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Access, Ulster County Partner On Mental Health Urgent Care

Courtesy of the Office of Ulster County Executive Pat Ryan
Ulster County Recovery Task Force Member James Shaughnessy; Ulster County Behavioral Task Force Member Tim Hunt; Deputy Commissioner, Ulster County Department of Mental Health Tara McDonald; Ulster County Executive Pat Ryan; Access CEO Ron Colavito

Kingston, New York is now home to a mental health, substance use urgent care facility. It comes as the county is reeling from an escalation of mental health and drug addiction issues during COVID and the reduction of related inpatient beds.

The June opening of the Ulster Mental Health and Substance Use Urgent Care came as a partnership between nonprofit Hudson Valley-based Access: Supports for Living and Ulster County, where Pat Ryan is county executive.

“We’re coming off of one of the hardest years, of course, in all of our lifetimes but, in particular, we’ve seen in Ulster County a real exacerbation of the mental health and addiction crises,” Ryan says. “We had suicides in Ulster County double from the previous year, fatal overdoses up 93 percent in Ulster County.”

Ryan says the uptick in numbers occurred in 2020, as compared to 2019. In May, the Democratic county executive formed a countywide Behavioral Health Task Force to identify gaps in the mental health and addiction landscape to inform potential investments. The walk-in mental health and substance use urgent care in midtown Kingston is among the first outcomes.

“The same way we treat a broken bone or a sprained ankle where you can show up to an urgent care and walk in and get the care you need, we want to have that same level of service and seriousness towards the mental health needs of the community,” Ryan says.

Ron Colavito is president and CEO of Access: Supports for Living. He says the urgent care center is in a building attached to HealthAlliance Hospital.

“So I’m happy to have people seek services there in a friendly, non-stigmatizing way,” Colavito says.  “It’s an urgent care. Walk in and get services, including access to psychiatry.”

In spring of 2019, Access opened two mental health and substance use urgent care centers in Orange County, in Middletown and Newburgh, with the help of federal funding. In two years, more than 4,000 people have received care at the Orange County urgent care facilities, a majority having never previously done so with Access. This includes the use of telehealth services. At the time, Colavito said he thought the facilities were the first of their kind in the region, if not the state. Colavito says the urgent care facility in Kingston builds on Ulster County’s Mobile Mental Health Team.

“So the county funds the Mobile Mental Health Team that we actually, we’re actually the service provider for,” says Colavito.

The Kingston project differs from the other two:

“We are adding a, essentially another mobile component for a nurse, a nursing care management function that’ll be able to come to people’s homes or anywhere in the community that works for them to support people seeking treatment for opioids, in particular, so that there’s more of an outreach,” Colavito says. “But that’s in addition to come see us in the center or call us. This is, we’re going to come to you and try to make that work and serve people really where they are and assist them in connecting to support because we don’t want to create a scenario where when people, in the middle of a crisis, have to go figure out the complex healthcare system. We want to simplify that, bring the services to them and help them navigate seeking treatment when they’re ready to do so.”

The Orange County locations added 24/7 virtual care during the COVID crisis, and Kingston has the same round the clock virtual service.  Michael Berg is executive director of Kingston-based Family of Woodstock, which provides services throughout Ulster County.

“We’re, we’re desperately in need of more mental health services. And the fact that there’s now a walk-in place that is presenting that it can provide service on a walk-in basis is terrific,” says Berg. “It doesn’t replace the need for more ongoing service, but it is a good emergency addition. We certainly will use this and refer to it, and I’m sure that they will refer to us as well.”

The Kingston facility came together in about a month’s time, with funding from both Access and Ulster County. Ryan says he was able to leverage some federal funding for addressing the opioid crisis to help set up the urgent care center. While COVID escalated the need for such services, Ryan says the demand existed well before the pandemic. And now, he says, HealthAlliance cutting the county’s only inpatient mental health and chemical dependency services exacerbates the problem.

“To be clear, the urgent care, the mental health urgent care is not meant to be a replacement for some of the inpatient beds that we lost, which we’re still working hard to return, but this helps address some of the gap left by that while we continue to work to bring those beds back,” Ryan says.

He says nine months ago, HealthAlliance shut down 40 inpatient mental health beds and 20 beds dedicated to chemical dependency and detoxification to make room for a potential regional COVID-19 specialized care center. Ryan thought the move was temporary.

HealthAlliance of the Hudson Valley responded in a statement, saying the community continues to have access to behavioral health services in Ulster County and that the long-established access point in the county for anyone in need of such services continues to be the Emergency Department at HealthAlliance Hospital in Kingston, which is open 24/7. Patients in need of acute inpatient substance abuse services can be admitted to HealthAlliance Hospital on Broadway. Inpatient mental health services are available at WMCHealth’s MidHudson Regional Hospital in Poughkeepsie.

The statement adds that, “outpatient care for a range of behavioral health conditions is now considered a national norm in this evolving area of healthcare, and the majority of individuals seeking behavioral health assistance at HealthAlliance Hospital are treated and released. To support community needs, HealthAlliance offers outpatient behavioral health and primary care services, such as addiction treatment programs, rehabilitation services and a methadone clinic. We have also participated in briefings with locally elected officials, state agencies and other stakeholders regarding additional short- and long-term solutions for behavioral health services in the area, including the possibility of permanent relocation of behavioral health beds to MidHudson Regional Hospital.”

Ryan has petitioned state officials, asking that they require HealthAlliance to return the inpatient beds. Colavito says the reduction in beds creates more of a need to provide bridge medications.

“Part of what’s been really successful in our urgent care model, in addition to just the volume of people we’re seeing, is the volume of bridge prescriptions we’re able to provide for people to remain on medications that are important to them and important to their mental health and health related to substance use,” Colavito says.  

Colavito says there are no immediate plans to further expand, though the model is replicable and he will explore where else in the Hudson Valley it makes sense. Here’s Ryan:

“Well, I hope that this meets a lot of the immediate need definitely in the sort of Kingston area and the northern part of the county. If this is a success, we would love to do more of these kinds of partnerships and initiatives with Access, or with other partners,” says Ryan. “I mean, I think what we’re trying to do here, and what I’ve tried to do on many fronts, is, in the midst of this crisis, let’s use it as an opportunity to try to be both creative and compassionate in delivering these kinds of services.”

The Ulster Mental Health and Substance Use Urgent Care is open for in-person services 10 a.m. – 6 p.m., Monday through Friday and virtually, 24/7. (888-750-2266, option 2)

The Registered Nurse/Care Manager for substance use treatment is also available by calling the Urgent Care or the Ulster County Mobile Mental Health Team at 844-277-4820.

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