Improving Community Health Through Integration

May 20, 2016   |  Tags: Blog   |  Tags: Behavioral Health Integration , Eastern Oregon , Rural , FQHC
Stephen P. Kliewer, D. Min.

In 2005 shortly after I became the Director Emeritus of Wallowa Valley Center for Wellness (WVCW),  a conversation started between myself and Dr. Elizabeth Powers, who was practicing at Winding Water’s Medical Clinic (WWMC).  A shared interest in effective interaction between primary medical care and mental health care facilitated an ongoing discussion about how our programs could work together more effectively. We began to dream of not just collaboration, but integration and we began to move together toward that goal. 

Winding Waters clinic began to work on new collaborative models of practice involving a focus on “teams” rather than individual providers.  The mental health program, wanting to expand its focus, sent three therapists through the behaviorist certification program at University of Massachusetts and picked up practice space in the new medical office building next to the local critical access hospital. With this step, we were able to embed our behaviorists in WWMC. We started to expand the collaboration to include other community partners, and put together the Wallowa Valley Network of Care. WVCW included a vast array of community partners (housing, transportation, parenting, domestic violence), as well as public health, other primary care clinics, local pharmacists, chiropractors, the hospital, and functional medicine providers.  Our goal for our county became 100% access, 0% disparity.  We were inspired by this goal and the hope to create a system that provided coordinated, wrap-around services that would address all the domains affecting health and wellness.  We developed a universal screening tool and began to work on communication, collaboration, and system enhancement, at which point thing began to rapidly move forward.

The network of care received a rural network planning grant, WWMC was designated as an Federally Qualified Health Center (FQHC), and WVCW was awarded a Substance Abuse and Mental Health Services Administration Primary Care Behavioral Health Integration (SAMSHA PCBHI) reverse integration grant.  A new clinical room is now finished at WVCW, and health education and nursing services are already in place.  In October, primary care providers will start to provide primary care services at this site 5 days a week.  We are hoping to become a Certified Community Behavioral Health Clinic (CCBHC) and continue the movement toward more radical integration. 

We are also excited to share that land has been purchased and plans are in place to build a new facility that will house mental health, addiction services, developmental disability services, parenting programs, day care, and primary care services under one roof. We hope that this will maximize the team concept and help each client easily access the full spectrum of services so that we can help promote optimal wellness for the people of Wallowa County, Oregon.

Stephen P. Kliewer, D. Min. is the Director Emeritus of Wallowa Valley Center for Wellness, a nonprofit agency that provides mental health, alcohol and drug, and developmental disability programs for Wallowa County, Oregon. He began work at WVCW in 2003. Dr. Kliewer received a BA from Whitman College in Walla Walla, Washington, graduating with a double major in philosophy and English literature.  He went on to receive a Masters in Divinity from Princeton Theological Seminary in Princeton, New Jersey and a Doctorate of Ministry from San Francisco Theological Seminary in San Anselmo, California.  He completed a Masters in Mental Health Counseling and is a Licensed Professional Counselor (LPC).  He has been a Presbyterian minister, worked for Medical Teams International, a nonprofit involved in both disaster relief and medical development projects, and served as an Assistant Professor in the Department of Family Medicine at OHSU for 10 years

Dr. Kliewer has published a book on diversity, Creative Use of Diversity in the Local Church (The Alban Institute, Washington D.C., 1987), authored an article on Medicine and Health care published in the Journal of Family Practice (August 2004), and was primary author of Healthcare and Spirituality  (2007, Radicliffe Medical Press), a basic text for healthcare providers.