Executives: Crisis Pushes Providers to Adapt and Modernize

At a time where good news is hard to come by, executives on a panel conducted during the Rx Drug Abuse & Heroin Summit on Tuesday said they have found one silver lining to the cloud that is the coronavirus (COVID-19) crisis: Behavioral healthcare is being propelled into a modern age with new protocols that could stick long after the pandemic subsides.

“I don’t think our normal is ever going to be the same,” Tim Robinson, JD, CEO and founder of Louisa, Kentucky-based Addiction Recovery Care said. “In all aspects of life, we’ll look at this differently. It’s a new reality to deal with.”

Addiction Recovery Care, which treats 1,100 patients (including 600 residential) at its 38 programs, formed a COVID-19 response team in early March, Robinson said. The company has implemented social distancing protocols within its living quarters, increased temperature checks, and moved staff members such as administrative and billing personnel to work-from-home arrangements. For outpatient clients, meanwhile, all services—group and individual counseling, case management and peer support—have been maintained through a telehealth platform.

The session’s other two panelists—Jennifer Hancock, president and CEO of Louisville, Kentucky-based Volunteers of America Mid-States, and Nick Stavros, MBA, CEO of Phoenix-based Community Medical Services—acknowledged the challenge of keeping up with ever-changing executive orders and directives in the multiple states in which their facilities operate.

Hancock said Volunteers of America Mid-States chose to follow the lead of Kentucky, the most restrictive of the four states where the company treats patients. Mindful that the disease of addiction doesn’t quit in a pandemic, the company, which has 600 residential patients, as well as others in intensive outpatient and outpatient programs, has focused on doing “whatever it takes to maintain service in the safest way possible,” Hancock said.

That has included staggering meal and transition times, limiting the number of patients in a room at a given time, and embracing telehealth, which Hancock said might not have happened had COVID-19 not forced the issue.

“We might have been resistant because we are comfortable with the face-to-face modality,” Hancock said. “But we’ve seen we can maintain a productive environment through telehealth.”

For Community Medical Services, maintaining services has meant finding ways to continue getting MAT patients their medications while limiting potential contact, Stavros said. Providing patients with a week’s worth of medication in one visit instead of requiring daily visits has meant weighing the risk of potential diversion vs. the risk of a CMS facility becoming the epicenter of a COVID-19 outbreak because of a high amount of in-person contact, Stavros said. About 50% of CMS patients have been deemed stable enough in their recovery to move into extended take-home for medications. Stavros said some have declined the option, feeling they need the stability of a daily program.

Even while giving patients enough medication to cover a week, CMS has maintained its level of contact by conducting various treatment activities through digital platforms. Stavros said fortunately, it was “an easy pivot” for CMS, as the company has relied on virtual internal meetings among staff long before the pandemic.

Hancock said Volunteers of America Mid-States has lost one outpatient client to COVID-19 and had another die by suicide during the crisis. She said the collateral damage of the pandemic could be a potential trigger for many patients early in recovery and those with co-occurring mental health disorders. In the meantime, her company is being more assertive in checking in with patients and giving them as much access to staff members as they need.

Robinson, meanwhile, remarked that it’s a realistic scenario that the demand for addiction treatment services could soar post-pandemic, and that many of the new policies and extra precautions behavioral healthcare providers are adding now should stick for the long term.

“Looking ahead, that will be important, because we’re all bracing for what is going to happen on the other side,” he said.