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Axis advances health care

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Monday, March 21, 2011 6:23 PM
Durango Herald/SHAUN STANLEY
In an example of integrating behavioral health with physical health care, Axis Health System’s Mary Gilden, left, attends a well-baby appointment with mother Lisa Sontag. Gilden, an early-childhood specialist, checks out 4-month-old Angela Evans and 2-year-old Mark Evans at Pediatric Partners of the Southwest.
Courtesy photo
Axis Health System’s 11,500-square-foot center in Cortez, seen here in an artist’s conceptual drawing, will integrate all aspects of health care — preventive, primary and behavioral — in one place. It’s set to open in January 2012.

DURANGO — The mental-health services that Axis Health System provides in conjunction with primary-care providers in Southwest Colorado is only halfway to where chief executive officer Bern Heath wants to go.

But Axis should take a major step in reaching its destination when it opens an 11,500-square-foot center in Cortez in January 2012 that integrates all aspects of health care – preventive, primary and behavioral – in one place.

Axis, formerly called Southwest Colorado Mental Health Center, is a 50-year-old nonprofit, funded by federal and state grants and by some local governments. Its Three Springs location offers inpatient behavioral health and detox centers.

But Heath, the CEO since 2001, has a larger vision. Health care has been fragmented far too long, Heath said in an interview last week.

Preventive measures have been all but ignored until recently, while physical and mental ailments are treated separately as if they were unrelated, Heath said.

“In reality, more than 50 percent of people seen by primary-care doctors for a (physical) complaint have a mental-health issue, too,” Heath said. “Seventy percent of prescriptions for mental-health problems are written in primary-care settings.”

Health care is most effective when clinicians recognize an array of symptoms and treat all disorders, Heath said.

The Axis clinic to be built at 635 E. Empire St. in Cortez is planned to do just that, he said. Axis already collaborates with primary-care doctors. He cited:

The successful treatment of a 2-year-old girl who had her parents at wit’s end with temper tantrums that began with the birth of a brother.

A 51-year-old obese woman with high blood pressure, plantar fasciitis (heel pain) and depression who was put on a regimen, including diet and exercise, that improved her physical and mental health.

At the new Cortez center, new patients will be asked about – in addition to the complaint that brought them there – medications they are taking and if they smoke, drink, use recreational drugs or exercise. They’ll be asked about their work, stress in their life and eating habits, and they will be screened for anxiety or depression.

Even receptionists will be trained to notice telltale symptoms such as shaky gait, skin color, loud talk or illogical thinking. Receptionists won’t diagnose or say anything to the patient but will alert medical personnel to possible issues.

“We intend to support local primary-care practices,” Heath said. “We want to take another step in changing the model of health care to one that treats the whole person.”

The Axis model benefits everyone for several reasons, Heath said, citing:

The population of the region is increasing, which requires more primary-care resources.

There is a shortage of primary-care doctors.

The aging population is pushing more patients into Medicare, which is less than break-even financially for doctors.

The large number of adult Medicaid and uninsured and underinsured patients strains private primary-care practices.

Axis sees a solution in its application for federally qualified health center designation, Heath said. If it qualifies, the agency will receive $650,000 annually for at least two years — and in perpetuity if it meets its goals.

Designation as a federally qualified health center would reimburse Axis at a higher rate than private-practice doctors for treating Medicare, Medicaid, underinsured and uninsured patients.

As a result, private-practice physicians could refer low-remuneration cases to Axis or work for Axis part time at a higher rate of pay and without the burden of administrative expenses.

Some physicians could be interested in extending their career by working part time.

Axis was called Southwest Colorado Mental Health Center from April 1960 until September 2009, when the name was changed to reflect a new direction.

The new name connotes a pivot point — an axis — around which integrated health care rotates, Heath said.

Axis, which has offices in Bodo Park and the Crossroads center in the Three Springs area, currently integrates behavioral-health services with primary care at five locations – a private pediatric practice in Durango; school-based health clinics in Durango and Cortez; a rural health clinic in Cortez; and a federally qualified health center in Dove Creek.

Dr. Cecile Fraley at Pediatric Partners of the Southwest has integrated an early-childhood specialist from Axis into her office. The presence of Mary Gilden two days a week has been “hugely successful,” Fraley said.

“She sees scheduled and unscheduled kids,” Fraley said. “We keep her running with problems that range from toilet training to attention deficit hyperactivity disorder to teens adjusting to go off to college.”

The new Axis center will fold primary care and wellness education into its programs for substance abuse and a spectrum of mental-health issues such as anxiety, depression, bipolar disorder and schizophrenia.

If Axis becomes a federally qualified health center, it will begin integrating services in Durango at the Riverfront Building next to the Durango Public Library in December.

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