The evolution of the opioid crisis has forced Valley hospitals to change how they identify and treat patients with substance use disorder.
Geisinger added certified recovery specialists (CRS) — those with direct experience in addiction and recovery — to its emergency rooms in Danville and the Shamokin area to appeal to patients presenting signs of drug abuse to seek treatment.
UPMC Susquehanna announced a project to open a specialized medical drug and alcohol detox center within the Sunbury Hospital. As of March 1, it added CRS, too.
Evangelical Community Hospital, Lewisburg, received $653,200 in federal funds for a multi-level approach in educating its entire professional staff about best treatment practices and eliminating stigma, plus having six clinicians and nurses across the hospital trained as chemical dependency specialists.
The select staff will enroll in a certificate program at Pennsylvania College of Technology, Williamsport. They represent the emergency department, intensive care, labor and delivery, social services, family medicine and ambulance crews.
“We started with key areas where there’s a more likely opportunity to meet people as they’re coming in to seek services,” Rachel Smith, vice president of human resources, Evangelical, said.
Evangelical also will explore using grant funding to add CRS to its own emergency department to bolster the existing warm handoff methods there, Smith said.
Evangelical teamed with the Hazelden Betty Ford Foundation to assess needs at the Lewisburg hospital.
The foundation credited Evangelical for its strong ties with community partners and an overall willingness to support practice methods to meet patient needs, Smith said. It also found room for improvement in creating a common language concerning addiction toward reducing stigma and utilizing standardized screening methods to identify patients potentially in need of treatment, she said.
“This speaks to a larger cultural effort we’ve been embarking on at Evangelical,” Smith said with respect to generational bias and cultural competence. “This is just an extension of what we’re trying to do, to treat every patient with the same level of compassion and care.”
The grant funding from U.S. Department of Labor is the largest share of the $1.1 million received by Central Pennsylvania Workforce Development Corporation in its effort to improve the chances someone in recovery has in gaining employment and build up a limited workforce in a climate where employers struggle to find new hires.
Central PA Workforce covers nine counties including Montour, Northumberland, Snyder and Union. It's developing three programs to job-train people in recovery seeking employment, train employers to spot warning signs of addiction and encourage treatment and improve workplaces to make them recovery friendly.
“They need workers. With the unemployment rate so low, we have to figure out where the workers will come from,” said Erica Mulberger, executive director, Central PA Workforce. “We’re working to tap into a population that pulled themselves out of the labor force.”
The Reboot Program for job training can provide up to six months of supplemented wages to employers willing to take on an employee in recovery.
“It shows we believe in this person,” Mulberger said.
Emergency departments by nature are routinely busy. So it goes for Geisinger.
Periods of peak volume can prevent clinicians and nurses from having in-depth conversations with patients, said Kristina Barron, operations director for emergency medicine, Geisinger.
Certified recovery specialists can fill that role and take time with patients presenting signs of substance use, she said. They’re employed at health system hospitals in Bloomsburg, Danville and Shamokin through a partnership with Gaudenzia, Northumberland Drug and Alcohol and CMSU. It’s a result of a grant from the federal Substance Abuse and Mental Health Services Administration.
UPMC Susquehanna also partnered with Gaudenzia for CRS.
The recovery specialists know addiction because they've experienced it themselves and learned what may work in terms of recovery: Inpatient or outpatient rehab, medication-assisted treatment, a combination of all three. Because their life experiences match what the presenting patient may be living, there exists connectivity that can’t be duplicated by someone who hadn’t gone through addiction themselves.
It can inspire the patient to pursue recovery or at the very least, continue engagement with the CRS outside the hospital and potentially seek treatment in the near-term, said Jordan Barbour, director of clinical operations for psychiatry and addiction medicine, Geisinger.
“They’ve been very successful at engaging patients,” Barron said. “Even just sitting there and being a companion.”
“I think the fact we’re identifying and connecting patients with a certified recovery specialist is a positive outcome. Even if a patient is not willing to go to treatment today, by establishing that relationship there’s a greater probability the patient will want to go to treatment and have the means to do so,” Barbour said.