NORWALK, Conn. (AP) - One hundred and eight times - that’s how many visits to Norwalk Hospital one repeat patient had in a single year.
“He was in every other day or so,” said Katherine Michael, medical director for Western Connecticut Health Network and founder of the Community Care Team at Norwalk Hospital. “He would drink too much and be in the community and someone would call 911 and he would be taken to the ER.”
Aside from struggling with alcohol dependence, John Smith - whose name is not being used to protect his privacy - was homeless and didn’t have the kind of insurance (Husky D) that allowed him access to good substance abuse treatment, Michael said.
“He’d be on a waiting list for three days,” Michael said.
Smith is not alone in his situation.
Legal issues, a dwindling number of psychiatrists and cuts to the state budget make it difficult for hospitals to ensure patients have the right supports in place to leave the hospital, said Dr. Charles Herrick, chair of psychiatry for Western Connecticut Health Network, which includes Norwalk, Danbury and New Milford hospitals.
The Community Care Team - made up of police, probation officers, mental health providers, primary care providers, housing agency staff and other social services workers - formed a partnership with Liberation Programs Inc., an addiction rehabilitation center that offered Smith treatment and a bed at their facility.
After a few weeks of persuasion, he enrolled and finished rehab in three months. But upon completion, Michael said, he didn’t have housing and relapsed within a few days.
“He went back to the program and this time when he came out we got housing for him,” Michael said. “I won’t say he’s not drinking at all, but his ER visits are less than five per year.”
The CCT formed after a 2012 Community Needs Assessment survey indicated Norwalk residents were most concerned with mental illness and substance abuse in the community.
The team helps adults who use the emergency department more than six times in six months by offering them access to food, insurance, housing, substance abuse treatment and a long list of other social services. The idea behind it: Access to social services reduces frequent ER visits.
“When they’re able to have transportation to doctor’s appointments then they don’t have to wait until they’re in such unstable conditions that they would have to go to the emergency room,” Michael said. “If they’re diabetic and only have access to McDonald’s and we can help them get to a food pantry with healthy food, we can help them not come to emergency room. It’s a little simplistic but that’s essentially how it works.”
The team measures its success by collecting data on ER use and how many patients are linked to services.
From April to September 2017, 149 patients used Norwalk Hospital’s emergency department more than six times in six months. As a group, the patients utilized the ER 1,035 times, Michael said.
A year later, with the CCT’s help, those numbers dropped from 149 patients to 125, with a total of 672 visits, a decrease of about 400 visits, Michael said.
As far as providing services, from February 2017 to February 2018, 75 percent of patients at Norwalk and Danbury hospitals were connected with housing assistance, 61 percent with addiction services and 77 percent with case management, according to hospital data.
Most patients were uninsured or under-insured single adults struggling with mental illness, physical health issues or substance abuse, CCT members said. About 45 percent received help getting insurance.
“One of the trends we’re seeing - and in the homeless population too - is we’re seeing more of an elderly population coming in over 65 and shelters are seeing that too,” said Staci Peete, CCT supervisor at Norwalk Hospital.
After noticing the trend in their data, they decided to launch a senior-focused Community Care Team in April, with providers more appropriate for an older population, Peete said.
The goal is to cut down on the number of seniors repeatedly visiting the emergency room, aiming for similar success like they’ve seen with their general CCT.
“I think I’ve seen increased success, for sure because care is so coordinated,” said Suzanne Curto, director of behavioral health at Norwalk Community Health Center.
For example, there are two big gaps in access to treatment, she said: long wait lists for substance abuse treatment when the patient “needs it and is ready” and access to psychiatrists for psychiatric evaluations and medications.
To address the need, Norwalk Hospital’s outpatient psychiatric clinic recently hired a psychiatrist now in charge of those two things, she said. CCT patients can utilize that service.
Michael pointed to Smith as a success story. With CCT’s help, Michael said, Smith’s health is better, he’s drinking less and he’s seeing his other doctors.
Information from: The Hour, http://www.thehour.com
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