Hudson River Health Care Inc. (HRHCare)
Connection to Moving Health Care Upstream
Hudson River Health Care Inc. (HRHCare) is a non-profit Federally Qualified Health Center with 26 sites serving 135,000 patients in southern New York. It is the anchor organization for Moving Health Care Upstream’s project focusing on childhood trauma and its consequences in Yonkers, a suburban city of 200,000 that borders on New York City.
Its core partner for the MHCU project is Westchester Jewish Community Services (WJCS), a non-sectarian human services agency that provides mental health and social services support for people in the county. WJCS has been serving the Yonkers community for more than 50 years and, through its Article 31 mental health clinic and Treatment Center for Trauma and Abuse, offers cutting edge mental health treatment to 2,000 Yonkers residents annually.
Our larger network of community collaborators include child advocates to county government, food banks, housing groups, homeless shelters, care management agencies and home health care providers.
The Community We Serve
Our Children and Families in ACTTION (Addressing Childhood Trauma Together in Our Neighborhoods) project is based in our HRHCare Valentine Lane Health Center that serves nearly 6,000 patients, mostly Hispanic families with limited English-language capability and in particular, the over 2,000 patients who are under 12, along with their families. Nearly all of our patients are below 200% of the federal poverty line, and most are at or below 100%.
We believe that there is a very high rate of trauma in the children we see which, undetected and untreated, can alter their development and lead to adverse mental and physical health outcomes when they reach adulthood. Over the last year and a half, we have deepened our integrated practice to screen families and children for adverse childhood experiences (ACEs) and provide services that more deeply address their medical, behavioral and social needs.
Our MHCU Partnership
The MHCU partnership has enabled HRHCare and WJCS to form a trauma-informed integrated care team that includes pediatricians, clinical staff, social workers and a pediatric care manager. All members of the team participate in ongoing trauma-informed training. Our goal for this practice is that it provides our patients an experience of safety and compassion that allows them to discuss the issues in their lives that so directly affect them and their health. Whether people are struggling with trauma or “toxic stress,” (which can include physical or sexual abuse, violence, bullying, addiction or a range of other adverse experiences), or other issues such as food or housing insecurity, our team is present, in the moment, to listen and respond. We have instituted structured workflows to screen for ACEs, but our vision is not just a better screening method. Along with this, we are creating a more deeply integrated approach to patient care that lets people know this is a safe place to talk about difficult and potentially painful things.
Screening instruments, while important, are just a small part of this. It is not unusual for us to find that people who do not identify any issue on the screening instrument come back to us a few weeks later to talk about a difficult or painful issue.
The team recognizes and promotes our patients’ resilience. We offer interventions ranging from supportive empathetic listening to care management to specialized trauma-specific psychotherapy. Our practice is to recognize and respect the unique individual’s needs and healing process while appreciating that safety and trust evolve over time. The long-term ongoing relationship with our practice provides our patients the reassurance that we are available to help when they are ready.
Our Solutions and Community Partners
Our work together has also involved other community partners, most notably Yonkers Thrive and Westchester Children’s Association GPS for Kids. Each organization has developed advocacy platforms to redress poor outcomes for Yonkers’ and Westchester’s most vulnerable and our engagement with them has lead to their respective reference to Adverse Childhood Experiences in their mission and goals.
Through Yonkers Thrives, we were recently approached by the Yonkers public school district to help them increase their awareness and sensitivity to issues of childhood trauma. We know that children who endure these experiences may become at risk for academic failure, depression, use of alcohol or drugs, social isolation, early pregnancy and HIV/AIDs. We are excited to partner with our schools in this work, which thus far has resulted in two discreet and well attended programs for teachers and parents on matters related to trauma informed care.
For More Information:
Contact Dr. Daniel Miller: firstname.lastname@example.org