Program Manager, Julie Breitigan, oversees residential substance use services at the Schwartz Center for Men and the recently opened Schwartz Center for Women. She sat down with the Kentucky Department for Medicaid Services, Substance Use Disorder (SUD) communications team to discuss the provisional certification process, the importance of peer support, and the impacts of COVID-19 on residential services.
Can you tell us a little about your facilities and the programs you provide?
Julie: We just opened the Schwartz Center for Women, which is a 28-day treatment facility. We are delighted to have separate facilities now with a 20-bed unit for men and a 16-bed unit for women. Some research indicates a 60% higher success rate when you separate the genders in treatment. Since the coronavirus outbreak, we did have to decrease the number of residents in each facility to keep everyone safe. We are trying to keep our admissions around 50% of our full capacity right now, just to help with social distancing.
Given that you just opened a new facility, what did the provisional certification process look like for New Vista?
Julie: The provisional certification process provided us an opportunity as a team to collaborate and organize our program plans on paper before we opened our doors. We looked over every detail from a staffing standpoint, such as determining what staff trainings and what staff credentials would provide our clients with the best care. We also spent a great deal of time balancing out the program plan to ensure the weekday and weekend schedule provided our clients with adequate therapy, recreation, education, and study time.
Have Substance Use Disorder enhancements impacted your organization?
Julie: Yes, the clients we serve have been able to benefit from more services including case management, vocational rehabilitation and more wraparound support in their recovery. We can provide seamless, comprehensive services. New Vista has a very comprehensive continuum of care. When the clients are only requiring outpatient services, they can engage in individual therapy, peer support or medication assisted recovery including methadone, suboxone or vivitrol. If their needs increase, they can be referred to sober living, intensive outpatient, or our 28-day residential programs. There's a whole continuum here so we can take care of people and meet them where they're are at any given time. We are a level 3.5 Level of Care, so we can accept clients who need more intensive treatment.
Do you plan on expanding your programming further?
Julie: New Vista just opened a transitional living program for women next to the Center for Women and Children in Richmond. The Center is another 28-day program where we treat pregnant women and new mothers with substance use disorders. The transitional living is a 60-day program, which provides a sober living step-down where clients still have access to peer support services and therapy groups in the evening. During the day, they're able to go out into the community, seek employment and slowly get back on their feet. Leaving the residential program can be such an overwhelming thing for our clients, we are glad we could offer this kind of transitional setting. Currently at Schwartz, we do have transitional housing for men, but the women go to the Richmond transitional housing, which just opened two weeks ago.
Do you have peer support on staff at your residential and transitional living programs?
Julie: Yes, all of our facilities offer peer support. Whether you're being seen outpatient, intensive outpatient, transitional living or residential, you're followed by peer support services. It's a huge cornerstone of all our programming. The training that the peer support specialists get is excellent, and the value they bring to the team is just remarkable. They are role models. When our clients are able to meet the peers, hear what they've gone through, and how they were able to build a healthy, sober life—it makes a huge impact. I can't imagine our program without our peer support specialists. Peer support specialists have also been critical to helping us provide support during coronavirus. People that work here are so passionate about recovery, because they live it. They've been in that position where you need this level of care and it's a life or death situation. Even in the midst of this coronavirus epidemic and all the added stress, our staff is incredibly committed to the population that we serve and in helping people when they need it the most. They are awesome at everything they do.
Speaking of coronavirus, how have you adjusted your programming due to COVID-19?
Julie: New Vista overall has really embraced telehealth, especially in our outpatient programs and groups. Instead of meeting in-person with a group, it's much safer now to do a Zoom room. Many of our clinicians throughout New Vista have embraced the technology and are seeing success with it. With residential services, we've only been able to use telehealth with certain tasks. The one thing that we've changed here is our intake clinicians are now working remotely, our other clinicians, peer support specialists, behavior health associates, nurses, psychiatrists, they are all still on-site.
Do you have any advice for providers who are wary of telehealth?
Julie: We were all a little nervous at first, too. You do lose some of that information that you get through body language. We are training our staff on strategies to work around that. But what has also happened is people are a little bit more open to sharing, because they're comfortable in their homes. You're getting a real glimpse of their daily lives. We have also seen clients be a little more open to sharing with each other in group sessions. When they're in the comfort of their home, they're a little bit more open. So, I think I would advise providers to just be open to the possibility that some positive things can come from telehealth.
What other steps have you taken in response to COVID-19?
Julie: New Vista took a number of precautions to protect clients and staff across the organization. We encourage frequent hand washing, social distancing, and all our clients and staff have been given cloth masks. We've had to adapt because part of our programming used to include taking clients out to AA and NA meetings in the evenings and on weekends, so we've had to explore online AA meetings. Instead of family visits, we've had to do Zoom family visits, and we have tried to maintain close communication with family through other methods. Additionally, the Fayette County Health Department has been really helpful. Any time we call with a question, they are really helpful. I would recommend that any residential program stay in touch with the local health department as the situation changes.
COVID-19 has impacted your residential center and your programming, but how do you think this has impacted you as a program manager?
Julie: As a leader, I've always felt a big responsibility for the people that I work with. So I feel very protective, not only of our clients, but of our staff. This situation has really forced me to examine their anxiety level, their stress level, and come up with creative ways to help support them. When there's such a large amount of stress in all facets of their life right now, making sure I'm doing a better job of checking in with them, taking care of them. We've been able to adapt some of their schedules a little bit to support them but checking in with them regularly is so important now.