‘We have been able to enhance services provided to these patients while outperforming predicted cost growth trends and maintaining quality.’
SOUTH KINGSTOWN — Laurie Robinson appreciates the assistance she and her husband have received from Integrated Healthcare Partners, or IHP, a statewide association of organizations that offers programs to help meet the behavioral health, medical, housing and other needs of vulnerable Rhode Islanders.
According to Robinson, the couple were living in a state-run hotel shelter when the state shut it down. They moved in with Robinson’s mother, who lives in a senior housing complex, but they could only stay two weeks.
“My husband has COPD, he has asthma, he’s got diabetes, you name it, he’s got it,” Robinson told Ocean State Stories. “I was really worried, like, what’s going to happen?”
That’s when a staff member at WellOne Primary Medical and Dental, one of the eight non-profit organizations in IHP where her husband was receiving care for his multiple health conditions, suggested she contact IHP.
The association found emergency placement for the couple in a hotel and granted them two extensions when they’d reached their time limit there. The same happened at the second hotel where they were placed.
“Me and my husband were so grateful,” Robinson said. “They took into consideration our health issues.”
Like her husband, Robinson lives with a disability. She worked several years in the retail shopping industry, but said the effects of a fall she took in 1989 created “post-traumatic stress and anxiety” that built over the years.
And those were compounded, she said, the night of Feb. 20, 2003, when she attended a concert by the band Great White at The Station nightclub in West Warwick. As the band was playing its opening song, a tour member set off pyrotechnics that quickly engulfed foam insulation and sent deadly smoke through the club. One hundred people were killed and some 200 were injured.
“I was stuck in the doorway,” Robinson recalled, “and was somehow lucky enough to get pulled out. Luckily, three of us went in the building and three of us came out alive. But I knew several people that passed.”
According to president and CEO Rebecca Plonsky Babigian, a licensed clinical social worker, Integrated Healthcare Partners was founded in 2018. “Our organization is a Rhode Island Medicaid Accountable Entity,” she said. What it means is we receive funding for 29,000 Medicaid-covered [individuals]. These individuals receive care though IHP’s eight non-profit organizations.
Using what Babigian described as “a data-driven approach,” IHP conducts analyses to proactively identify people who are at high risk of poor health outcomes across Rhode Island.
“We develop and implement new programs as well as enhance current programs to better support those in need of services and supports with a focus on individuals struggling with substance use and mental health. We know that mental health and substance misuse are a leading indicator of poorer health outcomes, particularly post-pandemic. Our programs also address social determinants of health, and our emergency housing program has been quite an incredible success for us.”
According to Babigian, IHP’s health programs focus on reducing hospital admissions and readmissions and “closing gaps” in care for marginalized populations. By reconnecting individuals to preventative, routine, and sick care through this program, “we can start to better solve for, things like ‘Supporting these individuals to ensure they receive an annual well visit by providing transportation. Are they due for a diabetes eye exam because they have a chronic condition? If they are due for a mammography for preventative breast cancer screening, we identity what barriers do we need to address to ensure the screening is completed.’
“All of the metrics we are responsible for to advance our system of care while improving health outcomes are reasonable and they are based in some great founding practices. And I think that overall, all of the accountable entities in Rhode Island have saved the state a significant amount of money.”
As an example, Babigian said that IHP has reduced emergency department visits by 30%.
“Historically, this population was using the emergency room a lot because some of these individuals on cold winter nights wanted to have a warm bed, a few meals, and a period of time to feel better, and they could find some respite in emergency room. They were also using the Emergency Room because they typically have so many chronic conditions and ailments that they used it as their primary care.” Now with our Emergency Housing Program, these individuals have over 40 days on average to receive temporary housing, medically tailored meals, and reconnect to primary and behavioral health care.
Another person who has benefitted from IHP services is a man whose middle name is Tom, who, like Robinson, lives with a disability. He asked that he not be further identified.
A man in his 50s, Tom said that when he lost his apartment recently he checked into a hotel while he considered his options for permanent housing.
While he was there, he said, “I got a call from my doctor just to check up on me for some other issues I have. I suffer from depression and anxiety and stuff and am on my meds so they called and they found out what was going on. I was in a hotel. I was upset. And I was just I don’t have a lot of money so I got in touch with [someone] at WellOne.
“They set me up with living arrangements for a couple of weeks, probably three weeks total, which really helped out rather than sleeping in my car somewhere. It was going to come to that if Integrated Health Partners didn’t step in.”
Meanwhile, the application Tom had made years before to the state’s Housing Choice Voucher Program was approved. With it, he was able to move into a two-bedroom apartment, which he would have been unable to afford otherwise. His sole source of income is from the Social Security Disability Insurance program, or SSDI.
Tom’s assessment of IHP?
“I can’t say how much I appreciate them,” he said. “Sometimes people just need a helping hand.”
Joining WellOne Primary Medical and Dental in IHP are Community Care Alliance, Comprehensive Community Action Program, East Bay Community Action Program, Newport Mental Health, Thrive Behavioral Health, Tri-County Community Action Agency and Wood River Health. Officials with four of them contacted by Ocean State Stories all spoke highly of IHP.
WellOne Primary Medical and Dental president and CEO Peter J. Bancroft said his organization has worked with IHP for several years. With that alliance, he said, “we have been able to enhance services provided to these patients while outperforming predicted cost growth trends and maintaining quality. A particular area of focus has been the social determinants of health including, but not limited to, housing and food insecurity.”
“This partnership allows us to integrate care for those shared patients with serious mental illness and substance use disorders,” said Jamie Lehane, Chief Strategy Officer for Newport Mental Health. “IHP is improving the health outcomes for these difficult to engage and treat individuals. IHP is also at the forefront of understanding that addressing social determinants of health such as emergency housing, food insecurity, employment, and supportive housing are critical to improving health outcomes.”
Community Care Alliance president and CEO Benedict F. Lessing Jr. hailed IHP’s “shift away from using Hospital EDs for acute behavioral health episodes toward greater utilization of community-based treatment services such as Emergency Services Teams, BH Link, 988 and diversion programs such as the Acute Stabilization Unit. This initiative alone has saved millions of dollars and lowered the total cost of care.”
The association’s emergency housing initiative, Lessing said, “reduces the likelihood that individuals will become hospitalized as a result of not having housing.”
Wood River Health president and CEO Alison L. Croke said: “IHP has invested in all our organizations in the form of technical assistance to improve our ability to participate fully in value-based purchasing arrangements. IHP’s efforts have allowed our organizations to pilot innovative solutions to improve the delivery of primary care and the integration of behavioral health with primary care.”
Grateful as they are for IHP’s assistance, Robinson and her husband face economic struggles the program is not designed to address. They live now in public housing, but their monthly SSDI payments only go so far.
“It’s a sticky situation,” Robinson said. “As far as the housing goes, we’re fantastic. But because my husband and I are on disability, we’re on a budget. He has 10 different prescriptions, plus oxygen for both of us. We only get $23 in food stamps. His check pretty much covers the rent, the telephones, the cable bill and money towards the food.
“My check comes the second Wednesday of the month and it takes care of my insurance on the car, the electric bill and the rest of the food for the month. I have fasciitis and degenerative arthritis in my knees. I believe now that my shoulder might be a torn rotator cuff. I had surgery on my hand and the other hand is acting up.
“Plus I have problems with my lower back and my neck. I can’t even go see my doctors because they’re $45 a pop. And then if I go to the doctor and he wants me to do physical therapy what am I supposed to do? Because that’s $45 a pop, too, and they want you to go like three days a week. It’s so wrong.”
According to the U.S. Census Bureau, 10.8% of Rhode Island’s 1.09 million people – adults and children — live in poverty.
“IHP can only do so much to address the social determinants of health that underpin health outcomes,” said Newport Mental Health’s Lehane. “It is a shame that in this wealthy country more isn’t done to eliminate poverty. It is unacceptable that in Rhode Island 10% of our residents live in abject poverty.”
