ADDICTION TREATMENT FACILITY CLOSING DOWN
Beacon House fell victim to the pandemic and lower reimbursements
PACIFIC GROVE >> An important player in the Central Coast’s drug and alcohol addiction treatment network for more than 60 years is closing at the end of the month, a victim of a combination of the pandemic and dwindling insurance reim
bursements.
Beacon House is a nonprofit in- patient alcohol and drug treatment facility in Pacific Grove that was founded in 1959. In 2018, it partnered with Chicago-based Gateway Foundation, which operates the largest network of treatment facilities in the U. S. Beacon House was Gateway’s only California part
ner, according to its website.
A spokesperson for Gateway confirmed the closing Tuesday and said it was a one-two punch of COVID-19 and health insurance companies not adequately covering in-patient treatment. Many people who would otherwise seek treatment are fearful of entering any type of medical setting because of the virus. She
said the census at Beacon House had fallen to two or three patients at any one time.
“This is a major loss for our community,” said Lisa Naylor, a nurse and director of Behavioral Health Services at Community Hospital of the Monterey Peninsula.
Community Hospital’s Recov
ery Center provides an intensive outpatient program specializing in alcohol and chemical dependency addictions. The pandemic is one driver contributing to increased drinking or drug use, including stress, anxiety and depression, health professionals say.
Ann Bispo, a mental health clinical nurse in Behavioral Health Services at Community Hospital, has seen increased numbers of patients struggling with substance use problems during the COVID-19 pandemic.
“Many people have relapsed in the context of not being able to go to in-person Alcoholics Anonymous and Narcotics Anonymous meetings for support, as well as due to the overall sense of isolation with shelter-in-place restrictions,” Bispo said.
Robin McCrae, the chief executive of Community Human Services, a Monterey-based nonprofit that operates both in- patient and outpatient recovery programs as well as other mental health services, said Beacon House has played a significant role in helping thousands of people get clean and sober and turn their lives around over the years.
“It’s sad to see this iconic institution close,” she said. “They were an important part of the recovery services network of providers in Monterey County.”
McCrae noted that demand for services has increased by about 10% at Community Human Services’ Off Main Clinic, which provides medicationassisted treatment for those addicted to opioids and severe alcohol addiction. Patient census numbers have risen from about 225 to 250 since March.
Community Human Services can accommodate the increased demand for its out- patient services, McCrae said, but at Genesis House, Community Human Services’ co- ed residential treatment center in Seaside, capacity is actually lower because of social distancing requirements and the need for quarantine and isolation rooms.
Beacon House only accepted cash and commercial insurance. Other residential programs in Monterey County accept Medi- Cal for low-income individuals seeking recovery. Sun Street in Salinas provides a men’s program and Door to Hope provides a women’s residential program. All programs in the county have instituted precautionary measures because of the pandemic.
Also putting financial pressure on Beacon House has been commercial insurance. Over the years, insurance companies began pushing back against the length of time people can receive treatment in residential settings. Most residential programs are based on a 28- to 30- day length of stay, but insurance companies now typically pay for just a week and a half, depending on the insurer, Gateway said.
When Gateway first partnered with Beacon House in 2018, Thomas Britton, chief executive of Gateway, said that residential treatment was critical for recovery from certain kinds of substance abuse.
“You can be nauseous, dizzy, throwing up, sweating,” Britton said specifically of those experiencing opiate withdrawal. “That’s the kind of thing that sends people out the door before they really engage in treatment.”
Now, the insured are beginning to push back against insurance companies. In a landmark classaction lawsuit filed against United Behavioral Health, an af filiate of United Healthcare, a federal judge in California on Nov. 3 ruled in favor of the plaintiffs during the remedies phase of the action.
Chief Magistrate Judge Joseph Spero of the U. S. District Cour t for the Northern District of California ordered United Behavioral Health to reprocess 67,000 mental health and substance treatment claims that it illegally denied over a six-year period, according to Psych-Appeal, a co- counsel to the plaintiffs in the class action.
“This order brings us one step closer to final relief for (United Behavioral Health insured individuals) subjected to years of systematic misconduct,” said Meiram Bendat, a Psych-Appeal attorney, in a statement. “The federal court has sent a clear message that when insurers promise to evaluate mental health claims pursuant to generally accepted standards of care, they will be held accountable to those standards. Profit motives will not be allowed to infect the claims administration process.”
The remedy order applies only to the participants in the class-action lawsuit, but precedents set in that case could affect other cases against insurance companies.