By Joey Tillson
January 28, 2010
I'm writing in reference to Juneau Empire's January 7th, 2010 article "City to investigate recovery clinic". I worked for Bartlett Hospital Rainforest Recovery (previously Juneau Recovery Hospital) as their receptionist in 2002 and then Insurance Verification, Medical Biller, Financial Counselor in 2003 until the middle of 2005 so I have some knowledge as to what the facility has gone through, including a name change in the hopes of keeping the facility afloat for Southeast Alaska. Bartlett Hospital and the Rainforest Recovery Center inspired me to get my degree in Health Care Administration.
The program is a good program, helping folks that want to be helped and those court-ordered treatment. The staff are there because of their faith in humankind. It is a thankless job when the unit is continually losing money because of lack of money to pay for the overhead. Let's not forget the issues associated with addiction, each one unique in its own way. Costs may seem astronomical but considering most accounts go to collections due to non-payment is just a drop in the bucket. If any money is recovered through collections, it's only a third of the actual charges. The same reason most health care costs go up nationwide due to non-payment, it punishes those who do by raising the rates to supplement those who don't pay. People who visit the emergency room for non-emergent care instead of seeing their primary care physician, then not paying the visit, etc.
No one wants to pay for chemical dependency. No one wants to pay for in-patient/out-patient care. The recovery hospital is in the RED. It has always been in the RED even when the City & Borough of Juneau owned it. Based on my observations, it's been a financial burden on everyone, including the client most of all. The client can't even get the care they need because of money, they don't have a job to pay for services because they're so sick from addition so they are refused the long term care they desparately need.
Bartlett offers a sliding-fee program for those indigent of affording the help needed to overcome their addictions based on money received from federal and state grants. However, it does not cover the costs. Bartlett tried to offer a "down-payment" of $500.00 and apply for the sliding fee for those who do not have insurance. Most of those accounts go to collections because of folks who break their contractual agreement with the hospital. Most insurances require pre-certification before admission on rehabilitation and even emergency detoxification has insurance requirements that need to be met. However, once insurance certification is done, that does not guarantee payment by the insurance.
When medical billing occurs with the insurance companies, for simple things such as an "Intake Assessment", usually requires the medical biller to provide medical documentation (doctor/counselor notes) to prove there is a problem. After that, if the client is in need of more rehabilitative services, the hospital again has to prove there is a need. And that doesn't mean it will be paid for either. The insurances usually set a cap (if they cover chemical dependency at all) of 24 sessions per year with a lifetime limit of 72 sessions, co-pays, etc. Or better yet, $24,000.00 for every TWO years with a lifetime cap of TWO years. You get my point, they put time limits on recovery. And if the client's insurance denies payment, it's the client's responsibility. If you don't kick the habit within their set limits, you're on your own! Not to mention, if the insurance denies the claim, it's the patient's responsibility. Most people do not understand what their Explanation of Benefits means.
Most folks have a terrible addiction problem, they've lost their kids, their homes, their self-esteem, their jobs, and even their lives because of addiction. It takes more than will power to kick the habit. It takes support of the community, the families, and the addict themselves. It is a sever problem in the state of Alaska most of all. If you go to www.samhsa.gov you can find all kinds of information, including statistics on addiction. The point I'm making is this problem is not going away any time soon, it will never look good on paper, and it IS the community's problem. Bartlett Hospital's Mr. Valliant, may he rest in peace, had a dream of helping people, ALL people and he took on a problem the community was having because he wanted to make a difference in the lives of the people he loved. He had inspired many to become healthy but lost his battle. But it doesn't mean his dream doesn't live on.
Bartlett has done whatever means possible to keep the recovery unit. They've changed the name, they've moved the detox unit to the behavioral health unit at Bartlett, they've applied for grants, they've become JCAHO certified, they've met the medicaid requirements, they've cut back on employee hours, and it's still not surviving. Why? Because again, no one wants to pay for the nation's dirty laundry.
I am reminded of the "Starfish" story posted on the nursing station door at the Rainforest Recovery Hospital. It talks of a man walking along the beach picking up starfish and tossing them in the water. Another person comes along and asks what that man is doing. He states he's saving the starfish. The person says, "How can you possibly make a difference? There are hundreds of thousands of starfish on earth!" The man reaches down and holds up a starfish to the other person. He says, "It makes a difference to this one." He then tosses the starfish into the water.
I am not an expert on solving this problem. I am an expert on observing there is a problem. Just as the rest of the community is. We see it every day and it's not just Juneau. The KAR house in Ketchikan has closed it doors due to financial burden and other issues. The whole state is in crisis over the substance abuse in our communities. When budget cuts happen, the first cuts occur with education, healthcare and public safety. No one wants to deal with the dirty secrets and financial burdens for human service. It's time to wake up! The problem doesn't go away, in fact, newer addiction trends are popping up all over the place. Educate yourself, do your part. Accountability: Own it!
Ms. Joey Tillson
Received January 26, 2009 - Published January 28, 2010
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