As of December 31st, 2023, SpringVale Health Centers will end their 24/7 Crisis Intervention Services. These changes will impact the Tuscarawas and Carroll County communities they have traditionally served and residents experiencing mental health crises will need to seek help through alternative resources.
Press Conference to Explain Changes
SpringVale Health Centers announced these changes and explained the circumstances leading to them in a December 20th press conference. JJ Boroski, Executive Director of SpringVale Health Centers and Licensed Clinical Counselor detailed the timeline of events that lead to the changes and the next steps for SpringVale.
Boroski explained that SpringVale’s 24/7 crisis response continuum of services, has served as an “emergency room” for individuals and families experiencing a behavioral health and/or substance use related crisis.” The Tuscarawas and Carroll County communities do not have a local psychiatric inpatient unit, so the crisis intervention clinicians have helped to resolve crisis situations, “assisting individuals and families in accessing higher levels of care outside of the communities, such as psychiatric inpatient care, detox services, and residential type placements.”
These services have been financed through Medicaid, third party insurances, and financial support of the local Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board for those who are uninsured. SpringVale began experiencing a reduction in the number of crisis assessments being completed in 2019 as a direct result of a policy change associated with Cleveland Clinic’s acquisition of Union Hospital.
The policy change directs crisis assessments to Cleveland Clinic’s “Central Intake,” located in Cleveland, OH. Instead of receiving face-to-face crisis services, individuals experiencing a personal crisis speak with a clinician via telephone or video conference. This policy change has led to a 73% reduction in the hours of crisis intervention services being provided through SpringVale and an approximate reduction in annual revenue of $210,000, which led to a financially unsustainable situation for SpringVale.
What’s Next for Crisis Care in Tusc and Carroll Counties?
The ADAMHS Board has sought to replace face-to-face crises with telehealth crisis intervention services. SpringVale is deferring to the ADAMHS Board to provide details regarding the evolving crisis care system and their plans for Telehealth.
SpringVale Health Centers will open a new immediate access site, to be known as RapidCare, that will offer both physical health urgent care services along with a behavioral health component. The RapidCare location will offer same day, walk-in face-to-face crisis assessments, diagnostic assessments, and short-term counseling.
Qualifying individuals will also have immediate access to appropriately prescribed psychiatric medications. These services will only be available during established business hours.They anticipate a soft opening on January 8, 2024 at 155 Garland Dr., in New Philadelphia. They will still operate their 24/7 Crisis Hotline and 5 bed Crisis Stabilization Unit from their Hospital Drive location.
Concerns for Quality Crisis Care Access
In their press release, SpringVale expressed concern for the, “consequences of diminished, face-to-face behavioral health crisis services,” in the Tucarawas and Carroll County communities. They emphasized the increasing need for mental health and crisis care, particularly in rural communities, with particularly emphasis on the rising completed suicide rates in the counties. They are concerned about the effectiveness of outsourced telehealth services in “acute crisis situations and do not have local knowledge of resources and people.
They state, “Without an effective and efficient crisis intervention system, individuals and families in crisis may be left without adequate support, leading to a worsening of their condition and a risk of potential harm to themselves or others. Families, already burdened with the weight of their loved one’s behavioral health struggles may face even greater challenges without the necessary resources and services in place.”
More Information and Resources
For more information on the SpringVale Health Centers services, visit the springvalehealth.org.
For more information on Tuscarawas and Carroll County treatment and support for addiction and mental health, visit the ADAMHS website.
Residents can also call the Local 24/7 Crisis Lines:
Tusc: (330) 343-1811
Carroll: (330) 627-5240
The full text of the SpringVale press conference announcement is posted below:
Press Conference
December 20, 2023
Good morning…On behalf of SpringVale Health Center’s Board of Directors and myself, I sincerely thank you for taking time out of your busy schedules to be here with us this morning. For those of you who may not know me, my name is JJ Boroski and I am the Executive Director of SpringVale Health Centers. I am a Licensed Clinical Counselor and have spent the last 26 years working in Ohio’s public behavioral health system, both as a direct service provider and as an administrator. Fourteen of those years have been dedicated to serving the Tuscarawas and Carroll County communities.
Holding a Press Conference is unusual for SpringVale, and this is the first time in our recent history. Given the gravity of the situation, this morning, I stand before you to discuss a critical change in our crisis system of care that demands the attention of everyone in our community – the discontinuation of 24/7 behavioral health Crisis Intervention services through SpringVale Health Centers – essential services that have played a vital role in our community since 2005. The discontinuation of these services is of such great concern to us, we believe it is necessary to stand before the community, in a spirit of complete transparency, and provide you with full information about the circumstances that led us to this point.
We believe that 24/7 behavioral health Crisis Intervention services are essential for individuals who are struggling with behavioral health and/or substance abuse challenges. Our 24/7 crisis response continuum of services, in essence, is an “emergency room” for individuals and families experiencing a behavioral health and/or substance use related crisis. Our Crisis Intervention services provide immediate support, intervention, and guidance to those individuals in crisis, offering a lifeline during their most vulnerable moments. These services have been a beacon of hope, offering comfort to countless individuals and families amidst their darkest times. Our mobile team of licensed clinicians are unselfishly available and ready to serve when regular business hours end – while many of us are in our beds sleeping at night, while we are in our homes celebrating holidays, and otherwise attending to matters during non-business hours. Our clinicians can quite frequently be found providing services in our local police departments and jails, our local emergency rooms, in our local school systems, and about anywhere a behavioral health crisis might arise. Due to our community not having a local psychiatric inpatient unit, our crisis intervention clinicians have become, and are, THE experts in helping resolve crisis situations, assisting individuals and families in accessing higher levels of care outside of our communities, such as psychiatric inpatient care, detox services, and residential type placements. These clinicians deserve our gratitude for their selfless service and the countless lives they have saved over the last 18 years.
When an individual needs to transition to a higher level of care, such as an admission to a psychiatric inpatient facility or a detox facility, the receiving facility requires that the individual is “medically stable” and must receive “medical clearance”. Quite often, this includes a physical examination by a healthcare provider, the completion of general lab work to rule out any physical health issues being manifested as psychiatric symptoms, and a drug screen. Other medical tests, such as CAT scans, MRIs and such, may be required when indicated. As a result of these requirements and based on the need to provide holistic care, our Crisis Intervention team has historically worked seamlessly and closely with our local hospital emergency medicine providers to coordinate the needed assessments and care. These services, through a relationship with our local ADAMHS Board, have been made available to anyone experiencing a behavioral health and/or substance use crisis, regardless of their ability to pay and regardless of what type of health insurance they may or may not possess.
Our 24/7 Crisis Intervention Services have been sustained through fee for service billings to Medicaid, third party insurances when allowable, and through the financial support of our local ADAMHS Board for those who are uninsured. In 2019 SpringVale began experiencing a reduction in the number of crisis assessments being completed. This reduction was a direct result of a policy change associated with Cleveland Clinic’s acquisition of Union Hospital. Whereas, historically, when someone went to Union Hospital emergency room experiencing a behavioral health and/or a substance use related crisis, SpringVale’s on-call crisis worker was contacted to perform an on-site crisis assessment. At the end of the assessment, the on-call clinician would either complete a comprehensive safety plan addressing the immediate needs of the individual or took the lead on facilitating placement for the individual. These safety plans often included linking the individual with local providers for follow-up care, developing call plans in which our hotline workers would make calls to the individual for added support, an/or making referrals for wrap-around services, including referrals to homeless shelters, food banks, and other community supports that could help resolve the crisis situation.
The policy change by Cleveland Clinic, as described to us, is for their emergency department to utilize Cleveland Clinic’s “Central Intake”, located in Cleveland, OH, to perform crisis assessments. This policy significantly changed the way in which members of our community accessed crisis services. Instead of walking into the hospital emergency department and receiving face-to-face crisis services, individuals experiencing a personal crisis were provided access to a telephone to speak with a clinician located in downtown Cleveland. It is our understanding this may have changed in that individuals are now connected via videoconferencing capabilities.
The gradual implementation of this policy change has led to a 73% reduction in the hours of crisis intervention services being provided through SpringVale and has led to an approximate reduction in annual revenue for the service of approximately $210,000. Consequently, we determined that this sizeable reduction was not financially sustainable.
Beginning in 2020, the ADAMHS Board graciously began subsidizing the monetary loss to ensure continuation of these vital services while we attempted to work through the policy changes with the Cleveland Clinic. Over the last 3 years many meetings have been held with representatives from Cleveland Clinic Union Hospital, the ADAMHS Board, and elected officials to address the issue. Even though many of those attending the meetings expressed an awareness that operational policies developed for sites in urban areas are just not effective for our rural communities of Tuscarawas and Carroll counties, there has been a reluctance toward policy change and community collaboration.
As a result of this reluctance to policy change, the ADAMHS Board requested SpringVale to develop a more “cost-effective” way of delivering crisis intervention services. This was quite impossible as our crisis services is already staffed at a minimal level. During non-business hours, we have one on-call clinician covering both Tuscarawas and Carroll counties. Reducing costs would involve reducing available hours, which would not be beneficial for our communities. The ADAMHS Board has informed SpringVale Health Centers that our financial subsidy supporting our 24/7 Crisis Intervention services will end as of December 31, 2023. They informed us that this subsidy is “not a good use of taxpayer funds” as it is a duplication of services. This statement was made in reference to the telehealth crisis services that are available 24/7 through the Cleveland Clinic Union Hospital emergency department.
We must not overlook the vast impact this change will have on our communities and the lives of our residents. SpringVale’s Crisis Intervention services extended well beyond the Cleveland Clinic Union Hospital emergency department. As previously mentioned, we provide services at Trinity Hospital’s emergency department, the Tuscarawas and Carroll County Jails, in various local law enforcement offices, and in school systems across both counties. We have emphasized this with the ADAMHS Board and they have unilaterally sought to replace face-to-face crisis intervention services by securing a contract with an out of county provider for the provision of telehealth crisis intervention services to these entities. Sadly, SpringVale was neither included in the planning for this change nor were we informed of this change. Instead, SpringVale’s leadership learned of these changes from our crisis intervention staff, who by mere chance, were told about the changes from personnel in the emergency room in which they were providing crisis intervention services. This information was received on December 2, 2023, the day before emergency departments and jails were instructed to begin contacting the out of county provider for telehealth crisis intervention services.
The consequences of diminished, face-to-face behavioral health crisis services will be vast and far-reaching. We know that behavioral health and substance use needs are dramatically on the rise. We know individuals are experiencing suicidal ideations at alarming rates and that completed suicide rates are considerably rising not only nationwide, but also right here in Tuscarawas and Carroll Counties. Yet, decisions have been made to defund face-to-face services and to move toward a system of telehealth delivered by out of county service providers who do not know our community like we do, do not know our people like we do, and may not know our remarkable system of resources available to individuals in need like we do.
While telehealth can be a valuable method of service delivery in some circumstances, we know and have directly experienced that it is not as effective in responding to emotionally intense, acute crisis situations. Several members of our community have already experienced tragic outcomes as a direct result of this out of county telehealth approach.
The purpose of this Press Conference is not meant to point fingers. It is not meant to cast any entity or any person in a negative fashion. It is to inform, to provide you as members of our great community with information from our perspective so that you may ultimately draw your own conclusions and, hopefully, feel compelled to advocate for the services you would like to see funded in our communities.
Without an effective and efficient crisis intervention system, individuals and families in crisis may be left without adequate support, leading to a worsening of their condition and a risk of potential harm to themselves or others. Families, already burdened with the weight of their loved one’s behavioral health struggles may face even greater challenges without the necessary resources and services in place. It is our duty as a not-for-profit community healthcare organization and we believe your job as community members to ask questions, and to advocate for those that are the most vulnerable in our communities.
Again, we will end our 24/7 Crisis Intervention Services on December 31, 2023. We will defer to the ADAMHS Board to provide details regarding the evolving crisis care system and their plans for telehealth.
As for SpringVale Health Centers, we will open a new immediate access site, to be known as RapidCare, that will offer both physical health urgent care services along with a behavioral health component. Our current on-call crisis staff members who will be impacted by this change will transition to our RapidCare location where we will offer same day, walk-in face-to-face crisis assessments, diagnostic assessments, and short-term counseling. Qualifying individuals will also have immediate access to appropriately prescribed psychiatric medications. It is our hope, through increasing timely access to care, we will help prevent situations from becoming a crisis. Unfortunately, these services will only be available during established business hours. We anticipate a soft opening on January 8, 2024 and the site will be located at 155 Garland Dr., in New Philadelphia. It is important to note that we will still operate our 24/7 Crisis Hotline and our 5 bed Crisis Stabilization Unit from our Hospital Drive location,
In closing, I would be remiss if I didn’t take this opportunity to again thank not only the crisis intervention specialists at Springvale Health Centers, but also the thousands of Tuscarawas and Carroll County residents who have trusted our agency when theirs lives felt most vulnerable. Thank you to our local law enforcement for your partnership and for dedicating countless hours to Crisis Intervention Training – our local law enforcement sets a high bar when it comes to managing difficult situations and identifying individuals who would benefit from immediate behavioral health care.
To the mayors of our various communities, thank you for your consultation and trust during this change of service – your support shows your dedication to the physical and psychological well being of our residents.
Lastly, I would like to thank our community and the thousands of individuals who entrust Springvale Health Centers as their medical home. We share this information, and, in the same breath promise to continue to grow our agency to see that the healthcare needs of our community are met, and to increase the accessibility of affordable, high-quality health care. We promise to offer our services with compassion, inclusion, and hope for a healthier future.
We will now have a few moments for questions.
