Jeff Lund is the National Consultant for Community Employment and Integration for UnitedHealthcare Community and State. Previously the Manager of Social Work, Employment and Habilitation for UnitedHealthcare Community and State. In his role, Jeff trains community-based care managers and manages internal and external stakeholder relations. He has also served on the National Foster Care Advisory Board and the Special Needs Advisory Board.
Every day, kids are placed into foster homes to wait for their forever families. My family made the decision 24 years ago to start providing a home for these kids, and we have since adopted six children out of the child welfare system. After arriving with us, each of our children has been diagnosed with one or more behavioral conditions, ranging from oppositional defiance disorder (ODD) and anxiety disorders to intermittent explosive disorder (IED), attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). One of our children also has a genetic physical disability, three have asthma and another has type two diabetes.
Between these different conditions, our household has always lived with higher needs than most. We engage with at least fifteen entities to manage everyone’s health. When my children were young, we were lucky to find a care provider who understood some of our specific needs. But a primary care provider alone could only do so much before we needed a specialist to help manage certain conditions and behaviors.
Finding care specialists has not always been easy. Some of my children are biracial, and it was important for us to find them a counselor who shared similar racial experiences. At the time, that left us with only two therapists to choose from in our entire state. Even finding a dentist who knows how to work with patients with ODD has been challenging. It’s not that these options don’t exist. It’s just difficult to find resources that point us in the right direction. An integrated approach to care begins to address this issue by creating networks of care providers and advocates who are familiar with complex needs.
Integration simplifies care for individuals
A few years back, my son needed a minor surgery that left him with a packed incision. I was instructed to remove the packing the next morning. But when the time came for removal, my son’s ODD kept him from allowing me to complete the removal. I called the surgeon, who only instructed that I try again. This went on for several days, each time the surgeon emphasizing the risk of infection but never offering an alternative solution.
Because I work for UnitedHealthcare, I was aware that there were options I could explore in this situation, and my son was eventually approved for sedation to have the packing removed. This solution was more cost-effective than having him end up in a psychiatric ward to manage his ODD, or in emergency care for an infection. But for many families, that is how the situation could have progressed.
In these types of circumstances, integrated care can provide advocates who understand behavioral and medical complexities and can connect families with care providers who have experience working with their unique conditions. This provides achievable next steps to get families the care they need.
Integrated care benefits care providers
Integrated care doesn’t just change the lives of individuals seeking treatment — it benefits care providers. Because my children have interconnected conditions, there are often extra considerations to take into account before landing on an appropriate treatment. With integrated care, providers have access to a network of professionals who understand unique conditions and are sometimes even familiar with the person in need of care. This makes it easier to get peer recommendations to help prevent provider burnout. And in the situation with my son, knowing providers who understand ODD and behavioral health triggers could have helped us get our need addressed sooner.
With my children, I never know when I’m going to need advocacy or an integrated care approach. But when I need them, it’s often an urgent situation that requires immediate attention. Care that empowers individuals — and provides advocates that understand a person’s unique needs — is a clear path for improving care experiences for anyone facing complex conditions.