Latest / Healthier Together: Larimer County's Public Health Podcast / A Look at Longview - Part 1

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A Look at Longview - Part 1 · Healthier Together: Larimer County's Public Health Podcast

0:01
Welcome to Healthier Together, Larimer County's
0:04
public health podcast, where we come together
0:05
for healthier lives, connected communities, and
0:08
real conversations. From your local public health
0:10
team, I'm your host, Tom. And I'm Joanna. This
0:13
is the first episode in our two -part series
0:16
about Summit Stone Health Partners and Longview
0:19
Behavioral Health Center in Fort Collins. Today,
0:23
we're talking about mental health crisis care
0:25
in Larimer County, the role the Longview Acute
0:28
Care Facility plays in the community, and how
0:30
their work is evolving. We're joined by Dr. Leslie
0:33
Brooks, Summit Stone's Chief Medical Officer
0:36
and Executive Director at Longview, and Cassie
0:39
D 'Amato, Summit Stone's Director of Acute Services.
0:42
Leslie and Cassie, thank you both so much for
0:44
joining us. Thanks so much for having us. To
0:47
start, can you both tell us a little bit about
0:49
Summit Stone and your individual roles? Absolutely.
0:53
So, Leslie Brooks, as you said, I serve as Summit
0:56
Stone's Chief Clinical and Medical Officer. I
0:58
have been with Summit Stone for about six years.
1:01
All of our clinical and medical services roll
1:03
up to my department. So I have purview over the
1:07
clinical and medical work that's being done in
1:09
our outpatient setting, as well as in our bedded
1:11
care at Longview and Garcia House. And I'm Cassie
1:15
D 'Amato, and I serve as Summit Stone's Director
1:17
of Acute Services, as you said. And I oversee
1:19
all of our clinical teams at our Longview Acute
1:23
Care Facility, our co -response and mobile teams
1:26
that respond to crisis in the community. our
1:28
Garcia House residential program, and some of
1:31
our outreach efforts. I've been with Summit Stone
1:33
for about 15 years now. So what brought both
1:38
of you to this work? Civil rights were foundational
1:41
to our family, and I was on my way to law school
1:44
for a long time. I worked for grassroots, you
1:48
know, community organizing, legal aid organizations,
1:51
and thought that was the way that I was going
1:53
to address. you know, our family's commitment
1:56
to human rights and civil rights and things like
1:58
that. I joined the Peace Corps and served in
2:02
sub -Saharan Africa. And so public health and
2:06
community health became my sort of lightning
2:09
rod to address human rights and civil rights.
2:13
Medical school, I worked for the Denver Department
2:16
of Public Health during the AIDS epidemic and
2:19
really began to understand what it meant to have
2:24
shared understanding of a disease process and
2:27
how challenging that was to translate to people
2:31
and manage that fear. I went to medical school
2:35
and graduated at the height of the opioid prescribing
2:38
crisis and really leaned into safe opioid prescribing
2:43
and teaching my community and communities around
2:46
the state about safe opioid prescribing. And
2:50
you can't do that work without encountering disordered
2:54
use of those substances and so leaned into addiction.
2:59
And the opportunity came up about six years ago
3:02
to work at Summitstone and to lead our Longview
3:07
efforts and was the job of a lifetime. I so appreciate
3:16
being able to have the privilege of working alongside
3:20
Dr. Birx every day. Learn something. knew and
3:24
opened my perspective every single day. So it's
3:27
just been this incredible journey. All jokes
3:30
aside, truly blessed. And for me, I think it's
3:34
always just been the want and the need to serve
3:37
and to serve the community in a way that is systemic
3:41
and that's collaborative and leaning into not
3:45
only systems and system improvement, but valuing
3:49
an individual's story. Everyone has a story to
3:53
share and a beauty in the story that is so unique
3:56
to them as individuals that has always just intrigued
3:58
me beyond anything. I've always been drawn to
4:03
serve and to serve people and to hear people
4:05
and to find a uniqueness in every step of the
4:09
journey. So it is, yeah, it's been a fun journey.
4:13
So for listeners who might not be familiar with
4:16
Longview, Can you just provide an overview of
4:19
how Longview came about and the services that
4:21
you provide? Absolutely. Can I start with SummitStone?
4:24
Of course. So SummitStone, SummitStone Health
4:27
Partners, has been in this community. We are
4:30
going to celebrate our 70th anniversary. We were
4:32
first connected with the county a long time ago.
4:35
We're one of the last to leave a county system
4:38
that used to be the standard before there were
4:40
standalone community mental health centers. and
4:43
have been a community mental health center or
4:45
currently a comprehensive safety net. So Summit
4:48
Stone is a community mental health center serving
4:50
Larimer County. We are the largest provider of
4:53
behavioral health services in the region, and
4:56
we offer a number of outpatient services. We
4:59
have a broad continuum of care for both mental
5:03
illness and substance use. Longview's story in
5:07
our community is a long one. So the sales tax
5:10
passed in 2018, and really the ask of our community
5:13
was to have a new day in behavioral health care.
5:17
And so the sales tax passed in 2018, and SummitStone
5:21
applied for and was a successful candidate for
5:24
the bid to be the contracted behavioral health
5:27
provider at Longview. Yeah, and I would say that,
5:31
you know, we are so fortunate to live in a community
5:34
that is willing to invest in behavioral services
5:37
in the way in which Larimer County has. To see
5:40
the Longview Acute Care Facility and Campus come
5:42
to fruition after years and years of planning
5:45
and identifying the need for behavioral health
5:47
services at the acute level of care, we're just,
5:50
you know, we say frequently that we are so fortunate
5:53
to live in a community that wants to invest in
5:56
the wellness and overall well -being of our community
5:58
members. Absolutely. It is remarkable that our
6:02
taxpayers, that our voters chose to tax themselves.
6:06
to make these services available. So what gaps
6:10
and services did the creation of Longview fill
6:13
in the community? So for many years, our withdrawal
6:18
management services, we were sending folks to
6:22
Weld County, to Boulder County, to Denver County,
6:25
all across the state, really, to receive withdrawal
6:28
management services at the level of care that
6:30
now Longview offers. Frequently, people were
6:33
utilizing emergency services or emergency room
6:36
departments. Law enforcement was responding to
6:39
behavioral health crises and triaging in the
6:41
field. The creation of Longview and the services
6:43
within the facility have now made withdrawal
6:46
management services and acute behavioral health
6:49
services accessible far more than what was. Summit
6:53
Stone has been part of the Colorado crisis system
6:55
since 2014, but it was at a much smaller scale
6:58
than what it is now. The volume that we're seeing
7:01
individuals receive behavioral health services
7:04
is far greater. We have regularly seen 750 individuals
7:10
or visits every month within the acute care setting.
7:13
And prior to that, prior to Longview going live,
7:16
we were probably seeing between 150 and 200 people
7:19
within our previous walk -in center. So the need
7:23
is real and the need was recognized by our community.
7:27
There was a great gap in being able to access
7:29
24 -7 behavioral health care in a way that is
7:33
now being addressed in ways that we didn't see
7:36
before. You mentioned that before people were
7:40
going to Weld County or Denver to receive this
7:42
care. From the patient perspective, what did
7:45
that acute care look like before Longview was
7:48
open? Well, I think that our community... utilize
7:51
the services that were available. I think our
7:53
emergency response teams responded to crises
7:56
in the community. Our mobile response team responded.
8:00
But when we didn't have a withdrawal management
8:02
facility to actually bring individuals to who
8:05
needed some substance use disorder treatment,
8:07
that triage just was elongated previously. So
8:11
now to have a facility within our community that
8:15
is truly in our backyard, that is accessible
8:17
to our emergency response teams. to our community
8:21
partners, to our outpatient providers and our
8:23
primary care physicians in our hospitals. That
8:26
coordination of care just helps alleviate the
8:30
stress that families and individuals had of leaving
8:32
outside of Larimer County. And now we're able
8:35
to connect people closer to their natural environments
8:39
and get connected to outpatient care as a transition
8:42
from our acute setting back into their natural
8:45
environment without such a long distance. the
8:49
gap in care that can happen when you're transitioning
8:51
between different levels of care in different
8:53
spaces. We owe a deep debt of gratitude to our
8:56
Weld County partners who were incredible partners
8:59
to us over many, many years of sharing in this
9:02
care. But, you know, what that 30 -minute drive
9:05
means to people, that 40 -minute drive means
9:07
to people who are in crisis is not nothing, right?
9:11
That is a significant challenge to overcome,
9:14
both in terms of getting them there. and in successfully
9:17
transitioning them back to their communities.
9:19
We all know that care is, the best care is local,
9:23
right? The best care happens in your backyard,
9:26
proximate to your home, proximate to your support
9:29
network. And while Weld County isn't that far
9:32
away, it may as well be a crevasse in terms of
9:35
what that means for folks who are trying to live
9:38
in recovery. I imagine the creation of Longview
9:41
then eased the burden somewhat on other systems.
9:45
like emergency departments and law enforcement.
9:48
Can you talk about that a little bit, how Longview
9:50
has benefited some of those other systems? Yes,
9:53
absolutely. And we are a work in progress. We've
9:56
been open since December 2nd of 2023. And all
9:59
of this is a bit of a work in progress. But absolutely,
10:02
we have a very close relationship with our emergency
10:05
department partners since before Longview opened.
10:08
So we, as Cassie mentioned, had an acute care
10:11
facility on Riverside. Many of our listeners
10:13
are probably familiar with that setting. It was
10:16
much smaller. We had two urgent care exam rooms
10:19
and 10 beds in that facility. So that care was
10:24
happening. We have had acute care and urgent
10:29
care and crisis care, bedded care for crisis
10:33
since 2014, 2015. So our relationship with our
10:37
emergency department partners is a longstanding
10:40
one. But with Longview, with the inception of
10:43
Longview, and the beds that we have available.
10:46
As of recently, as of the last few months, our
10:49
emergency department partners tell us that they
10:52
have seen a decrease of about 150 visits per
10:55
month. Wow. That they believe we are seeing that
10:59
they used to see. Yeah, one of the most important
11:02
parts of planning for the Longview Acute Care
11:05
Facility was to include our law enforcement partners,
11:08
our EMS partners, in the actual design of the
11:11
facility to where the facility was. welcoming
11:14
and designed for the warm handoffs from law enforcement
11:18
and EMS from the field to the facility. So in
11:22
design and planning prior to going live, we had
11:25
conversations around how we were going to be
11:28
able to ensure that the handoffs from the field
11:32
met the need of our law enforcement partners
11:34
and could be an actual diversion from the emergency
11:38
room services or an individual who potentially
11:42
may end up with charges and end up in jail. So
11:45
ultimately, we would like for this to be an opportunity
11:47
for a diversion from an emergency room visit
11:50
or a jail stay. If someone actually has a behavioral
11:54
health crisis identified in the field from law
11:56
enforcement and need the opportunity to engage
11:59
in treatment, that's what we have worked for
12:02
years with our law enforcement and criminal justice
12:04
partners in creating that opportunity. And by
12:07
having a team of co -responders, embedded with
12:10
our law enforcement partners that has certainly
12:13
helped facilitate the triage from the field to
12:16
the facility and really getting folks to the
12:19
right service at the right time with the right
12:21
level of engagement with a behavioral health
12:23
component. And that includes the field response
12:26
and the triage. So we can, if it's appropriate,
12:30
have someone come to Longview instead of walk
12:33
into an emergency department where there's a
12:36
variety of other medical traumas that are happening.
12:39
The Longview creates a warm and welcoming environment
12:41
that's focused on behavioral health very differently
12:44
than what an emergency department does. And like
12:48
Dr. Brooks said, it's a critical partnership
12:50
that we have with our emergency room partners
12:53
to triage because there's a variety of things
12:55
that we all triage at all times and work back
12:58
and forth between our emergency responders in
13:01
the field and our emergency room partners to
13:04
ensure that individuals are getting the right
13:07
care at the right time. One of the incredible
13:10
things about the investment that our community
13:12
has made in Longview is that it's built for the
13:15
work that we do. Riverside, we have enduring
13:19
and deep affection for that building where we
13:21
practiced for almost 10 years, but it wasn't
13:25
built for acute care work. We now have a sally
13:29
port, a drop -off section. It looks a lot like
13:32
an ambulance bay at an emergency department,
13:34
and it's a place where our law enforcement can
13:37
come. and drop someone off. And it works well
13:40
for both them and us. We learned a lot in standing
13:44
up Longview and in how to meet the needs of our
13:48
public safety partners who are dropping off.
13:50
And so we've got a strike team that comes to
13:53
the Sally Port and can meet our law enforcement
13:55
partners. And we worked hard together between
13:59
us and our law enforcement partners to figure
14:01
out what does that dance need to look like? As
14:03
you can imagine, some folks come and they get
14:06
out of the squad car and come on into our services
14:09
and others are more challenging. And so that
14:12
took a little bit of sort of dialogue and conversation
14:15
to figure out, you know, what does this look
14:18
like? Who participates in that sort of transition?
14:21
And we did so very collaboratively. Again, it's
14:24
a work in progress, but our great hope is that
14:27
our law enforcement partners can come and drop
14:29
off and then quickly get back to their jobs.
14:32
Our hope is that in 20 or 30 minutes, we can
14:35
make this transition. and our law enforcement
14:37
folks can get back to work. Some of the early
14:41
training that we had, we appreciated our law
14:44
enforcement partners coming to the facility and
14:46
walking through the facility prior to us going
14:49
live so they could understand what all existed
14:51
within the facility. Like Dr. Brooks said, we
14:54
have 10 exam rooms that look very much similar
14:57
to what an emergency room looks like. And then
15:00
we have three different bedded units. For our
15:03
partners to be able to understand what exists
15:06
within the facility and what levels of care individuals
15:09
will receive once they arrive at the facility
15:11
was an important part of our cross -training.
15:14
And we had briefings held out at the facility
15:17
for the first few weeks. So our law enforcement
15:19
partners from Fort Collins and Loveland and Larimer
15:22
County Sheriff's Office and Estes Park all were
15:24
able to join us. providing a little bit of introduction
15:28
to our staff and to the services that were there
15:30
in the environment that Dr. Brooks was talking
15:32
about that is, you know, designed for the intentional
15:35
use for our emergency response teams. So are
15:40
there any eligibility requirements to receive
15:42
services at Longview? None. And in fact, one
15:46
of Summitstone's core values are come as you
15:48
are. And so there are no eligibility requirements
15:51
for receiving services at Longview. I think one
15:55
of the things that we consistently stand behind
15:57
in our crisis care is individuals who are in
16:01
a self -defined crisis can access our care. That's
16:03
a wide variety of things, and that's really truly
16:05
self -defined. So if someone is struggling maybe
16:09
with their first bout of depression or suicidal
16:11
ideation, they can access care. Or if individuals
16:14
are receiving involuntary care and we're coordinating
16:17
with our partners, that's also really providing
16:20
care across the spectrum and where there's not.
16:23
an eligibility or criteria that either have to
16:26
be met or needs to be met prior to us being able
16:28
to provide an assessment through our urgent care.
16:31
And it sounds like that includes you don't need
16:33
a referral or a previous diagnosis to come and
16:36
get services. You do not. You do not. And to
16:39
Cassie's point, in our urgent care, we will assess
16:43
everyone, everyone who walks through the door,
16:45
no exceptions, who we admit to a bed, obviously.
16:50
has to meet medical necessity and other kinds
16:52
of medical necessity criteria, but there are
16:55
no eligibility requirements for coming and being
16:57
assessed in our urgent care. And an important
17:00
partnership that we have is also working with
17:02
our partners with 988. So SAMHSA stood up the
17:05
988 crisis line, and we actively dispatch our
17:11
mobile crisis team through referrals that come
17:13
through 988. So if an individual is calling 988,
17:17
the statewide and national crisis line, They
17:20
will actually coordinate with us to ensure that
17:22
that person receives an opportunity to receive
17:25
a mobile in the field, or they have our resources
17:29
and our local information about how to walk into
17:32
our Longview Acute Care facility and can be seen
17:35
24 -7, 365. That's fantastic. So we know that
17:39
cost is a common barrier for people who are seeking
17:42
health care in America, and I'm assuming that
17:44
mental health care isn't really that much different.
17:46
What does the billing process look for people
17:48
who, you know, can come to your facility and
17:51
what can they expect in terms of costs, you know,
17:53
when their visit at Longview is over? That's
17:55
a really good question. So generally speaking
17:58
at Longview, part of delivering health care services
18:02
period is ensuring that we bill people's insurance
18:04
wherever possible. And so we take all forms of
18:08
insurance and we'll attempt to to bill individual
18:11
insurance where possible. In the design of the
18:14
facility itself and the tax funding ensures that
18:17
if someone comes uninsured, that those services
18:20
will be covered so that really people are able
18:24
to receive services and will attempt all efforts
18:28
to bill existing insurances. But it's not a reason
18:32
not to try to access care because that's the
18:35
design of the facility itself and the tax dollars
18:37
is to ensure that people. are able to access
18:40
the care that they need and have the coverage
18:42
that's required. That's really great to hear.
18:45
One of the wonderful things about Longview is
18:47
that we have the appropriate adjunct medical
18:51
services to keep people safe in the facility.
18:53
And that includes lab and that includes pharmacy.
18:56
And we will bill for those things as well. Sometimes
19:00
we have to send labs out. Sometimes those send
19:03
-out labs have a cost and they may receive a
19:05
bill from a third -party lab vendor. Very unlikely
19:09
that they're going to get a bill from SummitStone
19:12
or and certainly not from the county because
19:14
we are the contracted provider, but they may
19:16
get a bill from third party vendors. Yeah. Again,
19:19
the nuances in American health care. That's just
19:21
how it goes. You both already spoke a little
19:24
bit about your community partners and, you know,
19:26
the lack of a need for referral and how you guys
19:28
work with law enforcement. But I am curious,
19:30
how does the follow up care look like for people
19:33
who have left Longview? Are there other partners
19:35
that you guys? partner with to help kind of facilitate
19:38
that warm handoff when they're ready to leave?
19:40
Yeah, absolutely. I think this is one of the
19:43
most important parts of care is ensuring that
19:45
not only we provide that immediate crisis intervention
19:48
where people can feel stabilized and safe and
19:52
we can appropriately safety plan to stabilize
19:54
that self -defined crisis, but it's also about
19:58
connecting to our community resources that do
20:01
exist. So really linking. back to outpatient
20:04
providers or lower levels of care that might
20:07
be more appropriate than an inpatient or a bedded
20:09
stay. We have a team of care coordinators that
20:12
start discharge planning the day of admission
20:15
if the one is staying within our acute care setting.
20:18
Our average length of stay is about three and
20:20
a half days in this acute setting, so we have
20:23
a little bit of time to ensure that we start
20:25
to write medications, identify appropriate diagnoses.
20:30
engage in treatment while individuals do stay
20:32
with us if they are admitted. And then link appropriately
20:36
to outpatient providers. Part of that is ensuring
20:38
that we have connections and that people have
20:40
primary care physicians that are set up and appointments
20:43
set up if they don't have an identified provider.
20:47
We link very frequently, obviously, to the Summit
20:50
Stone Behavioral Health Continuum that Dr. Brooks
20:52
talked about earlier. And if individuals don't
20:55
have Medicaid, we'll find external providers
20:57
or outpatient providers that take primary insurances
21:00
and ensure that they have appointments or at
21:03
least linkage to referral sources upon discharge.
21:06
And if possible, we really try to work with schools
21:10
and get schools the information. And if we have
21:12
an active safety plan that we can link to the
21:16
school teams, to DHS, our partners with DHS,
21:19
if it's coordinating, you know, between different
21:21
external providers. If we have the information,
21:24
if we have the releases of information, we want
21:26
to make sure that we're including as many collaterals
21:28
as possible to ensure people have a good network
21:32
surrounding them as they're discharging from
21:34
our care. That sounds like that would be really
21:35
important to have, especially when somebody's
21:38
leaving, you know, a period of crisis. Yeah,
21:40
absolutely. Yes. As Cassie mentioned earlier,
21:42
we see about 750 visits. Those are not individuals
21:46
necessarily, but 750 visits a month at Longview
21:51
and about 60 % of those folks, we're able to
21:54
safety plan and stabilize and get them back into
21:57
the community. Only about 35 % or so, 35 to 40%,
22:01
we actually admit to a bed at Longview. So SummitStone
22:05
recently launched a public data dashboard to
22:08
capture the work being done at Longview, which
22:10
captures some of that. Can you tell us a little
22:13
bit about how that dashboard came about? Absolutely.
22:16
I want to give a huge shout out to Paula Bernander,
22:19
who is Longview's biostatistician, and to Dr.
22:23
Jared Olson, who is the Larimer County Department
22:25
of Public Health and Environments senior epidemiologist.
22:28
I think I've gotten his title correct. We worked
22:32
collaboratively, our department and Dr. Olson,
22:35
as well as our BHS partners, on really committing
22:38
to We are going to make our data available to
22:42
the public. It is the public's tax dollars that
22:44
pay for this community asset. And we are going
22:47
to work hard to make sure that we turn over as
22:50
much of this data as is safe to turn over that
22:54
protects people's privacy to our community so
22:56
that they know how their dollars are working
22:58
at Longview. So it was long a deliverable for
23:01
us. We spent probably the first year or more
23:04
sort of just figuring out, are we delivering
23:06
the widgets that we're supposed to be? delivering.
23:09
And we were able to, you know, kind of get those
23:13
pieces stabilized and making sure that we were
23:15
just producing the number of urgent care visits
23:18
that we needed to and getting folks in, getting
23:20
folks admitted to a bed, opening up as many of
23:22
our beds as possible, and then found a space
23:25
to really go, okay, now it's time. Now it's time.
23:28
What do we need to turn over to our community
23:30
so that they understand how their tax dollars
23:32
are working? Quality Council that we stand up
23:41
and every three months we need to go over Longview's
23:44
data. How many folks are we seeing in urgent
23:47
care? How many folks do we put into a bed? What
23:49
are our demographics, et cetera? What did that
23:52
process look like behind the scenes to develop
23:54
the dashboard? Yeah, so we had a handful of meetings
23:58
with Dr. Olson and really sort of said, what
24:01
is it that our community want to know about the
24:04
work that we're doing at Longview? And there
24:07
was a lot of discussion around sort of the substance
24:10
use, because that was some of the primary drivers,
24:13
the gaps in our community that needed to be filled
24:16
and, you know, folks leaving the county to get
24:19
the substance use care that they needed. So one
24:21
of the stories that we really wanted to tell
24:23
was, are we filling that need? Are we filling
24:26
that gap in our community? And that is part of
24:29
the story that the Longview dashboard tells.
24:31
I think the other major story that that dashboard
24:33
tells is that. People who were getting their
24:37
behavioral health care at an emergency department
24:40
have shifted into getting their care at Longview
24:44
at a place that offers specialty behavioral health
24:47
care. We're not done. This is a work in progress.
24:49
But that offloading you were talking about earlier,
24:52
that unburdening of our safety net systems, I
24:57
think we've hit some significant strides in just
24:59
helping to... divert behavioral health care to
25:03
a behavioral health specialty setting. What did
25:07
the process look like to take into consideration,
25:10
to digest large amounts of data into a way that
25:14
any resident in Larimer County could take a look
25:17
and kind of get a feel for what's happening at
25:19
Longview? What sort of considerations went into
25:22
that? Lots of stakeholders. So we, again, meeting
25:25
with Dr. Olson, working with our own data team,
25:29
our biostatistician. Again, that quarterly quality
25:32
council taking the dashboard ideas to that group
25:37
and saying, does this tell the right story? What
25:40
are the important elements that we would want
25:42
to put on a dashboard that faces the public?
25:45
So there was some sketching out of, you know,
25:47
sort of what's the initial story that we want
25:49
to tell? And, you know, numbers people often
25:52
find themselves in a bit of a rabbit hole. You
25:55
know, I think this is really cool and I think
25:56
this is really cool. And really doing that stakeholdering
25:59
really. helps you pull out of that very niche
26:03
area and really begin to think about what does
26:06
an individual, what does a taxpayer, what does
26:09
a voter in our community want to know about how
26:12
their dollars are working? So those conversations
26:15
were really important. And I think an important
26:17
part to the process is also including individuals
26:20
with lived experience in our Quality Outcomes
26:22
Council and those who have maybe experienced
26:25
emergency room services or law enforcement services
26:27
or even services at Longview. what it is that
26:31
they wanted to see as well and what helped tell
26:33
their story. So what data is captured on that
26:36
dashboard? We really took a look at syndromic
26:39
surveillance data. So all of our local emergency
26:42
departments submit de -identified data to syndromic
26:46
surveillance and it really just sort of tells
26:48
the story of what kinds of visits they're seeing.
26:51
And so we took a look at syndromic surveillance
26:53
data for both mental illness visits, for substance
26:56
use visits, as well as for high acuity care visits,
27:01
high safety involved visits like emergency holds
27:05
and things like that. So that kind of data was
27:08
brought into the dashboard. And one of the stories
27:12
that the dashboard tells is that we cover data
27:14
from 2024 and 2025. And that initially in that
27:20
first year, our emergency departments were seeing
27:22
more mental illness visits and more substance
27:25
use visits than we were. And over the course
27:27
of time. We have seen more. We've seen that population
27:31
shift from our emergency departments to Longview.
27:34
And how frequently is the dashboard updated?
27:37
Right now, the dashboard is relatively static
27:40
and it gets updated around twice a year. So what
27:43
did you learn through the process of developing
27:45
this dashboard? Is there anything that kind of
27:47
popped out for you? I would say, again, to your
27:50
question earlier, Joanna, learning to tell this
27:53
story and learning to tell this story to our
27:56
community is skill. It takes some doing and some
28:02
thinking to really figure out what is the story
28:04
that you want to tell. And honestly, I think
28:06
if we had it to do over again when we updated,
28:08
we will put our emergency department story first.
28:11
The dashboard has three chapters, essentially,
28:15
sort of the work that we're doing, the integrated
28:18
care that we offer, and then it tells the story
28:21
of the offloading of our emergency departments
28:24
and looking at that syndromic surveillance data.
28:26
So you already spoke a little bit about the need
28:28
for transparency and making sure that the public
28:30
was aware of where funds are going. But how do
28:32
you envision some of your community partners
28:34
using this dashboard? Is there something that
28:36
you're hoping that they can kind of take away
28:37
from it? I think, one, just what are those tax
28:41
dollars doing? What are they producing? How many
28:43
visits are we seeing? And again, I think the
28:47
other story that the dashboard makes clear is
28:48
that we are filling a need where substance use
28:52
is concerned and we report on. the number of
28:55
visits and admissions that involve alcohol, that
28:57
involve stimulants, that involve opioids and
29:00
other drugs. One of the stories that the dashboard
29:02
tells is that alcohol remains king. We talk an
29:06
awful lot about our stimulant use disorder and
29:09
certainly our opioid crisis in our community,
29:12
but the one that doesn't often get talked about
29:15
anymore that remains most prevalent from a proportion
29:19
standpoint is our folks with alcohol use disorder.
29:22
And the dashboard tells that story well. I also
29:25
think the dashboard points to, if you build it,
29:28
you know, it will be utilized. The sheer volume
29:31
of people who have accessed care at the facility
29:34
speaks to the importance of the levels of care
29:37
that were identified as gaps in the system and
29:39
that it's accessible. I think the other thing
29:42
we would want our community partners to sort
29:44
of take away from this is, you know, so frequently
29:47
you'll learn about a new service or a new level
29:52
of care or a new organization because you get
29:56
a report or you attend a meeting, right? A dashboard
29:59
really sort of helps extend the reach of the
30:03
education that we can provide about Longview.
30:05
And I think that's one of the ways in which we
30:08
communicate with our partners is to send them
30:11
an easy link. Here's a snapshot of the work that
30:15
Longview is doing. What barriers still exist
30:18
to accessing acute mental health care in Larimer
30:21
County? Well, I think some of it is, you know,
30:23
ensuring that people know about Longview. I think
30:25
that it's been, you know, well marketed and people
30:28
are aware because it's been decades in the working.
30:30
But I also believe that, you know, there's maybe
30:33
new residents or others who haven't been a part
30:36
of the behavioral health environment or field
30:39
or have never had a, you know, a crisis that
30:42
will have they identify. So just ensuring that
30:45
that. people are aware of the services and that
30:48
they're available 24 -7, 365? Absolutely. I would
30:52
double down on that, just making sure that people
30:53
are aware of Longview. I think we still go into
30:57
community conversations where folks are like,
31:00
oh, what is Longview? And so I think we have
31:03
more work to do to make sure that folks understand
31:05
the work that we do and where we are and the
31:08
services that we provide. But I think across
31:12
communities, across states. access to behavioral
31:16
health care remains challenging, both from a
31:19
payer standpoint, both from are these services
31:22
available in my community? Are there enough of
31:25
them to support the needs in our community? And
31:28
I don't think that we are any different, even
31:30
though I believe that Longview has been incredibly
31:33
successful and has, you know, work to do. But
31:37
I think those remain barriers and certainly what
31:41
you just talked about. Tom, the fear that people
31:43
have of just walking through the door. What does
31:46
that look like? What does care look like for
31:48
these symptoms that I'm experiencing that I barely
31:51
understand myself? So I think those are challenges
31:54
that remain. What do you wish more people understood
31:58
about the work you do or the role of acute care?
32:02
I wish I could convince everyone how not scary
32:04
it is, but it can be frightening for people to
32:07
address these challenges. I guess I wish that
32:11
our community could collectively understand that
32:15
as a Summitstone service, we lean into our values.
32:20
We start with yes. We may not be able to provide
32:22
that thing, but we start from a place of what
32:25
you've asked for is entirely legitimate. Come
32:28
as you are. You don't have to use nice language
32:30
to come and see us. You don't have to be well
32:32
to come and see us. You don't have to be stable
32:35
to come and see us out at Longview. We are stronger
32:38
together. And we boldly raise the bar. And that
32:43
no one's alone, right? That we all do this together.
32:45
And I think that that is, you know, that's the
32:48
value and the philosophy that, you know, that
32:50
Dr. Brooks just relayed. And the dynamic nature
32:53
of the integration that we have in our acute
32:57
care setting is really powerful whenever you
33:00
have a physician next to a therapist, next to
33:03
a nurse, next to a psychiatrist and a psychologist.
33:06
And you have a team of... of people who are committed
33:09
to your well -being and to helping you along
33:12
in the journey. And we have a community that's
33:15
invested in doing this together. That's what
33:18
we hope that everyone walks away with, a positive
33:21
experience and an invitation to return. In next
33:25
week's episode, we'll pick up with Dr. Brooks
33:27
and Cassie to hear about the new youth wing at
33:30
Longview. To learn more about Longview in the
33:32
meantime, visit www .summitstone .org. You can
33:40
find links to learn more about the topics we
33:42
discussed today in the show notes. If you have
33:44
a question about public health in Larimer County
33:47
or a topic you'd like us to discuss, let us know.
33:50
Email us at healthiertogether at larimer .org.
33:54
Thanks for listening, Larimer County. Until next
33:56
week, stay well, stay connected, and remember,
33:59
we really are healthier together.