August 29, 2017
Thomas F. Hilton and Dennis McCarty
Never invest money you cannot afford to lose.
That admonition came from the late stock market expert,
Louis Rukeyser, in his 1976 book, How to
Make Money on Wall Street. This remains wise advice for anybody wanting to
invest a sudden windfall. Financial planners will tell you that there are three
things you can do with money. First, you can spend it. Spending is buying
something that will depreciate over time like a car. Second, you can invest it.
Investing is buying something that you hope will appreciate in time like stocks
or a house. Third, you can let it sit in the bank for a rainy day where it may
not do anybody any immediate good. Moreover, it might disappear on its own as
states often recoup unspent funds.
Our opinion is that, while devastating right now, the opioid
emergency is unlikely to last very long. We believe that it is risky to invest
short-term opioid emergency funds in service expansion because once that
funding is no longer available, you may not have the resources to serve your
increased client load. This type of investment only makes sense with a solid
plan for long-term capacity building, such as a funding commitment from
municipal or philanthropic sources. Short of that, service expansion may do
more harm than good in the long run.
Another option is spending
on things like new computers for staff, upgrading software and servers, or
redesigning your website. While all that stuff depreciates, it can also enhance
efficiency, which could translate into increased capacity and the need for more
future operating funds. Thus, some spending
can become an infrastructure investment.
The challenge is how
to decide; not just what to decide on. As the influx of added resources is
likely to affect everyone in your organization, they will likely and rightly
feel that they have a stake in its distribution. Managed carefully, the new
resources can energize staff members if the way the funds are spent is perceived
by all to be in the best interest of the organization and its clients.
Here are a few things you might consider doing – if opioid
emergency funds become available:
Capacity: Set up a committee to explore how funds might be used to expand capacity
knowing that resources will be finite. Meet with your state authority and
determine how they plan to prioritize additional funds.
Outreach: Politics usually causes emergency
funds to be wide spread and they may wind up in jails, courts, schools,
churches, half-way houses, etc. Creating working groups to explore
collaborating with other recipients might build some long-overdue bridges not
fully developed due to lack of start-up resources. It may enable you to collaborate
with local health centers and together build systems of care that included
opioid agonist therapy with buprenorphine. Health centers often struggle with
addressing opioid use disorder and may be willing to have your counselors see
patients with disorders at their health center.
Needs Assessment: Mike Dennis at Chestnut Health
Systems has often noted that a great many people with alcohol and substance use
problems are “multimorbid.” The new opioid crisis may have created a shift in
client needs from previous years. They may need more careful monitoring for
suicidality, education about what to do if they OD, help transitioning from
long-term unemployment, or accessing more intense recovery support, such as Oxford Houses.
The needs assessment should also consider the need for counselors skilled in
assessing and treating co-morbid mental health disorders. You may be able to
advocate for enhanced reimbursement so that your counselors can be paid better
and you can recruit and retain counselors with the skills needed to treat
complex patients.
Consensus Building: Once recommendations have been assembled, it
makes sense to call an all-hands meeting to discuss options. The feedback from
staff will help to optimize new expenditures, and likely build support for
putting the funds to good use.
What would you do? Share your thoughts in the comments section below.
About our guest bloggers:
Oregon Health & Science University.
No comments:
Post a Comment