With the hope that probationers will be less likely to land back in jail if they get the physical and mental care they need, Yuma County opened the North End Community Connections Integrated Clinic last year.
By all accounts, the clinic seems to be a success.
On Monday, the Board of Supervisors heard how the clinic is doing with a presentation by Interim Chief Probation Officer Mike Byrd; Kara Ahearn, chief clinical administrator of Community Health Associates; and George Owens, program manager with Arizona Complete Health.
The clinic has served more than 1,000 probationers and parolees since opening in June 2018. The initial goal was to see 500 probationers by October 2019.
“We more than doubled that,” Ahearn said. “Once we opened the doors, the floodgates seemed to open and we grew really, really fast.”
Mental health treatment historically has a very high no-show rate. The clinic has maintained a 66% show rate for intake appointments, a 64% show rate for medical appointments and a 56% show rate for psychiatric appointments.
“I think it’s safe to say our no-show rate was half of that with this population before. So we’re really encouraged by these numbers,” Ahearn said.
Owens pointed out that jail time and bookings for Arizona Complete Health members classified as moderate-high to high-risk offenders who receive services at the clinic have significantly dropped. He reported a 78% reduction in jail days served, a 50% reduction in bookings and a 46% reduction in crisis events.
A look at eight random high-risk clients found a 68% reduction in jail bookings and 96% reduction in days spent in jail.
“It’s very promising as far as what we’re doing,” Owens said.
He also noted a 250% increase in preventative care. “The big thing we’re trying to do with this population, which we’ve never really done, is we want to do more preventive health,” Owens said.
“We’re just trying to do things more in an engagement style of ‘come in here, let’s get to know you,’ and work with what they’re willing to do, instead of saying ‘to be part of this program you have to do this, this and this.’ This is not the population that’s going to do that. So what we’re trying to do is get them in the door, get to know them, have some level of engagement and keep trying to push them a little further down the road as far as what would be helpful for them,” he added.
“This was a momentous project that we took on with the help of the board, with the help of county administration,” Byrd said.
The building underwent a major remodel in order to turn it into a fully functioning clinic. “Within this clinic, we have created some very new ideas to try and make it a truly collaborative partnership,” he noted.
While there are 13 similar clinics around the state, the Yuma location is different because it is located inside the Adult Probation Office, which led to the creation of justice teams. Traditionally, probation officers work with a number of case managers. For this project, the clinic paired case managers with probation officers.
“So they work with the same person and speed up what they’re doing with their time, speed up what they’re doing with the information on the individual so they have better outcomes,” Byrd explained.
In addition, probation officers and case managers share goals and what they’re doing to reach those goals and get clients the proper treatment.
It also involves a lot of partnerships with organizations such as Goodwill and Arizona@Work, for housing, job placement, etc.
Ahearn described the clinic as a “warm and welcoming” one-stop shop with all services under one roof, which reduces treatment delays. When a member is referred for services, they don’t have to go to another location.
Onsite financial assessors determine financial eligibility. The majority of clients are covered by the Arizona Health Care Cost Containment System. The clinic is also open to the public and accepts private insurance and has a “very reasonable” sliding scale.
An array of behavioral health services are available, including assessments, individual therapy, group treatment interventions and peer support on parenting, mood management and substance abuse.
The clinic has onsite pharmaceutical services, and although they don’t dispense medication, they can have medication delivered to the clinic daily or the member’s home.
The medical facility does lab work and has a family nurse practitioner who does wellness and well woman exams. Ahearn noted that Yuma has high rates of COPD and diabetes so the clinic does regular breathing treatments. It also administers insulin especially to the homeless population.
“They come in every week, the same day, the same time. They’re hard to reach often so we’re really doing all we can to prevent them from going to an emergency department. We’re really encouraged by their attendance in showing up for those appointments,” she said.
Yuma remains under-resourced when it comes to psychiatry, so the clinic offers telepsych services with a nurse practitioner who can prescribe medication.
The clinic frequently acts as a “bridge” for people who are released from jail without medications. “Even if they can’t get in for a full eval, we’ll get them in, they can have face time with a provider, and at least give them enough medication until a full appointment,” Ahearn said.
Walk-ins are welcome too. She explained: “We’ve learned the population we serve doesn’t always keep appointments as scheduled, but we try to do everything we can when they do come in for a treatment group or a therapy session or peer support visit. ‘You missed your appointment. Can we get you in to see the medical provider?’”
Others around the state and nation are taking notice of the Yuma clinic’s success. They’ve been asked to make numerous presentations about the facility, and the clinic has also received several awards.
“We know it’s going to get better as it grows and as we perfect what we’re trying to do, but to walk downstairs and see folks sitting in the lobby waiting to see their doctor, waiting to see their psychiatrist, getting their medication on site, having all that stuff happen just on a regular basis has been really special,” Byrd said.
The North End Community Connections Integrated Clinic is located at 410 S. Maiden Lane, at the eastern entrance to the Adult Probation building. For more information, call 928-248-8282.