Community Health of Central Washington

Message from Dr. David Bauman

Match # 204412

Internship positions available: 3 

Number of Residency/Job positions: 1

Community Health of Central Washington (CHCW) is a Community Health Center (CHC) in Yakima, Washington. Yakima is a metropolitan community, rich in culture and, for a health professional, rich in opportunities to make a difference in people’s lives. CHCW provides quality healthcare through service and education. CHCW has been recognized as a level three Patient-Centered Medical Home (PCMH) and utilizes teams to provide integrated primary care behavioral health and other services for its patients. PCMH teams include a Physician, Medical Resident, or Advanced Practice Clinician as well as a Nurse, Medical Assistant, Behavioral Health Consultant, and Care Coordinator. Since 2006, CHCW has implemented the Primary Care Behavioral Health (PCBH) Model in which the Behavioral Health Consultant functions as a core member of the PCMH team.

Behavioral health interventions look like primary care visits (rather than specialty care visits). Visits are brief (15-30 minutes), limited in number (one to six visits per patient with an average of between two to three visits), and are provided in the primary care practice area so that the patient views meeting with the Behavioral Health Consultant as a routine primary care service. The main objectives of Behavioral Health Consultant interventions are to:

  • Assist the PCMH team in the recognition, treatment, and management of mental health and addiction concerns, chronic diseases, psychosocial issues, and health risk behaviors.
  • Improve patient functioning by teaching the patient one or more skills during a single or series of consultation visits.
  • Generate one or more recommendations for the PCMH team concerning how to intervene with the referral problem on an-ongoing basis.
  • Transfer skills and knowledge about behavior change principles to the patient, as well as to the PCMH team.

Interns will also rotate through Yakima Neighborhood Health, another CHC in Yakima and Affiliate member of the consortium.

In addition to providing PCBH services at a variety of clinics, interns will co-facilitate patient groups on topics such as chronic pain, weight management, and lifestyle changes. Interns will also complete critical analysis and quality improvement projects on topics of their choosing, allowing for a deeper level of knowledge in areas that interests them. Lastly, interns will progress in their training with other medical professionals and receive exposure to the Behavioral Scientist role of family medicine residencies. Monthly didactic training will be held at the HealthPoint administrative office in Renton, Washington and CHCW’s Central Washington Family Medicine clinic in Yakima, Washington. When didactics are in Renton, interns will have to travel between 2-2.5 hours. Community Health of Central Washington is a member of the National Health Service Corps (NHSC) loan repayment program.

In addition to the information provided on this page, you can watch the recording of the September 20th Training Director’s Panel below for additional information about this site.

NPTC Cascades Region Training Director’s Panel

Our Mission

Community Health of Central Washington was founded with one bold and clear vision: All people in our region should enjoy access to affordable and appropriate health care. Our mission is to provide quality healthcare through service and education.

Our Supervisors

Site Training Director

Arissa Walberg, Ph.D.

Dr. Walberg is the Site Training Director for the CHCW internship, a BHC and faculty member at Central Washington Family Medicine. She received her doctorate degree from Colorado State University in Counseling Psychology, where she specialized in health psychology and integrated behavioral health. Dr. Walberg completed her predoctoral internship at the Nebraska Internship Consortium in Professional Psychology, with placements at the University of Nebraska Medical Center and Creighton Medical School. As a post-doctoral resident at Multnomah County Health Department, Dr. Walberg implemented PCBH in a school based-health center. Her research interests include PCBH, integration of BH into medical centers, and medical trainee education. Dr. Walberg has authored and presented on a variety of behavioral health integrated related topics.

Primary Supervisors

David Bauman, Psy.D.
Regional Training Director for NPTC-Cascades

Dr. Bauman is a licensed psychologist and is the Behavioral Health Education Director at Central Washington Family Medicine, where he also serves on the residency faculty and as a behavioral health consultant. He completed formal training in the Primary Care Behavioral Health model and Acceptance and Commitment Therapy during his pre and post-doctoral experiences. His training supervisors have included both Jeff Reiter and Kirk Strosahl and he has received formal training from Patricia Robinson. Dr. Bauman has presented at a number of national conferences and authored book chapters on working with behavioral concerns in primary care. He currently serves on the leadership team of the Collaborative Family Healthcare Association’s PCBH Special Interest Group. He has experience in training medical providers and residents, as well as behavioral health consultants, regarding the integration of behavioral health care and implementation of ACT (and other behavioral approaches) within primary care and other medical settings.

Bridget Beachy, Psy.D.

Dr. Beachy is a licensed psychologist, is currently the Director of Behavioral Health at Community Health of Central Washington (CHCW), and leads a team of seven Behavioral Health Consultants (BHC). She is also a behavioral health faculty member at CHCW’s Central Washington Family Medicine Residency and has duties working as a BHC. She has received supervision from Dr. Strosahl during her postdoctoral fellowship. Dr. Beachy also completed her pre-doctoral training at HealthPoint, a federally qualified health center which is known for its robust Primary Care Behavioral Health (PCBH) program and was developed by Jeff Reiter. Dr. Beachy has experience in training medical residents, medical students, and BHCs in PCBH as well as Acceptance and Commitment Therapy (ACT) and Focused. Additionally, she has co-authored two book chapters addressing behavioral health in medical settings, and has given multiple presentations on integrated care both locally and nationally.

Ruth Olmer, Psy.D.

Dr. Ruth Olmer is a Behavioral Health Consultant at CHCW, since 2017. She earned her Doctorate in Clinical Psychology from Forest Institute of Professional Psychology in 2015. She spent her internship at Otis R. Bowen Center, a Community Mental Health Center, and her residency at VA Black Hills Healthcare System, a Veterans Affairs Medical Center. Dr. Olmer’s research interest include Neuropsychological screening within the PCHB model; effect of group treatment access on frequency of primary care utilization; couple and parenting interventions within the PCBH model. Her theoretical orientation is Systemic and Solution-Focused.

Steven Olmer, Psy.D.
*Supervisor at Yakima Neighborhood Health

Dr. Steven Olmer is a Licensed Marriage and Family Therapist and is the Site Training Director for Yakima Neighborhood Health Services. Dr. Olmer is a 2014 graduate of The School of Professional Psychology at Forest Institute He spent his internship and residency in Community Mental Health Centers, with an emphasis on psychological testing and individual/group/family therapy. His Theoretical Orientation is Family Systems; CBT; Solution Focused, and he has research interest in how medical conditions impact family relationships, and psychological assessments/testing relevant for primary care.

Training Opportunities

Across the internship year, CHCW interns will work in the five different medical clinics, including one rural and one homeless clinic, as well as an LGBTQ youth safe-space.

    • Central Washington Family Medicine (CHCW)
    • Naches Medical Clinic (CHCW)
    • Yakima Pediatrics (CHCW)
    • Yakima Neighborhood Health Services Main Clinic (YNHS)
    • Neighborhood Connections – Health Care for the Homeless (YNHS)

See map below for the location of these offices. The office location in Renton, is for reference for where interns will travel to didactic training monthly for the majority of the year. Four times a year didactics will be located in Yakima.

View CHCW Office Locations in a full screen map

CHCW will ensure an encouraging and supportive learning environment by including training that promotes inter-professional practice in the PCMH model of care; training in clinical environments that are transforming or have transformed to include integrated care with other health professionals; development and implementation of curricula to give interns the skills necessary to build and work in inter-professional teams that include diverse professions outside of medicine, behavioral health, and dentistry; development and implementation of curricula to develop leaders in practice transformation; development of faculty to teach practice transformation; and development and implementation of inter-professional faculty teams. Interns will be mentored, in part, by family medicine residency faculty, which will give them exposure to the behavioral scientist role in family medicine residencies.

Interns’ schedule will be 40 to 50 hours per week on a Monday through Friday schedule to be arranged between the intern and the clinic of placement. Interns matched at this site may be expected to work late (until 8:00 pm) one shift per week due to the clinic open hours. Interns will have a one-month orientation followed by three 16-week rotations described in more detail in the following sections. In general, interns in all rotations will be provided with the following experiences:

  • Group (1 – 2 clinics per month: GRP): Interns will assist in multiple groups offered at our clinics (e.g. chronic pain, teen health, and wellness group). They may also have the opportunity to identify unmet needs within the clinics and implement new group curriculums that address these needs.
  • Pairing with a medical provider (2-3 clinics per month: PAIR) In order to provide interns the experience of a primary care provider, interns will pair with an advance practice clinician (APC; physician assistant, nurse practitioner), resident or attending in their respective clinics. The experience will evolve over the year from solely shadowing the provider to providing population based health/pathway initiatives (e.g., completing co-visits).
  • Experiential Learning and Group Supervision (1 clinic per week: EL): One afternoon per week (except the week of consortium didactics) will be used to provide interns with an in-depth, interactive learning experience in which they will practice skills and discuss topics relevant to PCBH and the practice of psychology. This time will also be used for group supervision in the form of case presentations and consultation. This will take place at CWFM.
  • Projects and Paperwork Time (.5-1.5 clinics per week: PPW): Interns will have protected time each week to complete paperwork and work on projects. Projects include the Critical Analysis (see NPTC manual), the self-directed journal review, and the Quality Improvement project (described below). A minimum of 2hrs, with most weeks having 4-6 hours, will be allotted for this. Provided that paperwork is completed and adequate progress is being made on projects, this time may also be used for dissertation or other scholarly activities of the interns choosing.
  • Quality Improvement Project: Interns will design and implement a quality improvement project at a CHCW clinic. Quality improvement consists of systematic and continuous actions that lead to measurable improvement in healthcare settings and the health status of targeted patient groups. Interns will have the flexibility in the topic and are encouraged to focus on a quality improvement area that interests them. Interns will meet monthly with their project adviser, Dr. Ruth Olmer, who will assist in development and implementation of the project. The project will culminate in a presentation, forum TBA. Projects will not be penalized based on whether or not improvements are made but rather the thought, planning, and critical analysis that is put into the project.
PCBH Service Delivery: Pediatric Rotation

As a part of this 16-week rotation, interns will provide brief (i.e., 15-30 minutes) behavioral consultation services to patients in our outpatient family medicine residency clinic (CWFM) and our outpatient pediatric clinic (Yakima Pediatrics [YP]). Interns will be available for immediate, same day referrals (i.e., warm-handoffs) from primary care providers. They will also consult with the primary care team regarding behavioral health concerns. By the end of the year, interns are expected to function as independent BHCs and see on average 4-5 patients per clinic and 1.5 patients per hour.

Example Schedule

Monday Tuesday Wednesday Thursday Friday
AM CL PPW YP SUP/PPW CL
PM YP CL EL GRP (1st) /PAIR YP

CL = CWFM clinic, YP = YP clinic, PPW = Projects/Self-directed Journal Review/Paperwork, SUP = Individual Supervision, GRP = Group, PAIR = Paring with medical provider; EL = Experiential Learning/Group Supervision

Site schedules are a general guideline and interns may be required to make themselves available at other times as needed.

PCBH Service Delivery: Rural Rotation

As a part of this 16-week rotation, interns will provide PCBH services in our outpatient family medicine residency clinic (CWFM) and our outpatient rural clinic (Naches Medical Clinic [NMC]). As with the Pediatric rotation, Interns will be available for immediate, same day referrals (i.e., warm-handoffs) from primary care providers. They will also consult with the primary care team regarding behavioral health concerns. By the end of the year, interns are expected to function as independent BHCs and see on average 4-5 patients per clinic and 1.5 patients per hour.

Example Schedule

Monday Tuesday Wednesday Thursday Friday*
AM SUP/PPW GRP (3rd) /PAIR CL CL PPW
PM CL NMC EL NMC NMC

CL = CWFM clinic, NMC = NMC clinic, PPW = Projects/Self-directed Journal Review/Paperwork, SUP = Individual Supervision; EL = Experiential Learning/Group Supervision, GRP = Group, PAIR = Paring with medical provider

Site schedules are a general guideline and interns may be required to make themselves available at other times as needed.

Yakima Neighborhood Health Services

Yakima Neighborhood Health Services (YNHS) is a Community Health Center in Central Washington State and an Affiliate member of the Consortium. As an Affiliate member, YNHS will not match directly with interns, but rather serves as a rotation experience for CHCW. YNHS serves mostly low income and disadvantaged individuals and families, though everyone in the community is welcome. As a Community Health Center, we are governed by a volunteer Board of Directors, at least half of whom are users of our services. This model of governance keeps us focused on the needs of our patients and the community.

YNHS also has a special focus to serve the homeless, and residents in public housing of Yakima County. We have several satellite clinics, targeted outreach services, medical respite care, and housing programs to help homeless individuals and families work toward self-sufficiency in our community. We also provide housing, medical respite care, and support services for about 70 homeless households in Yakima County. We have six sites providing primary medical/behavioral health care, and three of them currently offer dental services. We also serve a significant number of migrant and seasonal farm workers, most of whom are Mexican-Americans working in our very agricultural communities in the Yakima Valley.

Our team includes pharmacists, behavioral health counselors, public health nurses, nutritionists, outreach workers, housing specialists, case managers, access (eligibility) specialists, dentists, dental hygienists, and a cadre of support staff. Together, our goal is to create a quality comprehensive system of care that is simple for our patients to navigate. Our counselors practice primary care brief therapy, using models of Trauma Informed Care and Cognitive Behavioral Therapy. It is a fast paced environment, both in the clinic and on the streets, and requires a great deal of flexibility, compassion, and creativity.

YNHS is also a member of the National Health Service Corps (NHSC) loan repayment program.

Interns with CHCW will spend one 16-week rotation at YNHS. Intern clinic hours will be split out into four different satellite clinics in Yakima.

  • YNHS Main Clinic (2 clinics: PC; 2 clinics: CL): Interns will provide four clinics per week of PCBH services at YNHS. During two of the clinics (PC), interns will be available for warm-handoffs, same-day consultations to patients and the medical providers. The interns will be present in the medical clinic and work with the medical team to provide same day access to patients. During the other two clinics (CL), interns will provide brief interventions to scheduled patients and complete follow-up visits. When interns do not have patients scheduled on these days, they will be expected to seek out warm-handoffs from the medical team.
  • Connections (2 clinics per week: CN): Interns will provide PCBH services at YNHS Connections’ program that specifically serves Yakima’s homeless population.
  • The Space (2 clinics per week): Interns will provide brief interventions at YHNS’ The Space, which is a safe space for LGBTQ youth (11-23 years old). During times there is limited need at The Space, interns will return to the YNHS main clinic to provide PCBH services.
  • The Depot (winter months only, 2 clinics per week: DP): Interns will provide brief interventions and PCBH services at YNHS’ The Depot, which is a resource center for the homeless population during the winter months. Interns will work as part of the team, which includes social workers and outreach specialists, to meet the demands of this underserved population.


Example Schedule

Monday Tuesday Wednesday Thursday Friday
AM CL PC PC 8-10 SUP CN
10-12 PPW
PM CL 1-3pm PC/SP  EL PC & SP CN
3-5pm PPW

CL = YNHS scheduled clinic; CN = Connections; PC = YNHS PCBH; SP = The Space; EL = Experiential Learning/Group Supervision; SUP = Individual Supervision

Site schedules are a general guideline and interns may be required to make themselves available at other times as needed.

APPIC Training Experiences

In 2015, 15.8% of CHCW clients were elderly, 38.9% were adults, 8.6% were adolescents, 36.7% were children, 29.2% were Hispanic, 12.5% were migrant and seasonal agricultural workers, 11.2% were limited English proficient, 3.8% were veterans, and 44.5% were below poverty level. Interns also work with an underserved, including homeless, population at YNHS as well as provide specific services to LGBTQ youths at The Space. As a CHC, CHCW provides exposure to diverse individuals.

Example patient populations (as listed by APPIC):

  • Children
  • Adolescents
  • Adults
  • Older Adults
  • Families
  • Outpatients
  • LGBTQI+
  • Ethnic Minorities
  • Spanish-Speaking
  • Rural
  • Low Income
  • Homeless

 

Example treatment modalities (as listed by APPIC):

  • Individual Intervention
  • Couples Intervention
  • Family Intervention
  • Group Intervention
  • Consultation/liaison
  • Crisis Intervention
  • Brief Intervention
  • Primary Care
  • Evidence-Based Practice

 

Example supervised experiences (as listed by APPIC):

  • Health Psychology
  • Women’s Health
  • Physical Disabilities
  • Anxiety Disorders
  • Trauma/PTSD
  • Sexual Abuse
  • Substance Use Disorders
  • Geropsychology
  • Pediatrics
  • Empirically-Supported Treatments
  • Public Policy/Advocacy
  • Program Development/ Evaluation
  • Supervision
  • Research
  • Administration
  • Integrated Health Care – Primary

The most commonly seen diagnoses/supervised experiences that interns can expect to be working with at this location include, but is not limited to, depression, anxiety, trauma, sleep concerns, obesity, hypertension, diabetes, substance use, adjustment disorders, and pediatric behavior concerns/parent training.

 

Salary and Benefits

Salary for the 2019-2020 Training Year: $25,000

Benefits provided at this site include:

  • 112 hours of PTO (vacation / sick leave)
  • 24 hours of Professional Development
  • Free health insurance
  • Free vision insurance
  • Free dental insurance
  • Disability insurance
  • Access to life insurance
  • Professional liability insurance (for those not already covered)

CHCW observes the following 8 holidays:

  • New Year’s Day
  • President’s Day
  • Memorial Day
  • Independence Day
  • Labor Day
  • Thanksgiving Day
  • Friday after Thanksgiving
  • Christmas Day

CHCW will also provide interns with laptops, access to the University of Washington Health Sciences Library, and access to the University of Washington Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Family Medicine Residency Practice and Research Network (WPRN).

More information about the Support and Benefits offered in each of our regions can be found here.

Intern Selection Process

All intern applicants will be considered for placement, though receipt of a Master’s degree is required at this site (rather than education-equivalent). Licensed or license-eligible applicants are preferred. Candidates are expected to have skill sets commensurate with applicants at the pre-internship level. A successful candidate will be one who is interested in working in a challenging and innovative setting of primary care. While not required, applicants that have past experience working in integrated care teams, primary care or other medical centers, and rural and underserved areas are preferred. While not required, preferred applicants would have a 1st or 3rd wave behaviorism background and experience in providing brief interventions for a variety of concerns. Candidates should also be willing and able to work successfully on an integrated care team, be self-motivated and high energy to meet the demands of primary care. They are expected to be dependable, prepared, curious, non-defensive, and open to constructive feedback.

Interviews may be conducted over the telephone or by teleconferencing. However, it is preferred that interviews take place face-to-face so that interns and the training site can determine the best fit. Candidates extended an interview invite will have the option of interviewing at the NPTC interview day in Springfield, MO or at CHCW in January. Location of interview will not influence selection of interns. Those candidates not invited to interview will be notified by letter.

 

Background Checks

CHCW does require a background check prior to internship. This background check is the Washington State Patrol background check. If there is a history of criminal activity on the background check the site would then request additional details of the situation from the individual. After receiving those details they would make a determination as to whether they could proceed with employment based on the relevance of the criminal activity to the job, if there is repeated history and what is the potential risk to employ them. In addition they take into consideration the amount of time between the conviction(s) to the present. Past criminal history does not immediately disqualify an individual for employment.

All interns are also required to be drug tested on their first day. The outcome of this test could potentially cause issues with the intern start date and/or match.

Interview Day

Interns applying to Community Health of Central Washington will have the option to attend an on-site interview in Washington on Monday, January 21st or 25th, 2019 as well as the NPTC universal interview day (more details about the universal interview day available here). Location of interview will not impact match rankings; rather, they offer multiple interview dates at different sites to allow travel flexibility for applicants.