{"id":23797,"date":"2015-12-22T09:03:30","date_gmt":"2015-12-22T17:03:30","guid":{"rendered":"http:\/\/spijue.wpengine.com\/news\/rainforests-red-tape\/"},"modified":"2015-12-22T09:03:30","modified_gmt":"2015-12-22T17:03:30","slug":"rainforests-red-tape","status":"publish","type":"post","link":"https:\/\/www.juneauempire.com\/news\/rainforests-red-tape\/","title":{"rendered":"Rainforest’s red-tape"},"content":{"rendered":"

Editor\u2019s Note: This is the third part of a series that examines why it\u2019s so hard for heroin and drug addicts to get into treatment in Juneau, and what some in the community are doing about it. To read Part One, click here<\/a>, Part Two, click here<\/a>, and for Part Four, the final installment in the series, please see tomorrow’s newspaper.<\/em><\/p>\n

Juneau\u2019s only residential drug treatment facility, Rainforest Recovery Center, has just 16 beds. But even if one is available, it doesn\u2019t necessarily mean that a drug user seeking treatment can get it.<\/p>\n

In order to get into Rainforest, there\u2019s a bunch of paperwork that needs to be completed first. It takes time, money and transportation, and for those in the throes of heroin addiction, it\u2019s one of the biggest barriers to getting through the doors.<\/p>\n

Family members, community agencies and recovery coaches like Kara Nelson and Christina Love can all help out, but oftentimes it\u2019s not enough. When a bed isn\u2019t immediately available to them, many drug users simply give in to cravings during the process and go back to using drugs to feel better.<\/p>\n

\u201cThe ambivalence can be huge,\u201d among drug users deciding whether to seek treatment,\u201d said Love, who has taken countless women under her wing and helped guide them toward recovery. \u201cWe lose a lot of them.\u201d<\/p>\n

To get into Rainforest\u2019s 28-day in-patient program, a person must first have a substance abuse assessment from either Rainforest or a referral agency, a tuberculosis test (PPD), an updated health and physical, and a filled out application for Rainforest.<\/p>\n

\u201cRainforest Recovery Center is not able to take people just kind of off the street,\u201d Dr. Jenna Hiestand, the medical director for Rainforest, said. \u201cIt\u2019s a residential program, and so an application (and packet) has to be submitted.\u201d<\/p>\n

There\u2019s sound reasoning why Rainforest requires all of the things in the packet, per the state grant that funds the center, Rainforest\u2019s new interim director Richard Nault said.<\/p>\n

The substance abuse assessment tells the center\u2019s staff that the person belongs there and requires that level of in-patient care. The tuberculosis test ensures that the client doesn\u2019t have the disease and won\u2019t spread it to others in the facility. (Tuberculosis is highly contagious and was once the leading cause of death in the U.S.) Likewise, the health and physical is a safety precaution to rule out any communicable diseases. The health and physical also lets the center know if the client has any other medical conditions they need to manage, such as liver disease or heart issues.<\/p>\n

But there\u2019s no one-stop shop to get all those things in order, and it\u2019s often a slow-going process. There\u2019s time involved in scheduling appointments at various locations, and then coming up with the money to pay for it.<\/p>\n

Nault said the health and physical is actually the hardest piece of the packet to complete because of the time and expense involved.<\/p>\n

\u201cRight now we have a stack of applications about this thick,\u201d he said, \u201cand they\u2019re incomplete because the health and physical isn\u2019t there.\u201d<\/p>\n

A health and physical is basically an examination by a physician. But it has to be recent, within 30 days prior to admission at Rainforest. That means if someone had a physical six months ago, they would have to get another. And it can cost around $300.<\/p>\n

\u201cFor the person who\u2019s not yet admitted, who doesn\u2019t the money to pay for the health and physical, doesn\u2019t have any insurance, that\u2019s a heck of a bind, and I\u2019m not sure how to get around it,\u201d Nault said.<\/p>\n

 <\/p>\n

On the fast-track<\/strong><\/p>\n

Recovery coaches Nelson and Love recently helped a woman addicted to heroin get into Rainforest within 48 hours, the fastest time they had ever seen.<\/p>\n

It was hectic, to say the least, and it almost didn\u2019t happen.<\/p>\n

It began on the afternoon of Wednesday, Dec. 9, with a phone call from a friend theirs who needed help getting a friend \u2014 a woman in her 20s \u2014 into treatment for heroin addiction. The woman had flown from Anchorage to Juneau specifically to go to Rainforest, desperate for help but without knowing that the facility is not set up to accept walk-ins.<\/p>\n

That afternoon, the woman opted to detox on her friend\u2019s couch, and by Thursday, it wasn\u2019t going well. She began threatening self-harm.<\/p>\n

\u201cUnfortunately, it was at the end of the day,\u201d Nelson said. \u201cBut we went ahead and called Rainforest, and they were getting ready to close and told us to call back tomorrow.\u201d<\/p>\n

They called Bartlett Regional Hospital\u2019s E.R. next, and told them they were bringing her in because of her mental health state.<\/p>\n

\u201cWe said we don\u2019t have the capacity to monitor her 24 hours a day, this is above our expertise,\u201d Love said.<\/p>\n

The woman\u2019s friend drove her to the E.R., where Nelson met her and stayed with her for hours. While there, Nelson worked on preparing all the paperwork she needed to be admitted to Rainforest.<\/p>\n

Nelson said there was a Rainforest application at the hospital, which she helped the woman fill out from the hospital bed.<\/p>\n

A Rainforest staffer had told Nelson earlier on the phone that they wouldn\u2019t be available to do a substance abuse assessment for the woman the following Thursday. So Nelson drove around town, trying to find an agency that could do it quicker. All of them said it would have to wait until the next week.<\/p>\n

Sometime during the evening, still at the hospital with the woman, Nelson received a phone call back from Nault. He said he could get the woman in for the substance abuse assessment the next morning (Friday, Dec. 11) at Rainforest. He also said the woman could get her TB test at Rainforest, which has never happened before in the past year and a half Nelson\u2019s been doing this. (\u201cThat was amazing,\u201d she said.)<\/p>\n

\u201cThings were totally different\u201d from the first time she called Rainforest on Wednesday to the phone call with Nault on Thursday, Nelson said.<\/p>\n

\u201cThe next day, everyone was accommodating, everything was streamlined, and they had the assessment ready for us,\u201d she said.<\/p>\n

The only thing they had left to worry about was the health and physical.<\/p>\n

On Friday afternoon, Nelson drove the woman to Juneau Urgent Care in the Mendenhall Valley to get it done.  The physical was a flat $150, but because the woman was a new patient there was also a $200 charge.<\/p>\n

Because Nelson said she wasn\u2019t expecting that extra $200 new patient fee, Juneau Urgent Care allowed her to do a payment plan. She had to pay the $150 up front, and was allowed to pay the $200 by the end of the month.<\/p>\n

Nelson said a family member of hers \u2014 an \u201cAngel donor,\u201d she said, who wished to remain anonymous  \u2014 donated the $150 to cover the physical.<\/p>\n

By 4 p.m. on Friday, Dec. 11, the woman was admitted as a patient at Rainforest, a momentous occasion that brought Nelson to tears.<\/p>\n

It was a good thing it happened quickly, Nelson said. The woman was beginning to doubt she could get in and started to want \u201cother means to feel better,\u201d as Nelson put it. But the woman stuck it out.<\/p>\n

\u201cThere\u2019s very few times where people are begging, \u2018I want to get clean, and I don\u2019t want to do this anymore, help me.\u2019 And that was her,\u201d Nelson said of the woman.<\/p>\n

It should be noted that the cost of treatment wasn\u2019t a factor in getting the woman into Rainforest. Per grant rules, Rainforest is prohibited from turning patients away based on their ability to pay.<\/p>\n

It costs about $30,000 on average to stay the 28 days in the center, but the center has a sliding scale fee and most of its clients are covered through the newly expanded Medicaid.<\/p>\n

That\u2019s not to say that the cost isn\u2019t a factor for those seeking treatment, or won\u2019t later become an issue when it comes time to pay up. But the policies in place at the center ensure that money is not a barrier to getting in the door.<\/p>\n

 <\/p>\n

Changes within <\/strong>Rainforest<\/strong><\/p>\n

Since coming on board to Rainforest in mid-October, Nault said he\u2019s tried to make some improvements in speeding up the process of getting patients through the door. It\u2019s a direct result of the efforts of Nelson, Love and others in the community rallying for change.<\/p>\n

Doing the TB test in-house, like for the woman in the above scenario, is a big one.<\/p>\n

\u201cOne of the things that we\u2019ve been doing to help get people in is if they\u2019ve got the health and physical, and if they\u2019re not symptomatic for tuberculosis, we\u2019ll take them in and administer the TB test the minute that they\u2019re admitted,\u201d he said on how it works. \u201cBut the health and physical (is needed beforehand and) helps to screen that there\u2019s no active symptoms of TB.\u201d<\/p>\n

Nault also noted that Rainforest has a new in-take person to process new clients, which should speed up that process.<\/p>\n

On a grander scale, he said the most important thing he can do right now is be \u201cvisibly responsive\u201d to the community, which is demanding easier access to drug treatment in light of a crippling and deadly heroin crisis that has claimed seven lives in Juneau this year. He\u2019s met with various agencies, as well as community members such as Nelson and Love about how to make it easier for drug addicts to seek treatment. Last Sunday, he also was a panelist at a public forum hosted by the \u201cJuneau, Stop Heroin, Start Talking\u201d group.<\/p>\n

Another big-picture change, he said, is really striving to ensure that everyone who comes to Rainforest seeking help doesn\u2019t leave empty handed, even if there\u2019s not a bed available. He said they will start asking people if they would like to get a head-start on out-patient services, or see what they can do to get them linked up to another agency that can help them \u2014 anything to give them \u201ca ray of hope,\u201d he said.<\/p>\n

\u201cI think we\u2019re really trying to work toward no one going away with nothing, and everybody getting something,\u201d he said.<\/p>\n

 <\/p>\n

Brainstorming<\/strong><\/p>\n

In light of some of the difficulties that addicts seeing treatment in Juneau face, several community members have been brainstorming ideas on how to make the process easier and faster.<\/p>\n

Nelson said she is already trying to elicit donations for a fund to help people pay for health and physicals.<\/p>\n

Michele Stuart Morgan, the local woman who formed \u201cJuneau – Stop Heroin, Start Talking<\/a>\u201d a few months ago to help break the silence and stigma surrounding heroin addiction, said that\u2019s something her task force wants to look at, too. Her group just became a non-profit last week under the umbrella of Juneau\u2019s National Council on Alcoholism and Drug Dependence. Morgan also met with Nault last week after hearing him speak during the panel she hosted for the community.<\/p>\n

One thing that\u2019s clear, Nelson said, is that people want to help. After last Sunday\u2019s panel discussion, a woman who heard of Nelson and Love\u2019s recent efforts to get the woman into treatment introduced herself. She told Nelson that she went to Juneau Urgent Care herself to pay the remaining $200 on the balance. It had already been paid \u2014 someone beat her to it.<\/p>\n

\u201cI have no idea who did that,\u201d Nelson said.<\/p>\n

She said she hopes to have a system in place soon for others willing to donate.<\/p>\n

Nelson will also be the first to tell you how happy she is with the recent changes and improvements at Rainforest. But the fact remains, she said, that it\u2019s still not enough.<\/p>\n

The problem of not having enough detox, treatment and recovery services for addicts isn\u2019t limited to Rainforest, she said.<\/p>\n

\u201cWe don\u2019t think we have the only answer, or we have all the answers, but what we know is everybody needs to be in the room,\u201d she said. \u201cEvery person. Because this is not a D.O.C. issue, this is not a JPD issue. This is not a Rainforest issue. In reality, the responsibility to change things lies on our community.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Editor\u2019s Note: This is the third part of a series that examines why it\u2019s so hard for heroin and drug addicts to get into treatment in Juneau, and what some in the community are doing about it. To read Part One, click here, Part Two, click here, and for Part Four, the final installment in the […]<\/p>\n","protected":false},"author":430,"featured_media":23798,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_stopmodifiedupdate":false,"_modified_date":"","wds_primary_category":4,"footnotes":""},"categories":[4],"tags":[75],"yst_prominent_words":[],"class_list":["post-23797","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-local-news"],"_links":{"self":[{"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/posts\/23797","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/users\/430"}],"replies":[{"embeddable":true,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/comments?post=23797"}],"version-history":[{"count":0,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/posts\/23797\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/media\/23798"}],"wp:attachment":[{"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/media?parent=23797"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/categories?post=23797"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/tags?post=23797"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/www.juneauempire.com\/wp-json\/wp\/v2\/yst_prominent_words?post=23797"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}