Primary Care means medical, dental, behavioral health in one Community Health location

“So many families have a belief about mental health services that it’s really for only when you are in an acute crisis.,” said Anne Hopkinson, LICSW, the social worker at Community Health Shorewell. “That would be the only time when you would see mental health services.” Hopkinson, who grew up in Addison County, says it’s important to understand that culturally, people in rural Vermont see behavioral health as separate from physical health and wellness. But it didn’t take long for them to understand that behavioral health is an integral part of primary care and overall wellness.

The primary care provided at Community Health’s Shorewell practice is different, Hopkinson said. When someone comes in and says to a doctor, “ I’m not doing well with my weight loss, I’m feeling really depressed about it. My self-esteem is in the toilet. My diabetes is terrible.” Hopkinson said a provider at Shorewell would say, ”Well, actually, we have somebody who can help with that. Would you like to meet Anne? She’s in the coffee room.”

Medical. Dental. Behavioral Health. The trident of care Community Health has consistently provided in its network of health and wellness services, defines accessible primary care for the residents of Addison County’s Champlain Valley at the Shorewell practice where all three are combined at its family-oriented practice.

When the Shorewell practice was established, integrating with the community was one of the first considerations. The name, Shorewell, comes from a combination of the two closest communities the practice would serve – Shoreham and Orwell. Shoreham’s rich agricultural heritage and Orwell as home to colonial America historical sites are where about 2,400 residents live, according to the last census. The close-knit towns and the surrounding area, including towns in New York state, make up the close to 1,500 patients who are served by Community Health’s Shorewell practice.

When Hopkinson started as a social worker in January 2020, there was some uncertainty that she was needed fulltime. “We were a little unsure how busy it would be, but it’s been a success,” said Community Health Behavioral Health Manager Christopher Chadwick. Most of the case load is for mental health issues such as depression, Chadwick said. A smaller number of patients are those with a substance abuse history.

Alyssa Potter, the practice manager at Shorewell, said she is surprised at the number of patients who see Hopkinson on a regular basis. “This is a small office with four providers,” she said. “With dental and behavioral health being in the same office it’s great for the patients. They are here, so let’s get things taken care of, and we are able to do that in this office.”

“A lot of new patients don’t know that we have dental and behavioral health here,” Potter said. “When they find out they think it’s great. We let them know our other Community Health clinics are open on the weekends and they have all of their patient information. They really appreciate that.”

Shorewell is the only practice in the Community Health network where medical, dental and behavioral health services are provided in the same location. The staff of 13 is “all about making patients part of the family and we are part of the community,” Potter said.

Some patients don’t understand what services they need, or why they feel so bad every day, Chadwick said. “When they get into their primary care appointment, their provider is able to understand a behavioral health issue that they might not have considered. Having behavioral health in the practice is a service line that is available to them.”

Shortly after the COVID-19 crisis began, all of the Community Health behavioral health providers transitioned to the Telehealth format.

“When we went to telemedicine for behavioral health we thought that at Shorewell no one would be able to do it,” Hopkinson said.  “My productivity actually went up,” she said. “People’s children were driving hours to set them up with telemedicine. People were coming to the parking lot to get WiFi. The dedication to staying in touch within the community and supporting each other to figure out how to get through, that was so real.”

“The Shorewell population tends to be older,” Chadwick said. “They were just starting with a new behavioral provider and on top of that we were telling them they were going to transition to telehealth.” But patients adapted. “The entire office staff at Shorewell has done an amazing job with the technology and scheduling and getting  patients set up with the service,” he said.

“I am really proud of our state,” Hopkinson said, regarding the pandemic response.

“Vermonters are so reclusive anyway,” she said. “We were social distancing our whole lives. A lot of time big news happens, and Vermonters watch from afar. It very rarely comes up here and  actually affects us. The hurricane was the last time something really big hit our state and this pandemic is affecting us and affecting the way we move around. We still have these old structures of community in place which really, really helped us,” she said.

“Collaboration with behavioral health has been great,” Chadwick said. “The Shorewell practice has done a great job to have patients continue to receive services from the safety of their homes and at the same time be able to continue the services they were having coming to the office.”

Another advantage of the system Community Health has created for behavioral health is helping patients with insurance coverage. “Once a provider submits a referral for behavioral health, we have our own referral specialist who immediately begins working on that patient’s insurance,” Chadwick said. They validate insurance coverage, and work with the insurance company to get the approval before the patient even schedules their appointment.

All Community Health practices are now open for in-person visits with medical, dental and behavioral health providers and telemedicine appointments will continue to be available.

The Community Health website and Facebook page have more information about primary care services and detailed contact information.