HJAR May/Jun 2024

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2024 13 health. Then we partnered with Hazelden Betty Ford in Minnesota. We had a lot of our staff go up there and go through their training course. Now ARcare itself is certified by Hazelden Betty Ford. Just because we're in a rural area, it doesn't mean that we haven't had the training. We really push for our leaders, especially, and our providers, to have excellent training. We have a PhD psychologist, a psychiatrist, a lot of counselors, nurse practitioners, and a few doctors who do substance abuse treatment. That's gone well. Our goal is to integrate substance abuse, behavioral health, and primary care. Our best examples of that are Paducah, Kentucky, and in Jonesboro, Arkansas. Editor What are they doing? Collier In the same clinic, you'll have a family practice doctor and then there'll be somebody receiving their substance abuse treatment and counseling by a behavioral health professional across the hall. It's all together; you don't have to go to a mental health building. Editor That's nice. I understand that ARcare provides transportation for appointments. What a wonderful concept for those who need it. How do you afford that? Collier A lot of it is just built into our budget. And that's a great question because we do some things that we don't try to make a big deal about. Our biggest thing that's truly something that we give back is a dialysis center in LaCroix, Arkansas where ARcare, since the day it opened, has provided transportation for those people on dialysis. We do dialysis Monday, Wednesday, and Friday; and in however many years, we've never missed a day of transporting those people. Now, we get ice, but our vans still don't miss transporting our patients. So, what we do there is probably the pinnacle of our transportation program. We take people to Little Rock, Jonesboro, andMemphis, and that's just part of our ser- vice because so many of our people, like I said, in a town likeAugusta or Cotton Plant or Brinkley, when they say, "Hey, the price of gas is high, people can't drive," that's not even a factor if they don't even have a car, if it’s just a bicycle. So, you probably don't want it to sound too poor, but that's kind of how it is. With some disabilities, they can’t get in their car and make it fromAugusta all the way to Little Rock anyway. It's 80miles. Editor Well, I just love what you’re doing as a concept because when you need it, you need it. Say, you might have a car, but it's not working. Collier Yeah, and we have one person who's getting ready to retire, and she has dedicated her life to doing all of our transportation. The biggest thing is getting drivers that can pass a drug test. Editor Interesting. You mentioned the drug situation several times. Talk to us about what is going on. You are boots on the ground. Are you hopeful? What do you think is happening? What do you think is going to happen? Collier I think it's a continuous problem. I think that it is a disease, that it is chronic, and I think it's very deadly; and we don't realize until someone we know passes away. The last funeral that I went to myself was a patient of mine who had overdosed on fentanyl. He was in his 40s, and he was in great shape. I can't say any more about his case, but I don't really see any sort of let-up. But ARcare — KentuckyCare and MississippiCare, too — we're going stay in that fight no matter what because you don't have another option. You can't give up on that. We welcome all partners or anybody else that wants to get involved. I'm not really doing a lot of prac- tice, but, gosh, even I still have patients — I think of two young men in the last year — who have passed away from overdoses, and both of them were in programs. So, we're not saying that our programs are a 100%. I see it as very challenging, andARcare is not where we want to be, yet. I don't know that we'll get there. We do have an addictionolo- gist in Jonesboro that we're very fortunate to have, and in North Mississippi, we have an opioid program that's pretty strong, and the one I mentioned in Southwest Kentucky. So, even within our footprint, there are some places we're stronger than others. Editor I heard a parent of a child who died of fentanyl say, "My child did not overdose. My child was poisoned." And I thought that was a really telling point because I think it's not monitored, so they don't even know what they're getting a lot of times. And then, if you're in recovery, isn't that almost a more dangerous time to use — right after? Collier Yes, it is. Maybe they've had a good, clean outcome and go to a halfway house, and they take a night out and go get some fentanyl and overdose because it is just a poison that they can't handle. They can't go back to the dose they were taking, and they die. For me and ARcare, we want to engage that. I know it sounds weird, but we are not as discouraged by that. We just think that that is our cross to bear. I think you asked me, "Is there hope?" Yes, I think there's hope. Is it overwhelming? Well, sometimes it's going to feel like it. And when you're there at a funeral of one of your patients, it sure feels like it. Editor What do you think the future's going to hold for ARcare? What would you like to have happen? Collier Medically, we've got some great people, and I want to see it become more like a center of excellence at a university level. We're still not there, but we copied University of Louisville's hepatitis C program. We have two or three of our providers certified, and that program is doing well. We are looking to become a center of