Quannacut is a Native American word for hope, or for a rainbow, and on the East End of Long Island the name has long been synonymous with the hope offered at Eastern Long Island Hospital’s addiction rehabilitation services, which have been providing shelter for substance abusers to turn their lives around since long before the current wave of opioids came ashore here.
In mid-July, ELIH got good news from New York State, which has awarded Quannacut with a $1.6 million grant to significantly expand its outpatient services in Riverhead, adding a women’s sober house and mental health and primary care services to its outpatient services.
The grant came from the New York State Department of Health’s Statewide Health Care Facility Transformation Program, aimed at changing the way health care is delivered statewide, particularly with regards to services utilized by Medicaid recipients, making it easier for people to receive preventative medical services, in part in an effort to reduce emergency room visits for non-emergencies.
ELIH opened its inpatient rehabilitation program in 1989, expanding with an outpatient program that moved from Mattituck to Harrison Avenue in Riverhead in 2001.
The outpatient building, just 5,000 square feet, is far inadequate and not laid out in a manner to meet current needs, said Quannacut Outpatient Services Director David Cohen. The hospital plans to lease a new space in Riverhead, with 10,000 square feet of space for the expanded program.
Mr. Cohen estimated that the outpatient program currently sees about 700 patients per year, with 300 active patients as of early August, a number that has steadily grown since the outpatient clinic opened, with a few big leaps over the past decade-and-a-half.
“Opiates is a big deal, certainly, but there’s less stigmatization than ever been about mental health and substance abuse disorders,” he said, adding that the reduced stigma is encouraging people to seek treatment.
The clinic holds walk-in intake hours on Mondays and Fridays from 9 a.m. to noon, a rarity in a field where there is often a long wait to receive care.
“We’re hoping with the new location to offer expanded walk-in hours,” he said. “I think a week is a long time to wait.”
Mr. Cohen said a big goal for the state in issuing the grant is to reduce hospital admissions, in part by the integration of primary care and mental health services, which would mean a change in the clinic’s license status. That type of care has long been hampered by regulatory blockades that are being lifted as state regulators come to grasp the benefits of integrated care.
“What we’re really looking to do is an integrated outpatient center that’s not bound by its license to just treat substance abuse disorders,” he said.
“Substance abuse is considered a mental disorder in the DSM5 (the handbook for diagnosis of mental illnesses). They’re a mental health condition and should be seen that way, but the field is not set up that way,” said Mr. Cohen. “I’d say 45 to 50 percent of our patients also have an underlying mental health issue. That’s a very high percentage, but it’s a testament to the skill of my staff. They’re very well-trained and excellent at diagnosis.”
Mr. Cohen said that, if the clinic receives an integrated license, people will not have to have a substance abuse issue to use the primary care or mental health services.
“There’s a new wave, in the past few years — we started to find that when people go to the hospital for emergency room visits (for a condition that could easily be handled by a primary care doctor), they also have mental health conditions,” he said. “And we conversely fount the same thing when people go to the hospital for mental health, they often have untreated and very treatable medical conditions.”
ELIH CEO and President Paul Connor shares that optimism.
“One of our purposes is to expand access to outpatient treatment, reducing the need for treatment,” he said, adding that ELIH also sees a large share of people with both substance abuse and other mental health disorders because the hospital has inpatient programs for both ailments.
The Riverhead clinic currently has a primary care doctor with experience treating substance abuse, Dr. Jared Pachter, in house once a week, but they plan to expand on those services in the new location.
“I think that we will have a more contemporary space that we can now design based on the needs of the patient,” said Mr. Connor. “The facility we took over wasn’t designed for groups or workshops. We had to kind of make it work for us. The space is not optimal. We now will have a wide open space we can design based on contemporary treatment modalities.”
He added that, with ELIH’s upcoming merger with Stony Brook University Hospital, Stony Brook, which has its own behavioral health program, may look into doing more programming in the new space.
Mr. Connor said the hospital will work on planning the new space and going through regulatory hurdles for the remainder of the year, with the hopes of beginning work on-site in 2018.
The women’s sober house, which will be within 15 minutes of Riverhead, is also a much-needed addition.
Mr. Cohen said that, while there are many sober houses on Eastern Long Island, most are run by private citizens.
“Sometimes they mean well, and sometimes they don’t, but even if they do, a lot of times they are in over their heads,” he said. “The only sober houses that I think are really competent are associated with professional organizations.”
Mr. Connor is happy to be able to provide the service to women.
“I think the women’s program will be well received,” he said. “There are problems with women being integrated into any program.”
“When people are discharged from a program, they often have a difficult time,” he said. “They get into an insidious cycle. It’s the nature of the disease. By expanding outpatient services, we believe we are going to have a significant impact on rehospitalization.”