At 50, CUHCC meets more needs than ever

By Susan Maas

The south Minneapolis clinic provides comprehensive team-based care for a richly diverse, primarily low-income patient population

What does sensitive, patient-focused, culturally competent health care look like? Roli Dwivedi, M.D., medical director of the Community University Health Care Center (CUHCC), tells a story: “The other day, a medical student and I were seeing a Somali patient. She came in for pelvic pain and headache,” Dwivedi says. Conferring with Dwivedi outside the exam room, the student suggested certain tests to explain her symptoms.

But Dwivedi had sensed anxiety in the patient. “I went back into the room, and I started asking more questions. My sense was, she is trying to conceive and she is not able to. So I asked, ‘Are you trying to conceive?’ And she said, ‘Yes. I think it may be my mind that is causing these symptoms, because I am unable to get pregnant.’

“In Somali culture, being able to conceive is very important,” Dwivedi explains. And for Dwivedi, really seeing the patient had revealed clues that didn’t emerge initially. It’s the kind interaction that can transcend language — and many languages are spoken at CUHCC.

The south Minneapolis clinic, celebrating its 50th birthday this year, serves a richly diverse, primarily low-income patient population. Its multidisciplinary team includes staff interpreters who speak Hmong, Lao, Somali, Spanish, and Vietnamese. The staff is diverse, too, and largely bilingual. 

Serving a global community

CUHCC has evolved a lot since its 1966 inception, when it began as a pilot project aimed at providing pediatric medical and dental care to the then-predominantly American Indian community in the Phillips neighborhood.

Today, CUHCC provides comprehensive team-based care — not just medical and dental, but also mental health services, pharmacy, victim advocacy, legal services, education, and now, care coordination — to nearly 11,000 patients from numerous countries, cultures, and faith traditions.  

“Our patients have complex medical and psychosocial needs,” says Dwivedi. “We are committed to being present in their lives, even when they leave the clinic.” 

When she joined CUHCC in 2009, there were no care coordinators on staff. Their addition has been hugely important, Dwivedi says. “The psychosocial care coordinator, for example, can go and assess the patient’s living situation. That helps a lot in figuring things out.” Patients feel more secure, she adds, knowing that they can reach out to an entire team.

CUHCC is one of the largest primary care teaching sites in Minnesota, providing work and educational opportunities for nearly 300 students and residents from medicine, dentistry, pharmacy, nursing, social work, and public health each year. 

Fourth-year medical student and aspiring psychiatrist Kelly Setterholm describes her recent monthlong CUHCC rotation as transformative. 

“I learned a lot of the usual primary care stuff, like how to help patients manage chronic disease. But at CUHCC, you also learn so much more,” she says. “What are the intricacies of providing good patient care to a Somali patient versus a Hmong patient? Culturally appropriate care, trauma care —these are hard to grasp in the classroom. At CUHCC, it’s alive, it’s happening right in front of you.”

What are the intricacies of providing good patient care to a Somali patient vs. a Hmong patient? Culturally appropriate care, trauma carethese are hard to grasp in the classroom. At CUHCC, it’s alive, it’s happening right in front of you.

– Kelly Setterholm, fourth-year medical student

‘Accessing patients’ lives’

Setterholm spoke of one patient, a man whose physical health challenges were compounded by homelessness, depression, and substance abuse. In collaboration with his CUHCC psychiatrist, she and other medical staff were able to help him improve his emotional state.

“The people at CUHCC, they are positive, they are flexible, they are kind, they are willing to try new things. And they’re so good at accessing patients’ lives,” Setterholm says. “Not just the docs, but also the nurses, the nurse practitioners, the interpreters, the scheduling staff. It’s so important to have caring providers from all of these disciplines under one roof.”

Dwivedi believes “everything is in place” at CUHCC to deliver the best possible care to the community, but she hopes to expand the facility so the team can serve more patients, more efficiently. “We could meet more patients’ needs if we had a bigger structure. Otherwise, all the ingredients are here.” 

And that makes Dwivedi excited to come to work every day. “I feel like I did another residency when I joined CUHCC. I think in the future, more providers will be interested in primary care if we can show them how this model works. I tell my patients, ‘I’m on your side, I want to walk with you so that you feel supported.”

 

Published on October 24, 2016

(Lead photo: Scott Streble)

Historical Photo of the CUHCC opening

CUHCC’s first half century

1966 
CUHCC, Minnesota’s first community health center, is founded by the U of M as a pilot project for pediatric health and dental care for low-income, predominantly American Indian families in south Minneapolis.

Early ’70s
A comprehensive mental health program and a growing focus on culturally appropriate care mark the new decade.

1975
An adult medical program is added to serve pediatric patients’ parents. 

Early ’80s
Demographics evolve with the arrival of Southeast Asian and other immigrants.

1991
CUHCC moves into its current building at 2001 Bloomington Avenue.

Mid ’90s 
East African and Latino arrivals add to the neighborhood’s diversity.

2012
The clinic adds medical and psychosocial care coordination.

Visit www.cuhcc.umn.edu to see more of the Community University Health Care Center’s milestones.

Coordinated care for people with diabetes

A $50,000 grant from the Medtronic Foundation is boosting CUHCC’s use of coordinated care to help people who have diabetes improve their health. 

Strategies include:

  • Assigning a care coordinator to each patient for up to a year.
  • Developing a diabetes action plan for each patient.
  • Connecting patients with pharmacy residents who will customize medication plans as needed.
  • Providing support such as transportation assistance, interpretation, smoking cessation, legal services, and mental health case management.
  • Helping patients to complete MNSure insurance applications and renewals.