Notes on Welcome Center and Contract Changes

Contract Changes and Psychology Services

• The new contract primarily focuses on medication consultation, which will reduce the need for psychology services.

• Marcyana’s role will likely be reduced as psychology services are no longer a requirement.

Transparency and Utilization of Space

• The current space has not been as effective as initially hoped (ten years ago).

• Behavioral health referrals or integrative care within the clinic can address emergencies involving foster children.

DCFS Requirements

• DCFS (Department of Children and Family Services) is only requesting medication consultation (provided by Lisa Hart).

Joint Psychiatry Integration

• There is comfort with joint psychiatry, which allows for integration with primary care.

Patient Care Changes and Welcome Center

• Significant changes are coming over the next three years regarding patient care.

• The centers are partnering with the county and DCFS to create a Welcome Center, set to open in the summer of 2026. This is viewed as a positive change.

Welcome Center Details

• The Welcome Center will replace the current Janana DCFS location.

• It will include respite beds to prevent children from sleeping in the building, providing a temporary residential hold space.

• A larger childcare room will be available.

• A clinical space will be provided for running triage services, improving workflow for social workers as a one-stop shop.

Workflow and Operations

• The process of making appointments will remain the same; there will be no overlapping of patients.

• The primary change is the location of triage services.

• Social workers in placement will stay at the childcare room until needed in the clinic.

• Operations will run 24/7.

Location of the Welcome Center

• The Welcome Center will be located at the former Cleveland Christian Home on Lorain Avenue near West 117 (specifically West 111-114).

• Janana will no longer exist.

• The Welcome Center aims to be a one-stop shop for all social worker needs.

HOPE Campus

• The facility is part of the HOPE campus (acronym), which includes:

  • The Welcome Center (front door).

  • A Wellness Center extension.

Advantages of the New Facility

• It is a 24/7 facility, providing a better environment than the current location.

• Uncertainty regarding ED renovations and potential relocation is eliminated.

• The new facility is designed to be a warm, friendly place for children.

Input on Clinic Design

• Stakeholders will have input on the design of the clinic space, including layout, storage, and workflow.

• The goal is to create a true clinic approach within the space.

• APNs and other team members will be involved in the design process to optimize workflow and patient experience.

• Considerations include patient flow from arrival to examination.

Transition Strategy

• The initial proposal is to maintain triages at the new location.

• The centers would prefer to move all services to the new location eventually.

• A strategic, intentional approach is needed to equip the clinics fully.

• Phase one involves triages, followed by phase two, which includes post-placement physicals and potentially a continuity clinic.

Comprehensive Services

• The facility aims to provide comprehensive services, including immunizations.

• The goal is to create a dedicated foster care clinic, which is unique among children service agencies.

• The model of care could be published if proven successful.

Collaboration and Team Integration

• MetroHealth team members will relocate to the new facility.

• The current model will be extended, with potential for expansion if needed.

• The aim is to maintain business as usual initially to ensure a strong bid.

• The partnership with the centers strengthens the bid, as the county is essentially partnering with itself.

Providence House

• The responsibilities related to Providence House are being reviewed for optimization.

• There is consideration of separating Providence House from foster care for a leaner, more decentralized model.

Patient Volume

• The anticipated patient volume is expected to remain the same initially but may grow due to the new campus environment.

• Increased show rates are expected if post-placement services move to the campus.

Integration of Services

• Children receiving psychiatry and counseling services will still come to the current location.

• The goal is to integrate appointments to reduce the burden on families.

• A monthly clinic may be established for aging-out youth, collaborating with “Place for Me” to capture this population.

Project Excitement and Renderings

• The project is viewed as exciting and a realization of long-term goals.

• Renderings and descriptions of the Welcome Center will be shared.

• The aim is to create a welcoming, integrated, and fully functional facility.

Collaborative Decision-Making

• Decisions will be made collaboratively with input from all team members.

• Practical details, such as room layout and equipment placement, will be considered.

Funding and Construction

• The Welcome Center is currently under construction and raising funds.

• Stakeholders will join planning meetings to provide input on the clinical space.

Operational Details

• MetroHealth will continue to manage supplies, IT equipment, lab services, and pharmacy needs.

• The IS infrastructure will remain the same.

• The move is viewed as transitioning to a new outpatient building.

Timeline and Transition Phases

• The transition to the triage phase is expected by the summer of 2026.

• Phase two, involving the full program, is anticipated by December 2026.

Psychological Services and Visit Structure

• The logistics of psychological services need to be addressed, including workflow changes.

• Reinstating one-hour visits may be necessary due to the reduction in psychology involvement.

Consultation and Referral

• Lisa Hart will continue to provide psychiatric consultation.

• For counseling, referrals to the behavioral health department will continue through the end of the year for those over seven.

• Foster care patients can be seen by any provider in child psychiatry but will no longer be part of a contracted service.

• Patients can be referred to any MetroHealth counselor, maintaining the freedom of choice.

Integrated Care and Emergency Protocols

• Consultation with psychiatry and integrated care will be available for urgent cases.

• Protocols will be developed for behavioral health assistance at the Welcome Center.

• Emergency medical situations will follow established protocols, including calling 911.

Safety and Security

• The 24-hour building will have security personnel.

• Normal business hours will extend until 9 PM to accommodate foster parents and agencies.

• Security measures will be in place during and after business hours.

Residential Facilities

• The Welcome Center and residential facilities are separate entities within the Hope Campus.

• The Welcome Center provides respite beds, while the residential side offers longer-term care.

• The focus is on providing foster care triage and medical home services within the facility.

Expansion and Continuity of Care

• There is room for growth, including potential continuity clinics for minor issues.

Partnership and Collaboration

• MetroHealth was approached to run the clinic within the facility, offering a unique opportunity.

• The centers will cover expenses such as utilities and equipment.

• Input from stakeholders is crucial to ensure the clinic design meets the needs of the team.

RFP and Service Continuity

• The services outlined in the RFP remain largely the same, with the exception of psychology services.

• The support of the Welcome Center strengthens the bid.

Excitement and Vision

• There is excitement about creating a dedicated foster care clinic within the foster care system.

• The goal is to design a bright, special, and welcoming space for patients and staff.

Clinic Space and Design

• The clinic space is expected to be large enough to accommodate growth.

• Stakeholders will have input on the design, including exam rooms and storage.

• Additional space outside the clinic may be available for future use.

Care Navigation and Staffing

• There is a desire to reintroduce care navigation, potentially with MAs or LPNs.

• Training opportunities will be explored to certify navigators.

• The shift schedule will be adjusted to accommodate extended hours, with considerations for work-life balance.

Support and Coordination

• The project has strong support, mitigating initial concerns about feasibility.

• Coordination with legal and lab services is ongoing.

• The county's request for psychotropic lab testing now aligns with MetroHealth's submission.

Lab Services and Testing

• Lab services will be handled by a courier, ensuring timely pickup and delivery.

• Point-of-care testing options, such as urinalysis and strep tests, are available.

Conclusion

• Stakeholder input is crucial to ensure the clinic is designed effectively.

• The project is viewed as exciting and promising, with strong support from all parties involved.