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A Letter from our Executive Director on Medicaid Reimbursements

Dear Recovery Café Supporter,

You can take action today that will truly make a difference. Our collective house is on fire. As someone who is immersed in the behavioral health care system on a daily basis, our system is teetering on collapse. We do not receive any Medicaid funding so there is no financial incentive for me to write this however our critical partners in this work do. If we don’t improve our current Medicaid reimbursement rates the results will be catastrophic. Please contact your legislators and ask them to support raising the reimbursement rate to 7%.    

I share this story as one example of many. As you know in response to COVID, Recovery Café hosts a monthly outside Resource Connection Day that connects people with tangible resources such as masks, hand sanitizer, clothing, food, a warm shower, bus tickets, science informed information about COVID and the vaccine, etc. as well as in person meeting with partner organizations such as vaccine teams, housing, employment, and free cellular phone plan providers. At our November event, the Vet Van was on site as well and we served a delicious Thanksgiving meal generously provided by the faith community of St. Joseph’s Catholic Church. 

Over the course of the event a young man and I struck up a conversation, he was there primarily seeking help for his dog and we talked about the many things people do when they first meet and are trying to find connection points. As he waited for his dog’s appointment our paths kept crossing along with opportunities for more conversation. At one point, he leaned in toward me and it was clear to me he wanted to talk about something he didn’t want everyone to hear. In a whisper (which through a mask is quite a whisper) he asked me if I could help him get into detox. This moment is what we in the field call “the window of opportunity.” It is a moment when a person is willing to not only admit they need help but to seek it. It usually also entails knowing that choosing this path is going to be physically and psychologically painful. A myth that exists to this day is that people on the streets are drinking/doing drugs because they want to party. This has never been my experience. People keep using because to stop often means letting go of a self-medication that makes life bearable (research suggests 9 out of 10 people that Recovery Café serves have suffered significant childhood trauma) and embracing a physically and psychologically very painful time. In essence many people who are addicted keep using/drinking, not so much to get high as to not get sick.  

I am sad to say I was a bit cagey in my response to this homeless young man. I didn’t want to create any sense of false hope so if we couldn’t connect him with detox, we might confirm what many people in his situation believe, that there is no reason to hope because things will never get better. With help from my Café colleagues we reached out to every detox service provider we knew to see if they had a bed available. I was struck by the fact that every major behavioral health provider I called included in their initial phone response that they were understaffed and may not return calls in a timely manner. We made close to 50 calls, leaving voicemails and navigated calling places where no one picked up and their voice mail was full. I kept checking in with the young man, letting him know we were trying and I could tell as the day progressed we were losing him, and eventually he left. We never did get a call back that day from the numerous providers we contacted. Most of the calls we made weren’t returned and one was only returned 2 weeks later. 

Everything is connected and our current hollowed out behavioral health system is failing us all. Ask any first responder, EMT, Fire, Police, bus driver, or homeless service provider and they will share that behavioral health challenges are a huge part of their work. As documented in the Seattle Times, the number of people working in healthcare has been shrinking while at the same time the need has been vastly increasing. Increasing the Medicaid reimbursement rate to 7% as recommended by the Washington Recovery Alliance won’t fix our system but at least it is a step toward shoring up desperately needed services. In this newsletter is a link to find your elected officials and I urge you to take action today. As always, thank you for being on this journey with us.

David Coffey