon, because obviously this is an important part of what you do and what the community needs and utilizes.

So we appreciate that very much.

You can check us out at wbgu.org.

You can watch us every Thursday night at 8:00 PM on WBGU-PBS.

We will see you again next time.

Goodnight and good luck.

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