Outpatient services to be expanded as part of the restructuring.

RiverView Health is in the process of restructuring its chemical dependency treatment division, Glenmore Recovery Center. This means outpatient services will be enhanced and expanded at the Crookston, East Grand Forks, Roseau and Thief River Falls locations, while detoxification and residential services will be discontinued at the Crookston location on Highway 2 and the Thief River Falls Halfway House.

The move will impact 35 staff at the facility just east of Crookston that fill 27 full-time equivalent positions.

Through this new restructuring, RiverView Health can continue to meet the needs of 90 percent of individuals needing chemical dependency treatment through outpatient services. Based on the Substance Abuse and Mental Health Administration's 2013 data on the prevalence of chemical dependency nationwide, 90 percent of individuals are treated in an outpatient setting.

Eliminating costly services to save most-needed
"Eliminating residential treatment services and expanding outpatient services allows RiverView Health to continue to meet the chemical dependency needs of our service area, without experiencing financial losses that must be subsidized by other parts of our health system,'' said RiverView CEO Carrie Michalski. "Because of a gap in revenue versus expense for residential chemical dependency services, Glenmore Recovery Center has operated at break-even to marginal losses for more than a decade."

Recent strains on state and federal budgets have decreased the reimbursement rates and encouraged transitions from residential care to outpatient care. Glenmore saw losses of $204,000 in 2011, $539,000 in 2012, and the projected loss for 2013 is $971,000. This trend is expected to continue for the foreseeable future.

What it all means
Detoxification services will end May 31. If a patient meets criteria for medical detoxification, he/she will be admitted to RiverView Hospital. If the criteria are not met, the individual will be transferred to the nearest detoxification facility. Currently, the closest facility is located in Nevis, Minn.

Inpatient services will end at Crookston's Glenmore campus on June 14. For individuals that require residential treatment, services are available at numerous locations, with Douglas Place in East Grand Forks and Prairie St. John's in Fargo being the closest. The Thief River Falls Halfway House will close June 30.

All timelines were designed to allow existing clients adequate time to complete their treatment.

Unfortunately, these changes do result in the reduction in the number of employees at Glenmore Recovery Center. Severance packages and retention incentives are in place for employees who participate in the transition through June 30, Michalski added.

Expanded outpatient services
Currently, 70 percent of the patients from RiverView's primary service area need outpatient treatment, which allows clients to receive high-caliber clinical care while maintaining commitments to work, family and home.

Outpatient services will include the following:

Day Treatment: This program serves individuals that meet criteria for a substance-use disorder that do not require 24 hour monitoring, yet require more than an intensive outpatient program. Day Treatment is 5 days a week from 8 am to noon each weekday. Day treatment includes education; individual, group and family counseling.

Intensive Outpatient Program (IOP): The IOP program is less intense than the Day Treatment Program. It is a minimum of 9 hours of service per week. Individuals in the IOP program will participate in individual, group and family counseling.

Relapse Prevention: This program typically lasts for 12 weeks and will consist of weekly, 2-hour group sessions. This program provides care to individuals that have completed a higher level of care and require on-going services to strengthen skills and insight.

Extended Care: This level of care is provided to those individuals that have completed a higher level of outpatient services but require additional care. This is often required when a person presents with clinically significant issues that require further attention. This service is provided on an individual basis.

Driving with Care (DWC); Driving While Impaired (DWI) education: RiverView has three certified DWC facilitators that provide a cognitive-behavioral treatment course for DWI offenders. A level 1 education program is provided for first time DWI offenders. This is a 12 hour education program delivered in six sessions. This education course is committed to reducing future impaired driving offenses and also future alcohol and other drug related problems.

Rule 25; Alcohol and Drug Assessments: Each of RiverView's licensed counselors provide Rule 25 assessments on a weekly basis. Rule 25 assessments are generally for people seeking to know if they are drug or alcohol dependent and what treatment options are available. Emergency assessments are also available.