One solution to the state's struggle to care for its physically sick and mentally ill sits on six wheels in a Puyallup parking lot—a mobile medical clinic.

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One solution to the state’s struggle to care for its physically sick and mentally ill sits on six wheels in a Puyallup parking lot.

The mobile medical clinic, parked in front of MultiCare Good Samaritan Behavioral Health one recent morning, brings primary medical care to the mentally ill, who may not get it otherwise.

The reasons for that are — like the unit — all over the place. Some just can’t get to the doctor’s office. Others can, but won’t walk through the door. And some simply can’t afford it.

As a result, they have diabetes, undiagnosed cancer and other diseases that eventually send them to the emergency room — and deep into taxpayers’ pockets.

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Here, this 38-foot mobile unit literally parks in front of the building where they already receive mental-health counseling. Patients are put at ease and get streamlined attention from a nurse practitioner with a background in mental health.

The mobile unit, a joint effort between MultiCare Health System and OptumHealth Pierce Regional Support Network (RSN), already has saved enough taxpayer money to make me wonder why these things aren’t traveling statewide.

Every week, this mobile unit spends one day at one of four mental-health clinics in Pierce County, including MultiCare Good Samaritan and Greater Lakes Mental Healthcare in Lakewood.

In 2009, the RSN served 12,121 patients. In 2010, it served 15,262 patients — a 25.9 percent increase — despite a $6.2 million decrease in state funding.

Need more? The program resulted in a 19.5 percent reduction in hospitalizations, saving more than $1 million that was used to start new programs, according to OptumHealth.

At a time when care for the poor and mentally ill has become less important on the state’s ledger, this program shows how much can be done with less, by coordinating services among agencies.

The program is the brainchild of Cheri Dolezal, the executive director of OptumHealth. She hated that I visited the unit attracted by how much money was being saved here.

It’s the patients she cares about.

“The focus isn’t on cost savings,” she said, “but on helping people get empowerment.”

I saw that in patient Deborah Hammond, 45, who lives in a Puyallup group home and was the first patient to visit the mobile unit when it started in March. She came back the other day to have a rash treated.

I sat with her in one of the mobile unit’s two treatment rooms and asked her about her mental and physical health. She has thyroid issues, she said, and diabetes.

Anything else?

“I’m bipolar,” she told me.

Is that it? I asked.

“Isn’t that enough?” she said.

Before she started with OptumHealth, “I was a real mess,” Hammond said. “Everything thing was going haywire with my body, and emotionally.”

She would see her mental-health doctor here, and her medical doctor in Tacoma.

“I was forgetting appointments, missing labs,” she said. “Just confusion.”

Her medical team was no better off: “One didn’t know what the other was doing,” she said.

Now, she said, all records are electronic, and her conditions have stabilized.

“I have a lot more energy.”

Rick Crozier, the director of integrated care for MultiCare Good Samaritan Behavioral Health, one of several sites the mobile unit visits, said many clients have doctors, but won’t go.

“Imagine when you have all this noise in your head,” Crozier said. “You never follow through.”

As a result, the mentally ill die 25 years on average before the rest of us due to lack of care, says a report by the national Association of State Mental Health Directors.

Steven Roberts, the nurse practitioner assigned to the unit, monitors blood pressure and performs other screenings, makes referrals to specialists and follow-up appointments.

Roberts spent 20 years working in behavioral health as a registered nurse, so he understands that patients can have trouble forming thoughts, be hyperactive, or have “latent limitations” that make quality health care difficult.

“In the rushed nature of the average doctor visit,” Roberts said, “the clients don’t feel they can fully express themselves.”

But here, he said. “They feel safe. We have the trust and rapport that they need.”

Nicole Brodeur’s column appears Tuesday and Friday. Reach her at 206-464-2334 or Money well-spent.

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