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Scenes from the October 2019 Gala

The 2019 Healthcare Heroes

There were eight winners in this third class, with two in the category of Lifetime Achievement, because two candidates were tied with the top score. The Heroes for 2019 are:

• Lifetime Achievement (tie): Katherine Wilson, president and CEO, Behavioral Health Network Inc.; and Frank Robinson, vice president, Public Health, Baystate Health;

• Health/Wellness Administrator/Administration: Emily Uguccioni, executive director, Linda Manor Assisted Living;

• Collaboration in Health/Wellness: Carol Constant, convener, Dementia Friendly Western Massachusetts; and director of Community Engagement, Loomis Communities;

• Community Health: Amy Walker, certified nurse midwife, Cooley Dickinson Health Care;

• Emerging Leader: Tara Ferrante, program director of the Holyoke Outpatient Clinic, ServiceNet;

• Innovation in Health/Wellness: Cristina Huebner Torres, vice president, Research & Population Health, Caring Health Center Inc.; and

• Patient/Resident/Client Care Provider: Shriners Hospitals for Children – Springfield.

Photography by Dani Fine Photography

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Cover Story Features Healthcare Heroes

Healthcare Heroes Class of 2019 to Be Honored on Oct. 17

When BusinessWest and Healthcare News launched Healthcare Heroes in 2017, there was no doubt this was a long-overdue award program in Western Mass. — in fact, we knew the challenge wouldn’t be finding quality nominations, but choosing just a handful to honor each year. Indeed, this year’s judges (see below) carefully studied about 100 different nominees in seven categories to choose the impressive group to be honored at this year’s gala in October.

Collectively, they are innovators and game changers in the region’s rich and vibrant healthcare community, and their stories — told on the following pages — reveal large quantities of energy, imagination, compassion, entrepreneurship, forward thinking, and dedication to the community.

There are eight winners in this third class, with two in the category of Lifetime Achievement, because two candidates were tied with the top score. The Heroes for 2019 are:

• Lifetime Achievement (tie): Katherine Wilson, president and CEO, Behavioral Health Network Inc.; and Frank Robinson, vice president, Public Health, Baystate Health;

• Health/Wellness Administrator/Administration: Emily Uguccioni, executive director, Linda Manor Assisted Living;

• Collaboration in Health/Wellness: Carol Constant, convener, Dementia Friendly Western Massachusetts; and director of Community Engagement, Loomis Communities;

• Community Health: Amy Walker, certified nurse midwife, Cooley Dickinson Health Care;

• Emerging Leader: Tara Ferrante, program director of the Holyoke Outpatient Clinic, ServiceNet;

• Innovation in Health/Wellness: Cristina Huebner Torres, vice president, Research & Population Health, Caring Health Center Inc.; and

• Patient/Resident/Client Care Provider: Shriners Hospitals for Children – Springfield.

3rd Annual Healthcare Heroes Gala
Thursday, October 17, 2019
5:30 p.m.-8:30 p.m.
Sheraton Springfield One Monarch Place Hotel
$90/person; $900/table of 10

PURCHASE TICKETS HERE

Submit nominations for 2020 consideration HERE

Deadline to submit nominations is July 10, 2020, 5 p.m. NO EXCEPTIONS.

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Meet the Judges

Bob Fazzi

Bob Fazzi has spent a lifetime making a difference in healthcare, most notably with Fazzi Associates, the company he started 40 years ago and incorporated in 1995. Its stated mission is to make a real difference in healthcare by strengthening the quality, value, and impact of home care, hospice, and community-based services. Fazzi Associates has been a leader and a pioneer in this sector, developing products and services — including the industry’s first home-health patient-satisfaction services — as well as research to make agencies stronger and better able to serve their patients. For this work, Fazzi was honored as a Healthcare Hero in 2018 in the category of Lifetime Achievement.

Mary Paquette

Mary Paquette, director of Health Services at American International College, is another 2018 Healthcare Hero, in the category of Patient/Resident/Client Care Provider. AIC is only the latest stop in a 35-year career that has seen her take on a variety of roles, from director of Nursing at Ludlow Hospital to per-diem hospitalist at in the GI Department of the Eastern Connecticut Health Network, to assistant director of Health Services at Western New England University — the job that became the springboard to her post at AIC. Since arriving at AIC 2012, she has turned a moribund health-services facility that few students knew about or ventured to into a thriving, innovative, important campus service.

Alan Popp

Alan Popp joined the Mason Wright Foundation as its Chief Executive Officer in 2008. His previous experience includes head of school and CEO at White Mountain School, a college preparatory school; and chief operating officer at Pine River Institute, a residential treatment center. He has also served as a consultant to more than 200 New England nonprofits, many of them providers of services to seniors. He serves on the boards of LeadingAge Massachusetts, Salvation Army Citadel Corps, and OnBoard Inc., and on the Leadership Council of the Alzheimer’s Assoc. of Massachusetts/New Hampshire. He is also a trustee of Antioch University New England and previously served on the campaign cabinet for the United Way of Pioneer Valley.

Healthcare Heroes

This Public Health Leader Is a Visionary and Innovator

Frank Robinson, Ph.D.

“Dr. Frank Robinson is a true visionary. He sees partnerships and systems that most other people don’t see. He doesn’t stop there … and he doesn’t allow other people’s short-sightedness or lack of imagination to get in his way. He persists because he loves to see other people, particularly young people, grow and thrive and achieve their dreams.”

Over the next few pages, you’ll read quite a bit of material that will help explain why Robinson, currently vice president of Public Health for Baystate Health, is one of two Healthcare Heroes in the Lifetime Achievement category for 2019. But none of the words to come can do that more effectively that those at the top.

They’re from the nomination form submitted by Jessica Collins, executive director of the Public Health Institute of Western Mass., a job Robinson once held himself, when the agency was known as Partners for a Healthier Community.

And Greater Springfield has, indeed, become a healthier community because of Robinson, who, over the past 35 years or so, has conceived or been closely involved with initiatives in realms ranging from children’s oral health to asthma; from food insecurity to sexual health; from health education to overall population health.

And who really knows if he would have been involved in any of that had it not been for … Hurricane Agnes.

The storm barreled into Elmira, N.Y. in late June, 1972, flooding the recently opened Elmira Psychiatric Center, where Robinson was working as a psychiatric social worker. That’s was, because the storm put him out of work.

He found new work essentially counseling youths displaced by the hurricane and relocated to nearby Elmira College.

“Dr. Frank Robinson is a true visionary. He sees partnerships and systems that most other people don’t see. He doesn’t stop there … and he doesn’t allow other people’s short-sightedness or lack of imagination to get in his way.”

“A call came out for help because these youngsters were running wild in the dorms unsupervised,” Robinson recalled, adding that he and a friend were dispatched to the scene because they were staff at a facility called the Elmira Neighborhood House — Robinson taught boxing there and knew most of the teens.

In some ways, Hurricane Agnes blew Robinson onto a different, more community-focused career path that, early on, featured extensive work with young people. And, by and large, he has stayed on that path.

Fast-forwarding through his résumé, he worked locally for the Mass. Department of Mental Health (at the same time as the other Lifetime Achievement hero for 2019, Katherine Wilson; see story on page 22); the W.W. Johnson Life Mental Health Center in Springfield; the Springfield Community Substance Abuse Partnership and Prevention Alliance, part of the Springfield Department of Health and Human Services; Partners for Community Health; and Baystate Health, first as director of Community Health Planning and now as vice president of Public Health.

At each stop, he has been a visionary and an innovator, leading initiatives ranging from the BEST Oral Health program to Baystate Academy Charter School to the Baystate Springfield Educational Partnership.

“Over the years, I have worked in positions that have advanced my specific interest in creating a healthier community and preventing health problems from occurring by giving people what they need,” he said while summing up his life’s work in a simple yet effective way, adding quickly that, while progress has been made, there is still a great deal of work to be done.

And he’s still doing it.

Indeed, Robinson, who turns 70 this month, acknowledged that he is working past what would be considered retirement age. He attributes this to both a passion for his work and the simple fact that he has some projects he’s still working on that he wants to see to conclusion.

These include something called 413 Cares, an online community-resource database that provides resource and referral information to residents as well as healthcare and social-service agencies across the region, and also works to make Baystate an “anchor network” within the region.

Explaining the latter, he said that, by adjusting and refocusing some of its spending — in such areas as goods and services, hiring, and real-estate facilities — an institution like Baystate can have an even more profound impact on the communities it serves.

“Simply by changing our business practices in terms of how we spend money — spending it deliberately, intentionally, to benefit communities where there’s been substantial disinvestment or there are substantial disparities — we can change those community conditions,” he noted. “That’s the healthcare anchor institution mission and vision.”

A lifelong desire to change community conditions for the better explains not only why Robinson is still working — and still innovating — but also why he’s a Healthcare Hero. Again.

Background — Check

Indeed, this will be Robinson’s second trip to the podium at the Healthcare Heroes gala.

He was one of a large contingent on hand to accept the award in 2017 in the category called Collaboration in Healthcare. The name on the envelope, if you will, was the Healthy Hill Initiative, or HHI, a broad effort to change the health landscape in the Old Hill neighborhood of Springfield.

Robinson, one of nearly a dozen players involved in the initiative who were gathered around a conference-room table at Way Finders to talk about it, described it as a program that existed at “the dynamic intersection of two social determinants of health — public safety and access to physical activity.”

And he should certainly know. In many respects, he has spent his whole career working to address the many social determinants of health, including poverty, food insecurity, inadequate housing, lack of transportation, domestic abuse, and the stress that results from all of the above.

Retracing his career steps, Robinson said there have been some pivots — such as the one forced by Hurricane Agnes — along the way, and also some pivotal moments.

One of the latter was the consent decrees that eventually closed Northampton State Hospital and Belchertown State School and the creation of community-based programs to serve the residents of those facilities.

Frank Robinson has been called a true visionary by those who have worked with him over the years, and a long list of accomplishments bears this out.

Robinson was involved in this work during his time with the Department of Mental Health, and he remembers it leaving him inspired in many ways.

“Both of those institutions were closed by forward-thinking insiders who worked with progressive outsiders, or advocates, and formed this sort of perfect union around change,” he told BusinessWest. “That was a pivotal event; I knew I could create large-scale community change if you got the formula right and if you got in front of problems, prevented problems, and worked to change the lives of individuals.”

And over the past 40 years or so, he has repeatedly demonstrated his ability to create community change by getting in front of problems and using teamwork to address them.

This has been the formula at each career stop, including a brief stint as deputy commissioner and superintendent of the Northeast Ohio Development Center in Cleveland in the early ’80s before returning to this area and working at the W.W. Johnson Life Mental Health Center, the community substance-abuse partnership, and especially at Partners for a Healthier Community, where Robinson spent nearly 20 years at the helm.

During his tenure there, his ability to convene, create partnerships, and stare down difficult problems resulted in several new initiatives to improve the overall health of the Greater Springfield community.

One such effort is the BEST Oral Health program, blueprinted to address the alarming problem that children with MassHealth had very limited access to oral-health preventive and comprehensive treatment services. Robinson secured state funding to launch a demonstration project in Springfield that became the BEST program; it created a local system of education, screening, and treatment for preschoolers to decrease oral-health disease.

Another example of coalition building during his tenure at PFC is the Pioneer Valley Asthma Coalition, which strives to improve asthma management and indoor air quality in Springfield and other area communities where substandard housing contributes to this ongoing health problem.

The Big Picture

Looking back over his career, Robinson said one of the goals — and one of the big challenges — has been to create change and generate solutions that would have an impact much longer than the typical three-year grant cycle.

“What you really need are initiatives with lasting impact where you can see change occur at a level where you improve the conditions of a whole population — where you can say, ‘we’ve changed community conditions,’” he explained.

With that thought in mind, he said there are two programs that “rise to the top,” as he put it, when he talks about career accomplishments.

One is the Baystate/Springfield Educational Partnership, an initiative that brings hundreds of students into the Baystate system to learn about careers in healthcare and places many of them in internships.

“Over the past 20 years, there have been substantial gains from our ability to work together across sectors and across organizations. And that’s new; there’s that essential element of trust across organizations that didn’t exist 15 years ago or 20 years ago, to be sure. And in spite of the competitive nature of social-service organizations in healthcare, there tends to be more agreement today that there is a public space where we can all come together and make a difference.”

These internships often lead to careers in healthcare, he went on, adding that, over the first 10 years of the program, there are many examples of this.

“Some of them are physicians, some of them are nurses — it’s across the whole spectrum,” he explained. “I know there are youngsters who are now physicians because of this program.”

The other program is the Baystate Academy Charter School, a 6-12 grade school based in Springfield and focused on healthcare careers.

The school graduated its first class of students, 45 of them, in June, said Robinson, adding that there was a 100% graduation rate and each graduating student was accepted at a two- or four-year college.

“The social determinant of health solution there is education,” Robinson explained. “The idea is that, if you graduate from Baystate Academy Charter School, you are college-ready.

“These two programs will be around long after I’m gone, producing change on a large scale and at a population level for our community,” he went on. “I’m very proud of both of them.”

Looking at the proverbial big picture from his unique vantage point, Robinson told BusinessWest there have been significant gains in many areas and many respects, especially when it comes to agencies and providers of healthcare working collaboratively, but significant challenges remain.

“Over the past 20 years, there have been substantial gains from our ability to work together across sectors and across organizations,” he explained. “And that’s new; there’s that essential element of trust across organizations that didn’t exist 15 years ago or 20 years ago, to be sure. And in spite of the competitive nature of social-service organizations in healthcare, there tends to be more agreement today that there is a public space where we can all come together and make a difference.

“This is especially true with matters of equity,” he went on. “We understand that there are significant challenges for large segments of our community, and the only way you’re to change those conditions is if people work together collaboratively and pool resources. There’s a clear recognition that this is the way to go.”

Elaborating, Robinson said there have always been coalitions, but today there is greater strength and “sophistication” to such partnerships, which has generated progress in a number of areas.

But when asked if Springfield is a much healthier community than it was 20 or 30 years ago, Robinson paused for several seconds and said ‘no.’

He based that answer on standard health measures and still-apparent gaps, or disparities, in overall care as viewed through what he called a “racial-equity lens.”

“If I compare poor people to the average, and black or brown people to the average, there are huge health-disparity gaps,” he noted. “The infant-mortality rate is still three times higher for black women than it is for white women; although the rate for black women has improved over time, the gap still exists.

“We find that same gap in issues such as low birth rate,” he went on. “These are measures not necessarily of the quality of healthcare, but measures of the conditions under which people live. Those gaps still exist, and so this city is still not healthy.

“We’re great as a community, and as a health system, when it comes to dealing with stuff that occurs inside the skin,” he continued, referring to the care provided at Baystate and other area facilities. “But if you think of health as things outside the skin that actually determine one’s health, we haven’t really improved there; poor people are sicker.”

These problems are not unique to Springfield, obviously, said Robinson, adding that most large urban centers continue to have these inequities in overall health based on income and opportunity. Progress has come, slowly, and the hope is that, by continuing to build coalitions and get in front of problems, more progress can be achieved.

This is what Robinson has spent a career doing, and he shows no signs of slowing down.

View to the Future

“Dr. Frank Robinson has worked tirelessly over the past 30 years to address public health and health inequities in our city and beyond. He is a recognized leader and a visionary in creating systems that make it easier for people to access needed healthcare services and creating systems in our neighborhoods that make it easier for people to make the healthier choice.”

There’s that word ‘visionary’ again. This time, it was put to use by Springfield Mayor Domenic Sarno, in that same nomination submission, as he went on about trying to put Robinson’s career, and his contributions, in perspective.

And visionary certainly fits. He’s been able to look at the community he serves, identify needs, and most importantly, create solutions for meeting those needs.

He’s spent a lifetime doing that, and that’s why he’s a Healthcare Hero.

George O’Brien can be reached at [email protected]

Healthcare Heroes

While She Manages People and Programs, Her Job Is About Changing Lives

Katherine Wilson

It’s probably fair to say that the discussions had at the dining room table when Katherine Wilson was in high school were not like those going on in most households in the mid’-60s.

Indeed, Wilson’s father was a physician, specializing in family medicine. Beyond the work at his practice, he was one of the pioneers of a sort when it came to the broad subject of healthcare management.

“From having a solo private practice, he got into the development of systems of delivery of healthcare,” she recalled. “He started an HMO, he was the first medical director of Community Health Center … my father was a big part of the systems that are now in place.

“We had discussions around the kitchen table about healthcare,” she went on. “His interest was in healthcare management, and he was progressive in his thinking at a time when they didn’t have community health centers and they didn’t have HMOs; he did a lot of work with the community physicians and community hospitals.”

One might say that Wilson, certainly inspired by not only those dinnertime talks, but later work at her father’s practice and in one of the first community health centers, has a made a career — a long and very successful career — of working innovatively and in partnership with others to find new and better ways to manage healthcare, and especially mental and behavioral healthcare, in this region and across the Commonwealth.

She’s done this in a variety of settings, most notably, for the past 30 years, as president and CEO of Behavioral Health Network Inc.

Created in 1992 through the merger of four entities — the Child Guidance Clinic of Springfield, Agawam Counseling Center, Community Care Mental Health Center, and the Hampden District Mental Health Clinic — BHN now serves more than 40,000 individuals annually in a service area that stretches across the four western counties.

There are 40 locations in all and more than 2,000 employees. Together, they provide and manage services that come in a variety of forms, from detox centers and ‘step-down’ facilities to a wide variety of counseling services for adults, youth, children, couples, and families; from a 24-hour crisis-intervention service to a host of developmental and intellectual disability services.

“In a society where, even today, stigma may still surround mental illness and those it affects, Kathy not only keenly understands, but goes to every length to help others understand as well. Kathy Wilson has changed innumerable lives for the better, and she’d be the first to say her work is far from finished.”

Wilson has spent the past three decades building and shaping BHN into a $115 million network that continues to expand and find new ways to provide care and a support network to those in need. In recent years, she has been at the forefront of efforts to better integrate general healthcare with behavioral healthcare, particularly in the Medicaid population, with the goal of driving down the ballooning cost of care nationally (more on that later).

And certainly this work to build and manage BHN goes a long way toward explaining why Wilson was chosen as a Healthcare Hero for 2019 in the Lifetime Achievement category. Actually, she is one of two who tied for the high score. The other winner is Frank Robinson, vice president of Public Health at Baystate Health (see story, page 19). Suffice it to say, these two won’t have to introduce themselves when they meet at the Healthcare Heroes gala on Oct. 17. They both worked for the Department of Mental Health in the late ’70s, and both worked to create community programs for residents of Northampton State Hospital and Belchertown State School after those institutions were ordered closed. And they’ve been working in concert on many initiatives ever since.

But there is more to this honor than the vast portfolio of programs and initiatives that is today’s BHN. Indeed, it’s also about a lifetime spent advocating for those with mental illness, substance-abuse issues, or developmental disabilities, anticipating and then meeting their needs, and then asking the difficult but necessary question, ‘what else can be done?’

It’s a philosophy, or mindset, perhaps best summed up with these words from her nomination form, submitted by her daughter, Amy Greeley, formerly a nurse manager at BHN:

“Kathy exemplifies a unique combination of innate compassion and fervent determination that’s led to the helm of a regionally renowned institution. It’s from a position from which she never stops working for greater, more advanced, and even more accessible services for all who need them.”

“In a society where, even today, stigma may still surround mental illness and those it affects, Kathy not only keenly understands, but goes to every length to help others understand as well. Kathy Wilson has changed innumerable lives for the better, and she’d be the first to say her work is far from finished.”

Care Package

It’s called the ‘Living Room.’

As that name suggests, this is a warm, home-like place where anyone age 18 or older can come to “regroup and get help,” said Wilson.

Elaborating, she said the facility, one of many that BHN has carved out of old, mostly unused or underutilized manufacturing buildings in the Liberty Street area, is one of the latest additions to the agency’s portfolio. It was designed for people in a developing crisis, a current crisis, or a post-crisis situation, and is a place where people “can find help from others who have had similar experiences and who can provide support, encouragement, and guidance,” according to a brochure on the facility.

The Living Room, as noted, is just one of dozens of facilities under the BHN umbrella, and its creation speaks to Wilson’s ongoing work — and mission — to continually find new and different ways to meet unmet needs and build support networks for those who desperately need them.

And, as mentioned, this has been her career’s work — going all the way back, in some ways, to those discussions at the dining-room table.

Retracing her route to the corner office at BHN, Wilson said that, after working at her father’s practice and other health settings while in high school and college, she eventually decided that psychology, not healthcare, would be her chosen field; she earned a bachelor’s degree in that field at Denison University and a master’s in clinical psychology at SUNY Plattsburgh.

After a very short stint as a psychotherapist, she applied for a job with the Department of Mental Health, and was hired as a planner during that critical time when Northampton State Hospital and Belchertown State School were ordered to close.

“It was my responsibility to identify individuals from both institutions, look at what their needs were, and see what we could create in the community,” she recalled, adding that she worked to develop some of the group homes that are in use today. “I also worked with agencies that began to adopt the agenda of creating community programs to support people, such as the Community Care Mental Health Center in Springfield, which created day programs so individuals could get some of their rehabilitation in a clinical setting.”

The consent decrees that shuttered the institutions in Northampton and Belchertown coincided with national initiatives imbedded within the Community Mental Health Act, established by President John F. Kennedy. It made federal funds available to create more community systems of care, said Wilson, adding that, locally, a consortium of agencies was created to administer this flow of federal money.

“We got together and said, ‘survival means you have to get bigger, you need to have a stronger base at the bottom to support what we do, and this will give us a platform for growth.”

Called the Springfield Community Mental Health Consortium, it administered a number of initiatives, including hospital supports, group-living environments, outpatient systems of care, emergency services, and more, said Wilson, who transitioned from working for the state to being employed with the consortium as a planner.

“It was my responsibility to help establish the Community Mental Health Center range of services,” she explained. “Now that we had more people in the community living with mental illness, we needed to create the system of healthcare support.”

When the Reagan administration closed the tap on federal money for these services, with funding to be secured through state-administered block grants instead, the agencies that were part of the consortium broke apart and continued to do their own work, said Wilson, who then went to work with Child Guidance Clinic of Springfield, first as Business and Finance director and then executive director of the Child Guidance Clinic of Springfield.

As funding for mental-health programs became more scarce, Wilson said, she and the directors of three other agencies — Agawam Counseling Center, Community Care Mental Health Center, and the Hampden District Mental Health Clinic — decided that the best strategy was to merge those entities into one corporation.

“We got together and said, ‘survival means you have to get bigger, you need to have a stronger base at the bottom to support what we do, and this will give us a platform for growth,’” she recalled, adding that this new entity would become BHN.

And over the years, it would continue to get bigger and widen that base of support, as those administrators knew it had to, through additional mergers and the addition of many new programs.

Room to Grow

As president and CEO of BHN, Wilson wears a number of hats and logs tens of thousands of miles each year traveling back and forth to Boston for meetings on a range of topics and with a host of groups and individuals.

As for those hats, Wilson said she is the face of BHN and, for many, a first point of contact. She also considers herself a problem solver and a “convener,” a strategist, a mentor for many, and even an interior designer.

“I’m often the one that picks the colors for the walls,” she said, referring to the seemingly constant work to open and renovate new facilities, not only at what has become a ‘BHN campus’ off Liberty Street in Springfield, but across the region, while also noting that much goes into to picking those colors.

All those skills have been put to use over the past 30 years, an intriguing time of growth and evolution for BHN as it responds to emerging needs within the community, said Wilson, who cited, as one example, profound expansion into addiction services.

“One of the areas we identified maybe 10 years ago is that we were seeing many more of the parents of the children we were seeing at the Child Guidance Clinic, and many more adults coming in to adult outpatient clinics having mental-health issues co-occurring with substance use,” she explained. “And we said, ‘we can’t just treat mental-health problems without acknowledging the fact that there is a substance-use disorder concurrently, and that we really need to think about building a system of care that serves that population.’”

As a result, BHN collaborated with Baystate Health, which had a community-based system of care that included a detox and some community group-living environments for post-detox care, said Wilson, adding that Baystate asked BHN to manage those facilities and eventually transfer them into its system of care.

“We inherited Baystate’s system of community services for those with addiction,” she said. “And once we did that, we got established with the Department of Public Health and its Bureau of Substance Abuse Services, and we became known as an agency that could handle co-occurring treatments as well as individuals whose primary diagnosis was addiction, and from there, they helped us grow a system of treatment for people with substance-abuse disorder, and that really took off because the state was making significant investments in that world.”

That system now includes two detox operations, two step-down facilities, and a number of beds in what are called ‘residential recovery,’ or group-living facilities, she told BusinessWest, adding that this is just one example of how BHN continues to grow and evolve.

And it’s also just one example of how Wilson has led efforts to improve access to a wide array of care at a time when more people need access. The creation of the Northern Hope Center and Recovery Services in Greenfield, blueprinted in response to needs created by the opioid crisis in Franklin County, is still another case in point.

And these initiatives provide ample evidence of the additional emphasis placed on integrated healthcare and behavioral healthcare with the twin goals of improving population health and bringing down the cost of care, said Wilson, adding that BHN has been at the forefront of these efforts.

“This is what the federal government wants its funding to support, particularly for the Medicaid population,” she explained. “This is the population whose behavioral health — addictions or mental health — really interfere with their managing health.

“You have this small group of people that is driving high costs to Medicaid and both commercial and private insurance,” she went on. “So the move these days is for physicians and healthcare systems to work with behavioral-health systems of care and provide wrap-around services for individuals to see if you can manage the behavioral health, because that will help bring the cost of healthcare down.”

BHN adopted this rather profound operational shift several years ago, said Wilson, adding that, overall, it is part of her job description to keep the agency on the cutting edge of trends and developments in healthcare, while also making sure it remains viable and able to function properly in the years to decades to come.

That means continuing to find more ways to grow the network (the ‘N’ in BHN), building upon its base of support, and developing new methods for providing all-important access to care.

When asked about her most significant accomplishment, she quickly changed the subject of that question to ‘we,’ meaning BHN, but in doing so still managed to sum up her career’s work.

“I think we’ve created excellent, value-based, top-of-the-line service delivery for people who need access, sometimes very quickly, to good treatment,” she noted. “I have excellent medical leadership on both the addiction and behavioral healthcare side, and we hire really good, skilled, competent people. So I think people who are not used to getting good access to care now get it.

“Also, we’ve hired so many people that we have helped come from an addiction to sobriety, reunification, and now they’re BHN employees,” she went on. “To me, that warms my heart to know that people have been able to turn their lives around with the help of BHN.”

Change Agent

Which brings us back to that passage from Wilson’s nomination form. There are a number of key phrases within it that explain why she will be at the podium on Oct. 17 to receive her Lifetime Achievement award.

There’s the part about battling the stigma attached to mental illness, something she’s been doing for more than four decades. There’s also that point about how she would be the first to acknowledge that her work isn’t finished — because it never is.

But perhaps the words to remember most are those concerning ‘changing thousands of lives for the better.’

Indeed, while Wilson manages people, programs, and facilities for BHN, changing lives is what she does for a living.

And that’s why she’s a Healthcare Hero.

George O’Brien can be reached at [email protected]

Healthcare Heroes

‘There’s a Magic Here,’ Built on Dedication, Innovation, and Culture

H. Lee Kirk Jr. was speaking at a public event recently, when a woman stood up to tell him about her 3-year-old grandson’s experience at Shriners Hospitals for Children – Springfield.

“She said, ‘when we take him to the doctor’s office or another healthcare provider, he cries going in, and he’s sprinting out the door to get back home. When he comes to Shriners, he’s sprinting on the way in and happy to be coming, and he’s kicking and screaming when he has to leave,’” he related. “There’s a magic here that’s really hard to get your arms around.”

But Kirk, administrator of the 94-year-old facility on Carew Street in Springfield, tried to explain it the best he could over the course of a conversation with BusinessWest after the hospital was chosen as a Healthcare Hero for 2019 in the Patient/Resident/Client Care Provider category.

“This is a special healthcare organization because of the mission,” he said. “The culture is unlike any other I’ve been involved in. We want to be the best at transforming the lives of kids. And we get the privilege of seeing that every day here.”

It’s a culture that employees find attractive, said George Gorton, the hospital’s director of Research, Planning, and Business Development, adding that consulting physicians from other hospitals say, after visiting, that it’s the happiest place they’ve ever worked.

“It’s a palpable difference,” he went on. “As employees, we love that caring, family feeling of being employed by an organization that aligns with our own personal mission. That’s just not seen anywhere else.”

Last year, the hospital produced some short videos with employees to celebrate the opening of its inpatient pediatric rehab unit. In one of them, a nurse hired specifically for that unit talked about how she’s wanted to be a nurse at Shriners since being treated there for a rheumatology issue when she was a child.

“She was in tears, expressing the joy and positivity she had, to be able to take that experience of receiving care and become the person who provides that care to other people,” Gorton said. “It was a really touching moment to hear her express that.”

Then there’s the boy Gorton — who’s been with Shriners for more than a quarter-century — examined decades ago in the motion-analysis center; he’s now a physician assistant at the hospital.

Gorton said it’s impossible to single out any individual person responsible for creating the generational success stories and culture that makes Shriners what it is. The judges for this year’s Healthcare Heroes program agreed, making a perhaps outside-the-box choice in a category that has previously honored individuals, not entire organizations.

Yet, the choice makes sense, said Jennifer Tross, who came on board two years ago as Marketing and Communications manager, because of that unique culture that draws people back to provide care decades after receiving it, and that has kids shedding tears when they have to leave, not when they show up.

“The day I arrived,” Tross said, “I went home and said, ‘I knew this place would change my life, and it has.’”

Countless families agree, which is why Shriners is deserving of the title Healthcare Hero.

Step by Step

When a boy named Bertram, from Augusta, Maine, made the trek with his family to Springfield in February 1925, he probably wasn’t thinking about making history. But he did just that, as the hospital’s very first patient. The Shriners organization opened its first hospitals primarily to take care of kids with polio, but Bertram had club feet — a condition that became one of the facility’s core services.

After the first Shriners Hospitals for Children site opened in 1922 in Shreveport, La., 10 other facilities followed in 1925 (there are now 22 facilities, all in the U.S. except for Mexico City and Montreal). Four of those hospitals, including one in Boston, focus on acute burn care, while the rest focus primarily on a mix of orthopedics and other types of pediatric care.

As an orthopedic specialty hospital, the Springfield facility has long focused on conditions ranging from scoliosis, cerebral palsy, and spina bifida to club foot, chest-wall deformities, cleft lip and palate, and a host of other conditions afflicting the limbs, joints, bones, and extremities — and much more.

While many of the hospitals overlap in services, each has tended to adapt to the needs of its own community. In Springfield’s case that includes pediatric specialties like rheumatology, urology, and fracture care, as well as a sports health and medicine program that includes three athletic trainers and a pediatric orthopedic surgeon with training in sports medicine.

H. Lee Kirk (left, with Jennifer Tross and George Gorton) says Shriners is a special healthcare organization because of its mission.

The latter, Kirk said, includes services to kids without medical problems, as the hospital works with schools, clubs, and leagues help provide more preventive and conditioning services and follow up when injuries occur.

Meanwhile, the BFit exercise program targets kids with neuromuscular problems who normally don’t participate in physical activity, sports, or even gym class. The program aims to improve the physical activity of this group, and does it by involving students from area colleges who are studying fields like physical and occupational therapy, exercise science, sports medicine, and kinesiology.

“They volunteer as personal coaches,” Gorton said. “The child learns to adapt their environment and become physically active, and those students learn what it’s like to care for children. Many have gone into pediatric healthcare to do that kind of training because of their experience here. They see it here, and it spreads like a good virus through the population.”

Then there was the 2013 community assessment determining that an inpatient pediatric rehabilitation clinic would fill a persistent need. That 20-bed clinic opened last year following a $1.25 million capital campaign that wound up raising slightly more — reflective of the community support the hospital has always received, allowing it to provide free care to families without the ability to pay (more on that later).

Still, more than 90% of the care provided in Springfield is outpatient — in fact, the facility saw 12,173 visits last year, a more than 40% expansion over the past several years.

The care itself, the clinical component, is only one of three prongs in the Shriners mission, Kirk said. The second part is education; over the past 30 years, thousands of physicians have undertaken residency education or postgraduate fellowships at the various children’s hospitals. In Springfield, residents in a variety of healthcare disciplines — from orthopedics to nursing, PT, and OT — have arrived for 10- to 12-week rotations.

The third component of the mission is research, specifically clinical research in terms of how to improve the processes of delivering care to children. That often takes the shape of new technology, from computerized 3D modeling for cleft-palate surgery to the hospital’s motion-analysis laboratory, where an array of infrared cameras examine how a child walks and converts that data to a 3D model that gives doctors all they need to know about a child’s progress.

More recently, a capital campaign raised just under $1 million to install the EOS Imaging System, Nobel Prize-winning X-ray technology that exists nowhere else in Western Mass. or the Hartford area, which enhances imaging while reducing the patient’s exposure to radiation. That’s important, Kirk said, particularly for children who have had scoliosis or other orthopedic conditions, and start having X-rays early on their lives and continue them throughout adolescence.

Averting Disaster

It’s an impressive array of services and technology, and collectively, it meets a clear need — and not just locally. While about 60% of patients hail from a 20-mile radius, the hospital sees young people from across New England, New York, more than 20 other states, and more than 20 countries as well.

Yet, only a decade ago, the hospital was in danger of closing. At the height of the Great Recession, the national Shriners organization announced it was considering shuttering six of its 22 children’s hospitals across the country — including the one on Carew Street.

In the end, after a deluge of very vocal outrage and support by families of patients and community leaders, the Shriners board decided against closing any of its specialty children’s hospitals, even though the organization had been struggling, during those tough economic times, to provide its traditionally free care given rising costs and a shrinking endowment.

To make it possible to keep the facilities open, in 2011, Shriners — for the first time in its nearly century-long history — started accepting third-party payments from private insurance and government payers such as Medicaid when possible, although free care is still provided to all patients without the means to pay, and the hospital continues to accommodate families who can’t afford the co-pays and deductibles that are now required by many insurance plans.

“It was a wise decision to accept insurance — but it was a controversial decision,” Kirk said. Yet, it makes sense, too. A very small percentage of patients in Massachusetts don’t have some kind of coverage, yet 63% of care at Shriners is paid for by donors — a disconnect explained by the fact that Medicaid doesn’t pay for care there, and gaps exist in other insurance as well.

So, if a family can’t pay, the hospital does not chase the money, relying on an assistance resource funded by Shriners and their families nationwide.

“Donor support allows us to provide free care,” Kirk said. “We don’t send families to collections and contribute to the number-one cause of personal bankruptcy in America, which is medical care. It’s a very unique model, and a unique healthcare-delivery system.”

And one that, as Kirk noted, treats a patient population that can be underserved otherwise. For instance, the cleft lip and palate program — a multi-disciplinary program integrated with providers from other hospitals in the region and serving about 30 partients at any given time — begins assessing some patients prenatally, and most need care throughout adolescence and even into young adulthood.

Those consulting relationships are critical to the success of Shriners, which doesn’t seek to compete with other providers in the region, but supplement them while striving to be, in many cases, the best place for young people to receive specialized treatment, whether for orthopedic conditions or a host of other issues.

When Kirk arrived in 2015, the hospital underwent a comprehensive self-assessment process that made two things clear, he said: that there’s a real need for what it does, and that it needs to reinvest in its core.

“And that’s what we did. And that’s about people, not bricks and mortar,” he went on, noting that the facility has added about 70 positions since that time.

“We’re a completely different place today than we were in 2009,” Gorton added, noting that the hospital is stronger in leadership, internal communication, and external connections. Among the 22 Shriners specialty hospitals, Springfield ranks second in the proportion of the budget offset by donations. “Why? Because we have a great relationship with the community. We’ve become more outward-facing, and we’re integrated everywhere in the community.”

The Next Century

Getting back to that 3-year-old who doesn’t want to leave when he visits Shriners, surely the hospital’s child-friendly playscapes and colorful, kid-oriented sculptures and artwork help create a welcoming environment, but those wouldn’t make much difference if the people providing care didn’t put him at ease.

That environment begins with employees who love what they do, Kirk said, and this Healthcare Hero award in the Provider category is definitely shared by all of them. Other families feel the same way, as the facility regularly ranks in the 99th percentile on surveys that gauge the patient and family experience.

“We have happy employees who love being here, who love working with kids, who love delivering the mission — and the patients and families sense that and respond to that,” Gorton said.

That’s why the hospital’s leaders continue to examine the evolving needs of the pediatric community and how they can continue to deepen its clinical relationships and expanding services most in demand — always with the philosophy of “mission over model,” Kirk said.

“We are always thinking about the future,” he added, “so we can sustain this healthcare system for the next 100 years.”

Joseph Bednar can be reached at [email protected]

Healthcare Heroes

This Leader Is Focused on Dismantling the Barriers That Limit One’s Ability to Thrive

Cristina Huebner Torres, Ph.D.

Dr. Cristina Huebner Torres was moving into a new home a little while back, and during the unpacking process happened to come across the essay she wrote while applying for entry to New York University for her master’s degree.

Re-reading it gave her the feeling that, career-wise, she really was doing exactly what she knew she always wanted to do. Well, sort of.

“I have always had a goal of creating a multi-cultural wellness center where people explore their health, bodies, creativity, minds and their holistic self through integrating movement, art, nutrition and other forms of … biomedical and traditional medicine,” she said, quoting from the essay, adding that at the time her work was largely focused on women and women’s reproductive health.

As things worked out, as vice president of Research & Population Health for the Caring Health Center (CHC) in Springfield, she’s working with a much larger constituency — and a much broader range of health matters. And rather than just ‘having a career’ at this facility, she has assumed a pivotal leadership role in efforts to not only study the many and persistent social determinants of health — such things as poverty, food insecurity, inadequate housing, crime, lack of transportation, and more — but doing something about them.

Her ongoing work has earned her the 2019 Healthcare Heroes award in the highly competitive category called ‘Innovation in Healthcare and Wellness.’

Huebner Torres has helped develop and administer a number of initiatives designed to improve the overall health and well-being of the generally underserved population that comes to the Caring Health Center, including creation of its Wellness Center.

Opened a decade ago — a significant milestone, to be sure — this facility lives up to its name and is a unique, innovative addition to a federally qualified community health center. It includes both a fitness center and a full kitchen, where individuals (generally referred to as patients, but also clients) can learn about general nutrition and how to prepare healthy meals for their families.

“After conducting a year and half of focus groups with community and patients, we found that the community was asking for a place where they could engage in group-based exercise, that was cost-free, culturally tailored, taught by someone who was licensed or trained in the area, and located within primary care,” she said, adding that the Wellness Center was developed to meet these community-identified needs.

“She is steadfast in her belief that services that are respectful of gender and sexual identity, widely accessible, culturally tailored, and based on the individual strengths and interests of the patient stand the best chance of bringing about long-lasting health.”

Huebner Torres said there are many ways to qualify and quantify the impact of the many facets of her work, and especially the wellness center, on the overall health and well-being of those served by the CHC. And she’s currently working to attain grants to help with this measuring process. But she believes there is already ample evidence that the center and other initiatives are helping to support patients actively engaged in their wellness.

And all of this is embodied — figuratively, but also quite literally — in an individual who asked to be identified only as ‘Lamont.’

He started coming to the wellness center the first day it opened, not long after his cancer surgery and when Huebner Torres was leading the fitness classes. Today, he leads several classes himself, helping a wide range of individuals with stretching, cardio exercises, and more.

He said these classes are doing what they did for him back when he first started.

“I had lost quite a bit of weight and wasn’t in very good shape,” he said, referring to the impact of the cancer medication. “I told my doctor, ‘I don’t want to stay home, I don’t want to deteriorate, I want to do everything possible that I can to get healthy.”

Many of those he’s now instructing arrive with a similar attitude, and this is exactly what Huebner Torres had in mind when she conceptualized the facility.

Her work, and her approach to it, is best summed up in this summation in the nomination submitted by CHC’s president and CEO, Tania Barber:

“Cristina’s core values and goals are informed by her belief that people are healthier when they feel safe and respected, eat nutritious foods, have opportunities for regular exercise, are knowledgeable about health and well-being, openly celebrate their cultural traditions, and receive services in their own language,” she wrote. “Her work is focused on dismantling the barriers that limit each person’s ability to thrive, both in the community at large as well as the healthcare setting, increasing access to community and social support, addressing structural bias, and promoting peer-led models are important aspects of her approach. She is steadfast in her belief that services that are respectful of gender and sexual identity, widely accessible, culturally tailored, and based on the individual strengths and interests of the patient stand the best chance of bringing about long-lasting health.”

Stress Test

As she talked about her work at the Caring Health Center, especially in the broad realm of the social determinants of health, Huebner Torres honed in on the subject of stress.

More specifically, she talked about how those who come to the CHC combat what would have to be considered a different, more virulent strain of stress.

“We’re not talking about a morning being stressful because you had some extra traffic on your daily commute,” she explained. “We’re talking about not having sufficient food every day for you and your family, and not having sufficient housing for you and your family, or many of those things co-occurring, and the effects of that over time.”

One might say researching this higher level of stress — resulting from those aforementioned social determinants of health — and doing something about it have become Huebner Torres’s life’s work.

As she noted, it was essentially her life’s ambition and she went on to earn a bachelor’s degree in Medical Anthropology from Mount Holyoke College, while also focusing on modern dance. She earned a master’s degree in somatic studies from New York University, and her doctorate in Epidemiology at the UMass School of Public Health and Health Sciences.

Cristina Huebner Torres stands in the kitchen in the Wellness Center at the CHC, which hosts many popular classes in cooking and nutrition.

Building on her undergraduate and master’s studies, she focused her doctorate in social epidemiology on the social determinants of chronic disease management. Her work considers the role of food insecurity and social stressors on the ability to prevent or manage diseases like diabetes and hypertension within community health center settings. She started her career at the Hispanic Health Council in Hartford, where she also interned while in college.

“This was an applied-research environment in a community-based setting, and it really set the stage for my career,” she told BusinessWest, “because I’ve been a community-based investigator, meaning that I find ways to create and partner in opportunities for conducting research within a public health practice and applied framework.

“It’s research driven by emerging trends within the community,” she went on, “and we use that research to inform opportunities for intervention that are culturally and community informed and making sure those interventions are actionable and integrated and sustainable.”

This explanation sums up her job description at the CHC, which she came to in 2007 as director of Research and Wellness. Since opening in 1995, the CHC has become the preferred health provider in Springfield serving a population that is diverse and challenged in many ways. Indeed, 70% of the more than 21,000 are Medicaid beneficiaries and the majority have one or more chronic illnesses. Nearly half of the patients speak languages other than English, and most live with medically complex conditions, often comprised of two or more chronic diseases, such as diabetes, hypertension, emphysema, heart disease, viral hepatitis, and chronic pain. And many patients also navigate behavioral-health conditions such as bipolar disorder, schizophrenia, depression, anxiety, post-traumatic stress disorder, or engage in opioid, alcohol, or other substance abuse.

The culturally diverse population served by CHC has many strengths as well as complex needs, and in her time at the CHC, Huebner Torres has collaboratively led the development of a number of services and programs to address them. These include an award-winning community health worker program that addresses the social determinants of health, as well as writing the grant to integrate the behavioral-health department with staffing and innovative programming to meet the culturally and linguistically diverse needs of refugee and immigrant individuals and families, and to support patients navigating multiple chronic co-morbidities.

Each of these innovations has been supported by leadership at CHC, she went on, and are sustained by a “tremendous collaborative team of dedicated and talented staff at CHC.”

The Shape of Things to Come

As she led BusinessWest on a tour of the Wellness Center, Huebner Torres started in the Wellness Center teaching kitchen.

There, she said, the center provides both nutrition education and cooking demonstrations, such as the very popular “Ask and Cook with the Dietitian!” sessions staged every Thursday by CHC’s registered dietician Vela Nicasio.

The kitchen-focused programs are designed to support patients as they look to follow primary-care treatment plans and recommendations for dietary improvements. The same is true of the workout facilities, which feature a number of cardio machines, weights, and large spaces for group classes in ‘stretching and restoring,’ cardio fitness, and open wellness (including one for women only).

‘Lamont,’ who first came to the Wellness Center the day it opened as a participant recovering from cancer surgery, is now an instructor.

The foundation of all that takes place in the center is the acronym CLAS, which stands for culturally and linguistically appropriate services, said Huebner Torres.

“It’s in the mission of what we do; it’s the heart of what the Caring Health Center does,” she explained, adding that the underlying goal behind creation of the center was to create a place where everyone could exercise and feel comfortable, including populations that just didn’t have such a space.

As an example, Huebner Torres listed Muslim women.

“They didn’t have a place to go because that place couldn’t include men, and it needed to not include music,” she explained. “And if you walk into any gym environment, there’s men and music. So early on, we created a Muslim-women-only exercise class, and it’s the first and only one in this area that we’re aware of.”

That class eventually became simply a women-only class because the Muslim women decided to open it to all women, she went on, adding that, overall, these classes and other programs are designed to help patients deal with health issues, but also the enormous amounts of stress they face in their lives — and do so in a group setting where they can interface with others facing similar challenges.

“A huge part of what people said they wanted in a center like this was for it to be group-based, and I think the concept of social support and social engagement, for many patients, becomes the number-one driving factor in why to attend,” she explained. “It’s not about ‘did I lose a pound or 10 pounds in so much time’; instead, it’s about ‘I was able to join in with other people like me and with some leadership that cares. And it was fun, I learned something, and I was engaging with people.’”

In short, the center and its programs are designed to educate and inspire commitment to getting healthy and staying healthy.

Which brings us back to Lamont.

“I started going to the wellness center once or twice a week, and I could really see myself making changes in my health,” he recalled, returning to the days and weeks after his cancer surgery. “I started to regain some strength and stamina, and from there I took it to another level; I started getting out to the park and running three or four miles a day, every other day. And I started working out at the wellness center four times a week.”

As he continued to grow stronger health-wise and become a role model, Lamont was advised by his doctor to become involved with a movement known as MOCHA — Men of Color Health Awareness, a name that goes a long way toward explaining what it is and does.

“Men of color have issues with going to the doctor and talking to the doctor, and that’s why a lot of us are dying today,” he said, adding that, as part of his participation in MOCHA, he gave a speech on this subject on the steps of Springfield City Hall.

He credits the Caring Health Center with saving his life when he had cancer, and now he gives back to the center through his role as a certified group exercise instructor and overall work to help others become actively engaged in their health and wellness.

“When it comes to stress, nutrition, getting off the couch and working out two or three times a week … all these things I learned from here,” he said, referring to the CHC and its wellness center. “I learned how to be proactive in talking to my doctor when things are going on and having a conversation.”

From a big-picture, community-health perspective, this is exactly what Huebner Torres had in mind when she blueprinted the Wellness Center a decade ago based on community and patient input.

Practicing Patience

In nominating Huebner Torres as a Healthcare Hero for innovation, Barber listed a number of attributes, all quite necessary for this kind of work.

For example, “Cristina demonstrates respect, consistency, and graciousness toward everyone she encounters. She listens well, speaks directly and honestly, and displays a quiet, well-timed sense of humor … she is intelligent, patient, and calm under pressure, and widely admired by those around her.”

When asked which of these is perhaps her strongest trait, Huebner Torres didn’t hesitate in saying ‘patience,’ adding that it’s more than a virtue when dealing with the complex issues she addresses every day — it’s a necessity.

“The other key factor — and perhaps most important of all — is partnership,” she said. “All of these initiatives are innovative and successful because of the team at CHC, the community, the patients, partner organizations and investigators, and the funders who have supported our efforts.”

“Nothing happens overnight — you have to be able to stick with it over time,” she went on.

Throughout her career, she has shown an ability to do just that, and the nutrition classes and group workout sessions at the Wellness Center are evidence that, when you do stick with it, you can bring about positive change in the lives of individuals — and in a community.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Nurse Midwife Gave Birth to an Intriguing Concept in Care

Amy Walker

‘Accountability.’

After pausing to give the matter some thought, this was the word a woman who chose to be identified only by her initials — S.M. — summoned when asked about what the New Beginnings program at Cooley Dickinson Health Care has given her.

There were other things on that list, to be sure, she said, listing camaraderie, friends, ongoing education, and even role models of a sort. But accountability, on many levels, was what was missing most from her life, and New Beginnings, which supports pregnant women with an opioid-use disorder with education, skills development, peer support, and goal setting, helped her develop some at a time when she needed it most.

“I wanted to come even though I was struggling to stay sober,” she said, referring to the regular group meetings attended by mothers facing similar challenges. “I didn’t have to come, but I wanted to; it’s hard to explain, but it was the beginning of me being responsible and accepting the fact that I was pregnant and here with the other women in the same situation.”

These sentiments speak volumes about why Amy Walker, a certified nurse midwife at Cooley Dickinson Hospital (CDH), created the program in 2018, and also about its overall mission.

“We want to empower women to be successful mothers,” said Walker, whose efforts to create New Beginnings have not only filled a critical need within CDH’s broad service area but earned her the Healthcare Heroes award in the ultra-competitive Community Health category.

She said the foundation of the program is a group approach, which is nothing new when it comes to expectant mothers, but it is new when it comes to this specific at-risk population, which makes New Beginnings somewhat unique and innovative.

“I wanted to come even though I was struggling to stay sober. I didn’t have to come, but I wanted to; it’s hard to explain, but it was the beginning of me being responsible and accepting the fact that I was pregnant and here with the other women in the same situation.”

“There are a couple of other places in the country that are doing this,” she explained. “There’s not a lot of studies on this yet, but it made sense, because it works so well in general and has these added benefits of providing community and more education, that it seemed like the way to go.”

While the program is still in its relative infancy (pun intended), it is already providing some rather dramatic, and measurable, results. Indeed, since the initiative was launched, 10 women with substance-abuse disorders who have participated in the program have delivered at the Childbirth Center at CDH, and nine of the 10 babies went home with their mothers. Walker believes that number would have been much lower had it not been for New Beginnings.

To send more mothers suffering from opioid-abuse disorder home with their babies, New Beginnings provides the many things these women need at this critical, and vulnerable, time in their lives. That list includes what amounts to a support network at a time when family and friends may be unable or unwilling to fill that role.

Indeed, S.M. told BusinessWest that, while her mother was quite supportive during her pregnancy and the period to follow, her friends were still using drugs, and thus, she didn’t want to be around them.

Support is provided in the months and weeks prior to delivery, during delivery, and then during the post-partum period, said Walker, adding that, while post-delivery is a challenging time for most all mothers, it is especially so for those suffering from opioid-abuse disorder.

“The riskiest time for relapse is in the post-partum period,” she explained. “We find that many women are able to maintain sobriety during pregnancy, but of course, the stresses of parenting, and sometimes parenting with limited resources, can be a triggering factor when it comes to relapse.”

The program also provides education and help to mothers with babies diagnosed with neonatal abstinence syndrome (NAS), the incidence of which is growing as the opioid crisis continues, said Walker.

Such babies are fussy, cry a lot, and are hard to soothe, she went on, adding that many remain in the hospital for several weeks. New Beginnings addresses these needs through something called the ‘eat/sleep/console’ method of evaluating and treating newborns with NAS, an initiative that results in shorter hospital stays and less opioid use for the newborn.

Above all else, New Beginnings provides a judgment-free zone that offers both compassion and quality care, said Walker, adding that all three ingredients are needed to properly provide for both mother and baby.

Pregnant Pause

Flashing back to her first New Beginnings group session roughly 16 months ago, S.M. remembers feeling relatively calm, but also a little uneasy about what she was getting herself into.

“I think was kind of numb and a little nervous,” she recalled, adding that she was struggling with sobriety at that time, when she was on methadone. “But at the same time, it felt comforting knowing what it was for; it was for women with addiction problems who were having babies. It was exactly what I needed at that time.”

S.M. said she was referred to New Beginnings several weeks earlier, about three months into her pregnancy and while she was still using heroin, which she described as her “drug of choice.” She said she was experiencing a number of emotions, but mostly anger — directed at herself.

“I was going through a really tough time accepting that I was pregnant,” she told BusinessWest while sitting in the same small room where the group sessions are held. “I couldn’t face the fact that I was using while I was pregnant, because I was really mad at myself. I came here because I wanted to do everything I could to try to do my best and get my life in order.”

Amy Walker says the New Beginnings program provides a critical judgment-free zone for pregnant women and new mothers battling opioid addiction.

In most every case, these emotions, these sentiments, and this particular drug of choice make S.M. typical of a growing number of women who are going through pregnancy while still using opioids or struggling with sobriety, usually through medication-assisted treatment such as methadone or Subutex, said Walker. She added that this growing demographic is an intriguing and sometimes overlooked aspect of the opioid epidemic — one that has now become a focal point of her work as a certified midwife.

And in many ways, this work reflects the values and passions (that’s a word you’ll read often) that brought her to the rewarding profession of midwifery — and will her bring to the podium at the Healthcare Heroes gala on Oct. 17 to accept the award in Community Health.

Our story begins during her undergraduate work when Walker took a job with Planned Parenthood in Gainesville, Fla. She worked at the front desk, selling birth-control pills and checking people in for their appointments.

“I was really inspired to grow in women’s health,” she explained. “I met nurse midwives and nurse practitioners who worked there, and started working in the Health Education department there, doing sex education, HIV-prevention outreach, and more, and from there I decided I wanted to go to midwifery school.”

She would earn her degree at Columbia University and, while doing so, see her career ambitions crystalize.

“My roots were really in gynecological care, but then I developed a love for caring for women and families during pregnancy and birth,” she explained. “I found that I love that intimate connection that you make with families.

“Meanwhile, one of my biggest passions was caring for underserved populations — people who maybe didn’t have access to all the care options,” she went on. “I wanted to provide them with the same type of care as someone who was more able to select what kind of care they wanted; that was really important to me.”

These twin passions have come together in a powerful way with New Beginnings, which Walker conceptualized several years after coming to CDH in 2014 after stints at Leominster Hospital and in St. Croix.

Tracing the origins of the program, she said it was one of many strategic initiatives that sprang from the work of an opioid task force created by CDH in 2016. That group’s work revealed that there were many unmet needs and, overall, that services needed to be better-organized and better-focused.

“I really wanted to be involved with that task force because I felt that the care we were giving to patients with substance-abuse disorders wasn’t really poor care, but it was all over the map,” she told BusinessWest. “There was no consistency in the messages that patients were getting and the education they were getting, and I knew that we could do better.”

One of those many efforts to do better is New Beginnings.

Delivering Results

At the heart of the program and its group sessions is the belief that women going through pregnancy while using opioids or trying to stay sober can benefit from being in the same room together, talking about their experiences, their emotions, their fears, and their hopes for the future.

And S.M.’s story, and her recollections of her year in the program, provide ample evidence that these beliefs are well-founded.

“It was really helpful coming here and knowing that there were other pregnant women who were either going through the same thing or had been there,” she said. “There were other women I’d met through New Beginnings who had kids and had them taken away. That made me feel … I don’t want to say better. It made me feel … well, not as mad at myself, knowing that someone else had been through this and had struggled with being able to have their kids in their life because of their addiction.

“I also came to know the risks of actually having her taken away,” she went on, referring to her daughter, who was playing with other children in the middle of the room as S.M. talked. “And knowing how mad I was just for using, that made me want to just do everything I could.”

These sentiments speak to that goal of empowering women to become successful mothers, said Walker, adding that empowerment comes through accountability and being responsible, but also through education.

And from the start, education has been one of the main focal points for New Beginnings, said Walker, who cited neonatal abstinence syndrome as an example.

“We expect it, and it’s treatable, but it can be challenging, because that baby may need a lot of soothing care, and sometimes needs to be held or soothed or rocked 100% of the time,” she explained. “All this could be challenging for anyone, but if you are someone with your own chronic illness who may not have a lot of support … all those things add up to make it really challenging.

“So if someone was coming into that without having any knowledge of how to care for their baby or what to expect from their hospital stay, that can be really shocking,” she went on. “I felt that we could do a better job of providing that educational prenatally, and there needed to be an avenue for that.”

Elaborating, she said that, typically, most pre-natal visits (for all women) run only about 15 minutes or so. This isn’t much time for women to learn or be supported. In response to this, she created two-hour group prenatal sessions for those involved with New Beginnings. The first hour would be the physical exam, she noted, while the other 90 minutes would be spent providing education and support in a group setting.

“We can cover so many more topics in that amount of time, as opposed to the 15-minute sessions, and you’re also speaking to many patients at a time,” Walker said. “And one of the great things about group prenatal care is that patients are able to hear from other patients and get their perspective.”

As noted earlier, the group sessions can extend to the post-partum period, which, as Walker said, is an extremely vulnerable time for those trying to stay sober.

“What we’re finding statistically is that the biggest risk for relapse is in the six- to 12-months post-partum time,” she noted. “Initially, in the first six months, there’s still a lot of that new-baby glow — even though it’s a hard time, there can still be sweetness. As they get older, it can get more draining; as one patient, who framed it in a good way, told me, ‘the newness wears off.’”

Only a year or so since working with its first participants, New Beginnings is generating measurable results.

Changing Room

S.M. told BusinessWest that the post-partum period was, indeed, a difficult time for her as she worked to keep sober amid the many changes and challenges that came into her life with motherhood.

She said she kept coming to group sessions staged by New Beginnings not because she had to, but because she wanted to — and needed to.

“I was having a hard time, but I just kept holding myself accountable,” she said. “There were days when I wanted to stay home and watch TV, but I made myself come to those meetings.”

She still struggles with being a mother — and with staying sober — but she knows she doesn’t have to face these challenges alone.

And that’s what New Beginnings is all about.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Assisted-living Facility Manager Leads by Example

Emily Uguccioni

It’s safe to say that, at the age of 13, most people don’t know what they want to be when they grow up.

But Emily Uguccioni thought she had it all figured out; she wanted to be an attorney or judge — a figure in the courtroom. At the very least, she knew what she did not want to do — work with the elderly.

But a volunteer position at the Alzheimer’s Resource Center in Connecticut changed her perspective. The facility, right across the street from her middle school, became the foundation for what would become a career she completely fell in love with.

“I wanted an assignment anywhere not near an old person,” noted Uguccioni when explaining her decision to volunteer at a nursing home, but not work with or near those living there.

All her friends read to residents or took them to activities, but she wanted no part of that; instead she got a job in the library organizing all the books. One day, she was instructed to bring a paper to a nurse on one of the units, and upon her arrival, she ran into an old woman.

“This lady said, ‘I’ve been here for four days, and no one has come to pick me up,’” Uguccioni recalled, adding that she did not realize at the time that people with dementia have a disassociation from time. This women had actually been living at the facility for several years.

Feeling bad for the confused woman, Uguccioni said she would try to resolve her issue and offered to get her a drink from the juice cart. Together, they sat and talked for a while until a nurse came by.

“I pride myself in knowing all the residents and all the family members here by name. I pride myself in knowing all the staff by name. I think I know a lot about the residents themselves in terms of what they like, what they dislike, and what might be a concern for them or their family, which is sometimes very different things.”

“She said, ‘you’re the only person in a week that has been able to get her away from that door,’” Uguccioni recalled, adding that, when word got back to the activities director that she was able to do that, she was promptly transferred from her library job and to a position as a resident volunteer.

Fast-forward to today, as Uguccioni sits as executive director at Linda Manor Assisted Living in Northampton, a facility she has put on the fast track when it comes to growth, vibrancy, and recognition.

Indeed, since arriving in 2015, she has doubled occupancy from 40 to more than 80, and there is now a waiting list.

Meanwhile, Linda Manor has been named the best assisted-living facility in Northampton by both the Daily Hampshire Gazette and SeniorAdvisor.com. Under Uguccioni’s direction, the facility has twice won the Silver Honor Affiliate Excellence Award through Berkshire Healthcare Services.

But it’s not so much what she’s accomplished as how that has earned her the Healthcare Heroes award in the category called Health/Wellness Administrator/Administration.

The ‘how’ boils down to a lead-by-example style and an ability to make each and every team member feel not only valued but a key contributor to the health and well-being of all the residents at Linda Manor.

Nicole Kapise-Perkins, Human Resources manager at Linda Manor, summed this up effectively and poignantly in nominating Uguccioni for the award.

“Emily’s fairness and open, engaging manner has had a huge impact on employee morale, and as a result, the services we provide to our residents and families is rated the best in the Northampton area,” Kapise-Perkins wrote. “She lets her staff members know they are appreciated, and they give 110% on the job.”

Manor of Speaking

One of the first things Uguccioni did when she came to Linda Manor was relocate her office.

She moved it out of the administration “suite,” as she called it, and into an office that any person can see the moment they walk into the lobby. This seemingly innocuous change is an effective representation of one of Uguccioni’s biggest personal goals as both a manager and a leader: visibility.

On any given day at Linda Manor, one could find her chatting with residents at breakfast, meeting with staff members to get updates about how they are doing, or attending a check-in meeting with residents and their families, an important time for both constituencies.

“I pride myself in knowing all the residents and all the family members here by name. I pride myself in knowing all the staff by name,” said Uguccioni, noting that there are more than 80 people working with her (not for her). “I think I know a lot about the residents themselves in terms of what they like, what they dislike, and what might be a concern for them or their family, which is sometimes very different things.”

This doesn’t sound like the 13-year-old who took a job in the library because she didn’t want to work around old people.

And it’s not.

As noted earlier, that chance encounter with the woman looking for someone to pick her up changed the course of Uguccioni’s career — and her life.

Emily Uguccioni’s goal is to make every team member know they are valued and a key contributor to Linda Manor’s success.

The volunteer experience she embarked upon after transferring out of library lasted three years until she was hired to be an activities assistant, where she worked at night and on weekends.

“When I was there, I got to see the operations of a nursing home, and I got to see what nurses do and how you interact with the residents and how important a long-term care facility is,” said Uguccioni, adding that this prompted her to explore options in healthcare degrees for her college education.

She graduated from Springfield College in 2006 with a degree in health services administration, knowing she wanted to end up at a higher-level administration or perhaps an executive-director position.

After graduation, she served as a therapeutic recreation director and managed the activities department in various assisted-living homes in Connecticut. Most recently, she worked as director of Operations and Services at Seabury Active Life Community in Bloomfield, Conn., a position she was offered when her previous boss left.

She came to Linda Manor just a year after it opened in 2014, and immediately commenced changing its fortunes.

The facility sits next to Linda Manor Extended Care Facility, also affiliated with Berkshire Healthcare Services, which opened in 1989, and Uguccioni immediately recognized opportunities to create synergies and potential growth for both facilities.

“My vision was to create community and to build a campus concept with the extended-care facility so that the community as a whole saw this campus as a place where housing meets healthcare, a unique concept without a buy-in fee that many of the competitors have,” she said. “Because we are not a ‘life-care community,’ the referral flow and process were not already built into the campus of care with a blink of an eye.”

Elaborating, she said that, while a strong, mutually beneficial relationship between the two facilities seemed like a natural outcome, it took time, patience, and diligence to make it work.

This meant months of working with Mark Ailinger, administrator at the extended-care facility, and his team to build a solid relationship.

“That [relationship] was missing, and I could see that right when I got here,” said Uguccioni, adding that was a problem that could have affected several facets of both facilities had it continued. In order for facilities like Linda Manor to be financially stable, Uguccioni told BusinessWest, maintaining a consistent resident census at or above the target, as well as managing controllable operating expenses, are crucial. But, in order to accomplish this, facilities need solid referral sources, and wellness programs and models for the residents. All this comes much easier when you can utilize the resources at the extended-care facility right next door.

So Uguccioni and Ailinger worked together to build trust between the two buildings so that the extended-care facility could become a consistent referral source at the assisted-living facility, and vice versa.

“It is one of my proudest accomplishments since my tenure here,” she said.

At Home with the Idea

But there have been many accomplishments since Uguccioni’s arrival, including those ‘best-of’ awards.

They are generally a measure of customer service, and Uguccioni said she believes quality in this realm is a function of having a staff that knows it is valued and appreciated.

Indeed, it takes a village to run a successful assisted-living facility that leaves residents and their families happy, and Linda Manor does that well by putting an emphasis on relationships.

To help staff members accomplish this, Uguccioni helps them realize the impact they have on residents, and the value they have in affecting their lives.

For example, she said a certified nursing assistant providing daily services to a resident, like giving medication or offering assistance in the bathroom, translates into much more than completing a simple task.

“You’re really here to be an integral part of that person’s day,” Uguccioni said. “You’re the first person that they see in the morning, and, therefore, their interaction with you really shapes how their day might be.”

This, she says, is the key to running a successful assisted-living community.

“If you don’t have a staff that’s committed and engaged, you don’t have anything,” she said. “I think that it’s really important that you have people and staff in general that are invested in their role and they realize the value that they have in assisted living, and what they mean to the people that live here.”

But building a strong, caring team is not an easy task in this employment environment. Uguccioni says one of the biggest challenges in running an assisted-living facility is that not many people seem to want to be aides.

“There’s a lot of open positions in healthcare for certified nursing assistants, and we don’t find as many people seeking that out as a desired level of employment,” she said, adding that she puts staff satisfaction high on her list in order to reduce turnover.

“I don’t ever want someone here to feel like ‘oh, I just work in housekeeping,’ or ‘I’m just the server in the dining room; what do I know?’ Everybody here knows a tremendous amount,” Uguccioni added. “It’s not just me that runs the building, it’s all of us. If one person could do it, I wouldn’t have everybody else that works here.”

This attitude has helped Linda Manor to continue to be recognized as one of the best assisted-living facilities in the area, and Uguccioni is always thinking about ways to improve.

“I’m always looking at how we can positively affect someone’s life through the residents and the families,” she noted, adding that she has positive experiences every day that remind her why she does what she does.

She recalls one instance from a few years ago, while she was covering for someone in the Admissions department while they were on vacation. A woman walked in looking for a place for her mom to live. The minute she sat down in Uguccioni’s office, she began to cry.

“This woman was in a terrible predicament. Her mother lived in a totally different part of the country, and she didn’t know how to talk to her to tell her she couldn’t live alone anymore,” she said.

In this instance, Uguccioni advised the woman not to tell her mom why she couldn’t live alone, but explain how living in an assisted-living facility would help her live an easier, happier life.

The next week, the woman got her mom on a plane and moved her into Linda Manor.

“Being able to help her, I really do feel like I have a pivotal piece to that,” Uguccioni said. “Every time I see her when she comes in, she says, ‘I thank you every day.’”

Live and Learn

When she reflects back to that experience she had at the Alzheimer’s Resource Center as a 13-year-old girl, Uguccioni is grateful that the nurse sent her to deliver that paper, because it put her on a path to a career she loves every day.

“If I hadn’t had that volunteer experience doing something that was completely out of my comfort zone, I would never have what I have today,” she said. “I would never be in this field at all.”

But she did go down that path, and doing so started her on her journey to be a Healthcare Hero.

Kayla Ebner can be reached at [email protected]

Healthcare Heroes

She’s Forging Pathways to Help People Overcome OCD and Hoarding Disorder

Tara Ferrante

To illustrate one of the many ways obsessive-compulsive disorder, or OCD, can manifest itself, Tara Ferrante said everyone has stood at a rail atop a high building, looked down, and thought, what if I jumped? It’s a little scary, and basically harmless.

“But with OCD,” she continued, “you actually evaluate that thought and think it could happen, and then, ‘I must be a terrible person to have that thought.’ Or it creates anxiety because that thought means something, and you have to do something to feel better.”

OCD often begins as an intrusive thought, she explained, and everyone has intrusive thoughts. What sets OCD sufferers apart, though, is their response to those thoughts. “Sometimes it’s a compulsion, sometimes avoidance — ‘I can’t be in tall places,’ or ‘I can’t be around knives, because I imagined myself stabbing someone once, so I must be a dangerous person. What person must think something like that? I must be a horrible person. People shouldn’t be around me.’”

But while avoidance — or whatever compulsive, repetitive action helps to mitigate that intrusive thought — might bring temporary relief, it also reinforces the initial evaluation of that thought, she went on, “so the next time that thought comes up, you’re stuck in that same cycle where you have to do something to feel better.”

Then there’s the behavior known as hoarding, which buries people, both psychologically and literally, in their own possessions because they’re unable to get rid of anything — presenting a wide variety of dangers.

“It can be a fire risk, or it can be a fall risk, especially as people get older, or someone may have other health issues and the path’s not wide enough for a gurney to get into their house for emergency support,” Ferrante said.

“It also causes people to isolate more — they’re afraid to have people in the home, or to reach out to people,” she went on. “There’s a thing called clutter blindness, where they might not see all the clutter, but when another person is there, it’s striking. There’s the shame and the guilt and everything else that comes up around that, so a lot of people do isolate more because of the clutter.”

Ferrante is program director of the Holyoke Outpatient Clinic at ServiceNet, one of the region’s largest behavioral-health agencies, and treats patients with a wide range of behavioral-health conditions. But it’s her work leading ServiceNet’s OCD and Hoarding Disorder Program that earned her recognition as a Healthcare Hero in the category of Emerging Leader.

To be sure, Ferrante doesn’t see herself as a hero — just someone passionate about helping people overcome behaviors that range, depending on the patient, from mildly annoying to completely debilitating.

“It feels so good to see people thriving in their lives who wanted to die at points,” she told BusinessWest. “While their lives may not be perfect by any means, they’re able to live their lives the way they want to, with much more ease.”

Starting the Journey

Ferrante’s journey in this specialized field began while working with a client who was experiencing extreme distress from OCD symptoms. She had read about emerging OCD treatments, learning that the most effective approach seemed to include a mix of structured clinical treatment and home-based and peer support.

So, two years ago, when ServiceNet’s senior leadership proposed the launch of an OCD program in Western Mass., she jumped at the opportunity to lead the program.

“They saw this area as a kind of desert in terms of people who can really specialize and are able to provide good care to people with OCD and hoarding disorder,” she explained. “I was super interested, and I expressed interest in overseeing it.”

“It feels so good to see people thriving in their lives who wanted to die at points. While their lives may not be perfect by any means, they’re able to live their lives the way they want to, with much more ease.”

Before launching the program, Ferrante and fellow clinicians first completed four days of training in OCD and hoarding disorder, then conducted a series of consultations with two nationally recognized experts on these conditions: Dr. Randy Frost, a professor of Psychology at Smith College, and Denise Egan Stack, a behavioral therapist who launched the OCD Institute at McLean Hospital in Belmont, a Boston suburb.

“We’ve been so lucky,” Ferrante said. “People have invested so much time and energy in our program to get it off the ground and get it going and helping me as a leader. It’s been really great.”

Currently, six ServiceNet clinicians provide specialized OCD and hoarding-disorder treatment at the agency’s Holyoke, Greenfield, and Northampton clinics. The program’s model continues to evolve, but several facets have crystalized, including the use of Smith College students as interns in the program. Frost trains the students for adjunct work in the community, such as conducting ‘exposures’ with clients battling OCD, Ferrante explained.

“They’ll give emotional support to people [with hoarding disorder] as they are sorting and discarding, or as they go out and practice non-acquiring — going to a store where they like buying things, and then not getting anything, sort of building up the tolerance of resisting that urge.”

Tara Ferrante says people with OCD and hoarding disorder span all ages and demographics.

The student collaboration has been valuable and productive, she noted. “We’re limited in how much we can get out into the community or into the home between sessions. The introduction of the interns has helped create steady progress.”

The term ‘hoarder’ is actually out of fashion, she noted, having taken on a stigma in recent years, thanks partly to TV shows that often vilify those who struggle with the condition. Frost has written extensively about the reasons people hoard; some call themselves ‘collectors’ or ‘finders-keepers’ because they see value in every item in their cluttered homes.

“That’s a strength, to be able to see value where other people don’t, or to see beauty where other people don’t,” Ferrante said. “But it’s a strength that’s gone too far, and that can make a hindrance in being able to get rid of things. Also, people don’t want to be wasteful, they don’t want things to go into landfills, and again, that’s really a wonderful quality — but it then impedes their quality of life.”

Hoarding is also a form of perfectionism, at least in the eyes of collectors, she went on. “You want to use something to its full ability, or it needs to go to the just right place. Or, if it’s going to be given away, it needs to be given to just the right person who’s going to love it fully, and if you can’t find that person, then you’re just going to keep it, and that can stall progress sometimes.”

As for OCD, like many mental-health conditions, it can differ in severity from one person to another, Ferrante said.

“Sometimes people can function pretty well, but even for those people who aren’t seeking treatment, it can affect their ability to have relationships, to get to work on time, even to leave their house,” she explained. “There are so many ways it can make people’s lives difficult. And even if they can function sometimes, they’re living in this constant state of anxiety and panic, which is really unpleasant.”

Then there are the more severe cases — stories of people unable to touch their children or their partners for years, or unable to leave their home, hold a job, or participate in life in any way.

The standard treatment in Ferrante’s program is known as exposure and response prevention, a form of cognitive behavior therapy.

“We form a relationship and create situations where they get exposed to the anxiety, the intrusive thought, and we don’t do the compulsion,” she explained. “We do it in a supported way at first, in session, and then we have the interns who can do that out in the community, and eventually we want people to do it on their own. We make exposure part of life — this idea of, ‘let’s turn toward anxiety rather than away from anxiety.’ It takes the power out of it, and they’re able to really start living their lives the way they want to be living.”

Many patients are treated with a combination of therapy and medications, often anti-depressants. “But not everyone needs meds,” she said. “I see a lot of positive outcomes with just exposure and response prevention on its own.”

Breaking Through

The ServiceNet program runs a series of support groups called Buried in Treasures, named after a book Frost co-authored. Ferrante also sits on the board of the Western Massachusetts Hoarding Disorder Resource Network, which puts on conferences that focus on what resources are available in the community for those who struggle with the condition. ServiceNet also brings in experts for lectures where mental-health professionals can earn CEUs for learning more about hoarding and OCD.

All this training is aimed at broadening resources for a patient population that cuts across all socioeconomic barriers and cultures around the world. Hoarding, in particular, is often seen as an older person’s condition, but that may be because they’ve had more time to accumulate, so the signs are more readily apparent.

Progress in overcoming a compulsion to hoard can be slow, Ferrante added. “That stuff didn’t get in the home overnight, and it’s not going to get out overnight. I mean, it can get out of the house overnight, but that generally is going to make things worse — it creates a trauma, it makes the person treatment-resistant, and doesn’t actually address how it all happened.

“It’s almost a guarantee, if someone has a forced cleanup, they’re going to fill their space up again,” she went on. “So we take a slower approach that looks at what got someone there and creates the skills they need to declutter on their own, and not have it return.”

While people who hoard often struggle with stigma, OCD sufferers are plagued with the opposite: the many Americans who think they have OCD because they have certain routines, and proclaim it with an odd sense of pride.

“They say, ‘oh, I’m so OCD,’ and it really minimizes it for people who are suffering,” Ferrante explained. “It’s not just being really clean or wanting things in a certain order. If those things are torturing you and you can’t function, sure, but people can have certain obsessions or compulsions and not have OCD. The ‘D’ part of OCD is that it’s impairing your ability to function, and most people who say, ‘I’m a little OCD’ … well, they’re not.”

On the other hand, it’s also frustrating for someone with OCD to be misdiagnosed, she added.

“I get calls from people saying, ‘I’ve been looking for help forever; no one knows what I’m talking about.’ Sometimes, when people think they’re dangerous because of an intrusive thought, then a therapist buys into that because they’re not sure what this is, and it reinforces that belief. But even suicidal thoughts can be OCD. People can get hospitalized when that’s not the right intervention. You want an expert making sure you’re making the right call there.”

Outside of her OCD and hoarding work, Ferrante continues to manage all the clinicians at the Holyoke clinic, and handles a caseload of about 15 patients at a time, dealing with a wide range of mental-health concerns, from substance-use disorders to trauma, anxiety, and depression. In that sense, she and her team were already doing heroic work before launching the OCD and Hoarding Disorder Program.

But since that launch, she’s been able to help a patient population that often finds it difficult to access resources — and wind up suffering in silence, and often falling prey to other conditions; in fact people who hoard are 80% more likely than the general population to develop depression.

“It’s amazing to see people get better,” she told BusinessWest, whether progress occurs quickly or not. “It’s not always simple — sometimes there’s more than just OCD going on, and it’s more complicated. But if people are coming in, they’re already motivated to do the work, and progress can be pretty quick.”

She thinks of the client who inspired her interest in OCD research, and said “it blows my mind” how far he’s come.

“It’s so, so great when people graduate and don’t need therapy anymore. To see even small progress — people being able to do things they couldn’t do before — makes my job totally worth it.”

Joseph Bednar can be reached at [email protected]

Healthcare Heroes

She’s One of Many Improving Quality of Life for People with Dementia

Carol Constant

As director of Community Engagement at the Loomis Communities, Carol Constant has developed a number of ways residents of the three sites — Loomis Village in South Hadley, Loomis Lakeside at Reed’s Landing in Springfield, and Applewood at Amherst — can be, well, engaged with the world outside their walls.

“It’s not a silo — we’re out supporting the community, and the community is invited to be a part of what we do,” she said, citing examples like supporting awareness walks, food drives, and other events relevant to area seniors.

But it was a resident of Loomis Village, named Rachel Tierney, who got her thinking about the concept of engagement in a new, broader way.

“She had been a long-time caregiver for her husband, and she’s a retired psychiatric nurse,” Constant said. “She had heard about the dementia-friendly movement, and when she saw my title, she approached me and said, ‘hey, do you want to think about this?’”

Constant did. In fact, the idea of dementia-friendly communities — a movement that aims to teach first responders, municipal workers, and business owners how to interact with people with dementia — appealed to her, so she was pleased when her first meeting in South Hadley, in March 2015, drew a wide range of stakeholders: fire and police chiefs, the town administrator, a librarian, the senior-center director, and Chamber of Commerce members, to name a few.

“They’re going to the bank, they’re going to the grocery store, they’re out in the community. So how can we, as a broader community, recognize it and be helpful to them?”

“We sat them down in a room and said, ‘we have this idea about educating and raising awareness about dementia. How have you experienced dementia in your daily lives?’” she recalled. “These are busy people, and we promised to take only an hour of their time, but just going around the room hearing the stories took an hour. Everyone had a story.”

That’s because, of the approximately 5.3 million Americans currently living with Alzheimer’s disease or some form of dementia, 70% are living in the community, rather than assisted living or nursing care — and 30% of that group are living alone. Going by these estimates, approximately 8,460 individuals with dementia in the Pioneer Valley are living in their homes, and 2,538 are living alone.

“They’re going to the bank, they’re going to the grocery store, they’re out in the community,” Constant said. “So how can we, as a broader community, recognize it and be helpful to them?”

More than four years after that first meeting, the loose coalition known as Dementia Friendly Western Massachusetts (DFWM) has drawn the support of dozens of area organizations, sponsored myriad awareness and education events, and, most importantly, made area communities better places to live for people with dementia.

It’s an effort that will only become more important as Baby Boomers continue to march into their senior years, living longer, on average, than previous generations. The number of Americans with Alzheimer’s is projected to rise by 55% by 2030, and by 2050, the Alzheimer’s Assoc. estimates the total number could explode to nearly 14 million.

Proponents of the dementia-friendly movement say greater public awareness and support programs will reduce the stigma of dementia and improve the quality of life for these individuals and their families. In addition, greater public awareness may lead to earlier detection and earlier treatment.

“There’s a huge stigma around dementia,” Constant said. “How can we make people recognize that there’s no shame in it, that nobody who has dementia did something bad? One of the goals is to destigmatize it because people get worried they’re going to embarrass themselves.”

It starts with small steps, she added. “Just check yourself. You may be in a hurry at the store, there’s a long line at the register, and this person is having a hard time counting their money. So slow down and recognize what’s happening and how to be helpful.”

For taking those steps along with a raft of like-minded individuals and organizations, Constant is positively impacting an often-forgotten population, and teaching entire communities that there’s plenty of work left to do.

Knowledge Is Power

The work of Dementia Friendly Western Massachusetts includes several basic activities, including:

• Education and training for those who might encounter an individual with dementia, including fire and EMT first responders, faith communities, and frontline workers in banks, retail stores, and restaurants;

• Development of support groups, memory cafés, and other programs that support individuals and their families; and

• Development of a website and materials that provide a calendar of events and resources available to families the region.

These supports are critical, Constant said, as research shows that supportive care helps people living with dementia and their caregivers experience less physical and emotional stress, better health, fewer hospitalizations, and less time in long-term-care facilities. Additionally, caregivers need support, as caring for someone with dementia puts a strain on their physical and mental health as well as relationships with other family members. Finally, educational programs that build awareness of the challenges faced by these individuals and their families will help assure that, when they are in the community, they are treated with respect and dignity.

To Constant, much of this work comes down to one question. “How can we be supportive of people in the community and destigmatize dementia? When they get embarrassed and shamed, they isolate and become depressed, and that does not help — that further exacerbates the problem for them. This is a movement to raise awareness and destigmatize dementia, in addition to providing education and support for people in the community about dementia.”

Carol Constant says many people with dementia are out in the community, and the community needs to know how to interact with them.

Take memory cafés, for example — places where people with dementia and their loved ones and caregivers can hang out and relax, free from the stress that often accompanies other community outings, because everyone knows everyone else in the room understands their experience.

“So often, we get caught up with caregiving, and we forget to have fun with the person we’re caring for,” she explained. “So it’s an hour, hour and a half where people can meet someone in a similar situation, hang out together, relax, and have fun.”

Memory Cafés have been established at Armbrook Village in Westfield and councils on aging and senior centers in Holyoke, South Hadley, Belchertown, Hampden, Greenfield, and Shelburne Falls. Heritage Hall East in Agawam is in the process of starting one.

Meanwhile, dementia support groups have been established at Armbrook Village, Heritage Hall East, Loomis House, the Holyoke Soldiers Home, and the Belchertown, Holyoke, and South Hadley councils on aging and senior centers.

Constant is gratified to be recognized as a Healthcare Hero, especially considering the category — Collaboration in Health/Wellness. On several occasions during her interview with BusinessWest, she emphasized that she can’t take credit for all this work; it’s about creating partnerships with area agencies that serve older adults. “We got the right people together in the room, and we started programming.”

Those partners in Dementia Friendly Western Massachusetts include the Alzheimer’s Assoc.; the communities of South Hadley, Holyoke, and Springfield; the Department of Elder Affairs; Holyoke Medical Center; WestMass ElderCare; Greater Springfield Senior Services; Holyoke Community College; Chapin Center; A Better Life HomeCare; Springfield Partners for Community Action; Grupo de Apoyo de Demencia at Baystate Medical Center; the Public Health Institute; PeoplesBank; O’Connell Care at Home; Massachusetts Councils on Aging; Silverlife Care at Home; River Valley Counseling Center; Safe Harbor Adult Day Services; UMass College of Nursing; Springfield College; and the Holyoke VNA.

The purpose of their collective efforts, simply put, is to build broader community awareness of the issues around dementia, not only through the website and materials promoting support resources and programs, but by encouraging and training organizations, agencies, and towns in the region to become involved in the dementia-friendly movement.

First Response

To date, DFWM organizations have established and led hundreds of educational programs across the region, including educational programs to a wide array of audiences, including first responders, city and town employees, nursing homes, rehabilitation centers, councils on aging, schools and colleges, hospitals, nursing homes, home healthcare agencies, chambers of commerce, businesses, Rotary clubs, faith communities, retirement communities, civic organizations, elder-law programs, and local and national conferences.

Each target audience has different needs and different ways to connect. For example, first responders often feel frustration when encountering people with dementia, because their role is often to stabilize a situation and then move on. When they encounter a situation where it’s obvious that someone in a home is struggling with dementia and may not have the supports they need, they often feel there’s not much they can do, Constant said.

With that in mind, Dementia Friendly Western Massachusetts developed a visual resource, the size of a business card, that’s printed, in both English and Spanish, with the contact information of organizations that can provide dementia-related resources to families. First responders can leave this card with a family when they feel it’s warranted.

“First responders rush in and rush out — assess the situation and get everyone safe. Then they leave,” Constant said. “There’s a sense of frustration when they know the situation is bigger than ‘we got the fire out.’ This is something they can hand to the family member.”

Or, when police arrive at a home, they might encounter someone who’s agitated and on edge, but not dangerous or mentally ill — they simply have dementia and are trying to navigate a stressful situation.

“Maybe we need to slow it down a little bit, make eye contact, get at their level,” she said. “When I talk to first responders, I see and hear that they do this naturally, but a little layer of education around it is also really helpful. And I’ve heard that from police chiefs in all the communities we’ve been working in.”

It’s just one way she and the other coalition members are changing the conversation around dementia — right down to the very words people employ.

“So much of the language we use around dementia is ‘afflicted,’ ‘stricken,’ ‘the tsunami’ — all this negative language,” she noted. “No wonder it’s stigmatized. So, how do we make people feel not ashamed, not embarrassed about it, and not isolated?”

The community education goes beyond words, as well, and gets to the heart of how people with dementia are treated. For instance, people will sometimes stop talking to an individual with dementia altogether — instead always addressing their companion — even though there’s often many years between diagnosis and the time when someone becomes so debilitated they can’t go out anymore.

“The essence of that person is still there,” Constant said, citing a Maya Angelou quote — not first uttered in reference to dementia, but nonetheless applicable: “people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

“They can still experience joy; they can still experience humor,” she went on. “So what are we doing when we say, ‘you are no longer able to cognitively keep up with this fast-paced conversation, so sit in the corner by yourself.’ One of the goals of all this work is to improve quality of life.”

That goes for everyone — individuals with dementia, their care partners, and the community as a whole.

Filling the Room

Constant is grateful the Loomis Communities gives her a “long leash” when it comes to her work with Dementia Friendly Western Massachusetts, but not surprised, as it’s really in Loomis’ best interest.

And she’s also thankful for the individual moments that demonstrate the value of engaging people with dementia fully in society.

“Having someone who’s living with dementia come up and talk to you and start a conversation and share their experience and that of their care partner, it’s wonderful to see,” she said. “If we can do one thing to make the quality of life for someone better, why wouldn’t we?”

When her mother-in-law was diagnosed with dementia 30 years ago, she added, she didn’t have the resources available today; no dementia-friendly initiatives existed back then. But she wishes they had. “I learned all my lessons the hard way. I wish I had known as much about it as I do now.”

Still, there’s a lot to learn, she added, and a lot of passionate people — again, this is certainly a collaborative award — working on improving quality of life, one person and one community at a time.

“It’s been great making these connections, and that’s really powerful,” Constant concluded. “If it was up to just one person to do this, it wouldn’t happen. It’s all about getting all the right people in the room.”

Joseph Bednar can be reached at [email protected]