A visit from Missouri Governor Mike Parson last week shone a spotlight on Places for People’s response to the COVID-19 Pandemic and the necessity of a quick pivot of telehealth.
Gov. Parson made brief remarks, and made it clear he wanted to hear from staff members. Gov. Parson said he wanted to hear how Places for People has dealt with the COVID-19 Pandemic, how the state has done, and “what we can do better,” adding later, “keep in mind as you talk to me, who are we missing?”
When the COVID-19 Pandemic started, Places for People devised a phased response to protect the health and well-being of those we serve and staff members. This included a quick pivot to providing services primarily through telehealth methods (video and telephone), which was made possible by changes to MoHealthNet policies. This shift to telehealth allowed Places for People to remain engaged with our current caseload, as well as continue to engage those still in need of support.
In her overview of Places for People and the organization’s response, Chief Executive Officer Laura McCallister said, “The other thing I just want to say about our staff and the people that we serve is they’re very resilient … and they go with what they’ve been given and we want to give them more and we want to give them better than what they have.”
In the organization’s most cautious phase of operation during the COVID-19 Pandemic, 80% of persons served were engaged solely by telehealth methods. Four hundred individuals required face-to-face interactions due to severity of symptoms or lack of connectivity to phone and/or internet.
This represented a fundamental shift, as Places for People has long been known for meeting people where they are and providing an individual approach to services. Vice President of Clinical Administration Tony Hilkin said of face-to-face visits in his comments to the governer, “That’s something that we’re very good at. That’s something that we have found excellence with.”
He explained that as the shift to telehealth started, it became apparent than voice-only telephone services would not be enough. There was a need in many cases for greater access to video conferencing. “Seeing someone on the other side just it creates such a more therapeutic dynamic session,” he said.
Places for People formed a pandemic task force that helped review workflows and recommend telehealth resources.
Access to phones, internet and video-enabled devices for individuals served by Places for People, and in some cases staff members, has been a primary challenge.
“We quickly found that person served or clients didn’t have access to smartphones, didn’t have access to consistent and reliable Internet,” Hilkin said.
Ninety percent of the people served by Places for People live below 30 percent of the federal poverty level. An internal survey found that 10 percent of individuals served owned a smart device – one that allows access to both Internet connectivity, video, and audio functionality.
Grants from Missouri Foundation for Health, St. Louis MHB, Deaconess Foundation, St. Louis County Humanitarian CARES, HHS Cares, Incarnate Word Foundation, as well as contributions from private businesses and individuals have helped our organization purchase PPE and enhance our telehealth resources.
Additionally, Missouri Health Net helped Places for People secure 300 Internet hot spots and 300 telehealth devices.
“Telehealth doesn’t replace the face-to-face opportunities that we hope to continue to be able to do,” Vice President of Clinical Services Barb Zawier told the governer. “But in some cases, it’s been life saving to be able to connect with people that way.”
She provided an example of working with individuals who are unhoused in encampments or in shelters. Staff members have worked to set up a telehealth service at Little Sisters of the Poor to allow people to access services quickly and get medication.
Zawier pointed out the organization has used telehealth services to maintain a presence in courts, jails, and in hospitals to provide access to care for individuals who need to connect to services.
Places for People Outpatient Therapy Program Manager Meagan Doty told Gov. Parson about the success her program has experienced with telehealth.
“The one thing we didn’t count on is that we have folks who are doing so well with these avenues of service provision,” Doty said. Telehealth options have helped bypass transportation issues and inefficiencies, it has also been beneficial for individuals who have a tough time discussing trauma face-to-face.
Doty asked the Governor to consider keeping policy changes in place in a Post-COVID-19 environment.
“I just want to really highlight the importance of offering these service delivery avenues post-COVID,” Doty said. “Because not only has it saved us time and money, it’s actually shown to have really amazing therapeutic outcomes for folks that have never been able to access these services.”
Recovery Center Specialist Joris Miller said echoed earlier sentiments, saying that “For some folks, it’s not the same and is not as great as the therapeutic relationship when it’s in person. But it is far better than not being connected at all.”
Miller told the governor that he would like to see greater resources available to help individuals learn how to use technology. He said right now he believes teaching individuals served by Places for People how to use technology is every bit as important as teaching them a therapeutic skill. Because without that education, “they will be left behind.”
“There already has been a big problem with the population we work with being disconnected from primary health care services. That distance will only be increased if people are not able to use this technology,” Miller said. “I don’t want to see people left behind.”
Vice President of Advancement and Development Johanna Jones closed the discussion by returning to Parson’s initial request, to tell him who the state might be forgetting.
“When you talk about ‘who am I forgetting,’ I think it’s important that we don’t forget that our employees – our 343 employees – are health care workers, they’re essential workers and they have been on the front line even in the height of the Pandemic.”
Jones wants to make sure these essential workers are able to have the resources they need to continue to support individuals living with mental illness and substance use concerns.
“We want to make sure that we have the equipment and that we can do all of the proper training with our employees and with our person served so that they can be as successful as they can and they don’t feel that we’ve forgotten them,” Jones said.