Safely providing care to more people in our community
May 26, 2020
Ken Loving, MD, CEO
As we cautiously and safely begin to expand the care we provide to our patients, I want to thank you for your continued support of our work at Access.
We know that repercussions from the COVID-19 pandemic will continue for our community, and that more people will need our care. We want to be able to help as many as possible in the months and years ahead.
This update provides you the latest information on our progress to expand our services in our Medical, Dental and Behavioral Health practices. Starting today, we are providing more options for routine dental care at all four of our clinics using a new model of care.
Watch the video below to learn more about our work today and in the weeks to come.
Safety is key in providing essential care
May 21, 2020
At Access, safety comes first for patients coming to our clinics for essential or urgent medical, behavior health and dental care during the COVID-19 pandemic.
The following measures create a safe environment at our clinics to meet the needs of our patients and our community.
Limiting the number of people in clinics: If telemedicine is a good fit to address your health concern, patients can meet with their provider by phone or video link instead of having an in-person visit.
We ask that you come to your in-clinic appointment alone if possible, with the exception of children and patients needing a caregiver.
Screening: When you come to the clinic, you will be screened for COVID-19 symptoms before being brought back to the clinical area. Staff are being screened for symptoms each work day as well. Any patient who has respiratory symptoms is scheduled for an appointment at our dedicated respiratory care location, now inside the William T. Evjue Clinic location where testing is available and free. Staff with symptoms are sent home and, if needed, tested.
Physical distancing: You will be taken to an exam room as soon as possible after completing screening and registration. If too many people are at the clinic at a time, you may be asked to wait in your vehicle or separate room if a vehicle is not available.
You will soon notice prompts or distancing reminders, such as directional signs and six-foot markers, and other measures at some registration desks.
Constant cleaning: Inside our clinics, we have removed all magazines, books and other printed materials, and high-touch areas including door knobs, chairs, tables and countertops are wiped down throughout the day. In addition, our cleaning vendors focus on cleaning these areas at the end of each day.
Protection for all: In our clinics we request everyone — staff, patients, visitors, vendors — to wear a mask. We will have cloth masks available at the entrances for those who do not bring their own. During your appointment, providers and staff will wear personal protective equipment (PPE) including gowns, masks and face shields. Other staff will be working at physically distanced workstations.
These high standards for safety reduce risk and ensure that our clinics continue to be places where more people in our community can receive quality care.
Safely providing essential care to patients
May 18, 2020
Kevin Fehr, MD
Chief Medical Officer
We have experienced a great amount of change over the past few months. The pandemic has forced us to innovate and change our model of care to meet the current needs of our patients.
And now, as we realize our pandemic response will continue into the foreseeable future, we need to continue our care related to COVID-19 and increase care opportunities for patients with other medical issues.
Today, May 18, we are opening an essential care clinic at the Joyce & Marshall Erdman Clinic and moving our respiratory clinic to a dedicated space at our William T. Evjue Clinic. The essential care clinic at the Evjue site will remain in place.
These changes will allow us to increase in-person care for a variety of patients, including those with chronic diseases like diabetes or high blood pressure or depression, who need regular, ongoing care that can’t be put off until the end of the pandemic.
I understand that people are so concerned about COVID-19 that they are delaying the care they need. Unfortunately, this can then lead to other health problems. For example, if a patient has kidney function that is declining and hasn’t had it checked in a while, or if they’re not monitoring their blood pressure, they could end up with serious health consequences that have nothing to do with COVID-19.
I think the challenge now is determining who needs to be seen, connecting with them, and finding ways to engage with them in their own care. Our staff is ready for this challenge. They have done an amazing job innovating and moving care forward since the pandemic began. Process improvement is something we’ve talked about for a long time, but now it’s alive and thriving. People are embracing ways to improve care for our patients and to support each other in the care team.
We need to find a way to live with this virus.
It is critical to have safety measures in place if we want to bring more people into the clinics. Patients with respiratory symptoms will continue to be seen in a separate clinic-within-a-clinic at our Evjue site. We’ll continue to use telehealth and other means to connect with patients, and only bring in people when it is necessary to address their ongoing care.
Additionally, we are limiting the number of people who come to the clinic, monitoring for symptoms, checking temperatures and requiring a face covering or a mask.
The changes we are making and the safety measures we are implementing will allow us to reconnect with more patients and help keep their health needs on track.
We’ll get through this together – now and into the future.
Planning safe dental care through the pandemic
May 11, 2020
Errin Pfeifer, DMD
Chief Dental Officer
At Access, we are proud to provide a full range of dental services to patient of all ages, from basic hygiene to complex restorative care. The COVID-19 crisis has changed the focus of our work, for now and into the immediate future.
Our main goal during the pandemic is to treat emergent need, keeping patients out of urgent care and emergency rooms so those facilities are free to focus on COVID-19 patients. Our work now focuses on serving patients experiencing swelling, trauma, bleeding or severe pain.
Currently, in-person dental care has become a smaller part of the care we are providing. Dental triage has now become a larger aspect of our care. Dental triage is a process by which the staff member who answers the phone also completes the initial screening and defers any patients who might want or need routine care to a later date.
If a patient expresses issues related to pain, swelling or trauma, they are transferred to a dentist to discuss their concerns. Patients can send photos to a secure email to help with their diagnosis, and the dentist can help a patient manage an issue at home or decide to schedule an in-clinic appointment – usually the next day.
This keeps most patients reassured about their dental concerns and brings into the clinic those who need our help emergently. It also has allowed us to identify and provide care to more than 50 new patients during the pandemic.
Many of our patients receiving in-clinic treatment need care to alleviate pain, often by way of a dental extraction. Other patients are coming in to have their dentures or partials repaired so they can continue to eat effectively.
One of the greatest challenges in providing these types of in-office care is making sure that both staff and patients are safe. COVID-19 is a respiratory illness passed through oral secretions. We have increased the use of personal protective equipment for staff, making sure that patients are also well-protected.
Additionally, when patients are in clinic, social distancing is practiced whenever feasible. We have virtually eliminated the use of waiting rooms and patients are given masks for the times they are not in active treatment.
Dental disease does not go away during a pandemic. As we look to the future, we will have a slow increase in what we can offer for more of the routine types of care that our patients need. We have been looking to the American Dental Association, Wisconsin Dental Association, and state guidelines to help guide our plans to open for more care. Of course, safety of our patients and staff remains of paramount concern and guides each decision we make and every workflow we implement. We are working diligently to obtain adequate supplies of Personal Protective Equipment (PPE).
When we begin to provide more opportunities for in-clinic care, we will look to begin using alternate ways to treat cavities and gingivitis that will halt disease progression. These will improve patients’ dental health and keep staff and patients safe.
In the near future, dentistry will focus more on disease mitigation, rather than traditional models of disease removal and replacement of structure, such as drilling and filling for cavities. Longer term, I hope to see a more blended model, with some traditional drilling as necessary, but also the use of disease-arresting medications.
Returning to pre-COVID treatment models completely would require immediate chairside testing for COVID-19 or a widely distributed vaccine. Until then, I believe the pandemic may cause a real paradigm shift for dentistry and planning the evolution of our practice is an essential endeavor.
Whatever may change in how we practice dentistry, our commitment to improving the health and improving the lives of our patients remains absolute.
Helping provide the basics is a community project
May 7, 2020
One of the things that sets Community Health Centers like Access apart is our ability to provide care that considers all the factors that impacts the health of our patients. Our team of Community Resource Specialists (CRS) focuses on connecting patients to the resources that everyone needs to access care and be healthy.
Fundamental resources have become in greater demand as a result of the COVID-19 pandemic. Many people have lost employment and income, insurance and access to necessities.
Providing this assistance to patients is how Access fulfills its mission to improve health and improve lives.
“It’s very rewarding to know that we are able to be there for them and help them navigate through this time,” said CRS team member Claudia Salgado.
Through strong community partnerships, we can connect patients with what they most need.
Options have expanded for people needing coverage such as BadgerCare and other insurance types. This has quickly opened access to for those who are newly unemployed and without health insurance coverage.
Affordable care and medication
Access established an Emergency Discount Program for patients who need help paying for care and medication. Providing a greater discount through the pandemic has given those in communities that often do not qualify for programs like BadgerCare or the Affordable Care Act a way to get care that is affordable.
People needing help putting food on their table have multiple options in our community. Our list is constantly updated to provide people the most efficient way for them to provide a meal for themselves and their family.
Lighthouse Christian Church and School in Madison, in collaboration with the African American Council of Churches (AACC), is one of these options. Volunteers pack and distribute 100 to 300 hot meals, in addition to providing a full food pantry and economic assistance to those in need. Efforts like this are possible through strong community collaboration with agencies including Second Harvest Food Bank and the United Way of Dane County.
With the pandemic, more people are looking for help finding shelter and paying rent. Both individuals and families are contacting us for help finding a place to stay. The community has stepped up with additional places that our CRS staff can refer them to and partners such as Centro Hispano which has an established fund to help pay for housing.
Our CRS team can assist patients in finding the best options for health coverage, financial help, food resources housing and more. They are there to navigate the application process with them and remove language barriers to getting what they need.
Patients needing help with resources can call (608) 443-5480.
In addition, contact United Way of Dane County’s 2-1-1 line to access a wide variety of assistance in our community.
Working to reduce behavioral health stigma
May 4, 2020
Elizabeth Zeidler Schreiter, Psy.D
These are unprecedented times. We have all experienced disruptions to our daily lives and uncertainty about the future. The COVID-19 pandemic has drastically changed how we work, play, and re-charge. Addressing emotional health and wellness is vitally important, now more than ever.
In this crisis, it is critically important to reduce stigma associated with behavioral health. We need to foster conversations related to emotional health and wellness and ensure that people have clear pathways to receive help. People throughout the community are being affected by this pandemic – especially our most vulnerable residents. This may involve job loss, financial strain, food insecurity and other stressors that can affect mental health and wellness.
At Access, we actively work with our patients to address these other social determinants of health and make connections to available resources in our community.
We offer behavioral health as part of our primary medical care services. Before the pandemic, our behavioral health team worked predominantly face-to-face with our patients, taking into consideration both verbal and non-verbal communication. We quickly adjusted to support physical distancing while ensuring patient access to crucial mental health care.
We began offering telephonic behavioral health visits to patients and are exploring options for video/audio support as well. Currently, approximately 95 percent of visits are being provided by phone, so we continue to support individuals with mental health and substance use disorder treatment needs, while also minimizing the risks of COVID-19 transmission.
In the past six weeks, we have conducted over 586 telehealth encounters to patients who needed behavioral health care.
I am continually humbled by the resilience of those we serve as we navigate these changes together.
Last week, we met with a patient with complex medical conditions. She was experiencing increased anxiety in response to the pandemic and changes in her regular access to specialty care services. We were able to engage in a mindfulness intervention over the phone, complete guided imagery, explore the mind-body connection and then assist the patient with scheduling a same-day virtual visit with her medical provider. The patient asked for a follow-up appointment with the same behavioral health consultant, noting the ease of access and an appreciation for connecting her with needed services so efficiently.
In addition, more patients are seeking care for substance use disorders. We can quickly connect patients with lifesaving treatment options including medication assisted treatment when appropriate. We also use behavioral strategies to promote recovery and we address co-occurring mental health concerns if needed.
I am so very proud of the entire behavioral health team. Their flexibility, teamwork and effective communication has ensured continuity of care for our patients at this critical time. We are finding new and innovative ways to provide care that will remain long after the pandemic is over.
May is Mental Health Awareness month. I hope we all can come together this month to bring increased awareness to mental health, promote resilience and reduce stigma.
If you or someone you care about is feeling overwhelmed with emotions like sadness, depression or anxiety, please know you are not alone. Be kind to yourself. Engage in daily self-care activities and give yourself permission to reach out for additional help/assistance via available behavioral health supports such as:
- Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Distress Helpline: (800) 985-5990
- National Alliance on Mental Illness (NAMI) HelpLine: (800) 950-6264
- National Suicide Prevention Lifeline: (800) 273-8255
Exceptional care under extraordinary circumstances
May 1, 2020
Over the past six weeks, Access has continued to provide exceptional care to our patients and to the community during the COVID-19 pandemic. The following are a few examples of the critical care that Access has been able to provide during this extraordinary time:
- One patient arriving at our essential care clinic was experiencing shortness of breath and cough upon her arrival. While this may have been a patient who could have been re-directed to the respiratory clinic under ordinary circumstances, she was also a person who was previously diagnosed with chronic obstructive pulmonary disease (COPD). We did not want to risk having this patient exposed to the COVID-19 virus at our respiratory clinic, but also wanted to protect patients at our essential care clinic if this patient was experiencing COVID symptoms. The patient’s doctor made a decision to see the patient in the parking lot of the clinic to make sure she received quality care as quickly as possible while also not jeopardizing the patient’s health any further or putting others at risk in the clinic.
- We cared for a 12-year-old boy who had been to the emergency department over a weekend with fever, pain and facial swelling. He was new to Access and living in Madison with his grandmother. The boy was developing slowly from a dental perspective, and decay in two of his teeth were an issue. We were able to receive a verbal consent over the phone from his mom to extract two of his primary teeth during his appointment. The ability to take quick action during this extraordinary time helped reduce a lot of pain and prevent serious infection for this child.
- At our respiratory clinic, a 37-year-old homeless patient living at a shelter was able to receive an evaluation and testing for COVID-19. Afterwards, the provider arranged the patient’s transfer to a community isolation facility at the Lowell Center for 14 days of self-isolation. To get the patient to the facility, a taxi ride was arranged by a member of our RN staff, and plans were made for the UW Health pharmacy to deliver medication to the facility to aid in his recovery.
- At our respiratory clinic, a 63-year-old patient with a severe alcohol use disorder and a history of COPD with worsening cough was evaluated for COVID-19. The patient had a history of repeated ER visits and hospitalizations until stable housing was established and the treatment of her alcohol use disorder was begun. During their evaluation, it was determined a follow-up Vivitrol injection (for alcohol dependency) was due and should be given during this visit. UW Health pharmacy staff were able to bring the medication in a cooler to the clinic in a quick manner and RN staff were able to administer the Vivitrol injection right away.
- At our respiratory clinic, in dental services, a 64-year-old woman with COPD had a dental extraction performed after her tooth, which had been scheduled for extraction, began to worsen. To complicate matters, the patient had been on antibiotics for a lung infection recently and was very nervous to be out of her house, given her risk factors. The protections and safety measures taken at the respiratory clinic allowed the extraction to be completed safely, effectively and efficiently.
Staff on the front lines of care
April 29, 2020
As Access shifted its focus to care for patients who have COVID-19 symptoms and essential care needs, staff members from across the organization stepped up to meet the challenge. Thanks to them, we can provide medical, dental, behavioral health and community resource services to thousands of people who need them, while keeping our patients, staff and our community safe from the virus.
These stories tell what it is like to be on the front lines of care at our clinics. They paint a picture of the essential function of a community health center.
Julia Green, RN
Being a front-line worker and providing care during this pandemic has meant many changes. Working at the Joyce & Marshall Erdman Respiratory Clinic, where we are providing care and testing for anyone experiencing cold and flu-like symptoms, flexibility and thinking creatively are the new norm.
We provide more care to patients through telemedicine and have greatly reduced staffing at the respiratory clinic to maintain social distancing.
To protect our patients and ourselves from contracting becoming sick, we allow only four patients in the waiting area at once. We quickly get each patient’s information — symptoms, vitals and risk factors — before taking them to a room. Everything from the computer, equipment, and chair is disinfected between each patient. The security guard even cleans the clinic door handles.
Patients have expressed many moments of gratitude for the work that we are doing. But what I most enjoy is giving patients and their families cloth masks donated from the community. We have masks in sizes to fit anyone 2 years old and up that we can give out free. Patients have been very thankful for these cloth masks. It feels good knowing that Access is able to help keep patients and their families safe while they are out in the community, hopefully helping to flatten the curve.
Being part of an organization that has pulled together and has not only helped our patients, but each other, during this difficult time has been very rewarding.
Nakkea Fitzgerald, Registration Specialist
There have been many changes in my work to answer patient calls and schedule them the care they need through the pandemic. Our work has been ever changing to meet needs, and each day is different. This keeps us on our toes!
We maintain social distancing by placing call center staff within our workspace and in different areas of the office. This way, we have enough people to answer patient calls and can get patients the care they need quickly.
A number of the patients I’ve talked to have expressed how much they appreciate that we’re still here helping them.
Demetra Sifakis, DDS
My workday has changed drastically to focus solely on emergency dental care. Patients leave the safety of their homes to come in because they have a dire need. This often leads to heightened emotions of concern for patients, and for us, creates a sense of purpose and duty.
Providing emergency dental care now involves being safe, decisive, swift and direct. Dental providers triage patients by phone and in most circumstances, the patient can email us photos we use to diagnose which patients need to be treated.
Every day that I have had the opportunity to treat patients during the pandemic reminds me of why I became a dentist. For every patient we treat in our clinic that is one less patient that will go to the ER or urgent care seeking help.
Prenatal care during COVID-19
April 27, 2020
Sara Downie, BSN RN
Access Prenatal Manager
The way Access has provided health care to our patients has changed in many ways due to the COVID-19 pandemic. Our prenatal care program is no different. We have made a variety of changes to ensure each patient (and their growing baby) are provided the best possible services under our new model of care.
In the first week of the pandemic, our entire staff worked together to find the best way to minimize the number of in-clinic prenatal visits, while ensuring patients received all the services they needed in a timely and effective way.
When the first stay-at-home order was issued, we received a tremendous number of calls from concerned prenatal patients. We were able to reassure them that Access had already put in place significant patient safety and social distancing measures.
As part of our restructuring of care, Access moved all essential care to our William T. Evjue Clinic. Moving to one clinic for in-person visits was a challenge. We have worked to coordinate visits so that patients can get multiple needs met at once. We can do this through a variety of ways; for example, coordinating an ultrasound with an upcoming OB visit or coordinating postpartum visits with other family appointments.
Our prenatal team still provides a full range of care and services, but we do this now in a way that keeps patients safe during the pandemic. Essentially everyone is doing their part, but in a different way. Both the midwives and family practice doctors are providing telemedicine for at least half our total visits. If a patient doesn’t have to come in for something specific such as labs, providers can conduct a visit by phone. Additionally, we have made lactation consultation easily available for mothers through telemedicine.
Telemedicine visits allow us to provide care quickly and efficiently. For example, our prenatal nurses can take an initial call from a patient, complete the new patient intake process, assist the patient with obtaining coverage and start the patient’s prenatal care in one phone visit.
Many of our patients struggle with finding affordable, reliable transportation. Because patients often rely on a bus or a cab to get to the clinic, offering a telemedicine visit is not only efficient, but also reduces both their anxiety and their potential exposure.
As we look to care for patients after the pandemic, we hope to use what we have learned to provide our patients with the most efficient and effective care—allowing us to meet patients where they are and provide them the best care in the most accessible way.
In a sense, it’s what Access is all about.
Meeting patient needs through telemedicine
April 22, 2020
More than 1,000 patients have received care through telemedicine visits at Access during the past month. This technology gives us the ability to provide care — medical, dental, behavioral health, resource counseling and more — while keeping everyone in our community healthy and safe through social distancing.
This innovative tool helps us take care of our patients by getting people care when and where they need it through the COVID-19 pandemic.
Patients who have concerns, not only about exposure to the virus, but also about transportation, time away work and finding childcare, are able to talk to a health care provider, behavioral health consultant, dentist and community resource specialist over the phone. While telemedicine visits currently are available only by phone, we are exploring the addition of video.
Having the telemedicine option has provided people experiencing anxiety a way to connect with our behavioral health team and strategize about ways to manage their concerns. It also provides patents who are experiencing dental pain a way to discuss and assess their condition with a dentist.
Others experience efficiency by using telemedicine. By working with our healthcare partners, we have been able to combine appointments for our prenatal patients, saving each a trip to the clinic and limiting exposure concerns.
This approach to care is an example of how we are better meeting the needs of our patients and doing our part to limit risk of exposure during the COVID-19 period.
Meeting ongoing essential needs
April 20, 2020
Ken Loving, MD, CEO
A little over a month ago, we radically changed the way we provide care for our patients at Access.
As the COVID-19 crisis affects more people in our community, the need for our services has never been more critical. In the last month, we have seen more than 2,000 patients in our medical, dental and behavioral health practices and provided COVID-19 tests to more than 100 patients.
We continue our respiratory clinic at the Joyce & Marshall Erdman Clinic and our essential medical and dental clinic at our William T. Evjue Clinic. Essential dental care is offered at our Dodgeville Clinic, serving six counties in southwestern Wisconsin.
We have also developed new ways of caring for our patients during this emergency, providing more than 1,000 telemedicine encounters to patients across all three of our areas of service.
However, along with these new approaches and new ways of providing care, we still need to meet the ongoing, essential needs of our patients.
For example, each year, more than 250 women receive prenatal care at Access. Working with our healthcare partners, Access has revamped how we provide our prenatal services. By combining appointments, offering telemedicine visits and providing resource counseling by phone, we can provide care to these patients efficiently and effectively.
One young woman shared with us how relieved she was that she could receive care in this new way, saving her an hour bus ride and limiting her exposure during the pandemic.
Our approach to prenatal care is one example of how we can better meet the needs of our patients by lessening transportation costs, promoting social distancing, and limiting risk of exposure.
Additionally, this week we helped new patients establish care at Access, providing emergency dental care to 17 new patients.
Of course, your support and encouragement these last four weeks have made this work possible.
A community health center is, by definition, based in the community itself. Our patients, community partners, business partners and donors work together with a common purpose: to create a healthier and more equitable community for us all.
I will continue to reach out regularly to update you about our work and the people we serve. Thank you again for your ongoing commitment. We will get through this together.
Learn more about new provisions in the CARES Act which encourage charitable giving to COVID-19 related charities.
Flattening the curve
April 17, 2020
At Access, we have changed the way we provide care to ensure that we are doing our part to flatten the curve and limit the spread of the COVID-19 pandemic.
We have been able to achieve this through a few large-scale changes, such as creating a respiratory clinic at our Joyce & Marshall Erdman Clinic for those with respiratory and COVID symptoms, but also through a variety of smaller but equally impactful ways, including:
- Monitoring for COVID-19 symptoms for patients entering our essential care clinic at the William T. Evjue Clinic.
- Creating social distancing standards at our clinics for both staff and patients.
- Offering telemedicine visits to medical, dental and behavioral health patients.
- Offering patient resource services via telephone.
- Encouraging prescription delivery or offering a system of prescription pick-ups for patients in their vehicles.
- Creating a paid leave program for staff members.
- Offering work at home options for staff members
- Requiring all employees to wear masks at our clinics as well as our administration office.
- Monitoring for COVID-19 symptoms for employees entering our work sites.
By taking these measures, our face-to-face encounters at our clinics over the past month have dropped by 90 percent in dental and 65 percent in medical – an impressive measure of success during this period of social distancing.
However, the need for in-person care remains, and the measures we have taken have also allowed us to provide essential care to our patients in a safe manner at our William T. Evjue Clinic. While many regular checkups and non-essential appointments have been postponed or are now provided telephonically, those with urgent needs continue to have access to care at this clinic, which also helps keep people out of urgent care or emergency rooms when they do not need to be there.
Together with Wisconsin’s stay-at-home order, the social distancing measures that Access has taken over the past month have been an effective tool in preventing the spread of COVID-19. In the weeks and months to come, Access will do all that is necessary to continue to flatten the curve and help our community and our patients get through this extraordinary time together.
Tools to manage your mental well-being through COVID-19
April 15, 2020
Martha Saucedo, LCSW
Behavioral Health Consultant, Latinx Community Liaison
While we are staying safe at home, many have feelings of isolation, fear and anxiety. Even though we are all going through the COVID-19 pandemic together, it is difficult to feel like we are really together while keeping apart.
This series of short videos provide support and tools to help people manage their mental wellness through this difficult time. The messages have become an important way to support the Latinx and broader community and normalize the feelings that we all share in dealing with COVID-19.
In addition to relaxation techniques, meditations and the importance of developing a routine while home, we discuss topics including grieving. Many may not recognize that they are grieving those things in our lives that came to an abrupt and unexpected halt. Employment, important events like graduation, sports tournaments, time with loved ones and social time with friends.
It is normal to feel sad, angry and frustrated about these things. Writing down or journaling your feelings about all that was lost is a great way to identify them and describe the emotions that you are feeling. Doing so will help to bring you serenity and acceptance.
It is important for us all to realize how easy it is for our brains to enter a state of fear and make that the default. It is even more important to know that we all have the power to control that response and how to do this. By starting your day with some physical activity you enjoy and by expressing gratitude instead of going on social media or with news, we can set a different tone for our day. Everyone has simple things to be grateful for even amidst a difficult situation. Acknowledging these can bring you calmness and positivity to help you manage the more difficult things in your day.
During the pandemic, it seems like things are out of control and it is scary. I hope that these messages give you ways to help your emotions. Watch them as many times as you want, in the moment and become more centered with the feelings you are experiencing.
Doing this can not only help you manage your own well-being, but provide the calm that your immune system needs to keep healthy, safe and strong.
In addition to being part of Access Community Health Center’s Behavioral Health team and Latinx Community Liaison, Martha is a member of the Latino Health Council and Latinx Mental Health Council.
Stories to share, thanks to give
April 13, 2020
Ken Loving, MD, CEO
This is the time of year that we gather together at our Celebration of Service Dinner to recognize both the work of Access and the community support that makes this work possible. Although our dinner was cancelled this year due to the extraordinary events around the COVID-19 pandemic, there are still stories to share and thanks to be given. Watch the video below to hear these stories and learn about the work we are currently doing in our clinics.
Thank you once again for your extraordinary support. We will get through these difficult times together.
Care at our Respiratory Clinic
April 10, 2020
Kevin Fehr, MD, Chief Medical Officer
Our primary goal for setting up our new model of care during the COVID-19 pandemic was to help people socially distance – both patients and our own staff. I think we have been successful in doing that by separating our two clinics and having people with respiratory symptoms come to just one site – our new Respiratory Clinic at the Joyce & Marshall Erdman Clinic.
I have been overwhelmed by the flexibility and the adaptability of the providers and the staff to adapt to this new model of care. We asked staff at both the Respiratory Clinic and the Essential Care Clinic (at the William T. Evjue Clinic) to make enormous changes in a very short period of time. These are changes that would normally take months or years to implement. We were able to get them done in a matter of days and weeks.
Our staff has been just incredible in their willingness to step up and support the team, to innovate and to make sure that patients are receiving quality care as we transition to a very different model of providing health care. I think the teamwork and the ways people are communicating have been exceptional in these difficult times.
At the Respiratory Clinic, where I work as a provider, we have two or three nurses, two or three support staff and three providers on site each day. This model of care has allowed us to have a smaller staff that is comfortable with putting on the personal protective equipment (PPE) and completing the testing that is required. We have maintained a consistent group of staff and rotated a few people in to assure we have enough backup.
When a patient comes in to the Respiratory Clinic, a support staff member meets them at the door and proceeds to take their basic, vital information. Patients are then taken to one of two mobile workstations that are located in what was previously the clinic’s waiting room. The nurses meet with the patient to gather information about their symptoms and their medical history. From there, the patient is brought to an exam room. The provider then gowns up in full protective gear, meets with the patient and does any testing they may think is pertinent.
As you can imagine, patients coming to the clinic are worried about their symptoms in the midst of this COVID-19 pandemic. Yet despite the new way of receiving care, our patients have really appreciated having access to talk to a provider to see if testing for COVID-19 is needed. Additionally, we have been able to offer testing to patients who would not otherwise have access to it.
We have now seen over 100 patients at the Respiratory Clinic since we started. These are patients who may have ended up in the emergency room or urgent care, or would have been seen at our other clinic, intermingling with people who did not have respiratory symptoms. We have been able to support the community during this crisis by providing care to some of our most vulnerable citizens, and helping keep people out of urgent care or emergency rooms when they do not need to be there.
We are focused on continuing to provide exceptional care to our patients even as the volume of work increases or as we start to enter a surge of COVID cases. I think we have set things up really well and have exceptional teams in place to handle that.
When things return to normal, we are hoping that we can continue to build on some of the things we have learned in handling the pandemic, like telemedicine, that will shape our model of care into the future.
Sustaining our work, sustaining our patients
April 8, 2020
Ken Loving, MD
In our third week of caring for our community amid the COVID-19 pandemic, I would like to thank all of you for your ongoing generosity.
Our work as a community health center would not be possible without this support. As we navigate this crisis, we will continue to draw upon your counsel and your support and update you about our patients and our work.
We continue to use our Joyce & Marshall Erdman Clinic to see patients with fever and respiratory symptoms, and to test for COVID-19 when indicated. At our William T. Evjue Clinic, we are caring for patients with essential medical and dental needs. Our Dodgeville dental clinic staff continues to provide care to patients from six southwestern counties.
More and more we use technology to communicate with our patients across all three of our areas of service. This is consistent with our goal of supporting social distancing while still meeting the needs of our patients in the most effective way possible.
Our medical team is looking for every opportunity to provide care over the phone when it makes sense for the patient. Our providers are reviewing their scheduled appointments and identifying patients who can be served with a telephone visit. We also have multiple providers available to serve patients who call us with urgent needs. Many of these telehealth visits provide care and support that is nearly equivalent to what we would have done in person.
Our behavioral health staff is working to meet an increased need for their services. Almost all our behavioral health consultants are working remotely, providing telehealth-based care to our patients.
Since we are limiting our dental services to urgent treatment, we have a dentist assigned each day to triage patient needs over the phone. This week more than 50 calls were received daily for dental triage.
We expect telehealth to remain an important tool for patient care as we manage our way through the pandemic.
We are actively looking at new ways to sustain our work in these challenging times.
We have been working closely with the state, the Wisconsin Primary Health Care Association and others to identify how telehealth services are eligible for reimbursement. We are evaluating options that may be available to community health centers through federal, state and local efforts.
While many of our staff are working in our clinics, many more continue working from home or on paid leave. Maintaining ongoing employment, compensation and health insurance for our staff remains a critical priority for Access. We must maintain our exceptional workforce to ensure care for our patients through the pandemic and in the months and years to come.
Many of our patients are feeling the impact of the pandemic, with job loss and the loss of insurance coverage.
As part of our sliding discount program, uninsured patients who inform us that they are experiencing any hardship due to the pandemic automatically qualify for the greatest discount. We will offer this discount through May 1, and longer if needed.
In our pharmacy, any uninsured patient who informs us of a hardship is now given our greatest discount, with a $7.50 charge for a 90-day supply of medication. We will also be working with our colleagues at UW Health Billing to work with patients who have COVID-19-related expenses.
Finally, we are piloting an insurance screening for individuals who are contacting our Call Center to establish medical care, but do not have insurance. This process will inform potential new patients of coverage options as our sliding discount program.
Thanks to the many of you who have demonstrated your commitment to Access by supporting our work during the COVID-19 pandemic. If you would like to make a gift to Access, you may do so on our website or by using this form.
We will get through these difficult times together. Thank you again for your extraordinary support.
Reflections on our work
April 6, 2020
Julia Weiser, MD, William T. Evjue/Essential Care Clinic
My first reflection on our work is how grateful I am for our leadership and the administrative teams who have calmly and deftly guided us through the upheaval of all our routines and norms. In the past three weeks, our clinic managers have met my anxious questions and concerns with such grace, and I am inspired by how they’ve led by example through all of this. I want to emulate their approach to crisis by being both more receptive and more responsive, more patient and more flexible.
My next reflections were on how grateful I am for our patients. The economic and social fallout of the pandemic has already taken an early toll on our vulnerable patient population. Despite outsized hardship and valid fears, nearly everyone I’ve seen or talked to has inspired me with acts of resiliency, courage, and compassion. I’ve also noticed that patients have been going out of their way to express their gratitude and support through all this, and I’ve come to realize that patients want to take care of us as much as we want to take care of them. I’ve never felt so keenly that our patients are not just recipients of our hard work, but an active part of our enormous team, who share directly in our organization’s goals and core values.
Finally, I’ve been reflecting on how grateful I am for the people I work with every day. I know it sounds odd, but I’m actually glad for all the meetings and huddles we’ve had recently. I’m profoundly grateful for the time I’ve spent with all my colleagues – other providers, nurses, support staff, behavioral health consultants, registrars, administrators. I’ve even had the chance to spend more time on the telephone with our front line phone operators (whose important work is so vital and appreciated during this crisis).
It’s always been a privilege to work with so many talented, dedicated people, and right now it is truly a unique privilege. With most of the population forced into isolation, I am grateful that I still get to witness firsthand those qualities which sustain my firm belief that we are going to get through to the other side of this pandemic together.
In the past two weeks, I’ve been inspired by countless acts of selflessness, grace, optimism, humor, generosity, patience, ingenuity, resiliency, courage, vulnerability, trust, honesty, and integrity. In the midst of fear and uncertainty, I’m grateful to be weathering this storm with my teammates at Access.
Patient Resources in a time of need
April 3, 2020
As we respond to the health needs of our patients during the COVID-19 pandemic, our patients (and many in our community) are also dealing with many of the difficulties that have resulted from the pandemic, such as job loss, reduction in hours and pay, and an inability to pay for bills that are occurring during this time.
At Access, our Patient Resources team is here to help patients who may be experiencing hardship during this extraordinary time. We have an ability to connect patients to the resources they may need – including housing referrals and food assistance, employment guidance and affordable health care counseling. We also have trained experts to answer questions and help patients find the best coverage under the Healthcare Marketplace, BadgerCare program and our sliding fee discount program.
As you can imagine, our Patient Resources team have been asked questions about food and housing quite regularly over the past few weeks, and our specialists are doing what they can to connect them with organizations and groups that are currently providing assistance. It can be an especially difficult process as some of the resources and availability can change on a daily basis.
But, despite all the disruption caused throughout our region by COVID-19 , our community has come forward to help support those in need. And, Access and our Patient Resources team is here to help our patients find the assistance they need throughout this trying time.
If you need help in finding the resources you need, please call a Patient Resources Specialist with any questions at (608) 443-5480.
Additionally, the following are a few helpful resources that may also help in the coming weeks and months:
- United Way 211 – Call 2-1-1 to talk to a specialist who can connect you to local programs and services that can help.
- Madison Metropolitan School District – Find food sites near you where lunch and breakfast will be distributed while schools are closed.
- Marketplace Insurance – If you need to apply for health insurance due to lost coverage.
- BadgerCare Plus – If you need to apply for BadgerCare Plus coverage.
- COVID-19 Unemployment Info
- Dane County Department of Human Services COVID-19 Updates
Reinvention is a continual process in response to COVID-19
April 1, 2020
Ken Loving, MD, CEO
Access has implemented a new model of care that meets the current needs of our patients, adheres to social distancing and prevention of the spread of COVID-19 and keeps our staff safe and financially secure.
The second week of our intensive response to the COVID-19 pandemic required us to continue to reinvent our care for patients and our support of staff members.
What remains the same, is our commitment to doing our work at the highest standard and for the greatest good, for both our patients and our community.
Thanks to so many of you who have reached out to us this last week to offer your support and guidance as we continue to work at the front lines of the pandemic.
Care for Patients
We continue to operate our Respiratory Clinic at the Joyce & Marshall Erdman Clinic, where we can test patients and staff for COVID-19. To avoid potential spread of the virus, any patient with cold or flu-like symptoms is seen there. All other patients are seen for medical and dental care at the Essential Care Clinic at our William T. Evjue Clinic. We also offer essential dental care at our Dodgeville Clinic, serving 6 counties in southwestern Wisconsin.
We are caring for more people who are now unemployed or underemployed, anxious about their future and concerned about access to health care, and we continue to take on new patients who need our services.
As always, staff spent a significant part of the week going the extra mile for patients. For example, our medical, dental and behavioral health teams are providing care to our patients through telehealth visits. Last week, patients received behavioral health support over the phone, a critical need in these uncertain times of anxiety and fear. Our dentists worked with call center staff to provide triage care to patients and setting appointments for those with urgent issues who might otherwise wind up in Urgent Care or an Emergency Department. We also piloted having one of our medical assistants working with a medical provider to care for a patient through a telephone encounter. Our goal remains to treat our patients efficiently, effectively and with the utmost compassion.
Our administrative staff and leadership dramatically changed the way they work, practicing social distancing by using technology to meet, share work and connect from sites across Dane County and beyond.
Supporting our Staff
I have been so impressed and moved by the extraordinary commitment by all our Access staff as we navigate the challenges of COVID-19.
While many of our staff are working in our clinics, many more are working from home or are on paid leave. Despite their own concerns about the pandemic and the economy, every day our staff remain committed to our patients and this new way of working together.
We remain steadfast in our support of our staff. We must emerge from this crisis with our staff intact. We need them in the moment to care for our patients today and will need them to do the same in the months and years to come.
We will need your support to continue our work through the pandemic and into the future. Our face-to-face patient encounters have dropped by significantly, a measure of success during this period of social distancing. At the same time, it is deeply troubling from a financial perspective as we are paid for our work on a per encounter basis.
I know that you share a deep commitment to our patients and our work in this time of uncertainty and challenge. If you would like to make a direct gift to Access, you may do so online here or with this form.
We will continue to inform you of our work and the challenges of our patients, our community and our staff. Thank you for your tremendous, ongoing support.
We will get through this together.
Behavioral Health Care Resources
March 30, 2020
In the midst of all the many changes occurring at both our Erdman/Respiratory Clinic and our Evjue/Essential Care Clinic, the need for behavioral health care remains as strong as ever for our patients. In fact, during times like this, where stress management and coping are essential, we have noticed the need for behavioral health visits has only increased.
Our behavioral health care team has adapted to our clinical changes and the increased demand for services by making themselves available to meet with patients over the telephone, along with one staff member always being available in person at the WTE/Essential Care Clinic.
But, we also know that we can’t meet with everyone, and that many more people are being affected by the stresses and uncertainty of our current situation.
And so, our behavioral health care team has provided the following list of resources for patients – and for anyone who needs help – during this extraordinary time:
- Facts about COVID-19 (English & Spanish available)
- Taking care of your emotional health (English & Spanish available)
- Helping children cope with emergencies (English & Spanish available)
- Managing Stress and Anxiety
- National Alliance on Mental Illness (NAMI) Comprehensive Guide
- American Psychological Association (APA) Building Resilience
And, please remember, if you or someone you care about is feeling overwhelmed with emotions like sadness, depression or anxiety, or is feeling like they may harm themselves or others, please call 911.
You can also contact the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline at (800) 985-5990 or the National Suicide Prevention Lifeline at (800) 273-8255.
Additionally, if you would like to talk to a behavioral health professional about issues regarding Covid-19 or any other behavioral health issue, don’t hesitate to call Access at (608) 443-5480. We are here to help.
Our Rapid Response
March 27, 2020
Ken Loving, MD, CEO
As you know, Access quickly created a new model of care for our patients in light of the COVID-19 pandemic.
Just over a week ago, our Joyce & Marshall Erdman Clinic on Park Street in Madison shifted its focus to one that serves patients experiencing any type of respiratory symptoms. Patients who are experiencing these symptoms can be evaluated and tested in a safe clinical environment. In just over a week’s time, we have provided numerous tests for COVID -19, along with other respiratory diseases. A special thank you to the staff who volunteered to be part of this care team. They truly exemplify our mission to provide high quality care for our patients.
Concurrently we converted our William T. Evjue Clinic to an “Essential Care Clinic.” Only patients who absolutely needed care were seen; for example, pregnant women, children under 2 years of age needing immunizations, patients with acute problems like severe depression, chest pain, a fall, or acute dental pain and infection. Patients are encouraged to call in to make appointments in order to best direct their care. We deploy a nurse in the vestibule of the clinic to ask screening questions and check the temperature of all patients and family members before entering the building. If patients arrive with respiratory symptoms, we immediately arrange transportation for them to the Erdman/Respiratory Clinic. Over the past week, we have been able to see many patients in need at this new Evjue/Essential Care Clinic, while offering even more patients the opportunity to receive care over the telephone or via MyChart.
As the week closed, we became more concerned about social distancing at the Evjue/Essential Care Clinic where more employees were located. On Friday, we changed seating arrangements and workstations and sent additional people home to work remotely.
I believe the work we have undertaken over the past week has truly shown Access at our best. We have been able to transform our model of care quickly to serve our patients and our community in the best way in the midst of such an unprecedented crisis.
I’m confident the work being done over the past week, and for the weeks to come, will be key in minimizing the spread of this virus and will help us all return to a normal way of life as soon as possible.