Hartford Business Journal

18 Hartford Business Journal • August 24, 2020 • www.HartfordBusiness.com Pandemic upends nonprofit therapy treatment model By Liese Klein Special to the Hartford Business Journal J ane Garcia has gone on scav- enger hunts with her young clients, played board games and even traveled around the world via Google Earth. A licensed professional counselor and art therapist at Community Health Resources in Manchester, Gar- cia has been doing all of her work with young people in recent months via videoconfer- encing or "tele- health," a mode of treatment that she said had been both challenging and rewarding. "I think I can safely speak for other therapists and say that telehealth is exhausting," Garcia said. "It is tiring on the eyes and the body. As we are also impacted by the pandemic, … staying fully present for so many sessions, every day, and continuing to hold space for our clients, could partly be why it seems more draining on multiple levels." But telehealth offers many benefits, Garcia added, allowing more flexibility and creativity in her work with chil- dren suffering developmental trauma. "The variations in play and fun with screen-sharing has been a blast," Garcia said. "There have been some in-real-time moments when be- ing able to share something and look together has made a positive impact." In a few hectic weeks in March, Garcia and her coworkers at Com- munity Health Resources joined many Connecticut nonprofits that provide mental health, substance abuse and other forms of counseling in abruptly shifting from in-person to remote services using video confer- encing and phone lines. Now nearly six months into the switch, providers are taking stock and looking ahead to a future where more hu- man services are provided online and remotely. "People appre- ciate having the flexibility to use telehealth right now because it helps keep everybody safe," said Heather Gates, president and CEO of Community Health Resourc- es (CHR). A nonprofit with 27,000 clients across central Connecticut and 900 employees, CHR spent more than $100,000 in the first weeks of the COVID-19 lockdown to acquire the technology needed to make its counselors available online. "On March 13, everybody's real- izing we need to change our service delivery model," Gates said. Pay parity Since the bulk of CHR's $67-mil- lion annual budget comes from gov- ernment programs, the nonprofit looked to the state to approve the switch to telehealth. "It was something that we knew could make a difference," Gates said. "It was an absolute lifeline for the people we're serving." Gov. Ned Lamont responded quickly, signing an executive order on March 10 that relaxed rules on the use of telehealth for a range of health services and required insurers to reimburse virtual visits at the same rate as in-person visits. Legislation passed in July extended the new rules until March, which attracted opposi- tion from the Connecticut Association of Health Plans, which represents major carri- ers including Aetna, Anthem, Cigna and United Healthcare. The insur- ers fully sup- port wider use of telehealth, but object to imposing reimbursement parity without allowing for the usual negotiation process, said Susan Halpin, execu- tive director of the association. "Mandating anything in statute in terms of reimbursement from our perspective just goes in the opposite direction of trying to control health- care costs," Halpin said. Other concerns include treat- ment quality and HIPAA compliance in telehealth, along with the risk of duplication of services. For example, some patients may seek both tele- health and in-person visits when only a single visit would suffice, Halpin said. The surge in telehealth has also corresponded with declines in vacci- nations, which are often provided in tandem with in-person doctor visits. "We have to be careful not to promote one modality over another," Halpin said. "We want to make sure people are getting the care that they need, and that may be in-person care. There's still a lot to be learned about how this mode is going to best serve consumers going forward." State Rep. Catherine Abercrombie (D-Meriden), co-chair of the legisla- ture's Human Services Committee, said she supports extending parity beyond March due to enthusiastic feedback on telehealth from non- profits and others. "It's been so successful from a provider's point of view, but more im- portantly, from the consumer's point of view, it has been working," Aber- crombie said. She said she has heard from families with autistic children who have thrived in virtual meetings with health providers and social work- ers who are using teleconferences to successfully help troubled clients. The pandemic jump-started a long process of approval for telehealth across payment models that had left the state lagging in terms of adop- tion of new technologies, she added. "Connecticut has been a little behind when it comes to telehealth," Aber- crombie said. "[Adoption during the pandemic] validated what some of us thought we should be doing for years." At Community Health Resources, many counselors and their clients hope the transition to telehealth will have lasting impact, Gates said. An immediate advantage from the switch was reported by many clients who had struggled in the past to make it to appointments, Gates said. "We serve so many individuals who have major transportation problems that we knew adopting telehealth would improve access to care," she said. "Going forward, telehealth will be a permanent part of our service delivery mode. It has been a lifeline for our clients and it has been a lifeline for providers, it has been absolutely critical." As the clinical supervisor of CHR's Child Outpatient Clinic in Manches- ter, Garcia said she expects to con- tinue to offer counseling to clients through videoconferencing technol- ogies long after the pandemic ends. "I think telehealth is here to stay and that is a good thing," Garcia said. "I think I will always want to use it, at least as a back-up option." This story was done with support from the Hartford Foundation for Public Giving. NONPROFIT NOTEBOOK Susan Halpin, Executive Director, Connecticut Association of Health Plans Heather Gates, President and CEO, Community Health Resources State Rep. Catherine Abercrombie (D-Meriden) PHOTO | CONTRIBUTED CHR therapist Nicolle Wargo working with a child via telehealth. Wargo works in CHR's Child Outpatient Clinic in Bloomfield.

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