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Strategies to fight addiction paying dividends

New Mexico organizations are combining new behavioral health high tech and low-tech strategies to fight addiction across Navajo reservations in northern New Mexico. In addressing some of the root causes of these issues, the W.K. Kellogg Foundation introduced the Pathway’s Project, a four-year program that began this year to identify and address many of the underlying causes of these conditions. They identified Bernalillo, Doña Ana, Gallup-McKinley and San Juan County as locations to launch job creation programs.

Organizations such as Gallup’s Na’ Nihzhoozhi Center Inc.’s (NCI) has 26,000 admissions every year and is the nation’s busiest treatment center with many repeat customers. The detox center was the result of an effort 30 years ago, which began when more than 5,000 people marched from Gallup to Santa Fe to demand assistance from state lawmakers and received $400,000 for a study to build a detoxification center. The hospital then received $2 million in an ongoing yearly federal grant, out of which NCI was born.

The leader of that effort in the 1980s and ’90s was David Conejo, who returned in 2014 as the CEO of Rehoboth McKinley Christian Health Care Services (RMCHCS), where he continues to lead the fight against addiction with traditional tactics but also behavioral health care innovations that have captured the attention of the health care industry.

Tackling addiction

Conejo took a financially failing hospital and turned it around with the help of William Kiefer, the hospital’s chief operating officer. Recognizing the root cause of the region’s health problem was addiction, Conejo revitalized a former rehab building on the hospital’s grounds and with some fundraising launched the Behavioral Health Treatment Center. It is operated by Ophelia Reeder, a long time health care advocate for the Navajo Nation and board member of Gallup Indian Medical Center. Bill Camorata, a former addict, is the Behavioral Special Projects Director. He opened “Bill’s Place,” an outdoor facility where he and hospital volunteers treat the homeless with meals, clothing and medical triage as part of Gallup’s Immediate Action Group, which he founded and serves as president. The center has treated more than 200 addicted residents since 2015 and has a staff of 30 who manage residents’ case work, provide behavioral health services and are certified in peer support.

High tech in high gear

From this traditional form of behavioral health addiction treatment, Conejo has turned to health information technology in his pursuit of behavioral health care remedies. He leveraged government insurance changes in Medicare and Medicaid Services (CMS) under the Obama administration. Rather than traditional acute care services, CMS began to shift its focus on preventive care, identifying a 6-to-1 cost-savings ratio.

Conejo recognized that RMCHCS would benefit by offering preventive-care services, which fit perfectly with his behavioral care plans while creating a new revenue center through reimbursements by CMS. To achieve this, he recognized the need for the convergence of hospital information across clinical, financial and operational systems.

At the end of 2017, Conejo teamed up with Zoeticx, a Silicon Valley-based health care software company. The company provides health care system interoperability and applications designed to integrate and streamline hospital patient data for CMS services. The applications include annual wellness visits for patients over age 60, chronic care management for illnesses such as diabetes, and care transition, the elusive link between physical and behavioral health services. Conejo integrated data from the hospitals’ three clinics, which enable tracking of wellness visits, provide doctors with a physical care assessment guide through preventative exams and map out the risk factors for potential diseases in patient follow-up visits.

These apps also integrate patient medical records in a way that could meet CMS and private insurers billing requirements. As a result, RMCHCS’s business is growing with almost full insurance compliance and RMCHCS has received a bonus check for $80,000 from Medicare for containing costs, in addition to new revenues.

As a benefit to Gallup residents, hospital physicians can now spend more time with patients.

Telemedicine next step

Conejo’s next big technology push will be a telemedicine program enabling reservation patients to be seen by mobile health care physicians connected by satellite to the internet to extend the hospital’s outreach to patients who can’t visit the hospital. This will enable patients to be treated as if they were at one of the hospital’s clinics, with all their data entered into the appropriate systems and ready to be whisked off to insurance organizations.

David Dallago

David Conejo

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