February 1, 2025 • 35 mins
What happens when a hurricane hits not just the physical landscape but also the heart and mind of a community? Join us on this compelling episode of Head Inside Mental Health, where we sit down with Dr. Eric Levine, President and CEO of CooperRiis, to discover the resiliency of community during a disaster. Eric shares his firsthand experiences, detailing the immense impact the storm had on the community in Asheville and the surrounding areas. His vivid recounting of the storm’s destruction and dedication of the staff at CooperRiis paints a powerful portrait of human endurance and compassion in the face of adversity.
Together, we explore Eric and his teams managed to maintain high-quality mental health services under such severe pressure, emphasizing the crucial role that dedicated staff and strong community support play during disasters. Eric opens up about the emotional toll on caregivers, highlighting the exhaustion and trauma that persist long after the storm has passed. We examine the challenges of sustaining compassionate care in an overwhelmed system, touching on complex issues like insurance reimbursement and resource allocation. This episode raises important questions about the sustainability of mental health support systems in crisis situations, urging listeners to consider the critical need for resources to support our most vulnerable populations.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello folks, thanks for joining us on Head Inside
Mental Health, featuringconversations about mental
health and substance usetreatment with experts around
the country sharing theirthoughts and sights and practice
perspectives on the world ofbehavioral health care.
Broadcasting on WPVM 1037, thevoice of Asheville, independent
commercial free radio, I am ToddWeatherly, your host
(00:22):
therapeutic consultant,behavioral health expert.
Today, returning to the show, Ihave Dr Eric Levine.
Eric is the president and CEOof Cooper Ease, a residential
healing community serving adultsaffected by the challenges of
mental illness and co-occurringconditions that want to move
towards healthy and fulfillinglives.
They have two locations here,west North Carolina, asheville,
(00:43):
and the Healing Forum Campus inMill Spring.
Eric has his doctorate ineducation leadership, an ed s in
career transition andassessment, a master's in
special ed from GeorgeWashington University and a BA
in psychology from theUniversity of Maryland.
But we won't hold that againsthim.
Eric has more than 30 years ofworking in education, advocacy
and mental health, having servedas a consultant and in numerous
(01:03):
leadership and executive rolesin the field.
Avid kayaker and golf ballhacker like myself, he joins us
today to talk about the impactof Hurricane Helene and the
resulting floods and damage tohis campuses and to the mental
health community in our area.
Dr Levine, welcome back to theshow.
Speaker 2 (01:20):
Thanks, todd, always a pleasure to spend time with
you.
Speaker 1 (01:23):
Oh, yes, I'm certain that you feel that way.
You know, I feel like I have togive you a hard time as often
as I possibly can because I justdon't see you that much.
You're too busy these days.
We let off the conversationtalking about the river
conditions opposed to lean, butthe recovery process in this
town looks like one of the audioequalizers.
(01:48):
You've got one area of townthat barely got damaged and
they're full on and everything'sgoing just right.
But if you drive throughBiltmore, everything's still
under recovery, everything'sstill being repaired and there
are spots that still.
You drive through swananoa andit still looks like a disaster.
I got to drive by the ashvillecampus not too long what last
(02:11):
week or so and it looks prettygood.
You know from what it wasbecause I, I saw it right after
the storm and you, like so manyothers, just had.
It was high enough not to get,not to have the river reach it,
but there was trees down, thenetwork was down.
You know we couldn't callpeople, we couldn't, and your
story just about like day after.
(02:32):
Tell that story a little bit,because I think it's kind of
it's incredible.
You know not only one, what youhad to deal with but two how
you pivoted.
So tell the story about.
Let's start with day afterhelene.
Speaker 2 (02:44):
Tell me what I mean, let me actually start three days
before helene, because I don'tknow that people, really, that
the area got eight inches ofrain, that the helene was on the
friday and tuesday, wednesdayand thursday down to the green
river to check it out, you, youknow, just because I wanted to
(03:06):
see.
You know, I go down there allthe time and at that point on
Thursday the water was out ofthe banks and onto the road and
it was a problem and Helenehadn't gotten here.
In fact I was lucky to get outof there.
That was kind of a stupid thingI did, but I got out.
And then Helene happened onFriday the 29th and then over
(03:28):
the course of that storm, Withthe water already being over the
banks, like water already there, we're already at flood stage,
and then we got 20 inches ofrain and 70, 75 mile an hour
winds, and it absolutelydevastated the entire region.
Down where we are in Mill Spring, we are nine miles from the
(03:54):
Lake Lure Dam and four milesfrom the Lake Adger Dam, and we
were getting notifications ofimminent, catastrophic failure
of those dams was coming, and sowe were all making plans to
evacuate our farm property andwhat to do.
And we're getting these localannouncements, text messages
with circles of impact on them,and so it was pretty wild.
(04:16):
But then it happened, andAsheville and the surrounding
areas.
You know, just go look on a maparound Asheville, you know
you've got Chimney Rock and LakeLure and Burnsville and Spruce
Pine and of course, ashevilleitself just got hit, swannanoa,
I mean.
The rivers blew up 20 or 30feet over flood stage and so
(04:41):
everything washed down you knowthe canyons, if you will and
into Asheville and to Swannanoaand just wiped out everything in
its path.
I mean, the amount ofdevastation was remarkable.
Now, fortunately, our campusesdid not have major structural
damage.
So I'm not going to in any waysuggest that I had it bad.
(05:04):
You know it was a little bit ofdifferent type of bad, but I
have staff who lost everything.
I have staff who lost theirhomes.
I have staff who had to abandontheir positions and move out of
the area because they didn'thave a place to go anymore.
You know, at the time we had 60some residents and multiple
residences and treatmentprograms that we needed to take
(05:28):
care of.
And I'll tell you, well, beforeI tell you so the storm happens
on Friday.
Asheville is completely cut offfrom the world.
There was no way intoAshevilleville, there was no way
out of asheville.
The french broad river was atan epically high level and there
(05:50):
and it was washing out bridgesand roads and trees and trees,
and I mean yards.
Yeah, it's really hard to evenimagine, you know, downstream um
, the rocky broad river blew outof its banks and wiped the town
of Chimney Rock off the map.
Speaker 1 (06:08):
Yeah, it didn't exist Like a town.
Never sat there before.
Speaker 2 (06:11):
Right, I mean one side of it there are buildings,
but the side that was on theriver got destroyed and to this
day there's still no roadbetween Chimney Rock and Batcave
.
I mean you have to go all theway around, but it's very
devastated.
So, you know, thousands ofpeople lost everything.
(06:33):
But we've got, you know,programs in Asheville and we
can't talk to them, we can'temail them, we have absolutely
no communication.
Speaker 1 (06:38):
There's no cell signal, there's no Wi-Fi.
I mean, even the providers thatare sourcing Wi-Fi are out.
Speaker 2 (06:45):
Out.
We couldn't even get peoplethrough a two-way radio system
to the EMS, completely cut off.
And about two or three dayslater Jim, my director of
maintenance, showed up in myhouse I guess it was a Sunday
night and he said I found itlike 1030.
And his wife showed up.
(07:08):
Because we were coming up withsome creative ways to get into
town, because we have.
We knew that we had residentsthat needed emergency medication
, so we were trying to figureout some ways to get in, but he
said I got a way in.
We went in, I guess Mondaymorning and made our way to our
Cooper recent Asheason-AshvilleTreatment Center in the Montford
area and I was greeted by Dana,our managing director, who had
(07:33):
been there for three daysstraight, and she looked at me
and said we got to do something.
So we loaded everybody up in thevans we had there and evacuated
the entire facility down to thefarm.
Speaker 1 (07:47):
Loaded up the truck and moved to Beverly.
Right we had to.
Speaker 2 (07:52):
They had nothing.
They had no water.
I mean that turned out to beprobably one of the biggest
challenges was the need forpotable water.
Gasoline is one thing.
It wasn't super cold yet butyou needed gasoline to run
whatever generators we had.
But not having water is whatbrought out a vicious side in
human nature.
I saw some wild stuff going onin town.
Speaker 1 (08:14):
Yeah, at the grocery stores and at the gas stations.
It was, I mean, for a week.
It was rough.
Speaker 2 (08:20):
There was looting going on.
I mean I won't go into some ofthe crap.
Well, I was going to not saythat, but yeah, I had a staff
member observe a shooting whensomeone tried to cut the gas
line.
You know there were gas linesof you know miles long and some
dude decided he was going to cutthe line like that.
(08:47):
So it was wild.
But we uh, we managed to geteverybody from Asheville in our
Asheville community programhouses and our Cooper recent
Asheville treatment center,loaded up and brought down here
to the farm and we just we foundspace here on the farm for over
45 people and, and you know, we, and every day for the next
couple of weeks, all of my, mymanagers and leaders and and
(09:10):
community members, we would allmeet and say, okay, what do we
got to do?
Today?
We'd meet right up here in thishouse that I'm sitting in right
now.
It was like a command center andit was, you know.
We would look up and it'd beone o'clock, you know, and we,
we would spend the day sendingpeople out go find gas, go find
gasoline, go find water.
You know how are we doing onfood, because we've got a
walk-in fridge and a walk-infreezer that didn't have
(09:32):
generator backup.
So we had a limited amount oftime before.
We were going to be in troublethere, but fortunately-.
Speaker 1 (09:39):
You lost power at the farm as well.
Is that right?
Speaker 2 (09:41):
We lost power to the farm as well.
Is that right?
We lost power to the farm, butI still had water at the farm
right and I have a generatorthat runs the lodges but doesn't
run the kitchen, though I dohave a, an alumni, who's made a
donation to help us get a wholehouse generator.
So the next in a thousand yearswhen this happens again, I'll
have generator power I don'tknow if it's going to be a
(10:03):
thousand.
Speaker 1 (10:03):
We may be maybe a little sooner than that.
Speaker 2 (10:05):
Maybe.
So I don't know God, I hope not, but you know so.
So the the immediacy of thisthing was what do we do?
What do we do in the middle ofthe storm?
What do we do?
Trees were falling and you know, and you know.
We have policies, and proceduremanuals and disaster
preparedness stuff.
Speaker 1 (10:27):
Yeah, I mean it's generic stuff.
Speaker 2 (10:30):
Yeah.
Speaker 1 (10:30):
I mean, I've written it, I've seen it Back when I was
with you guys and it was likeyou get the sheriff or you get
the fire department and they'vegot you know, they've got their
blanket, kind of rubric stuff.
It doesn't tell you how toactually act.
Speaker 2 (10:45):
It didn't.
Speaker 1 (10:46):
It didn't.
Speaker 2 (10:47):
And so where we went with it in the moment when it
was really hitting the fan is Ijust started thinking Maslow,
you know.
Speaker 1 (10:55):
Hierarchy of needs baby, that's right.
Speaker 2 (10:57):
And it really was about food and shelter, yeah, so
we made sure that everybody hadfood, we made sure that
everybody had a dry place, andwe just went with that and lived
in 12-hour increments for awhile, and then things got
better at the farm.
First, um, ashville remained amess.
They didn't have water for sixweeks, um, and that was terrible
(11:22):
.
Speaker 1 (11:23):
I mean it was not potable water.
They ended up with flushablewater somewhere in there, but
they didn't have potable.
I mean, I was running waterback and forth into town because
we had access to water, livinga little further out in the
country and just taking jugs tofamilies and to my wife's work
and to my mom and that kind ofthing, and you'd ride into town
(11:47):
and just see what was kind ofgoing on.
It was wild.
But you know and that brings meto this point, and you
mentioned it when the wheneverything happened initially,
which is, I don't think peoplereally understand we think about
, we think about maslow, youknow shelter, food safety and
(12:08):
that's your baseline level.
But you're talking about adisaster like this and you're
talking about people who sufferfrom mental health challenges
and maybe they're on a verycritical medication.
I mean, you and I both knowindividuals who are on
medications.
Maybe they're on anantipsychotic and they're
receiving a shot, and we knowthat their symptoms start to
(12:29):
crop up even right before theyget their shot.
Speaker 2 (12:33):
Yeah.
Speaker 1 (12:33):
And then to miss that shot or to miss that med dose
that they need next can be, Imean, devastating for them.
Yeah, devastating for them.
Yeah, and you know, fortunatelyyou guys I mean fortunately you
guys had another campus thatyou could go to.
Fortunately we're very lucky.
Speaker 2 (12:53):
We're very lucky.
Our campuses did okay.
It's the people all around usthat you know, were really
crushed and my staff I mean somany of them were crushed.
I've got a couple of peopleclose to me I will call them out
by name.
They probably wouldn't wantthat but lost everything.
I mean lost their homes.
I've got I've got one gentleman, very important guy here, who
(13:20):
when the flood was happening andthe water was rising through
his house, he put on his lifejacket to get into his house to
get some supplies.
He had to walk through movingwater to get some essential
supplies out of his home whichhe ended up losing.
Speaker 1 (13:33):
Then you've got people who are out in the
community.
I've got a couple of clientsthat are like this.
I had one that got dislocatedright before the storm and then
two weeks was just gone.
We couldn't find it.
We didn't know what.
You know I'm happy to say thathe re-emerged, you know, with
(13:54):
like several layers of clotheson and, you know, dirty and
muddy in the boots andeverything else.
But, you know, ended up at oneof the places.
Uh, we have 12 baskets here inthe community.
It's a gathering place for alot of folks who just need a
meal or need a place to befinally showed up there and we
were able to get services andcare and a place for him to live
and all those kinds of thingsset up.
(14:15):
But it was.
I can't imagine, you know,being somebody who didn't have a
campus that wasn't impacted ordidn't have care providers like
at Cooper East, which are verydialed into you know med
management, caring for people'sneeds and having compassion for
individuals who are sufferingfrom conditions.
You know mental healthconditions and the needs that
(14:36):
that requires, which is specialbeing out in community and not
having that as a resource.
Did you guys get to see any ofthat kind of anybody trying to
seek out help from you, or didyou see any of that coming in
and out as you were trying tomake preparations for the
Asheville campus or trying toget people in and out?
Speaker 2 (14:55):
People outside of the community looking for help.
We saw a lot of that.
At one point my maintenancedirector had hundreds of gallons
of water that he was deliveringto our community houses in
Asheville and he got surroundedby people thinking he was, you
know, giving out stuff to thecommunity.
It got a little scary there fora minute.
(15:16):
It almost felt likecivilization was breaking down
there within the first couple ofdays.
People were rightfully so justcompletely panicked about what
was happening and we helped outwherever we could.
Speaker 1 (15:28):
You know, our first priority was to take care of our
community.
Speaker 2 (15:31):
Like you said, we have very vulnerable adults here
and I could not be more proudof how this community came
together and took care of itselfand took care of each other.
It was pretty amazing, actually, itself and took care of each
other.
It was pretty pretty amazing,actually, and but you know, the
message I wanted to send today,though, is, um, while in the
(15:52):
moment, I feel like my staff didan incredible job and took care
of our residents really well,most of those residents have
moved on back into their livesand we've got new residents uh,
the storm is not over for mystaff.
I was talking to Lisa Shackmantoday.
Speaker 1 (16:11):
Lisa is my chief uh program officer he's been on the
show as well, yeah.
Speaker 2 (16:16):
I said I, I I'm talking to Todd today and about
Helene and I said what you knowbecause I was so, we're so in it
, it's to, it's hard to reflecton it without you know.
And I said what, what jumps outat you?
And she said the longer, the,the, the unending impact on
(16:39):
staff today to this day.
You know, during the storm andin the aftermath of the storm
day.
You know, during the storm andin the aftermath of the storm,
we are really great as acommunity of coming together and
linking arms and taking on acrisis.
We're in the crisis business.
This is what we do and I feelso proud of how this group came
(16:59):
together.
But what she reminded me of isthat you know, you, when you put
all that energy into, intodealing with what we dealt with
as a community, you, you're ableto have the emotional energy in
the moment to deal with it.
Speaker 1 (17:16):
You know you got the endorphins going right, right,
it's like the firefighters incalifornia now yeah you know
what've been unbelievable.
Speaker 2 (17:25):
They've been such amazing heroes, you know.
But at some point, when thefires are out, the fires are not
out.
You know what I mean.
Speaker 1 (17:34):
Yeah, and we're seeing that here with our staff.
Speaker 2 (17:37):
We're seeing staff that are just exhausted,
emotionally exhausted, you knowit's like there's this he used
all these endorphins to getthrough the moment, but then
that stuff dissipates and whatare you left with?
And so we're.
We're trying as best we can totake care of people, but we've
seen a lot of people leave.
We've had a lot of residentialstaff, a lot of staff who said
I'm just too tired to keep doingthis yeah, I mean it's a trauma
(18:00):
response really.
Speaker 1 (18:01):
I mean that's it's true for human beings across the
board, kind of no matter whatyou're doing, um, but you know,
if you, especially in somethingthat's been a topic in in this
show before, which is, you know,there's a certain kind of
person that can work in in thiskind of work, and we know that,
um, and and not everybody whocomes to it is built to do it
(18:24):
long term, I think that if youhave something that is your own
trauma, that kind of takes fromthis well, that you have the
amount that you thecompassionate care, the being
able to approach people who arehaving a difficult moment or are
symptomatic, that need just alittle bit of extra, which is
(18:46):
something that kind of Capriceis known for, you know, giving
people this very compassionatespace to live and be and find
community.
But it takes patience and ittakes time and it takes, at
times, a lot of energy.
If you've got somebody incrisis, you know they may need
support for hours and hours oreven days on end, and so you
(19:06):
know, I think that people get,if they have their own tax that
they're dealing with, they findthat that well is diminished.
Speaker 2 (19:17):
And I think we're seeing that.
I think we're seeing that forsure, yeah, you know, we met
every day I mean, my team and Imet and, just like I said, we
lived in 12 hour increments interms of what do we have to do
next?
We need I mean I said I hadstaff that would spend literally
three or four hours a daytrying to find five gallons of
(19:39):
gasoline.
And I know one day I drove over200 miles looking for gasoline.
I practically had to go toGastonia to fill up, you know, a
five gallon jug of gasolineBecause we needed to.
You know, we had generators insome of our houses and we needed
to try to keep those fridgescool.
Speaker 1 (19:56):
How did you navigate the med situation Like how did
that look?
Speaker 2 (20:00):
That actually, you know that was one of those
things that was.
We're really lucky.
Our head nurse, Betsy, here atthe farm, has a great connection
with our bulk med provider andthey were able to stay open, so
we were able to.
We were able to stay OK withmedications campus.
Speaker 1 (20:29):
You guys have, you know, psychiatrists that are
involved in the program andconnected to you guys.
Were they able to do like youcouldn't do?
Virtuals, you couldn't.
You know, maybe they couldn'tget there we had.
Speaker 2 (20:35):
Wi-Fi, which we didn't have for the longest time
.
But we, what we did with ourclinical team in Asheville is we
set up a shuttle service andevery day at 630, they met in
Asheville and got on our vansand drove to the farm, and so we
were able to keep providingservice.
Speaker 1 (20:54):
Wow, I mean, talk about, you know, just being
resourced.
It's like, well, let's do whatwe got to do.
You know, let's figure out.
I mean, live in every live in12 hour increments is is hard on
a person, no matter what, butadding the complicating features
of caring for others while inthe middle of a disaster, it's
(21:14):
just such a big, it's such atall order man, it's a tall
order, but I, I don't.
Speaker 2 (21:19):
I want to be careful.
You know, I also spent sometime volunteering up in chimney
rock or in weaverville, wherethere was legit devastation,
where you know I've got video.
I drove up to, uh, um, what'sthe place up on the green river?
Um you know, yeah, yeah, um andseeing the river had been out of
(21:45):
its banks by a hundred yardsand knocked down mature trees
for as far as you can see, andthere were parts of homes along
the river that were whole homeswashed away and trucks and
tractors rolled up in debris,and I mean Like folded around
things yeah.
I've got video of all of that.
It's just incredible, justincredible.
(22:07):
So in that regard regard from aphysical damage standpoint we
did okay and I'm not going tocomplain at all.
I mean, what good would that do?
Speaker 1 (22:17):
um, but well, I think the thing that we can speak to
like this is that he and this issomething a big topic for me,
and you know me well enough toknow it's just a big topic, not
just for me but for you, who'sbeen an advocate as well you
know there's this great divide.
(22:37):
We know that there's a dividebetween public mental health and
private mental health andthere's this kind of narrow
bandwidth in between whereinsurance is involved and
actually paying for stuff, butit's narrow, very narrow, very
narrow.
Involved and actually payingfor stuff, but it's narrow, very
narrow, very narrow.
Now we're trying to widen thatgap, but it's slow and insurance
companies keep fighting.
For you know, I got a greatinsurance story.
(23:00):
If you have time, well, let'sget into it here in a minute.
But the thing I want to I wantto point at is, even in a
disaster and some of it was luck, some of it was being high
enough to be away from the river, or in a location that was a
little buffered two campuses,those kinds of things there's
some features to the reason whyCooper East was able to do well,
but more than any of that isjust the fact that you've got
(23:26):
appropriate staffing processes,the ability to draw on resources
, activate, you know, sendingpeople out and getting things
that you're going to need andmoney, honestly, like you know,
and we've got a budget that wecan work with and we've got
people that can go and respondand we can do the things that we
need to do to care for thepeople that we've that we're
(23:48):
committed to serving.
We can do the things that weneed to do to care for the
people that we're committed toserving.
And the divide that existsbetween the public side and this
private side.
It's like here you've got anexample of a therapeutic
community residential treatmentprogram that was actually able
to forward this disastersuccessfully was actually able
(24:10):
to forward this disastersuccessfully.
It's like if you were to takeout key points of what you would
pass off to public mentalhealth, what would you say they
are?
Speaker 2 (24:22):
Key points.
Well, regardless, I'll try toanswer this, todd, that's a
tough question.
Well, regardless, I'll try toanswer this, todd, that's a
tough question, regardless ofresources and keep and yeah,
(24:44):
we're fortunate in that myalumni community saw that we
were struggling and needed thisor needed that.
We had a family donate a Wi-Fisystem to us, we had another one
, you know, dedicate or donate acouple of generators to us, and
we had people just send usmoney to go buy what you needed.
So that helped a lot for sure.
But the one thing I think thatwe have in common more in common
than not is the concept thatprograms are people and you
(25:09):
can't have a good program,whether it be public or private,
and be effective, unless youhave really fantastic people.
And I have fantastic people whoreally put their needs.
Second to taking care of ourstaff, they did amazing.
I've got wonderful and amazingfounders in don cooper,
(25:31):
elizabeth reese, cooper, they,they, they suffered tremendous
damage on their property inbatcave I think.
They were without services foralmost, I think, 23 days.
They had nothing.
They were running out of waterand propane and everything and
and their road washed away andthey had a neighbor killed in a
landslide.
(25:51):
But those two have beenunwavering in their love and
support for Cooperese.
So what could I tell the public?
Speaker 1 (25:59):
system Program is people.
Speaker 2 (26:00):
I'm not really answering your question, because
I think we both have greatpeople that choose to work
because I've worked in publicand I've worked in private and
what they both have in common isthe people that stick are
really excellent, selflesspeople.
I know I was talking with someof the public agency folks and
(26:20):
they were completely overwhelmedby this.
You know there's a lot ofpeople that just lost all
services because their systemswent down yeah.
So I don't know.
I think sometimes I I sometimeswonder that the secret to
bridging that divide betweenpublic and private is figuring
out a way to do this in asmaller set of communities
(26:44):
instead of this giganticinstitutional model where
everybody is kind of lost, youknow.
I think, that public education.
Our school systems are way toobig.
You know we've lost the abilityto have relationships with kids
, and I think the same is truewhen it comes to public and
private services like what we'retalking about.
Speaker 1 (27:04):
Yeah, you can't box store it.
Speaker 2 (27:06):
No, and what holds us together at Cooper Reese and a
lot of the really excellentprograms that I'm connected to
collegially is our size.
We're small, so therefore wehave relationships with each
other.
I mean, we get mad at eachother plenty, but that's okay.
Speaker 1 (27:22):
Right you know, I mean you have the capacity to
serve 60 people.
Speaker 2 (27:29):
No, we can serve 80 or 90 people.
Speaker 1 (27:32):
Well, I was going to say at the residential level and
then transitional levels ofcare.
Yeah, and that's.
I mean that's not a smallnumber of people in my view.
But when you look at communityneeds it does become small
because they're staring in theface at hundreds.
But I think you're rightgetting it down to manageable
sizes, manageable caseloads.
Program is people.
I mean, we can get to thenitty-gritty of that, but that's
(27:53):
kind of the over, that's the.
That's the overarching theme.
It's a good way to kind ofsummarize it.
It's like well, program ispeople.
You know, whether that's peersupport or whether it's your
staffing or whether it's, youknow, your, your clinically
privileged psychologist or nursepractitioners, that's out there
making sure med management'sdone right.
There are all kinds of wayswhere that principle can apply
(28:18):
and I think it would kind ofshrink it down to become
something that's actuallymanageable.
Because I would say that on thepublic side you'd probably get
the very common and real answerthat what they face is
unmanageable.
Right, it's like well, it's not.
Speaker 2 (28:37):
But you have to be resourced.
That's the issue is, you've gotto have resources.
You have to have dedicatedresources to support the most
vulnerable people in ourcommunity, and I worry about
that today a lot more than I didyesterday.
Speaker 1 (28:53):
Well, that brings us to this insurance thing.
Tell your insurance story.
Insurance plays a huge role inhow this is playing out today.
Speaker 2 (29:02):
Well insurance in terms of reimbursement for
services insurance.
Speaker 1 (29:06):
That's correct.
Speaker 2 (29:06):
yes, Okay, so my program in Asheville, our Cooper
Rees at Asheville program, isan in-network provider and
that's a relatively new thingfor Cooper Rees, but we went
in-network with some of themajor providers.
My program here at the farm isnot we do some out-of-network
reimbursement, but one of thebig challenges Right right.
Speaker 1 (29:28):
Courtesy billing right.
Speaker 2 (29:29):
But one of the big challenges Right, Sorry,
Courtesy billing, right, Right.
So one of the big challengesduring the storm was that I had
all these people in our CooperReese at Asheville program who
were receiving in-networkbenefits and and it's a really
challenging experience to dothat, because my clinicians have
to see people a certain numberof times a week and then they
(29:50):
have to write a note that sayscertain things and the doc has
to see them and the nurse has tosee them, and it all goes into
an electronic health recordwhich the insurance company will
look at every so many days andthen they decide how many more
days of funding they're going toprovide and there are a lot of
rules around and never is thenumber of days they're going to
(30:11):
provide actually the number ofdays that the person probably
needs, or very rarely.
Absolutely true.
But in order to becomecredentialed as a in-network
provider, I had to.
Organizationally, we had tojump through a lot of hoops and
a lot of them, frankly, arebureaucratic derivative.
(30:34):
I have to be careful because,you know, whatever my reps might
see this, so anyway.
So on the day that we evacuatedCooper Reese at Asheville, we
moved these folks who are innetwork down to my farm, which
is not in network, and so youwould think that in a national
emergency disaster like this,that the insurance companies
(30:57):
would be no problem.
We will continue to reimburseand forgive and you take care of
our members.
God love you.
You would think.
Speaker 1 (31:09):
Negative.
Speaker 2 (31:10):
Wasn't that easy and I won't call out one provider,
but one provider in particular.
I had to have a Zoom meetingwith all their who's and
whoville and explain what wewere doing and beg them to
continue to honor theirin-network relationship with
their members who are now 40miles away, safe, getting the
(31:31):
same exact services.
Because I moved all the nurses,I moved their doc down here.
They were getting the sameexact level of service, but I
still had to beg and borrow toget them to continue.
And they did, and they did.
But that was huge Becauseimagine if they had said I'm
sorry, dude, you moved and thatlocation is not accredited, so
(31:52):
you're just going to have tosend them home.
Well, I can't send them homebecause there's nowhere for them
to go.
They can't leave.
Speaker 1 (31:57):
Well, you know you're talking about something here,
because I've been asking aboutthis a lot.
You're really back to this.
Program is people scenario.
That addresses the issue thatwe're referring to and I've
talked about it with wildernessfolks who are, you know, facing
closures and things like that,or people who do different kinds
of therapies, some of whichCooper East even has, but, like
(32:21):
you know, experiential therapieslike equine therapy or even
horticulture therapy, likeequine therapy or even
horticulture therapy.
If we stop telling people wherewe're doing it and it's like,
look, this person's going to getall those basics, they're going
to get a doc and they're goingto get a therapist and they're
going to get groups and they'regoing to get all of this care,
(32:43):
and we are qualified to providethat, whether I'm at this campus
or this campus or I'm in a barn, I'm capable of delivering good
therapeutic care and providinggood therapeutic outcomes.
And if we stop fighting overwhere you are, say that
facilities don't have to bechecked off and things like that
, but the exercise of trying toprove that what you're doing is
(33:08):
being done in the right locationor in the right environment is
is ridiculous to me, um, and waybeside the point.
So program is people.
Speaker 2 (33:21):
yeah, not necessarily your campus it worked out and
everybody did what I feel wasright the process of getting to
right in the middle of trying tofind gasoline and water and
Wi-Fi service.
Speaker 1 (33:35):
You were not appreciative of.
Speaker 2 (33:37):
I did not appreciate that.
But at the end of the dayeverybody was cared for and they
reimbursed for more days thanthey probably would have.
But we had to jump through afew hoops to make that happen.
Speaker 1 (33:50):
And again.
Speaker 2 (33:51):
You know I had caravans of clinicians coming
down, 26 every day for fourweeks to make sure that
continued to happen.
So really my undyingappreciation to my folks who
were getting up two hoursearlier than they normally would
, leaving their homes that hadno water, no power, no nothing,
(34:12):
and coming down here and we, wemade sure everybody was fed.
Speaker 1 (34:15):
But that's awesome.
Well, I mean it's.
It was quite the thing toendure, eric.
Thanks for you know justrunning us through what the
experience was like for you guysat Cooper East.
Thanks for caring for people sowell.
I appreciate that you guys wereable to contain community and
provide in the ways that you did.
I wish everybody had the chanceto experience that level of
(34:38):
care and compassion, but we'llfigure it out before long.
We're just going to keeptalking about it.
Speaker 2 (34:45):
I appreciate that.
If anyone's listening and needscare, call us.
We've got availability.
We'd love to serve you.
Speaker 1 (34:51):
And Asheville program is in network.
Speaker 2 (34:54):
In network Yep.
Speaker 1 (34:56):
That's awesome, Eric.
Thanks for coming on the showtoday.
This has been Head InsideMental Health with Todd
Weatherly on WPBM 1037, theVoice of Asheville.
We'll look forward to beingwith you next time.
Hello folks, thanks for joining us on Head Inside
Mental Health, featuringconversations about mental
health and substance usetreatment with experts around
the country sharing theirthoughts and sights and practice
perspectives on the world ofbehavioral health care.
Broadcasting on WPVM 1037, thevoice of Asheville, independent
commercial free radio, I am ToddWeatherly, your host
(00:22):
therapeutic consultant,behavioral health expert.
Today, returning to the show, Ihave Dr Eric Levine.
Eric is the president and CEOof Cooper Ease, a residential
healing community serving adultsaffected by the challenges of
mental illness and co-occurringconditions that want to move
towards healthy and fulfillinglives.
They have two locations here,west North Carolina, asheville,
(00:43):
and the Healing Forum Campus inMill Spring.
Eric has his doctorate ineducation leadership, an ed s in
career transition andassessment, a master's in
special ed from GeorgeWashington University and a BA
in psychology from theUniversity of Maryland.
But we won't hold that againsthim.
Eric has more than 30 years ofworking in education, advocacy
and mental health, having servedas a consultant and in numerous
(01:03):
leadership and executive rolesin the field.
Avid kayaker and golf ballhacker like myself, he joins us
today to talk about the impactof Hurricane Helene and the
resulting floods and damage tohis campuses and to the mental
health community in our area.
Dr Levine, welcome back to theshow.
Speaker 2 (01:20):
Thanks, todd, always a pleasure to spend time with
you.
Speaker 1 (01:23):
Oh, yes, I'm certain that you feel that way.
You know, I feel like I have togive you a hard time as often
as I possibly can because I justdon't see you that much.
You're too busy these days.
We let off the conversationtalking about the river
conditions opposed to lean, butthe recovery process in this
town looks like one of the audioequalizers.
(01:48):
You've got one area of townthat barely got damaged and
they're full on and everything'sgoing just right.
But if you drive throughBiltmore, everything's still
under recovery, everything'sstill being repaired and there
are spots that still.
You drive through swananoa andit still looks like a disaster.
I got to drive by the ashvillecampus not too long what last
(02:11):
week or so and it looks prettygood.
You know from what it wasbecause I, I saw it right after
the storm and you, like so manyothers, just had.
It was high enough not to get,not to have the river reach it,
but there was trees down, thenetwork was down.
You know we couldn't callpeople, we couldn't, and your
story just about like day after.
(02:32):
Tell that story a little bit,because I think it's kind of
it's incredible.
You know not only one, what youhad to deal with but two how
you pivoted.
So tell the story about.
Let's start with day afterhelene.
Speaker 2 (02:44):
Tell me what I mean, let me actually start three days
before helene, because I don'tknow that people, really, that
the area got eight inches ofrain, that the helene was on the
friday and tuesday, wednesdayand thursday down to the green
river to check it out, you, youknow, just because I wanted to
(03:06):
see.
You know, I go down there allthe time and at that point on
Thursday the water was out ofthe banks and onto the road and
it was a problem and Helenehadn't gotten here.
In fact I was lucky to get outof there.
That was kind of a stupid thingI did, but I got out.
And then Helene happened onFriday the 29th and then over
(03:28):
the course of that storm, Withthe water already being over the
banks, like water already there, we're already at flood stage,
and then we got 20 inches ofrain and 70, 75 mile an hour
winds, and it absolutelydevastated the entire region.
Down where we are in Mill Spring, we are nine miles from the
(03:54):
Lake Lure Dam and four milesfrom the Lake Adger Dam, and we
were getting notifications ofimminent, catastrophic failure
of those dams was coming, and sowe were all making plans to
evacuate our farm property andwhat to do.
And we're getting these localannouncements, text messages
with circles of impact on them,and so it was pretty wild.
(04:16):
But then it happened, andAsheville and the surrounding
areas.
You know, just go look on a maparound Asheville, you know
you've got Chimney Rock and LakeLure and Burnsville and Spruce
Pine and of course, ashevilleitself just got hit, swannanoa,
I mean.
The rivers blew up 20 or 30feet over flood stage and so
(04:41):
everything washed down you knowthe canyons, if you will and
into Asheville and to Swannanoaand just wiped out everything in
its path.
I mean, the amount ofdevastation was remarkable.
Now, fortunately, our campusesdid not have major structural
damage.
So I'm not going to in any waysuggest that I had it bad.
(05:04):
You know it was a little bit ofdifferent type of bad, but I
have staff who lost everything.
I have staff who lost theirhomes.
I have staff who had to abandontheir positions and move out of
the area because they didn'thave a place to go anymore.
You know, at the time we had 60some residents and multiple
residences and treatmentprograms that we needed to take
(05:28):
care of.
And I'll tell you, well, beforeI tell you so the storm happens
on Friday.
Asheville is completely cut offfrom the world.
There was no way intoAshevilleville, there was no way
out of asheville.
The french broad river was atan epically high level and there
(05:50):
and it was washing out bridgesand roads and trees and trees,
and I mean yards.
Yeah, it's really hard to evenimagine, you know, downstream um
, the rocky broad river blew outof its banks and wiped the town
of Chimney Rock off the map.
Speaker 1 (06:08):
Yeah, it didn't exist Like a town.
Never sat there before.
Speaker 2 (06:11):
Right, I mean one side of it there are buildings,
but the side that was on theriver got destroyed and to this
day there's still no roadbetween Chimney Rock and Batcave
.
I mean you have to go all theway around, but it's very
devastated.
So, you know, thousands ofpeople lost everything.
(06:33):
But we've got, you know,programs in Asheville and we
can't talk to them, we can'temail them, we have absolutely
no communication.
Speaker 1 (06:38):
There's no cell signal, there's no Wi-Fi.
I mean, even the providers thatare sourcing Wi-Fi are out.
Speaker 2 (06:45):
Out.
We couldn't even get peoplethrough a two-way radio system
to the EMS, completely cut off.
And about two or three dayslater Jim, my director of
maintenance, showed up in myhouse I guess it was a Sunday
night and he said I found itlike 1030.
And his wife showed up.
(07:08):
Because we were coming up withsome creative ways to get into
town, because we have.
We knew that we had residentsthat needed emergency medication
, so we were trying to figureout some ways to get in, but he
said I got a way in.
We went in, I guess Mondaymorning and made our way to our
Cooper recent Asheason-AshvilleTreatment Center in the Montford
area and I was greeted by Dana,our managing director, who had
(07:33):
been there for three daysstraight, and she looked at me
and said we got to do something.
So we loaded everybody up in thevans we had there and evacuated
the entire facility down to thefarm.
Speaker 1 (07:47):
Loaded up the truck and moved to Beverly.
Right we had to.
Speaker 2 (07:52):
They had nothing.
They had no water.
I mean that turned out to beprobably one of the biggest
challenges was the need forpotable water.
Gasoline is one thing.
It wasn't super cold yet butyou needed gasoline to run
whatever generators we had.
But not having water is whatbrought out a vicious side in
human nature.
I saw some wild stuff going onin town.
Speaker 1 (08:14):
Yeah, at the grocery stores and at the gas stations.
It was, I mean, for a week.
It was rough.
Speaker 2 (08:20):
There was looting going on.
I mean I won't go into some ofthe crap.
Well, I was going to not saythat, but yeah, I had a staff
member observe a shooting whensomeone tried to cut the gas
line.
You know there were gas linesof you know miles long and some
dude decided he was going to cutthe line like that.
(08:47):
So it was wild.
But we uh, we managed to geteverybody from Asheville in our
Asheville community programhouses and our Cooper recent
Asheville treatment center,loaded up and brought down here
to the farm and we just we foundspace here on the farm for over
45 people and, and you know, we, and every day for the next
couple of weeks, all of my, mymanagers and leaders and and
(09:10):
community members, we would allmeet and say, okay, what do we
got to do?
Today?
We'd meet right up here in thishouse that I'm sitting in right
now.
It was like a command center andit was, you know.
We would look up and it'd beone o'clock, you know, and we,
we would spend the day sendingpeople out go find gas, go find
gasoline, go find water.
You know how are we doing onfood, because we've got a
walk-in fridge and a walk-infreezer that didn't have
(09:32):
generator backup.
So we had a limited amount oftime before.
We were going to be in troublethere, but fortunately-.
Speaker 1 (09:39):
You lost power at the farm as well.
Is that right?
Speaker 2 (09:41):
We lost power to the farm as well.
Is that right?
We lost power to the farm, butI still had water at the farm
right and I have a generatorthat runs the lodges but doesn't
run the kitchen, though I dohave a, an alumni, who's made a
donation to help us get a wholehouse generator.
So the next in a thousand yearswhen this happens again, I'll
have generator power I don'tknow if it's going to be a
(10:03):
thousand.
Speaker 1 (10:03):
We may be maybe a little sooner than that.
Speaker 2 (10:05):
Maybe.
So I don't know God, I hope not, but you know so.
So the the immediacy of thisthing was what do we do?
What do we do in the middle ofthe storm?
What do we do?
Trees were falling and you know, and you know.
We have policies, and proceduremanuals and disaster
preparedness stuff.
Speaker 1 (10:27):
Yeah, I mean it's generic stuff.
Speaker 2 (10:30):
Yeah.
Speaker 1 (10:30):
I mean, I've written it, I've seen it Back when I was
with you guys and it was likeyou get the sheriff or you get
the fire department and they'vegot you know, they've got their
blanket, kind of rubric stuff.
It doesn't tell you how toactually act.
Speaker 2 (10:45):
It didn't.
Speaker 1 (10:46):
It didn't.
Speaker 2 (10:47):
And so where we went with it in the moment when it
was really hitting the fan is Ijust started thinking Maslow,
you know.
Speaker 1 (10:55):
Hierarchy of needs baby, that's right.
Speaker 2 (10:57):
And it really was about food and shelter, yeah, so
we made sure that everybody hadfood, we made sure that
everybody had a dry place, andwe just went with that and lived
in 12-hour increments for awhile, and then things got
better at the farm.
First, um, ashville remained amess.
They didn't have water for sixweeks, um, and that was terrible
(11:22):
.
Speaker 1 (11:23):
I mean it was not potable water.
They ended up with flushablewater somewhere in there, but
they didn't have potable.
I mean, I was running waterback and forth into town because
we had access to water, livinga little further out in the
country and just taking jugs tofamilies and to my wife's work
and to my mom and that kind ofthing, and you'd ride into town
(11:47):
and just see what was kind ofgoing on.
It was wild.
But you know and that brings meto this point, and you
mentioned it when the wheneverything happened initially,
which is, I don't think peoplereally understand we think about
, we think about maslow, youknow shelter, food safety and
(12:08):
that's your baseline level.
But you're talking about adisaster like this and you're
talking about people who sufferfrom mental health challenges
and maybe they're on a verycritical medication.
I mean, you and I both knowindividuals who are on
medications.
Maybe they're on anantipsychotic and they're
receiving a shot, and we knowthat their symptoms start to
(12:29):
crop up even right before theyget their shot.
Speaker 2 (12:33):
Yeah.
Speaker 1 (12:33):
And then to miss that shot or to miss that med dose
that they need next can be, Imean, devastating for them.
Yeah, devastating for them.
Yeah, and you know, fortunatelyyou guys I mean fortunately you
guys had another campus thatyou could go to.
Fortunately we're very lucky.
Speaker 2 (12:53):
We're very lucky.
Our campuses did okay.
It's the people all around usthat you know, were really
crushed and my staff I mean somany of them were crushed.
I've got a couple of peopleclose to me I will call them out
by name.
They probably wouldn't wantthat but lost everything.
I mean lost their homes.
I've got I've got one gentleman, very important guy here, who
(13:20):
when the flood was happening andthe water was rising through
his house, he put on his lifejacket to get into his house to
get some supplies.
He had to walk through movingwater to get some essential
supplies out of his home whichhe ended up losing.
Speaker 1 (13:33):
Then you've got people who are out in the
community.
I've got a couple of clientsthat are like this.
I had one that got dislocatedright before the storm and then
two weeks was just gone.
We couldn't find it.
We didn't know what.
You know I'm happy to say thathe re-emerged, you know, with
(13:54):
like several layers of clotheson and, you know, dirty and
muddy in the boots andeverything else.
But, you know, ended up at oneof the places.
Uh, we have 12 baskets here inthe community.
It's a gathering place for alot of folks who just need a
meal or need a place to befinally showed up there and we
were able to get services andcare and a place for him to live
and all those kinds of thingsset up.
(14:15):
But it was.
I can't imagine, you know,being somebody who didn't have a
campus that wasn't impacted ordidn't have care providers like
at Cooper East, which are verydialed into you know med
management, caring for people'sneeds and having compassion for
individuals who are sufferingfrom conditions.
You know mental healthconditions and the needs that
(14:36):
that requires, which is specialbeing out in community and not
having that as a resource.
Did you guys get to see any ofthat kind of anybody trying to
seek out help from you, or didyou see any of that coming in
and out as you were trying tomake preparations for the
Asheville campus or trying toget people in and out?
Speaker 2 (14:55):
People outside of the community looking for help.
We saw a lot of that.
At one point my maintenancedirector had hundreds of gallons
of water that he was deliveringto our community houses in
Asheville and he got surroundedby people thinking he was, you
know, giving out stuff to thecommunity.
It got a little scary there fora minute.
(15:16):
It almost felt likecivilization was breaking down
there within the first couple ofdays.
People were rightfully so justcompletely panicked about what
was happening and we helped outwherever we could.
Speaker 1 (15:28):
You know, our first priority was to take care of our
community.
Speaker 2 (15:31):
Like you said, we have very vulnerable adults here
and I could not be more proudof how this community came
together and took care of itselfand took care of each other.
It was pretty amazing, actually, itself and took care of each
other.
It was pretty pretty amazing,actually, and but you know, the
message I wanted to send today,though, is, um, while in the
(15:52):
moment, I feel like my staff didan incredible job and took care
of our residents really well,most of those residents have
moved on back into their livesand we've got new residents uh,
the storm is not over for mystaff.
I was talking to Lisa Shackmantoday.
Speaker 1 (16:11):
Lisa is my chief uh program officer he's been on the
show as well, yeah.
Speaker 2 (16:16):
I said I, I I'm talking to Todd today and about
Helene and I said what you knowbecause I was so, we're so in it
, it's to, it's hard to reflecton it without you know.
And I said what, what jumps outat you?
And she said the longer, the,the, the unending impact on
(16:39):
staff today to this day.
You know, during the storm andin the aftermath of the storm
day.
You know, during the storm andin the aftermath of the storm,
we are really great as acommunity of coming together and
linking arms and taking on acrisis.
We're in the crisis business.
This is what we do and I feelso proud of how this group came
(16:59):
together.
But what she reminded me of isthat you know, you, when you put
all that energy into, intodealing with what we dealt with
as a community, you, you're ableto have the emotional energy in
the moment to deal with it.
Speaker 1 (17:16):
You know you got the endorphins going right, right,
it's like the firefighters incalifornia now yeah you know
what've been unbelievable.
Speaker 2 (17:25):
They've been such amazing heroes, you know.
But at some point, when thefires are out, the fires are not
out.
You know what I mean.
Speaker 1 (17:34):
Yeah, and we're seeing that here with our staff.
Speaker 2 (17:37):
We're seeing staff that are just exhausted,
emotionally exhausted, you knowit's like there's this he used
all these endorphins to getthrough the moment, but then
that stuff dissipates and whatare you left with?
And so we're.
We're trying as best we can totake care of people, but we've
seen a lot of people leave.
We've had a lot of residentialstaff, a lot of staff who said
I'm just too tired to keep doingthis yeah, I mean it's a trauma
(18:00):
response really.
Speaker 1 (18:01):
I mean that's it's true for human beings across the
board, kind of no matter whatyou're doing, um, but you know,
if you, especially in somethingthat's been a topic in in this
show before, which is, you know,there's a certain kind of
person that can work in in thiskind of work, and we know that,
um, and and not everybody whocomes to it is built to do it
(18:24):
long term, I think that if youhave something that is your own
trauma, that kind of takes fromthis well, that you have the
amount that you thecompassionate care, the being
able to approach people who arehaving a difficult moment or are
symptomatic, that need just alittle bit of extra, which is
(18:46):
something that kind of Capriceis known for, you know, giving
people this very compassionatespace to live and be and find
community.
But it takes patience and ittakes time and it takes, at
times, a lot of energy.
If you've got somebody incrisis, you know they may need
support for hours and hours oreven days on end, and so you
(19:06):
know, I think that people get,if they have their own tax that
they're dealing with, they findthat that well is diminished.
Speaker 2 (19:17):
And I think we're seeing that.
I think we're seeing that forsure, yeah, you know, we met
every day I mean, my team and Imet and, just like I said, we
lived in 12 hour increments interms of what do we have to do
next?
We need I mean I said I hadstaff that would spend literally
three or four hours a daytrying to find five gallons of
(19:39):
gasoline.
And I know one day I drove over200 miles looking for gasoline.
I practically had to go toGastonia to fill up, you know, a
five gallon jug of gasolineBecause we needed to.
You know, we had generators insome of our houses and we needed
to try to keep those fridgescool.
Speaker 1 (19:56):
How did you navigate the med situation Like how did
that look?
Speaker 2 (20:00):
That actually, you know that was one of those
things that was.
We're really lucky.
Our head nurse, Betsy, here atthe farm, has a great connection
with our bulk med provider andthey were able to stay open, so
we were able to.
We were able to stay OK withmedications campus.
Speaker 1 (20:29):
You guys have, you know, psychiatrists that are
involved in the program andconnected to you guys.
Were they able to do like youcouldn't do?
Virtuals, you couldn't.
You know, maybe they couldn'tget there we had.
Speaker 2 (20:35):
Wi-Fi, which we didn't have for the longest time
.
But we, what we did with ourclinical team in Asheville is we
set up a shuttle service andevery day at 630, they met in
Asheville and got on our vansand drove to the farm, and so we
were able to keep providingservice.
Speaker 1 (20:54):
Wow, I mean, talk about, you know, just being
resourced.
It's like, well, let's do whatwe got to do.
You know, let's figure out.
I mean, live in every live in12 hour increments is is hard on
a person, no matter what, butadding the complicating features
of caring for others while inthe middle of a disaster, it's
(21:14):
just such a big, it's such atall order man, it's a tall
order, but I, I don't.
Speaker 2 (21:19):
I want to be careful.
You know, I also spent sometime volunteering up in chimney
rock or in weaverville, wherethere was legit devastation,
where you know I've got video.
I drove up to, uh, um, what'sthe place up on the green river?
Um you know, yeah, yeah, um andseeing the river had been out of
(21:45):
its banks by a hundred yardsand knocked down mature trees
for as far as you can see, andthere were parts of homes along
the river that were whole homeswashed away and trucks and
tractors rolled up in debris,and I mean Like folded around
things yeah.
I've got video of all of that.
It's just incredible, justincredible.
(22:07):
So in that regard regard from aphysical damage standpoint we
did okay and I'm not going tocomplain at all.
I mean, what good would that do?
Speaker 1 (22:17):
um, but well, I think the thing that we can speak to
like this is that he and this issomething a big topic for me,
and you know me well enough toknow it's just a big topic, not
just for me but for you, who'sbeen an advocate as well you
know there's this great divide.
(22:37):
We know that there's a dividebetween public mental health and
private mental health andthere's this kind of narrow
bandwidth in between whereinsurance is involved and
actually paying for stuff, butit's narrow, very narrow, very
narrow.
Involved and actually payingfor stuff, but it's narrow, very
narrow, very narrow.
Now we're trying to widen thatgap, but it's slow and insurance
companies keep fighting.
For you know, I got a greatinsurance story.
(23:00):
If you have time, well, let'sget into it here in a minute.
But the thing I want to I wantto point at is, even in a
disaster and some of it was luck, some of it was being high
enough to be away from the river, or in a location that was a
little buffered two campuses,those kinds of things there's
some features to the reason whyCooper East was able to do well,
but more than any of that isjust the fact that you've got
(23:26):
appropriate staffing processes,the ability to draw on resources
, activate, you know, sendingpeople out and getting things
that you're going to need andmoney, honestly, like you know,
and we've got a budget that wecan work with and we've got
people that can go and respondand we can do the things that we
need to do to care for thepeople that we've that we're
(23:48):
committed to serving.
We can do the things that weneed to do to care for the
people that we're committed toserving.
And the divide that existsbetween the public side and this
private side.
It's like here you've got anexample of a therapeutic
community residential treatmentprogram that was actually able
to forward this disastersuccessfully was actually able
(24:10):
to forward this disastersuccessfully.
It's like if you were to takeout key points of what you would
pass off to public mentalhealth, what would you say they
are?
Speaker 2 (24:22):
Key points.
Well, regardless, I'll try toanswer this, todd, that's a
tough question.
Well, regardless, I'll try toanswer this, todd, that's a
tough question, regardless ofresources and keep and yeah,
(24:44):
we're fortunate in that myalumni community saw that we
were struggling and needed thisor needed that.
We had a family donate a Wi-Fisystem to us, we had another one
, you know, dedicate or donate acouple of generators to us, and
we had people just send usmoney to go buy what you needed.
So that helped a lot for sure.
But the one thing I think thatwe have in common more in common
than not is the concept thatprograms are people and you
(25:09):
can't have a good program,whether it be public or private,
and be effective, unless youhave really fantastic people.
And I have fantastic people whoreally put their needs.
Second to taking care of ourstaff, they did amazing.
I've got wonderful and amazingfounders in don cooper,
(25:31):
elizabeth reese, cooper, they,they, they suffered tremendous
damage on their property inbatcave I think.
They were without services foralmost, I think, 23 days.
They had nothing.
They were running out of waterand propane and everything and
and their road washed away andthey had a neighbor killed in a
landslide.
(25:51):
But those two have beenunwavering in their love and
support for Cooperese.
So what could I tell the public?
Speaker 1 (25:59):
system Program is people.
Speaker 2 (26:00):
I'm not really answering your question, because
I think we both have greatpeople that choose to work
because I've worked in publicand I've worked in private and
what they both have in common isthe people that stick are
really excellent, selflesspeople.
I know I was talking with someof the public agency folks and
(26:20):
they were completely overwhelmedby this.
You know there's a lot ofpeople that just lost all
services because their systemswent down yeah.
So I don't know.
I think sometimes I I sometimeswonder that the secret to
bridging that divide betweenpublic and private is figuring
out a way to do this in asmaller set of communities
(26:44):
instead of this giganticinstitutional model where
everybody is kind of lost, youknow.
I think, that public education.
Our school systems are way toobig.
You know we've lost the abilityto have relationships with kids
, and I think the same is truewhen it comes to public and
private services like what we'retalking about.
Speaker 1 (27:04):
Yeah, you can't box store it.
Speaker 2 (27:06):
No, and what holds us together at Cooper Reese and a
lot of the really excellentprograms that I'm connected to
collegially is our size.
We're small, so therefore wehave relationships with each
other.
I mean, we get mad at eachother plenty, but that's okay.
Speaker 1 (27:22):
Right you know, I mean you have the capacity to
serve 60 people.
Speaker 2 (27:29):
No, we can serve 80 or 90 people.
Speaker 1 (27:32):
Well, I was going to say at the residential level and
then transitional levels ofcare.
Yeah, and that's.
I mean that's not a smallnumber of people in my view.
But when you look at communityneeds it does become small
because they're staring in theface at hundreds.
But I think you're rightgetting it down to manageable
sizes, manageable caseloads.
Program is people.
I mean, we can get to thenitty-gritty of that, but that's
(27:53):
kind of the over, that's the.
That's the overarching theme.
It's a good way to kind ofsummarize it.
It's like well, program ispeople.
You know, whether that's peersupport or whether it's your
staffing or whether it's, youknow, your, your clinically
privileged psychologist or nursepractitioners, that's out there
making sure med management'sdone right.
There are all kinds of wayswhere that principle can apply
(28:18):
and I think it would kind ofshrink it down to become
something that's actuallymanageable.
Because I would say that on thepublic side you'd probably get
the very common and real answerthat what they face is
unmanageable.
Right, it's like well, it's not.
Speaker 2 (28:37):
But you have to be resourced.
That's the issue is, you've gotto have resources.
You have to have dedicatedresources to support the most
vulnerable people in ourcommunity, and I worry about
that today a lot more than I didyesterday.
Speaker 1 (28:53):
Well, that brings us to this insurance thing.
Tell your insurance story.
Insurance plays a huge role inhow this is playing out today.
Speaker 2 (29:02):
Well insurance in terms of reimbursement for
services insurance.
Speaker 1 (29:06):
That's correct.
Speaker 2 (29:06):
yes, Okay, so my program in Asheville, our Cooper
Rees at Asheville program, isan in-network provider and
that's a relatively new thingfor Cooper Rees, but we went
in-network with some of themajor providers.
My program here at the farm isnot we do some out-of-network
reimbursement, but one of thebig challenges Right right.
Speaker 1 (29:28):
Courtesy billing right.
Speaker 2 (29:29):
But one of the big challenges Right, Sorry,
Courtesy billing, right, Right.
So one of the big challengesduring the storm was that I had
all these people in our CooperReese at Asheville program who
were receiving in-networkbenefits and and it's a really
challenging experience to dothat, because my clinicians have
to see people a certain numberof times a week and then they
(29:50):
have to write a note that sayscertain things and the doc has
to see them and the nurse has tosee them, and it all goes into
an electronic health recordwhich the insurance company will
look at every so many days andthen they decide how many more
days of funding they're going toprovide and there are a lot of
rules around and never is thenumber of days they're going to
(30:11):
provide actually the number ofdays that the person probably
needs, or very rarely.
Absolutely true.
But in order to becomecredentialed as a in-network
provider, I had to.
Organizationally, we had tojump through a lot of hoops and
a lot of them, frankly, arebureaucratic derivative.
(30:34):
I have to be careful because,you know, whatever my reps might
see this, so anyway.
So on the day that we evacuatedCooper Reese at Asheville, we
moved these folks who are innetwork down to my farm, which
is not in network, and so youwould think that in a national
emergency disaster like this,that the insurance companies
(30:57):
would be no problem.
We will continue to reimburseand forgive and you take care of
our members.
God love you.
You would think.
Speaker 1 (31:09):
Negative.
Speaker 2 (31:10):
Wasn't that easy and I won't call out one provider,
but one provider in particular.
I had to have a Zoom meetingwith all their who's and
whoville and explain what wewere doing and beg them to
continue to honor theirin-network relationship with
their members who are now 40miles away, safe, getting the
(31:31):
same exact services.
Because I moved all the nurses,I moved their doc down here.
They were getting the sameexact level of service, but I
still had to beg and borrow toget them to continue.
And they did, and they did.
But that was huge Becauseimagine if they had said I'm
sorry, dude, you moved and thatlocation is not accredited, so
(31:52):
you're just going to have tosend them home.
Well, I can't send them homebecause there's nowhere for them
to go.
They can't leave.
Speaker 1 (31:57):
Well, you know you're talking about something here,
because I've been asking aboutthis a lot.
You're really back to this.
Program is people scenario.
That addresses the issue thatwe're referring to and I've
talked about it with wildernessfolks who are, you know, facing
closures and things like that,or people who do different kinds
of therapies, some of whichCooper East even has, but, like
(32:21):
you know, experiential therapieslike equine therapy or even
horticulture therapy, likeequine therapy or even
horticulture therapy.
If we stop telling people wherewe're doing it and it's like,
look, this person's going to getall those basics, they're going
to get a doc and they're goingto get a therapist and they're
going to get groups and they'regoing to get all of this care,
(32:43):
and we are qualified to providethat, whether I'm at this campus
or this campus or I'm in a barn, I'm capable of delivering good
therapeutic care and providinggood therapeutic outcomes.
And if we stop fighting overwhere you are, say that
facilities don't have to bechecked off and things like that
, but the exercise of trying toprove that what you're doing is
(33:08):
being done in the right locationor in the right environment is
is ridiculous to me, um, and waybeside the point.
So program is people.
Speaker 2 (33:21):
yeah, not necessarily your campus it worked out and
everybody did what I feel wasright the process of getting to
right in the middle of trying tofind gasoline and water and
Wi-Fi service.
Speaker 1 (33:35):
You were not appreciative of.
Speaker 2 (33:37):
I did not appreciate that.
But at the end of the dayeverybody was cared for and they
reimbursed for more days thanthey probably would have.
But we had to jump through afew hoops to make that happen.
Speaker 1 (33:50):
And again.
Speaker 2 (33:51):
You know I had caravans of clinicians coming
down, 26 every day for fourweeks to make sure that
continued to happen.
So really my undyingappreciation to my folks who
were getting up two hoursearlier than they normally would
, leaving their homes that hadno water, no power, no nothing,
(34:12):
and coming down here and we, wemade sure everybody was fed.
Speaker 1 (34:15):
But that's awesome.
Well, I mean it's.
It was quite the thing toendure, eric.
Thanks for you know justrunning us through what the
experience was like for you guysat Cooper East.
Thanks for caring for people sowell.
I appreciate that you guys wereable to contain community and
provide in the ways that you did.
I wish everybody had the chanceto experience that level of
(34:38):
care and compassion, but we'llfigure it out before long.
We're just going to keeptalking about it.
Speaker 2 (34:45):
I appreciate that.
If anyone's listening and needscare, call us.
We've got availability.
We'd love to serve you.
Speaker 1 (34:51):
And Asheville program is in network.
Speaker 2 (34:54):
In network Yep.
Speaker 1 (34:56):
That's awesome, Eric.
Thanks for coming on the showtoday.
This has been Head InsideMental Health with Todd
Weatherly on WPBM 1037, theVoice of Asheville.
We'll look forward to beingwith you next time.
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