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Addiction recovery agency takes new direction

Rochester Business Journal
March 8, 2013

Huther Doyle is in the midst of a transition.
 
The Rochester-based non-profit organization has long operated the largest freestanding outpatient substance abuse clinic in Western New York, and now the agency is looking to expand in a new way.
 
This April, Huther Doyle is set to open a primary-care medical facility for the underserved and often marginalized clients it sees in other programs.
 
"We're part of a collaborative of Monroe County-based regional providers, and we've been hearing that the large Spanish-speaking population has a hard time getting access to care," says Robert Lebman, president and CEO of Huther Doyle.
 
The setting will allow Huther Doyle to better integrate primary medical care with its mental health services. The organization works with people seeking treatment for addiction, including a wide range of clients-those from the Hispanic community, adolescents starting at age 12, people with HIV and others-with mental illness.
 
Huther Doyle is seen as a pioneer in the use of interventions in addiction recovery. The organization provides addiction recovery education to family members and loved ones of patients, and after the intervention they are given services to foster ongoing involvement.
 
By moving into providing primary care to this at-risk population, Huther Doyle will have greater ability to keep its patients on track to recovery, Lebman says.
 
"Often we're treating a physical ailment, but the people are not getting better because of their drug or alcohol problems," he says. "Or sometimes they're being prescribed opiates for pain even though that triggers their addiction."
 
Because Huther Doyle works with people who often are uninsured or underinsured, the new primary care clinic will not draw patients away from other practices, Lebman says.
 
In fact, focusing on the emergency health needs of this population should alleviate some pressure on the entire local health care system, says Brett Sobieraski, chairman of Huther Doyle's board.
 
"These are people who would have to go to the emergency room when they need medical care, everything from a cold to a sprained ankle," Sobieraski says.
 
That will also help achieve a larger goal of lowering the region's health care costs. The Finger Lakes Health Systems Agency has identified a number of cost savings if patients can be served in primary care and kept out of the more expensive emergency care settings.
 
"We talked about this with the consortium of health care providers we work with, and they saw it as a no-brainer," Lebman says.
 
By integrating this level of care with the other services Huther Doyle provides, patients get a kind of one-stop shop, Sobieraski adds. The organization can tailor primary care to work with the addiction recovery services that patients receive and vice versa, he says.
 
The care center is set to open with a physician and bilingual nurse practitioner, though Lebman says it will expand as the base of clients grows. He expects the clinic to have about 300 patients at its opening, and within a few years it could serve 1,000 or more.
 
While it plans to grow, the organization also faces an increasingly difficult funding environment, Lebman says. Though the agency-which reported nearly $4.5 million in revenue for the fiscal year ended Dec. 31, 2011, the most recent data available-has been able to meet its budget through the last few years, this past year brought a deficit.
 
The difficulty has come largely from changes to reimbursement rates, Sobieraski says.
 
"It's hard to forecast a budget with that moving target of reimbursements," he says.
 
Changes to reimbursements have brought other challenges outside of the agency's budget.
 
"There have been changes in the reimbursement rates, and that's had a particular impact on us," Lebman says. "Those rates for us have always been group-oriented, and the latest change slashed the reimbursement rate for groups and increased it for individual staff. That's difficult because that level of care is more time- and labor-intensive."
 
Despite the difficulties, he says, the organization is always looking for chances to grow. Monroe County Sheriff Patrick O'Flynn and District Attorney Sandra Doorley are both board members, which helps create pathways for offenders to be referred to the agency for treatment.
 
Lebman also is optimistic about opportunities that could come from the primary care clinic.
 
"If this proves to be a success, and we think it should, it will be a significant help to our organization and will go a long way in keeping people in treatment and engaged," he says.3/8/13 (c) 2013 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email service@rbj.net.


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