This referral is intended to provide targeted support to key people in our communities to help them stay healthy or navigate health challenges. The goal is for me to provide some extra help and support as a physician or health coach to ease the burden of navigating health challenges. 

Types of Services Offered:

- Education, counseling, and guidance on health issues and options to address them. 

- Health & lifestyle change coaching. 

- Resource navigation, including resources to support medication or health care affordability. 

- Advocacy in terms of supporting constructive engagement with other health professionals and providing documentation of needs. 

- Completing some types of paperwork based on specific details and circumstance (e.g., I might be able to complete work accommodation paperwork, sports or procedure clearance paperwork, or paperwork documenting an absence from work. However, I am not typically a good fit to complete Social Security Disability or disability benefits paperwork). 

- Self-management skill building support, including ensuring taking medications as directed, and taking accurate home blood pressures. 

- Emergency preparation support, including support in completing the Patient Advocate form and understanding health care options and resources. 

Qualification Criteria: 1. Identified by either of you as being someone who is an important or impactful member of your community (This determination is solely up to your discretion. Your referral is sufficient as meeting this criteria for me.). 2. 18 or older. 3. Is physically in Michigan or Ohio. 4. Does not need care to address an urgent medical issue (e.g., cold, flu, new stomach pain/diarrhea/loss of blood, worsening leg swelling/shortness of breath/chest pain, current episode of psychosis/active suicidal or homicidal ideation/mania). 

Cost: I will work with anyone referred to me by a trusted source to try to ensure cost is not a barrier. No-cost, reduced-cost ($50/hr), or trade-based (e.g., trading my services for produce, art, education/training, discounts on goods or services, priority in working with my clients) options are available.

Best Fit: Currently, I am the best fit to work with English-speaking adults who are struggling to manage a chronic health issue, or who are trying to figure out how to address a new health issue or concern. Additionally, they likely are uninsured or are underinsured, or otherwise having trouble affording care from traditional sources. 

Limitations: 1. I currently do not have the capacity to offer these services in Spanish. I am actively working to change this, but this is a limitation for now. 2. I do not take insurance, and I am not a Medicaid or Medicare provider. The cost for my professional services are something I can make sure is affordable for anyone I work with, even if that means providing the services at no cost. However, I am limited in my ability to diagnose, treat, and otherwise manage medical conditions, especially for people who have some form of insurance coverage. Ultimately, I believe there are many ways I can be uniquely helpful, but I am not able to offer full-spectrum medical care like a typical primary care provider (PCP) through my business because of its structure and resource limits. 

Information Privacy & Mandated Reporting: This visit is treated like any other health care visit, with the information obtained as part of this visit being considered private, confidential, and protected by physician-patient privilege. However, as a licensed physician, I am a mandated reporter. This means I am legally obliged to report and/or take other steps to address the following: 1. harm or neglect of a child or elder, 2. immanent threats of harm to oneself or others. In cases of harm or neglect of an elder, elders who have the capacity to make their own decisions will have the ability to work with Adult Protective Services to determine next steps. In cases of harm or neglect of a child, Child Protective Services (or the equivalent authority) will determine next steps. My goal is never to cause challenges for people or their families, and I try the best I can to navigate tough situations in a way that is respectful and empowering for everyone involved. However, I believe it is important for everyone to be aware of my legal obligations when deciding whether or not they want to work with me. Please make sure anyone you refer to me is aware of these legal obligations. I will also confirm their understanding of these legal obligations before igniting work with any person.

This 2-hour, in-home consult is offered to help older adults take steps to be prepared for emergencies and holistically promote safety, wellness, and autonomy as they age.

Typical Visit Components:

- Assess current health and wellness concerns. 

- Assess comfort and confidence in managing current health issues. 

- Assess comfort and confidence in completing activities of daily living. 

- Assess for medication error and fall risks. 

- Assess for possible unmet health and wellness needs. 

- Provide education & counseling to help optimize health and wellbeing.

- Discuss strategies for getting the most out of health care visits.

- Discuss strategies for being prepared in case of a health emergency.

- Discuss the Patient Advocate designation form & assist in completion if needed. 

- Discuss additional advanced care planning concerns. 

- Discuss strategies for increasing social connection and sense of purpose. 

Information Privacy & Mandated Reporting: This visit is treated like any other health care visit, with the information obtained as part of this visit being considered private, confidential, and protected by physician-patient privilege. However, as a licensed physician, I am a mandated reporter. This means I am legally obliged to report and/or take other steps to address the following: 1. harm or neglect of a child or elder, 2. immanent threats of harm to oneself or others. In cases of harm or neglect of an elder, elders who have the capacity to make their own decisions will have the ability to work with Adult Protective Services to determine next steps. My goal is never to cause challenges for elders or their families, and I try the best I can to navigate tough situations in a way that is respectful and empowering for everyone involved. However, I believe it is important for elders to be aware of my legal obligations when deciding whether or not they want to work with me.

Qualification Criteria: 1. Person is at least 50 years old. 2. Is physically in Michigan or Ohio. 3. Does not need care to address an urgent medical issue (e.g., cold, flu, new stomach pain/diarrhea/loss of blood, worsening leg swelling/shortness of breath/chest pain, current episode of psychosis/active suicidal or homocideal ideation/mania). 

Cost:  An intensive 2-hour house call visit through my practice typically costs $900. I offer this service publicly at the discounted rates listed below:

- $0 or non-monetary exchange - Indigenous Elders.

- $50 - Non-Indigenous Elders who are Uninsured, or have Medicaid or a Market Place insurance plan, or who are unable to afford their medical bills.

- $250 - All other non-Indigenous Elders.

However,   I will work with anyone referred to me by a trusted source to try to ensure cost is not a barrier. No-cost, reduced-cost ($50/hr), or trade-based (e.g., trading my services for produce, art, education/training, discounts on goods or services, priority in working with my clients) options are available.

Limitations: 1. I currently do not have the capacity to offer these visits in Spanish, but hope to be able to offer at least 1-2 Spanish-language visits per month in the near future.