Our new patient services program, Care Coordination, is helmed by Tessa: It was put into place to help our patients who need resources beyond our sexual and reproductive health care.
Tessa’s role is to coordinate any social service needs and to take the load off the patient.
“They may be in crisis or going through trauma,” Tessa said. “It’s hard for people to navigate these services.”
Tessa traveled to nearly all the health centers and learned from staff that intimate partner violence (IPV) resources were an area of major need.
The vast majority of patients referred to Care Coordination are identified while screening for intimate partner violence and sexual/reproductive coercion. Patients are also identified regarding substance abuse, homelessness, mental health concerns, and after abortion care.
“Staff didn’t always know what to say when a patient was screened for intimate partner violence and said ‘yes,’” Tessa said. “Of course we’re hoping for a ‘no’ —because you don’t want anyone to be experiencing that.”
All medical assistants are trained to spot the signs of intimate partner violence, and training is provided to center managers as requested. Any health center staff can then refer to Care Coordination.
Tessa discussed the process of talking with a person who has been identified as experiencing intimate partner violence or sexual/reproductive coercion.
“It’s important to match the patient’s tone and to be aware of their body language,” she said. “They could have been harmed recently; it’s important to establish if they’re safe now. The trauma might have been years ago, but they might need these resources now. We also provide tips and scripts for staff on what to say.”
How often does she get a referral from a health center?
“This happens every day, more than once. All the time,” she said.
A patient is contacted by Care Coordination after their initial visit at the health center. The initial call serves as an informal needs assessment — including any necessary crisis intervention, education, and/or patient advocacy.
Due to the occasional lack of services within the patient’s region, or barriers (like transportation, lack of insurance, or monetary issues), the patient is provided with a number of other potential options. Follow up occurs several days later to ensure the patient was able to attain services.
Tessa formerly worked in rape crisis, and was an advocate on a hotline. She went with victims to the hospital, to court, and/or to file police reports.
Tessa explained what attracted her to this type of work.
“I’ve always found it easy to stand up for people who couldn’t stand up for themselves,” she said, “and trying to be that strength when they’re at the toughest point in their lives.”
Tessa can relate to many different issues she encounters with patients. Her mom was a single mom and her stepdad had substance abuse issues.
I always think to myself: “Be the person you needed when you were younger.”
Some of our patients have never had anyone to confide in.
“Sometimes a person will say, ‘I’ve never even had a friend who cared so much,’” she said. “I tell them that they’re the expert on their own life. I’m never going to tell anyone what to do; I’m going to support them. I try not to approach patients with an expectation of what they need. What we think they need may be very different than what they think they need.”
There are an incredible number of people who need resources, especially the homeless.
“We have so many people, and each county is very different. Homeless services are the most difficult to navigate. There are almost never shelter openings. And people need so much more than just housing — they may need mental health, substance abuse, or immigration help.
“There is a lot more funding for Intimate Partner Violence shelters than homeless shelters,” she said.
She recognizes that staff are affected by the trauma of our patients, due to their natural empathy.
“Some patients may not be ready for our help,” Tessa said. “And our providers can leave work that day feeling the weight of the trauma, and it’s something that needs to be processed. If you’re still thinking about it when you get home, then you probably need to talk about it. You might be thinking, ‘Did I say the right thing, is there anything else I could’ve done,’ etc. It’s important that people know: We’re here to offer you support — including our providers.”
Staff are also able to use Care Coordination: They can reach out to discuss difficult cases, and will be provided emotional support and linkage to any necessary services.
A Patient Navigator position was recently added to the Care Coordination team. In addition to working with patients, they screen organizations to ensure they can meet patient needs, and research and partner with other community organizations in order to be able to refer our patients to them.
Partnerships are currently being developed through: San Diego Youth Services – I CARE Program, working with youth who are at risk of/are currently being sex trafficked; the THRIVE Study, working with women who have been raped to provide care and research on the relationship between how sexual violence impacts HIV acquisition; and The Transgender Health and Wellness Center, which serves as a resource center for trans and gender non-conforming people in the Coachella Valley area and beyond.
“The community partnership piece is really important,” Tessa said. “It’s nice that we can work with other organizations that are separate but equal in removing barriers to patient care.”
Tessa said that not every patient is ready to discuss their situation or be open to resources. But: “Even if they’re not ready, you’re planting a seed,” she said.
What’s the best part of the job?
“The best part is the surprise that you can hear in patients’ voices when you follow up with them,” Tessa said. “You can change their life. And they don’t always know Planned Parenthood can do this for them.”
If you have questions or comments for the Care Coordination team, contact them at: [email protected].