♪ ♪ ♪ ♪ UP NEXT ON "CYCLE OF HEALTH..." TONIGHT'S TOPIC: A NEW PATH TO WELLNESS.

TONIGHT WE DIVE DEEP INTO THE WORLD OF HOLISTIC WELLNESS AND INTRODUCE YOU TO AN EXCITING NEW INSTITUTE THAT'S CHANGING THE GAME WHEN IT COMES TO INTEGRATED CARE.

WE'RE JOINED BY MEDICAL PROFESSIONALS THAT ARE LEADING THE CHARGE IN THIS WELLNESS REVOLUTION TO DISCUSS HOW INTEGRATED CARE CAN TRANSFORM OUR LIVES.

♪ ♪ >> HELLO AND WELCOME TO CYCLE OF HEALTH, I'M DR. RICH O'NEILL.

TONIGHT'S TOPIC: A NEW PATH TO WELLNESS.

TONIGHT WE DIVE DEEP INTO THE WORLD OF HOLISTIC WELLNESS AND INTRODUCE YOU TO AN EXCITING NEW INSTITUTE THAT'S CHANGING THE GAME WHEN IT COMES TO INTEGRATED CARE.

WE'RE JOINED BY MEDICAL PROFESSIONALS THAT ARE LEADING THE CHARGE IN THIS WELLNESS REVOLUTION TO DISCUSS HOW INTEGRATED CARE CAN TRANSFORM OUR LIVES.

LET'S MEET OUR GUESTS: JENNIFER SPEICHER, ASSOCIATE ADMINISTRATOR OF AMBULATORY SERVICES AT SUNY UPSTATE MEDICAL UNIVERSITY.

DR. ANDREA SHAW MEDICAL DIRECTOR AT THE CENTER FOR INTERNATIONAL HEALTH AT SUNY UPSTATE DR. BRIAN RIEGER ASSISTANT PROFESSOR OF PSYCHIATRY AMBULATORY CARE FROM SUNY UPSTATE BEFORE WE GET INTO THE DISCUSSION, OUR CYCLE OF HEALTH TEAM VISITED THE BRAND NEW NAPPI WELLNESS INSTITUTE AT UPSTATE UNIVERSITY HOSPITAL TO LEARN ABOUT THE RANGE OF SERVICES THEY OFFER AND HOW THEIR THOUGHTFULLY DESIGNED FACILITY IS GEARED TOWARDS FOSTERING HOLISTIC WELL-BEING.

FOR BOTH STAFF AND PATIENTS.

LET'S TAKE A LOOK.

>> SO THE NAPPI WELLNESS INSTITUTE WAS DEVELOPED TO BRING ALL OF THE AMBULATORY PRACTICES AROUND UPSTATE UNDER ONE ROOF.

PATIENTS FROM PEDIATRIC TO GERIATRIC PRACTICE WITH DIABETES, INTERM MEDICINE, INCLUSIVE HEALTH SERVICES AND NEWLY DEVELOPED CENTER FOR INTERNATIONAL HEALTH ALL HOUSED HERE AND I THINK ONE OF THE MOST UNIQUE FACTORS IS INTEGRATED BEHAVIORAL HEALTH IN ALL OF THOSE PRIMARY CARE CLINICS.

>> WE ARE REALLY LOOKING AT THIS KIND OF ONE STOP HEALTHCARE MODEL, WHERE OUR OLDER ADULTS CAN COME IN AND SEE A NUMBER OF CONNECTED HEALTHCARE PROVIDERS AND GET THEIR CARE IN ONE PLACE.

>> REALLY FOCUSING ON TEAM BASED CARE RATHER THAN INDIVIDUAL PROVIDER FOCUSED CARE.

WE ARE DOING WHAT WE CAN TO TAKE CARE OF OUR EMPLOYEES AND FOCUS ON WELLNESS.

IT'S NOT JUST RECRUITING FOLKS BUT MAKING SURE THEY WANT TO STAY AND THEY'RE HAPPY HERE.

THIS BUILDING IS THE FIRST WELL CERTIFIED BUILDING IN ALL OF NEW YORK STATE FOR A HEALTHCARE INSTITUTION.

>> THE WELL CERTIFICATION ENHANCES OUR DESIGN ON SEVERAL TOPICS, AIR QUALITY, TEMPERATURE, HUMIDITY, NUTRITION, FITNESS, THINGS WE MIGHT NOT THINK ABOUT WHEN WE ARE BUILDING A BUILDING.

SO PERFECT EXAMPLE IS EVERY SINGLE ONE OF OUR WATER FOUNTAINS ARE FILL STATIONS TO MAKE SURE THAT WE HAVE YOU KNOW, FRESH POTABLE PARTY FOR PEOPLE TO HAVE-- WATER FOR PEOPLE TO HAVE IN REUSABLE CONTAINERS AS MUCH AS POSSIBLE.

AIR QUALITY, WE HAVE ONE OF THE GREATEST HIGHEST GRADES HVAC SYSTEMS, AND NUTRITION, THE CAFETERIA ONCE BUILT OUT WILL HAVE A HIGHER LEVEL OF REGULATIONS FOR THEIR FOOD.

SO 50% OR MORE FRESH FRUITS AND VEGETABLES DAILY.

LOW SUGAR CONTENT IN THEIR FOODS.

CLEAR LABELING.

LABELING FOR NOT ONLY NUTRITION BUT FOR ALLERGENS AS WELL.

WE HAVE WITNESS IN MIND WHEN IT COMES TO THE STAIR WELLS, STAIR WELLS ARE RUBBERIZED, BEAUTIFUL LIGHTING, PAINTED IN A WAY THAT IS INVITING.

EVEN ON SOME OF THE STAIRCASES IT TELLS YOU HOW MANY STEPS YOU CLIMBED AT THE END OF THE STAIRCASE.

I THINK THE BEST COMPLIMENT WE GET FOR ANY OF OUR NEW SPACES, THE CANCER CENTER, THE CHILDREN'S HOSPITAL, NAPPI WELLNESS INSTITUTE AND ANY BUILDING WE BUILD MOVING FORWARD IS THAT IT DOES NOT FEEL LIKE A HOSPITAL SPACE.

THAT'S ON PURPOSE.

IT'S MEANT TO FEEL MORE LIKE HOME: OPEN, LIGHT, COLORS, ART, WE REALLY PRIDE OURSELVES ON MAKING THAT SHIFT IN CHANGE.

IT DOESN'T HAVE TO BE STEAL, DAG NET-- STALE, STAGNANT WHITE PAINT.

>> OUR GOAL FOR OUR PATIENTS IS TO STAY IN THE COMMUNITY AS LONG AS POSSIBLE AND GET WHATEVER SUPPORTS THEY NEED TO HELP THEM DO THAT.

>> TO BE ABLE TO HEAL, YOU NEED A HEALING ENVIRONMENT AND THAT'S WHAT THE NAPPI WELLNESS INSTITUTE IS BASED ON.

>> SO, TELL US ABOUT INTEGRATED CARE.

HOW IS THIS IMPORTANT?

>>Y WITH-- WELL, AS THE DIRECTOR OF THE INTEGRATED CARE PROGRAM AND PSYCHOLOGIST, IN MY CASE, IT REFERS TO INTEGRATING MENTAL HEALTH SUPPORTS AND HELPING PATIENTS WITH THEIR HEALTH BEHAVIOR.

BUT REALLY WHEN WE THINK ABOUT NAPPI, WE CAN THINK ABOUT INTEGRATED CARE IN A MUCH BROADER SENSE.

>> SO WHEN YOU ARE SAYING HEALTH BEHAVIOR, YOU MEAN THINGS WE CAN DO TO KEEP OURSELVES HEALTHIER OR GET OURSELVES HEALTHY AGAIN.

>> THAT'S RIGHT.

OUR BEHAVIOR CONTRIBUTES A LOT TO OUR HEALTHINESS, ESPECIALLY WITH CHRONIC DISEASES SUCH AS DIABETES.

>> HOW ABOUT YOU FOLKS?

WHAT IS YOUR TAKE ON THIS?

>> SO THIS WHOLE INSTITUTE REALLY BRINGS TOGETHER A LOT OF PRIMARY CARE ASSETS, ALL UNDER ONE UMBRELLA.

I LEAD OUR PROGRAM THAT WELCOMES NEW REFUGEES TO SYRACUSE AND INTEGRATES THEM INTO PRIMARY CARE, GIVES THEM A PRIMARY CARE HOME.

AND REALLY MEETS THE NEEDS OF THE HIGH LEVEL OF SOCIAL DETERMINANTS THAT THESE REFUGEES NEED IN ORDER TO BE SUCCESSFUL AND HEALTHY HERE.

>> I THINK AS AN ADMINISTRATOR CONSIDERING INTEGRATED HEALTH IN PRIMARY CARE, IT'S IMPORTANT TO RECOGNIZE THAT SYRACUSE HAS BEEN CITED AS ONE OF THE POOREST CITIES, LARGE CITIES IN ALL OF THE UNITED STATES.

>> SADLY.

>> AND THEREFORE ADDRESSING PHYSICAL HEALTH IS JUST ONE ASPECT TO KEEPING OUR POPULATION HEALTHY.

AND SO INCLUDING ASPECTS SUCH AS MENTAL HEALTH WHICH Dr. RIEGER TALKED ABOUT AND GIVING OUR PATIENT THE BEST CHANCE AT BEING PRODUCTIVE.

THEY CANNOT GO TO SCHOOL OR WORK IF THEY'RE NOT HEALTHY AND THAT'S THE ROLE THE PROVIDERS IN THIS BUILDING PLAY.

>> THE MISSION OF THE NAPPI IS TO PROVIDE REALLY A WHOLE RANGE OF SERVICES TO ANYBODY WHO COMES THERE; INCLUDING NEW PEOPLE TO THE COMMUNITY, IMMIGRANTS TO THE COMMUNITY.

>> AND THERE IS A WHOLE RANGE OF SERVICES BECAUSE TO BE HEALTHY, WE HAVE TO ADDRESS A WHOLE RANGE OF PROBLEMS.

IT'S NOT JUST INFECTIOUS DISEASE ANYMORE.

JUST THE STRESS AND TRAUMA GROWING UP IN A DIFFICULT CIRCUMSTANCE CAN HAVE A SIGNIFICANT INFLUENCE ON YOUR HEALTH AND NEED TO BE ADDRESSED.

>> I UNDERSTAND ONE OF THE KIND OF UNIQUE ASPECTS I'VE NEVER HEARD OF IS A FOOD PHARMACY.

IS THAT WHAT YOU CALL IT?

>> SO ONE OF THE GREAT ASSETS OF THE BUILDING IS PARTNERING WITH COMMUNITY AGENCIES.

WE DON'T PRETEND DO THIS ON OUR OWN, SO WITHIN THE BUILDING WE HAVE A PARTNERSHIP WITH THE FOOD BANK OF CENTRAL NEW YORK SO THAT AS PATIENTS COME THROUGH, JUST AS THEY'RE SCREENED FOR MEDICAL ISSUES, THEY'RE ALSO SCREENED FOR FOOD INSECURITY.

AND IF ON A PARTICULAR DAY, A PATIENT OR A FAMILY IDENTIFIES AS NOT BEING ABLE TO FEED THEMSELVES OR THEIR FAMILIES, WE HAVE OUT OF OUR PHARMACY, THE ABILITY TO DISPENSE IMMEDIATE NEEDS, BUT ALSO MORE IMPORTANTLY, GET THOSE PATIENTS LINKED UP WITH SOCIAL WORK AND CASE MANAGEMENT FOR LONG-TERM SOLUTIONS AND RESOURCES THAT ARE SUSTAINABLE FOR THEM.

>> SO YOU ARE REALLY TAKING A LOOK AT THE PERSON'S WHOLE LIFE AND SEEING WHAT ARE THEIR NEEDS?

WHAT IS GOING TO HELP TO PERSON BE HEALTHY IN THEIR WHOLE LIFE?

>> I CAN EXPAND ON THAT AS REFUGEES COME TO SYRACUSE WITH BACKGROUND OF YEARS OR DECADES OF PERSECUTION AND TRAUMA, THEY ARRIVE WITH LANGUAGE BARRIERS, WITH SYSTEMS BARRIERS, WITH LIMITED TRANSFERABLE SKILLS, AND IN ORDER TO SUPPORT THEIR HEALTH, YOU HAVE TO BUILD A SYSTEM THAT ALLOWS THEM TO INTEGRATE AND UNDERSTAND, SO IT MEANS BRINGING THE PHARMACIST INTO THE CLINIC, THE SOCIAL WORKER, INTERPRETER, CASE MANAGER, THE CARE MANAGER, NUTRITIONISTS WITHIN THE BUILDING, RESPIRATORY THERAPISTS WITHIN THE BUILDING.

ALL OF THESE INTERPROFESSIONALS WORK IN AN INTEGRATED WAY TO TRY TO SUPPORT THE CARE BETTER SO THAT PEOPLE AREN'T JUST COMING INTO A 15-MINUTE VISIT WHERE IF YOU SPOKE ENGLISH AND WERE RAISED IN THE SYSTEM, MAY UNDERSTAND YOUR HEALTH AT THE END OF THE VISIT.

WE NEED ADDITIONAL SUPPORTS IN PLACE TO SUPPORT A VULNERABLE POPULATION THAT MAY NOT COME WITH THE SKILLS NEEDED TO UNDERSTAND THEIR HEALTH.

>> AND WHETHER YOU ARE A REFUGEE OR NOT PATIENTS WHO GO TO THEIR DOCTOR REALLY TRUST THEIR DOCTOR AND SO THE IDEA THAT THERE ARE OTHER SERVICES THAT ARE RIGHT THERE, SO WHEN Dr. SHAW CALLS IN A BEHAVIOR HEALTH PERSON, WE COME IN THE ROOM AND THE PATIENT SEES OH, YOU WORK WITH Dr. SHAW AND WE LOVE Dr. SHAW, SO WE ARE GOING TO BE WILLING TO TALK TO YOU IN A WAY AT THAT TIME WE MIGHT NOT HAVE OTHERWISE.

>> YES, SO THE SENSE OF SAFETY AND AUTHORITY TRANSFERS TO THE PERSON WHO IS COMING IN THE ROOM?

AND IT TRANSFERS TO THE TEAM THAT HOPEFULLY IS THERE TO TAKE CARE OF IT.

>> AND I THINK ULTIMATELY, ONE OF THE ADVANTAGES THERE IS THE GOAL OF KEEPING PATIENTS OUT OF THE MANDELA DEPARTMENT.

BEING ABLE TO ADDRESS A GREATER NUMBER OF NEEDS IN AN INTERDISCIPLINARY WAY THROUGH PRIMARY CARE IS MORE LIKELY TO GIVE THE PATIENTS THE SKILLS AND THE RESOURCES THAT THEY NEED SO THAT THEY ARE NOT PRESENTING IN THE MANDELA DEPARTMENT, WHICH IS ALREADY OVERLOADED REALLY WITH ACUTE ISSUES SO MEETING PATIENTS WHERE THEY NEED TO BE AND SO WE HAVE A BALANCE IN THE COMMUNITY.

>> I'M THINKING THAT IS GOOD FOR THE PBL HEALTH OF THE COMMUNITY.

SOMEBODY GOES TO THE MANDELA ROOM, IT COSTS AN ENORMOUS AMOUNT OF MONEY IT RAISES THE QUESTION FOR ME ABOUT, YOU KNOW, I'M GUESSING A LOT OF THE PEOPLE WHO COME TO LIKE, FOR INSTANCE, CENTER FOR INTERNATIONAL HEALTH WOULD BE ON MEDICAID AND THE FEES MEDICAID PAYS ARE UNSUSTAINABLE FOR HEALTHCARE INSTITUTIONS HOW DOES THE INSTITUTION SURVIVE?

I'M WORRIED FIVE YEARS FROM NOW NAPPI WILL BE CLOSING BECAUSE THERE IS NOT ENOUGH MONEY TO KEEP IT APLOAT?

IS THAT A REASONABLE FEAR AS AN ADMINISTRATOR, FOR INSTANCE?

>> I DON'T THINK IT'S A REASONABLE FAIR FEAR.

ONE THING HAS AN EFFECT ON ANOTHER.

WHEN WE HAVE INAPPROPRIATE UTILIZATION OF SERVICES WE ARE NOT ABLE TO SERVE THE SICKEST OF THE SICK WHICH DOES REIMBURSE APPROPRIATELY.

>> SO IT'S A BALANCE.

>> BUT WHEN WE HAVE PATIENTS THAT DON'T NEED THAT LEVEL OF CARE AND WE HAVE LONG WAIT TIMES, THE HOSPITAL IS NOT ABLE TO DO WHAT IT NEEDS TO DO WE ARE IN A TRANSITIONARY PERIOD MOVING FROM VOLUME TO VALUE IN DELIVERING CARE THAT IS MORE HOLISTIC THAT FOCUSES ON OUTCOMES.

NEURAL, THE PAYMENT MECHANISMS AS YOU TALKED ABOUT HAVE NOT QUITE CAUGHT UP YET AND THAT'S WHERE THE COMMUNITY PARTNERSHIPS ARE ESSENTIALLY, YOU KNOW, SO THAT WE ARE NOT JUST A SINGLE PRIMARY CARE PROVIDER TRYING TO ATTACK ALL OF THE NEEDS OF THE PATIENTS BUT WORKING WITH THE FOOD BANK, WORKING WITH THE DIAPER BANK, WORKING WITH OTHER COMMUNITY PARTNERS TO ADDRESS THE NEEDS OF OUR PATIENTS, WORKING WITH SCHOOLS NO ONE PROVIDER CAN DO THIS ALONE.

>> YOU WERE GOING TO SAY SOMETHING?

>> WORKING ACROSS SILOS IN THE COMMUNITY SETTING AND WITH PAYERS, SOMETIMES PEOPLE TALK MEDICAID BRICK WALL BUT YOU HAVE MANAGED MEDICAIDS THAT ARE VERY INTERESTED IN THE QUALITY OF THE CARE THAT THEIR PATIENTS ARE RECEIVING AND THEY'RE VERY INTERESTED IN KEEPING PEOPLE OUT OF EXPENSIVE EMERGENCY MEDICINE CARE.

FOR EXAMPLE, A FEW YEARS AGO WE GOT SOME GRANT FUNDING TO HELP US DEVELOP A PROGRAM THAT HELPED SUPPORT SOME OF THESE QUALITY METRICS WITH REFUGEES AND WHEN WE SHOWED THAT HEALTH NAVIGATORS, PEOPLE WHO ARE CULTURALLY AND LINGUISTICALLY ALIGNED WITH REFUGEES CAN HELP THEM NAVIGATE THROUGH THE SYSTEM AND SPECIALTY APPOINTMENTS WE FOUND BETTER HEALTH OUTCOMES.

AND UNITED HEALTHCARE WAS INTERESTED IN THAT AND SUBSEQUENTLY TURNED TO HELP FUND THOSE SALARIES FOR HEALTH NAVIGATORS SO COMMUNITY-BASED WORK, BUT WORKING WITH MEDICAID, WORKING WITH THE COMMUNITY AND US SHOWING THE CARE OUTCOMES, IS WHAT HELPED THAT TO BE FUNDED SO I THINK QUALITY-BASED PAYMENTS ARE AVAILABLE IN CERTAIN ARENAS AND ARE A DIRECTION THAT PEOPLE WANT TO GO WITH THIS CARE.

DO YOU TRACK OUTCOMES OR HAVE METRICS FOR THAT.

>> THERE ARE QUALITY MEASURES REQUIRES FOR CENTER FOR MEDICARE SERVICES BUT CLINICS LIKE OURS ARE INTERESTED IN DEVELOPING QUALITY IMPROVEMENT INITIATIVES SO IF YOU TAKE DIABETES AS AN EXAMPLE, IT'S A SIGNIFICANT CHRONIC HEALTHCARE ISSUE THAT IS AFFECTED BY MANY THINGS, INCLUDING FOR EXAMPLE, DEPRESSION SO AS A QUALITY TARGET AND A WAY TO LOWER THE BURDEN AND COST TO THE SYSTEM, IF WE CAN TREAT DEPRESSION IN INDIVIDUALS WHO ARE STRUGGLING WITH DIABETES AND THEY OFTEN COME TOGETHER, WE CAN IMPROVE THAT PATIENT'S ABILITY TO MANAGE THEIR HEALTH IS THERE A CENTER.

>> >> THE JOSLIN DIABETES CENTER IS ON THE FIFTH FLOOR.

THEY TAKE CARE OF BOTH ADULTS AND PEDIATRIC PATIENTS BUT INCREASINGLY, THEY'RE MANAGING A BULK OF THEIR PATIENTS WITH DIABETES AND TO HAVE THOSE CONSULTANTS JUST ONE OR TWO FLOORS UP FOR A QUICK CONSERVATION AND THE PATIENTS THAT NEED MORE INTENSE LEVEL OF ENDOCRINE SUPPORT TO GO UP ANOTHER FLOOR TO SEE THE SPECIALIST, COME DOWNES STAIRS AND THEIR PRESCRIPTIONS ARE READY IN THE PHARMACY BEFORE THEY LEAVE THE BUILDING IS EXTREMELY CONVENIENT AND IMPROVES ADHERENCE.

>> I LOVE THAT IDEA.

NOT HAVING TO TAKE A TRIP TO THE PHARMACY IN THE MIDDLE OF THE WINTER FOR SOMETHING, JUST WALK DOWNSTAIRS.

>> AND WE HAVE A PSYCHOLOGIST IN THE PEDIATRIC AND ADULT SIDE OF THE JOSLIN DIABETES CENTER.

>> IF I WAS ON INSULIN, I MIGHT FEEL DEPRESSED ABOUT HOW THINGS ARE GOING FOR ME SO YOU CAN HAVE SOMEONE CALLED A PSYCHOLOGIST AND COME IN RIGHT ON THE SPOT AND SAY LET'S TALK ABOUT WHAT IS GOING ON SOMETIMES THE PSYCHOLOGIST MIGHT BE TIED UP WITH ANOTHER PATIENT BUT THE IDEA IS WHEN WE ARE NOT WITH PATIENTS, TO BE AVAILABLE OFTEN SITTING RIGHT IN THE SAME SITTING SIDE BY SIDE WORKING TOGETHER.

>> IF I'M A PATIENT IN THE COMMUNITY RIGHT NOW OR SOMEBODY WHO IS NO THE A PATIENT BUT WANT TO BECOME A PATIENT AT YOUR INSTITUTE, HOW DO I DO IT?

>> THE POST IMPORTANT THING IS TO UNDERSTAND WHAT WHAT YOU ARE LOOKING FOR, WE HAVE PEDIATRIC CARE, INTERNAL MEDICINE, Dr. SHAW'S CLINIC, INCLUSIVE HEALTH SERVICES AND GERIATRIC CENTER.

THE BEST WAY TO SEEK GUIDANCE AS TO THE MOST APPROPRIATE PRACTICE TO SEEK TO JOIN WOULD BE CALLING M.D.

DIRECT, WHICH IS A LINE THAT'S AVAILABLE THROUGH UPSTATE WHERE PROFESSIONALS WILL HELP GUIDE YOU IN YOUR DECISION AND MAKING CONTACT WITH THE PRIMARY CARE OFFICE TO GET CONNECTED WITH WHATEVER SERVICES AND THEY WOULD FUNNEL YOU IN THE RIGHT DIRECTION AND WHAT ABOUT HOW ABOUT FOR NEW REFUGEES WHO MAYBE DON'T KNOW HOW TO USE THE PHONE SYSTEM YET?

>> SYRACUSE IS A VERY WELCOMING COMMUNITY.

WE HAVE THREE RESETTLEMENT AGENCIES THAT WE WORK VERY CLOSELY WITH AND SO 1% OF THE REFUGEES WHO GET RESETTLED IN THIS COUNTRY TOWM TO SYRACUSE.

1200 IN THE LAST YEAR AND LOOKING AT CLOSER TO 1500 NEXT YEAR.

AND JUST OVER HALF OF THEM WILL COME TO UPSTATE FOR PRIMARY CARE CATHOLIC CHARITIES, INTERFAITH AND RISE ARE THE ONES WHO BRING THE NEW CASES TO US.

>> SO THEY HAVE-- THEY COME DIRECTLY TO YOU.

A GREAT EXAMPLE OF HOW THE COMMUNITY IS WORKING TOGETHER THE SERVICES, INSTITUTE IS INTEGRATED WITH THE COMMUNITY IN A WAY THAT I HAVE NEVER HEARD OF BEFORE.

AS A PSYCHOLOGIST, I WONDER WHERE CAN I SEND THIS PERSON?

IT SOUND LIKE YOU FOLKS ARE DOING THAT SORT OF AS THE CENTRAL MISSION OF THE INSTITUTE.

>> WE ARE IN THE PAY BY STEPS OF IT.

IT DOES TAKE THE ENTIRE COMMUNITY, THE HOSPITAL CAN'T DO IT, A PRIMARY CARE OFFICE CAN'T DO IT AND THE COMMUNITY AGENCIES CAN'T DO IT ON THEIR OWN NOR CAN THE SCHOOLS.

AND SO WE HAVE LEARNED IT'S ESSENTIAL FOR ALL OF US TO POOL OUR RESOURCES BOTH FINANCIAL AND INTELLECTUAL, TO SUPPORT OUR COMMUNITY THE BEST WE CAN TO SET IT UP FOR SUCCESS IN THE FUTURE.

>> WE JUST HAVE A COUPLE OF MINUTES LEFT.

ARE THERE OTHER THINGS THAT YOU FOLKS WANT TO SAY BEFORE WE GO?

>> I THINK WE HAVE TALKED ABOUT THE SERVICES WE ARE PROVIDING AT UPSTATE BUT TALKING BEFORE WE GOT HERE TODAY ABOUT THE MESSAGE THAT INTEGRATED CARE IS A GOOD IDEA BECAUSE ALL OF US HAVE MEDICAL NEEDS, WE HAVE EMOTIONAL NEEDS.

WE HAVE YOU KNOW, SOCIAL DETERMINANTS THAT ARE INFLUENCING US.

SO THE MESSAGE OF THINKING BROADLY ABOUT HEALTH MAKES A LOT OF SENSE, BOTH FOR PROVIDERS AND FOR PATIENTS WHEN YOU THINK ABOUT YOURSELF AND YOUR FAMILY.

>> AND ADDING TO THAT CONCEPT OF WELLNESS, I THINK JUST HAVING A SPACE THAT CREATES A SAFE SPACE WHERE THOSE REFERRALS CAN BE MADE AND WHERE WE CAN WORK ACROSS SILOS AND WE CAN REALLY FOCUS ON PREVENT TIFFT R OF-- PREVENTATIVE HEALTH AND KEEPING PEOPLE HEALTHY AND OUT OF THE HOSPITALS IS HOW THEY WILL LEAD PRODUCTIVE HEALTHY LIVES.

>> SOMEBODY SAID A DIAPER BANK.

WHAT IS THE DIAPER BANK?

>> DO YOU WANT TO SPEAK TO THE DIAPER BANK?

>> AS YOU BRING IN ANCILLARY SERVICES AND PEOPLE ARE STRUGGLING ON A NUMBER OF FRONTS, IT'S IMPORTANT TO MEET THOSE SOCIAL DETERMINANT NEEDS.

AND SO WHILE THERE IS DIAPER BANKS SCATTERED ACROSS THE CITY, THERE IS A COUPLE OPPORTUNITIES WITHIN THE WELLNESS INSTITUTE TO BE ABLE TO, WHEN YOU ARE COMING FOR WELL CARE, PREVENTATIVE CARE, ALSO BE ABLE TO RECEIVE DIAPERS, FREE OF CHARGE TO THE PATIENT; PATIENTS WHO ARE IN NEED WILL RECEIVE.

>> THAT'S ONE OF LIKE AS A FORMER PARENT AND NOW A GRANDPARENT, YAY!

I CAN REMEMBER TIMES WHEN WE WERE ABOUT TO RUN OUT OF DIAPERS AND IT WAS AN EMERGENCY.

IT REALLY IS.

I MEAN IT'S LIKE A DISASTER IF YOU DON'T HAVE SOMETHING TO TAKE CARE OF THAT ESSENTIAL HUMAN NEED.

THAT'S ABOUT ALL THE TIME WE HAVE.

I WANT TO THANK OUR GUESTS JENNIFER SPEICHER, ASSOCIATE ADMINISTRATOR OF AMBULATORY SERVICES AT SUNY UPSTATE DR. ANDREA SHAW MEDICAL DIRECTOR AT THE CENTER FOR INTERNATIONAL HEALTH AT SUNY UPSTATE DR. BRIAN RIEGER ASSISTANT PROFESSOR OF PSYCHIATRY AMBULATORY CARE FROM SUNY UPSTATE AND FELLOW SIGH PSYCHOLOGIST.

LET'S PAUSE FOR A MOMENT AND INJECT A DOSE OF HUMOR INTO OUR CONVERSATION.

LAUGHTER NOT ONLY BRIGHTENS OUR DAY BUT ALSO COMES WITH A SET OF SCIENTIFICALLY-BACKED HEALTH BENEFITS AS DOES BEING A VEGETARIAN.

HOW ABOUT SOME HEALTHY FRUIT AND VEGETABLE JOKES.

BRIAN, WHAT DO YOU GET WHEN YOU CROSS A DOG WITH A DAISY?

>> I DON'T KNOW, RICH, WHAT DO YOU GET?

>> A COLLIE FLOWER.

NOW, ANDY, WHY DON'T EGGS TELL EACH OTHER JOKES?

>> I HAVE NO IDEA.

>> BECAUSE THEY'D CRACK EACH OTHER UP.

>> RICH, I HAVE ONE FOR YOU.

>> OKAY!

>> DID YOU KNOW THAT I USED TO BE THE ADMINISTRATOR OF OLD McDONALD'S FARM?

>> WHAT DID DO YOU THERE?

>> I WAS THE C.I.E.I.O.

THE.

[LAUGHTER] AND TO VIEWERS, WE COULDN'T FIND ANY SALAD JOKES.

SO IF YOU KNOW ANY, PLEASE LETTUCE KNOW.

IF YOU WOULD LIKE TO SUBMIT A JOKE FOR LAUGHTER IS THE BEST MEDICINE OR TO SEE MORE OF YOWR PROGRAM, VISIT WCNY.ORG/CYCLEOFHEALTH.

TO HEAR OUR NEW COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM FOR 'CYCLE OF HEALTH,' I'M PSYCHOLOGIST DR. RICH O'NEILL.

ENJOY THIS WEEK'S MINI CHECK UP FROM THE NECK UP.

COMING UP NEXT AND THANKS FOR CHECKING IN.

>> HI, I'M PSYCHOLOGIST Dr. RICH O'NEILL WITH THIS WEEK'S CHECK UP FROM OUR WHICH NECK UP.

FORMULA FOR FUN OR.

♪ JOY WITH THE WORLD ♪ WELL, FOLKS, MY DAD WAS BORN ON A HARD SCRABBLE IRISH FARM ABOUT TWO GENERATIONS AFTER THE POTATO FAMINE KILLED A THIRD OF IRELAND.

HE CAME TO THE U.S. TO ESCAPE HUNGER, WORKED FOR THE NEW YORK CITY SUBWAY 35 YEARS, PASSED ALONG THE JOB OF CLIMBING THE LADDER TO DOCTOR OR LAWYER TO ME.

PSYCHOLOGIST ISN'T EXACTLY STETHOSCOPE AND SCAP WILL BUT CLOSE ENOUGH.

AS A KID I WAS NOSE IN THE BOOKS.

THEN COLLEGE, FIVE YEARS OF GRAD SCHOOL, BEEN LEARNING TO PLAY MORE EVER SINCE.

AND NOW I HAVE A FORMULA FOR FUN TO PASS ALONG TO MY FELLOW ALL WORK AND NO PLAY WORKER BEES.

STEP 1: CHOOSE THE FORK IN THE ROAD TO FUN.

2.

DO WHAT YOU WANTED TO MAKE FUN.

3: PLAY ALONG WHEN OTHERS JOIN IN BECAUSE THEY'RE FUN IS CATCHING.

FOR EXAMPLE, I LOVE RUNNING SO ONE DAY AT LUNCH INSTEAD OF GLUEING MY BUTT TO THE CHAIR, INHALING MY SANDWICH, ANSWERING 20 MORE OF THE INFINITY OF EMAILS, I CHOSE THE FORK TO FUN.

POPPED ON MY RUNNING DUDS, TROTTED OUT SMILING, CHECKING OUT THE TREES, CLOUDS, SUN, BLAZING ACROSS THE S.U.

SQUAD.

I COME UPON FIVE GUYS ON SOME BENCHES.

AS I'M FLAMING BY, THE NEAREST GUY JUMPS UP, RAISING HIS ARMS.

THEN THE NEXT GUY AND THE NEXT.

THEY'RE GIVING ME THE WAVE!

LIKE A STADIUM OF FOOTBALL FANS!

I'M THRILLED.

POINTING AT THEM, POINTING AT ME!

LOOKING AT EACH OTHER IN THE EYE, THEY'RE BEAMING AND BOUNCING HYSTERICALLY AND FOR THOSE GLORIOUS MOMENTS, AN AGING POTATO HEAD ONCE REMOVED AND A BUNCH OF COLLEGE GUYS ARE JUST PLAYING, SHARING THE MAGICAL JOKE OF LIVING.

SO DEAR DEPARTED DAD, THANKS, AND EVERYBODY HOW ABOUT WE GIVE EACH OTHER THE WAVE AS WE PUT THE FORMULA TO FUN TO WORK AND PLAY!

I'M Dr. RICH O'NEILL.

THANKS FOR CHECKING IN.

>> FOLKS, HERE I AM AFTER GETTING A NEW HIP GOING IN FOR A FOLLOWUP CHAT WITH MY SURGEON.

HAPPY AS A CLAM ON MY BIKE.

SO IF YOU WANT TO LEARN ABOUT HIPS AND KNEE REPLACEMENTS, STICK AROUND.

WATCH THIS HIP ACTION.

♪ ♪ ♪ ♪ YOU FEAR YOUR EARS NO LONGER HEAR SO CRYSTAL CLEAR.

♪ PEEK IN AND LISTEN TO DOCS WHO DO THE FIXING ♪ TO OUR CYCLE OF HEALTHY.

IF YOU ARE SEARCHING FOR RESEARCH AND KEEP YOUR BOTTOM... WANT A CHECK UP FROM THE NECK UP OR ACHING WON'T LET UP, WONDER HOW MUCH MOVING CAN GET YOU BACK TO GROOVING,... ♪ ♪