New program aims to combat opioid epidemic in rural Georgia

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Two individuals interacting at a hospital reception desk. One person is standing behind the desk, smiling and wearing a black top with a badge, while the other, holding a manila folder, is engaging in conversation. Visible on the desk are a computer, a telephone, and various office supplies.
Mountain Lakes Memorial Hospital Life Care Specialist Mandy Kuntz, left, converses with Amy Upchurch, R.N. Photo courtesy the Georgia Rural Health Innovation Center

The Georgia Rural Health Innovation Center, Mercer University School of Medicine and the CWC Alliance are working together to combat the opioid epidemic affecting rural communities in Georgia. With opioid overdose deaths rising, particularly in rural areas, the partnership is implementing the Life Care Specialist pilot program in rural communities.

The Life Care Specialist program, previously successful at Grady Memorial Hospital in Atlanta, has now officially debuted in two rural hospitals: Mountain Lakes Medical Center in Clayton and Stephens County Hospital in Toccoa.

One individual making a profound impact as a Life Care Specialist is Mandy Kuntz, a Rabun County native.

Kuntz was cleaning homes for a living while completing her bachelor’s degree when she met Cammie Wolf Rice, the founder of CWC. Rice’s son and namesake of CWC, Christopher Wolf, lost his 14-year battle with opioid dependency due to chronic pain.

“I am in recovery myself,” said Kuntz. She and Rice instantly connected over her personal addiction recovery journey, now eight years and counting. “Cammie said, ‘You can be a Life Care Specialist, this new role that I’ve got.’ I said, ‘I’m ready!’”

It would be three years from their initial conversation before the Life Care Specialist position would be ready for installment at Mountain Lakes Medical Center. In the meantime, Kuntz graduated from college and enrolled in Liberty University’s online master’s program in clinical mental health counseling.

Just ahead of her appointment as a Life Care Specialist, Kuntz completed rigorous training, which included a didactic curriculum of online learning modules about the history, physiology and treatment of addiction along with exposure to practicums at Grady Memorial Hospital. In March, she officially started her role at Mountain Lakes.

“It is something different. It is encouraging,” said Kuntz. “There are times where I can’t help people, and I really want to, but I am able to sit with them and hear about their pain.”

Education and support

A Life Care Specialist is an important part of the care team for patients dealing with traumatic injuries, diseases, post-surgery recovery — all scenarios that involve significant pain and that can lead to one’s dependency on opioids.

Rice said, “Many times addiction starts with one prescription, and it starts in the hospital.”

According to research conducted through the Life Care Specialist program at Grady, many patients may not be aware that their prescription is an opioid and the risks associated with those medications.

Life Care Specialists, like Kuntz, provide direct intervention, education, support and a pain management plan to individuals while they are being treated for acute injury or surgery. They also work with individuals who come to the hospital with pain medication dependency to wean off of the medication.

“People who have substance use disorders do not know how to cope with their mental health and turn to unhealthy coping skills to appease their trauma, pain and grief,” said Kuntz. “By teaching people coping skills, I’m able to offer them tools to put in their toolbox.”

An example of a skill Kuntz has used with patients is the progressive muscle relaxation technique in which the patient consciously tenses and relaxes muscles throughout the body, which can make them calmer.

Dr. Jerry Spivey, pain management physician and anesthesiologist at Mountain Lakes, views Kuntz as an extension of his pain management program for patients.

“I am making her an integral part of the program in that she gives real-life information to the patient as to why narcotics can ruin somebody’s life,” he said.

He looks forward to seeing what Kuntz’s influence will have on patients as she progresses in this new role of a Life Care Specialist.

In addition to helping patients in the hospital setting, Kuntz also helps connect patients with resources in the community. One of the things uncovered in the Life Care Specialist program at Grady was the presence of co-morbidities such as domestic violence, food insecurity and addiction. Kuntz created a binder of resources located in Clayton, such as the food bank. Additionally, she shares information about help lines that can provide assistance and connect resources with those in need.

Certified positions

Kuntz embodies the compassionate spirit one needs in the Life Care Specialist role. Though formal education is valued, Rice expressed the deeper importance of the innate qualities needed for a Life Care Specialist to be successful and effective in each patient’s healing or recovery journey.

She said, “In going into rural areas, we want to hire trusted people in the community. What we are looking for in an individual is what you are born with. That is compassion, empathy, love, a caring heart, and that they’re non-judgmental. The faculty of Mercer University can teach all the other things.”

The Life Care Specialist training program for rural communities is an accredited certification through Mercer University School of Medicine. The online learning modules include an introduction to CWC, the social determinants of health and implicit bias, opioid education, pain management, addiction and treatment, mental health, trauma, and grief and mourning.

In addition to the academic training, Life Care Specalist trainees enroll in a skills training curriculum to include the specific required technical skills of a Life Care Specialist. Other technical skills include the Community Resiliency Model training, motivational interviewing, Narcan administration, and the health care privacy and medical records requirements and regulations. After the academic requirements are completed, each trainee is paired with a Life Care Specialist trainer and participates in a clinical practicum. Upon completion of the practicum experience, the trainee becomes a certified Life Care Specialist.

While a degree is not a requirement for any Life Care Specialist, Kuntz considers her education in counseling to be particularly useful.

“I believe in a lot of ways my education has prepared me to be present with people just in the small amount of time we have together,” she said. “It has all aligned for a reason for me to do this job. I truly believe all that I am learning in this position and in my education will help me to fulfill my purpose on this journey I’m on.”

Stephens County Hospital will soon fill a Life Care Specialist position as an addition to the hospital’s case management department.

“This really does pave the way for us to do something we have wanted to do for a while. With the finite resources and limited availability for training and curriculum, us doing this on our own is not feasible,” said CEO Van Loskoski. “We see so much value for our community in this program.”

Life Care Specialist positions at Mountain Lakes and Stephens County Hospital are funded for two years, but Rice and the CWC team, along with hospital leadership and community partners, are working to create a sustainable model, which includes attaining an insurance code for billing.

“We want this to be a position forever,” said Rice.

The significance of the Life Care Specialist program extends beyond individual interactions, as it represents a collaborative effort to build stronger, healthier communities in the fight against opioid misuse and dependency. To learn more about the program, visit cwc.ngo/solutions/.

 

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