Suicide spotlights intersection between insurance and recovery

  • The main entrance to Behavioral Health Network’s detox facility at the former Lunt Silversmith property in Greenfield. Recorder File Photo

Recorder Staff
Published: 2/17/2017 10:48:29 PM

GREENFIELD — The 7-month-old Franklin Recovery Center got caught in the glare of social media this week following the suicide in its lobby of a distraught 63-year-old veteran, an alcoholic in crisis.

The longtime county resident, Daniel Dowd, who identified himself as suffering from post traumatic stress disorder and alcoholism, left behind an angry and anguished note, spread on Facebook. His core complaint focused on the center’s apparent inability or, in his mind, unwillingness to take him into its detoxification program.

Since the death a week ago, members of the recovery community in Greenfield, specifically members of the Behavioral Health Network, which oversees and runs the recovery center on Federal Street, have spoken out to address issues raised by the suicide, while declining to discuss specifics of this case citing federal confidentiality rules.

Police Chief Robert H. Haigh Jr. said the shooting death was in fact a suicide and that the detective on the case found a note on the body of Dowd that corroborated the authenticity of the “suicide note” that circulated online.

“When someone does something in this manner, in a very public manner, you certainly don’t want to ignore the situation,” Haigh said. “You don’t want to shortchange it.”

In addition to the police investigation, a state Department of Public Health probe is underway. A state spokesman would only say, “We are aware and are actively investigating the circumstances of this tragic death, and cannot comment further until our review is complete.”

The Franklin Recovery Center has been licensed to provide detoxification services by DPH’s Bureau of Substance Abuse Services since May 2016.

Insurance

In light of the suicide, leaders at Behavioral Health Network, the Regional Opioid Task Force and The Recovery Project all noted the importance of finding immediate care for addicts who decide they want help. But finding that help with or without insurance has never been easy, one of the reasons that the state supported creation of the 64-bed recovery center in Greenfield. County residents seeking help in residential programs for themselves or others before last summer had to work the phones, scouring facilities in Springfield, Worcester or Boston to find a bed.

Within 48 hours of opening last summer, the Greenfield center was full — though with constant turnover. Currently there are 32 beds for the short-term detoxification and 32 beds for the second-step care, which if used, typically lasts the state-required 14 days.

“Some days I walk in and I’m like, ‘homeless shelter, psych unit, detox.’ That’s what we’re running,” Dr. Ruth Potee, medical director of the Franklin Recovery Center, said of her experience so far. “I didn’t know that’s what it was going to be like.”

Just how the center operates and who it can accept has been a prominent point of confusion following the suicide. It isn’t a state-funded facility but relies on private insurance and Medicaid money to keep its doors open.

If prospective patients have no insurance, they can be admitted to the Recovery Center, and the state covers the cost. If prospective patients have insurance that doesn’t contract with the Recovery Center, or are “underinsured,” commonly by Medicare, then they cannot be admitted to the center. Instead, the center staff tries to find other available options and if the prospective client desired, arrange to transport the person to somewhere with an available bed that takes the insurance or to a hospital emergency room or if the case is relevant, to the Northampton VA Medical Center.

“In fact, having zero insurance is better than having the wrong insurance,” Potee said. “But once you have insurance, you can’t pretend to have zero insurance. That’s fraud.”

Potee and the Senior Vice President of BHN, Candy Darcy, said fewer than 5 percent of their prospective patients have the “wrong” insurance, so that the inability to help is rare.

“We try to contract with every insurance provider out there,” Darcy said. “Some of them just won’t pay for detox services.”

Further, if a prospective patient is not able to walk or maintain their vital signs, the center cannot admit them.

“I’m not running a hospital,” Potee said. “I don’t have 20 nurses. It’s the level of care that is considered the state’s level of care, which is that people have to be functioning, walking, talking and not have such acute medical needs that they need an IV.”

Those patients are offered transport to the ER and a bed kept waiting for them for when they are stabilized, said Potee, who noted that they can’t force anyone to the ER or alternate programs. Hospital ERs are obligated to provide that care with or without insurance, often losing thousands of dollars in uncompensated care.

The VA hospital in Northampton will accept patients regardless of mental or physical circumstances, as long as they are eligible for VA care, Public Affairs Officer Andre Bowser said. Franklin Recovery Center would offer to transmit an eligible veteran there as long as beds were available.

Also, the Recovery Center sometimes has stretched its protocols. Most of its patients arrange admission by telephone, so that when they arrive, insurance issues have already been resolved. But if someone wants help and walked in at night or on the weekend when the center administrative staff isn’t available to check insurance and there happens to be an available bed, the person might be admitted temporarily. When the immediate treatment is concluded, if the insurance does not check out, then the center will refer that patient to somewhere that does take his or her insurance to continue the care.

The Recovery Center does not run a waiting list, but instead emphasizes immediate service.

Reaction from addiction community

Members of the regional Opioid Task Force, which worked hard behind the scenes to establish the Recovery Center in Greenfield, say this incident points to the need for continual improvement in addiction programs and policies statewide.

“In some ways, we need to go back to our roots, ” said John Merrigan, task force co-chair, about the group’s education outreach objectives.

Sheriff Christopher Donelan, another task force co-founder, said he hopes to work with the task force to push state officials in Boston to consider changing rules.

“Let’s focus on the crisis first and the insurance second,” he said.

Local leaders in recovery have urged members of the community to refrain from particularly negative social media comments like those that swirled around the internet based on Dowd’s note, clearly written in a time of distress and anger, saying it doesn’t help.

“Finger-pointing or hashing out old stuff is not going to help at all. It’s going to take away the focus from this individual who was in a crisis moment,” said Michael Lewis, director of The RECOVER Project, a peer-to-peer participatory program for people in and seeking recovery from all forms of addiction.

Longtime friend Wid Perry said of Dowd, “I choose to remember him as an energetic and proud Shipmate Sailor who served his country well and made a positive difference in my career.”

Perry said Dowd was passionate and sometimes intense about his musical interests and national politics, “but I think for Dan it was our Navy connection that meant the most to him.”

Impact on staff

Potee noted that it’s difficult for nurses and her staff at large to feel positively when vitriolic voices fill social media, especially if the comments aren’t necessarily based on facts.

She defended the facility’s staff as hard working professionals who care deeply about their work and their patients.

Since the suicide, the parking lot has had a security officer. The center will re-evaluate safety protocol, but Potee emphasized that this recent incident is a rare situation.

“We don’t consider our clients to be unsafe people,” Potee said. “I’m not running a jail, I’m not running a courthouse. This is a treatment facility. I don’t think that guns in a public setting are very common in this part of the world. I don’t live in fear and most of my staff doesn’t.”

She said her staff has experienced stress of late because of turnover by peers leaving for higher paying jobs at private clinics that have opened in the region lately.

“We’re hiring like mad right now, so that will de-stress the amount of stress my staff is under because they’re all working so hard right now.”

Instead of working eight-hour shifts, nurses have been pushed to closer to 12-hour shifts, Potee said.

 

You can reach Joshua Solomon at:
jsolomon@recorder.com
or 413-772-0261, ext. 264




Greenfield Recorder

14 Hope Street
Greenfield, MA 01302-1367
Phone: (413) 772-0261
Fax: (413) 772-2906

 

Copyright © 2019 by Newspapers of Massachusetts, Inc.
Terms & Conditions - Privacy Policy