Melanie's Story: Integrated care allows for right connections

Melanie & Kelly pose for a photo

Melanie Ferebee is a patient of Family Medicine Physician Dr. Jenifer Dodge and Physician Assistant LeeAnne Yonchek. Melanie's care team expanded to include Clinical Care Manager Kelly Hunt, MN, RN, CNL who helped connect her to safe and consistent housing.

September 15, 2021

“It never fails that someone connects with me at just the right time.”

This is how Helena resident Melanie Ferebee speaks about her care team at St. Peter’s Health.

Melanie is a patient of Family Medicine Physician Dr. Jenifer Dodge and Physician Assistant LeeAnne Yonchek. She sees them often for help controlling her diabetes, COPD, heart disease and other serious health conditions. Melanie had also been hospitalized on a number of occasions due to complications from her chronic conditions.

Dr. Dodge’s care team expanded shortly after Melanie started seeing her for care, and Melanie was soon connected with new care team member Clinical Care Manager Kelly Hunt, MN, RN, CNL.

St. Peter’s primary care providers use an integrated care approach, which means information is shared among diverse team members like care managers, social workers, behavioral health professionals and pharmacists. The goal is to establish a comprehensive treatment plan that addresses biological, psychological and social needs of the patient.

After Kelly and Melanie’s first visit together, it was clear that for Melanie’s health conditions to improve and stabilize, she needed to find safe and consistent housing.

Melanie had been homeless since October 2019. “It’s already overwhelming enough to manage one chronic condition, let alone several” Kelly said. “So we took one step at a time and connected Melanie with the right resources.”

Melanie found housing through local nonprofit Good Samaritan Ministries in Helena. After some time of couch surfing, sleeping on the streets and in her van, Melanie is feeling more at home. She is proud to share that she has also made tremendous strides in managing her diabetes. 

“We both knew that we couldn’t fix everything all at once, but we could do something step by step,” Kelly shared.  

Now that Melanie has safe and stable housing, Kelly still calls to do frequent check-ins. They discuss upcoming and past appointments, and if needed, Kelly helps connect Melanie with other members of her care team like pharmacists to help with proper medication management.

Melanie and her care team have developed quite the bond. The first time Melanie met LeeAnne Yonchek, PA in person, LeeAnne went out to Melanie’s car in between appointments to walk her dog while Melanie went to the lab unexpectedly for additional lab work.

“It has really helped me to have a team,” Melanie said. “Back in the day, you just had your doctor. Now, you have all sorts of support people. Kelly in particular plays a big role in keeping me going. She reminds me how hard I work and of my successes which motivates me and helps me pull through.”

When asked what’s next on your health journey, Melanie responded, “My main focus is continuing to keep my sugars under control… and a power chair to help me get where I need to go.”

While Melanie sings praises of her entire care time, Kelly reminded her, “you do the hard work, Melanie, and you continue to do the work. It’s inspiring.”