Monthly Update
Pew Research Center survey found that 46% of U.S. adults have a family member or close friend who is addicted to drugs or has been in the past. The experience is common across demographic and partisan lines and comes amid a sharp increase in U.S. drug overdose deaths. Learn more here.
Patient Profile
An oncology social worker at a local hospital reached out to Casa de Salud regarding "Marisol," an uninsured, foreign-born patient that was facing barriers to care due to her insurance status and lack of access to transportation. The social worker explained that Marisol lives in a rural part of Missouri where most transportation resources available to cancer patients, such as non-emergency medical transportation services, were not an option for Marisol due to her distance from the hospital, and Marisol did not have reliable transportation to make the hour and a half journey to receive treatment. 
Casa's GUIA Program agreed to take on Marisol's case and utilize our arrangement with Uber Health to ensure she could get to her appointments. However, shortly after taking on the case, the GUIA case manager assigned to Marisol realized that she lived outside of Uber Health's service area. So it was time to get creative.
The GUIA Program Coordinator determined exactly where the boundary of Uber Health's service was in relation to Marisol's home. The Coordinator then found a safe location (the parking lot of a fast food restaurant) within the boundary from where the Uber driver could pick up Marisol. After Marisol found a friend who could drive her as far as the restaurant, the arrangement was put into motion.
GUIA is actively seeking treatment options closer to Marisol's home or, alternatively, in another state where she has family. In the meantime, Casa's work on behalf of Marisol has provided the means for her to receive the chemotherapy sessions she requires.
Volunteer Spotlight

This month our Spotlight shines on Gary Ratkin, MD,
who has served as a Casa medical provider since July of 2012. From the beginning, Dr. Ratkin has held a clinic on a weekly basis at a minimum, making him one of our most active volunteer doctors. He also serves as one of Casa's Medical Directors, assisting with clinical oversight and the credentialing of new providers.

Gary Ratkin, MD

Dr. Ratkin was excited to learn about Casa de Salud six years ago when he began to consider projects he could become involved with in retirement from his specialty practice. Dr. Ratkin said, "The opportunity to practice primary care Internal Medicine in a well-organized environment that was transitioning to a chronic care model was appealing to me. I was also happy to learn more about the navigation services that were so useful for our patient populations."
Dr. Ratkin went on to say that, "While I understood much of the Spanish our patients spoke, the availability of incredible interpreters at every visit made it a better experience in patient care than I could have imagined. I came from a team-based practice so I have also come to appreciate our nursing, medical assistant, reception and administrative staff as part of the continuum of care I have seen evolve. I have also been privileged to meet the diverse group of professionals who are engaged in providing the best care possible for our patients."
With regard to the future, Dr. Ratkin hopes to recruit like-minded primary care providers to become engaged with Casa and provide medical and mental health services to an even wider range of immigrants.
Everyone at Casa is grateful to Dr. Ratkin for his dedication to the organization and the excellent care he provides to every patient he treats.
Congrats Julieta!

Julieta Barrios, Casa's Front Desk Coordinator, completed the necessary studies to graduate last month from Washington University in St. Louis with an Advanced Certificate in Premedical Studies.

Julieta Barrios

Julieta's background is in education, having graduated from the University of San Diego with a degree in Ethnic Studies and worked for Teach for America in Washington, DC. But it has been her goal to study medicine.
"This certificate puts me one step closer to medical school!" Julieta exclaimed. "With my education and the invaluable experiences I've gained while at Casa de Salud, I feel even more determined to pursue a career in medicine."
The Advanced Certificate in Premedical Studies program provides the opportunity for people who did not initially focus on medicine to study the sciences and to prepare for entrance into competitive medical schools and other professional programs in the health sciences. The fact that Julieta was able to successfully complete her certificate work at one of the nation's top universities while also working full time in her demanding job at Casa speaks to the caliber of person she is.  
Congratulations, Julieta!
¡Zocaloco! Will Return!
The 2019 edition of ¡Zocaloco! will take place on Saturday, May 4 at Saint Louis University's Wool Ballroom. There will be some updates to the event to make it even more fun. Stay tuned to this newsletter for more information.
If you took photos at the photo booth during the gala last month and want digital versions, you can find them here.
Supporting Casa
Please, consider a tax deductible donation to Casa today. You can mail a check to our office at 3200 Chouteau Avenue, St. Louis, 63103, give on line, or by texting "casa" to 314-270-1992.
Your generosity makes Casa de Salud the premier resource for affordable and quality care for the foreign-born community in the St. Louis region!
Watch Our Video!
Casa de Salud - Compassionate Path to Wellness 
Mexican Cónsul Visits Casa
Alfonso  Navarro   Bernachi, Cónsul of México based in Kansas City, Missouri, visited Casa last month to tour the new Mental Health Collaborative.  
Cónsul Alfonso Navarro (right) with  
Casa President Jorge Riopedre    
The Consulate of Mexico in Kansas City is the official representation of the Mexican Government in the states of Kansas, Missouri and Western Oklahoma. Part of Cónsul Navarro's activities include reaching out to the Mexican and Mexican-American communities in these areas to inform them about the available consular services.  Cónsul Navarro has also been touring the region to better explain the importance of the upcoming elections in Mexico to the people of Missouri ( click here to read his op-ed in the St. Louis Post-Dispatch).
All of us at Casa de Salud thank Cónsul Navarro for making the time to tour Casa and learn more about what we are doing to assist immigrants of all nationalities to get access to needed care.
Amazing Friends
Casa de Salud's affiliate group, Friends of Casa, had a "Talk & Tapas" meet and greet for prospective members at the home of Casa's Founder, Bob Fox. 
Bob Fox (standing) greets members and guests  
of Friends of Casa    
The guests heard updates about the Mental Health Collaborative and the work that Casa will be doing, with the support of a generous grant from Missouri Foundation for Health,  to further serve non-Latino immigrants and refugees. In addition, the Chair of Friends, Geoff Whitlock, encouraged everyone to come out to the Amazing Taco Race Scavenger Hunt on July 14.  
Geoff Whitlock provides updates about upcoming Friends of Casa events 
He also provided information about the third annual Trivia Night.  This year the theme will be Marvel vs. DC.  Come as your favorite superhero for a fun-filled night of food, drinks, and competition, along with awesome auction items!
For more information about either of these events contact the Event Chair, Lauren Masterson-Rodriguez.  If you're interested in joining Friends of Casa, contact the group's Membership Chair, Cristina Duncan. 
Provider Anniversaries

Casa thanks the following providers who celebrate their anniversaries with us this month:
Frank Kim Anderson, MD - 6 Years

Kate Barth, RN - 2 Years  

David Montani, MD
- 4 Years 
Letter from the President
No sooner is there yet another school shooting, or for that matter a mass shooting of any kind, than the mantra of access to mental health services starts pouring forth from the mouth of politicians and activists. Paul Ryan, speaker of the House of Representatives, summed this up when he opined that "mental health is often a big problem underlying these tragedies." And yet mass shootings by people with serious mental illness represent one percent of all gun homicides each year, according to the American Psychiatric Association.
Not only, then, does this mindset misrepresent the facts, it also conceals the real impact of access disparities, including homelessness, incarceration, job and family instability, and clinical health issues. Even so, the Patient-Centered Primary Care Collaborative reported that two-thirds of all primary care physicians report not being able to access outpatient behavioral health for their patients.
Some of this is due to a shortage of providers, a factor often cited by America's Health Insurance Plans, a national trade association representing companies that sell health insurance coverage.
But cost is also a major factor. A national survey by the U.S. Substance Abuse and Mental Health Services Administration showed that unaffordability was the most common reason for not receiving mental health services among adults who needed it. A separate study revealed that consumers pay 10% - or nearly $20 billion - of mental health care bills out of pocket.
For all these reasons, Casa launched its Mental Health Collaborative (MHC), and I am very grateful to our founding partners -- Bilingual International Assistance Services, Saint Louis University, St. Francis Community Services, and St . Louis Psychoanalytic Institute - as well as our newest partners, Great Circle and Multicultural Counseling and Research Center, for their outstanding work. In just three months of operations, we have already had over 400 appointments for behavioral health services at the MHC.
But we must do more. The Regional Health Commission noted that in 2016 almost a fifth of Emergency Room visits in the region were at least partially related to mental health diagnoses (primary and secondary) . And according to the American Association of Suicidology , Missouri has the 14th highest suicide rate in the nation. We can't just accept this. There are steps we can take, some obvious, some less so
Clearly we should strive for healthcare reform that ensures meaningful standards of care and includes quality mental health care on-site to make this work competitive with private practice and other professions. And loan forgiveness programs for those new to the field could help increase the availability of mental health professionals.
There are also broader initiatives to pursue: social workers and therapists on the staff at schools with high risk populations; accessibility to Nurses for Newborns, Parents as Teachers, and accredited early childhood programming so that children get a healthy start in life; and neighborhoods that include access to healthy food, community centers, and quality schools. These may seem far afield from mental health, but as the non-profit industry writer Vu Le has observed, "Mental health will affect employment will affect housing will affect early learning will affect youth development will affect safety."
This has been a lengthier letter than usual from me, but the stakes couldn't be higher. We need to recommit to providing the access to care that our community members need so that we all benefit.
Jorge Riopedre
President, Casa de Salud

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