The District 19 Community Services Board (CSB), based in Petersburg, Va., provides mental and behavioral health services to nine localities in the greater Tri-Cities area -- Petersburg, Colonial Heights, Hopewell, Prince George, Dinwiddie, Surry, Sussex, Greensville and Emporia. Jennifer Tunstall, the executive director of the District 19, says that while the need for service has increased, the methods for delivery of those services have changed, and become more difficult in some cases, due to the social distancing guidelines in place to combat the spread of the novel coronavirus and the disease it causes, COVID-19.
Fee-for-service revenue streams have slowed to a trickle for District 19, according to Tunstall, making funds tight. Intensive outpatient services, such as for substance abuse treatments, require several hours of in-person contact, and are no longer taking place because of the pandemic. The district's office is closed, and District 19 is limited to offering "tele-health" services, done remotely via telephone or video conference.
"Tele-health" services, though, cannot meet the demands of every patient, and in fact makes treatment unavailable to many. Many of District 19's patients have low income and do not have access to internet capable devices for video conferences. Some, Tunstall says, do not even have phone access. District 19 has lost contact with some people that were being treated prior to the pandemic's onset.
In addition to technological barriers, District 19 cannot bring treatment directly to patients as it has done in the past. Tunstall says that the CSB often would hold "community-based" treatments, implanting themselves in communities of need to offer services where problems resided.
Now, District 19's care providers are stuck at home, hoping that those who need them will seek out their services.
District 19's employees have felt the emotional toll of the pandemic, Tunstall said. Their's is a field that requires empathy, and the limitations of the pandemic have drained the emotional reservoirs they use every day.
"It's hard for people. We are, of course, in public behavioral health, so we are working to provide care to those individuals who are the most vulnerable population," Tunstall said. "Our staff, they're used to going above and beyond to meet the needs of the individuals, and so when you put in the restriction of not being in physical contact with them, that can make it very difficult."
Tunstall says that there has been an influx of new patients coming to District 19 for treatment, despite the limitations brought on by the pandemic, but even that has created more costs for the district.
District 19 had only just begun to explore "work from home" and "tele-health" options before the pandemic, Tunstall said. With the onset of COVID-19, they were forced into making investments that they had not foreseen.
"We really weren't set up for everyone to be tele-working," Tunstall said.
District 19 purchased laptops for workers, and had to pay fees for video conferencing services. The increased costs exacerbated the funding issues caused by the drop in fee-for-service treatment. District 19 was forced to reach deeper into its pockets just as revenue streams were drying up.
In late April, the Virginia Department of Behavioral Health and Developmental Services announced that it received a $2 million grant from the U.S. Substance Abuse and Mental Health Services Administration to help alleviate funding issues for CSBs like District 19, but Tunstall was unsure how much of that money District 19 would see. She said she was "hopeful" the grant would have a local impact.
The local impact of COVID-19, though, is already certain, though the extent of that impact is yet unknown. Tunstall says she expects that when the "old normal" returns and District 19's office re-opens, they will be able to take a more precise measurement of COVID-19's toll of the mental and behavioral health of the Tri-Cities.
"We're concerned about the impact that it has on the community and I think we're definitely going to have an increase in our services once we are able to provide them back to our normal operating style," she said.
©2020 The Progress-Index, Petersburg, Va. Distributed by Tribune Content Agency, LLC.
