Influential Visits Pave the Way for Behavioral Health Initiatives in Rural Iowa

Director Garcia visit

In a significant development for Iowa, influential lawmakers are turning their attention to the critical needs of behavioral health across Iowa, particularly in rural areas where access to comprehensive services and reimbursements remain a challenge. Recent visits from prominent figures underscore a renewed commitment to addressing the root causes of substance abuse and promoting mental health support in communities throughout the state.

Director Garcia visitOn National Rural Health Day (November 16th), Iowa Health and Human Services Director, Kelly Garcia, and State Epidemiologist, Dr. Robert Kruse, visited MRHC and the Recovery Center. Their presence underscored the critical need for integrated behavioral health services, with a focus on mental health and substance abuse. Engaging with healthcare professionals, community leaders, and the hospital’s board and senior leadership team, Director Garcia and Dr. Kruse discussed collaborative solutions to improve statewide healthcare and to also address the unique needs of rural communities.

During her visit to Manning on September 12th, Iowa Attorney General Brenna Bird highlighted the importance of tailoring initiatives to the unique challenges faced by these areas stating, “Rural communities often encounter barriers in accessing quality healthcare and addiction treatment services. The opioid settlement funds are one-time funds that could provide an opportunity to bridge those gaps and make a lasting impact on the lives of those affected by opioid addiction in our rural communities.” Brenna Bird

Earlier this year, agreements were reached with manufacturers, distributors, and pharmacies to provide nearly $50 billion in payments for state and local governments across the nation. Funding was distributed to each state, and in Iowa a portion of those funds were distributed to each county for the county supervisors to disperse locally. The rest of the funds are currently held at the state level with the anticipation that lawmakers will determine appropriations in the next legislative session.

Charles GrassleySenator Charles Grassley as well as Republican presidential candidate and North Dakota Governor, Doug Burgum, accompanied by his wife, Kathryn, also visited MRHC earlier this fall to gain a better understanding of the healthcare needs affecting rural areas and the unique position of MRHC and the Recovery Center.

These visits provided lawmakers with a firsthand look at the Recovery Center’s efforts to support residential and outpatient recovering addicts. MRHC, serving as a model for rural healthcare services, became a platform for discussions on comprehensive strategies to address behavioral health challenges, reimbursements, and access to care in rural Iowa.Doug Bergum

Director Garcia emphasized the importance of addressing behavioral health needs, stating, “By understanding the challenges faced by the communities across our state, utilizing research-based methodologies, and taking a comprehensive approach to address the most critical health needs, we can develop targeted and effective strategies to improve our overall health outcomes.”

These visits reflect a broader, bipartisan commitment to address rural healthcare challenges in a unified and strategic way. This holistic approach starts with a grassroots understanding of the challeng es affecting rural hospitals accompanied by discussions to adjust policies at the state and federal levels. These collaborations reflect an aligned dedication to build healthier and more resilient commun ities across the state.

As Iowa takes a significant stride forward in the battle against opioid addiction, the opioid settlements stand as a beacon of hope for rural communities. MRHC Administration and the leadership of the Recovery Center are taking this opportunity to educate local county supervisors as well as statewide leaders to better understand the services that already exist, their vision for addressing this epidemic, and the potential for MRHC and the Recovery Center to serve even more clients and their families.

Iowa Attorney General Brenna Bird Advocates for Rural Healthcare and Substance Abuse Treatment During Visit to MRHC

Brenna Bird visit

Iowa Attorney General, Brenna Bird, underscored her commitment to enhancing rural healthcare and tackling the challenges of substance abuse during her visit to Manning Regional Healthcare Center (MRHC) and the Recovery Center on September 12th. Brenna Bird visit

Attorney General Bird, known for her dedication to addressing critical issues affecting communities, spent the day engaging with healthcare professionals, touring the facility, and discussing key priorities related to rural healthcare access and substance abuse treatment. During a meeting with key hospital leaders, Attorney General Bird emphasized the vital role of rural healthcare in ensuring all Iowans have access to quality medical services.

“Rural communities are the backbone of our state, and it is crucial that we invest in and support healthcare facilities such as Manning Regional Healthcare Center,” Attorney General Bird stated.

The Attorney General toured the various departments meeting doctors, nurses, and other front-line staff to gain a firsthand understanding of the challenges they face in delivering healthcare services to rural populations.

Brenna BirdOne of the key highlights of Attorney General Bird’s visit was her exploration of the Recovery Center at Manning Regional Healthcare Center, where she engaged in discussions with addiction treatment specialists, counselors, and individuals in recovery. She expressed her deep concern about the rising prevalence of substance abuse issues in rural areas and emphasized the importance of comprehensive treatment options.

“The opioid epidemic has touched every corner of our state, and rural communities are particularly vulnerable. We must ensure that individuals battling substance abuse have access to effective and compassionate treatment close to home,” Attorney General Bird remarked.

In outlining her priorities related to rural healthcare, Attorney General Bird committed to working closely with healthcare providers and community leaders to address issues such as healthcare workforce shortages, infrastructure improvements, and access to mental health services. She also pledged to advocate for policies that support the expansion of substance abuse treatment programs and improve access to mental health resources in rural areas.

MRHC CEO, Linn Block, expressed gratitude for the Attorney General’s visit, stating, “We appreciate Attorney General Bird’s attention to the unique healthcare needs of rural communities. Her commitment to supporting initiatives that address substance abuse is particularly significant in our ongoing efforts to provide comprehensive care to our residents.”

As Attorney General Bird concluded her visit, she reiterated her dedication to collaborative efforts that bridge the gaps in rural healthcare and substance abuse treatment. “By working together, we can build stronger, healthier communities across Iowa,” she affirmed.

Attorney General Bird’s visit to Manning Regional Healthcare Center serves as a testament to her hands-on approach in addressing critical issues impacting the well-being of Iowans.

“We are thankful for the Attorney General’s visit to MRHC and appreciate her taking time to learn about the unique services we offer here as well as the challenges we face with regard to rural healthcare funding and staffing,” shared MRHC CEO, Linn Block.

Manning Regional Healthcare Center has recently become a popular site for politicians as the organization has been able to successfully manage rural healthcare challenges and continues to work hard every day to provide exceptional patient care. Read about other recent politicians visiting MRHC: U.S. Senator Grassley visited the hospital and Recovery Center. Presidential Candidate & North Dakota Governor Burgum

Dalton Lytle Finds Hope In Recovery and Joy in Helping Others

Recovery Counselor, Dalton Lytle, CADC

“We save lives here and I’m grateful to be part of that,” shared Dalton Lytle, Recovery Counselor who works at Manning Regional Healthcare Center (MRHC). “Manning Recovery Center has changed my life for the better. I am proud to be an employee here and represent what recovery can do for someone.”

Lytle attended college for a short time before beginning his career in bridge construction for eight years. He never intended to return to college, let alone work in an office as an addiction counselor, but after personally receiving treatment at the Recovery Center, he moved to Manning and took a job opportunity as a part-time tech at MRHC. Lytle shares how his personal experience with addiction and recovery helps him relate to his clients on a personal level.

Recovery Counselor, Dalton Lytle, CADC“After working at the Recovery Center for a while it was clear to me that this is what I want to do for a living – help suffering addicts find hope in recovery,” explained Lytle. “Going through treatment here myself, I know the pain and struggles that our clients are going through. Being able to relate and help them through it is very rewarding and I want to continue doing that.”

Lytle is very passionate about his career at MRHC because he has personally reaped the benefits from the Recovery Center’s treatment and urges other addicts to seek help. “The reason I love my job is because I get to help people save their lives,” stated Lytle. “I went through treatment here in 2019. My life was a complete disaster and I had very little hope that things could get better. The Recovery Center showed me that there is hope and gave me the tools to save my life. I could not have done it without the Recovery Center. Treatment was such an eye-opening experience for me. I want to continue helping those who suffer addictions find the same hope that I was given. It’s pretty amazing to see someone come into treatment feeling hopeless and broken, and then watch them transform into a new person full of joy and hope,” Lytle explained.

The saying ‘Find a job you enjoy doing, and you will never have to work a day in your life,’ rings true for Lytle. “I like working at the Recovery Center because when I get up in the morning, I am excited to go to work. I had never had that feeling before, so it is special,” exclaimed Lytle. He boasts that the best thing about working at MRHC is the easy-going and supportive environment. “It makes work enjoyable and that’s a pretty cool thing.”

“My role at the Recovery Center continues to expand the longer I work here,” explained Lytle. When Lytle was a counselor tech, he was responsible for taking clients to outside meetings and facilitating group sessions, along with various other client needs. “I have recently been promoted to counselor and my role here has expanded. I now get to help our clients more than before by having my own clients that I work with on an individual basis. When it comes down to it, I am here to provide guidance and support for our clients so that they can start a new life in recovery,” stated Lytle.

The biggest issue Lytle wants to bring to light is that addiction happens everywhere, including rural areas. “The Manning Recovery Center is unique. There is something special about this place. Many have said that this is the best treatment center in the state and other surrounding states,” explained Lytle. Although the Recovery Center at MRHC may be rural, Lytle believes that to be an advantage. “I think we stand out because we care about our clients. The groups are smaller here compared to other treatment centers and that makes for a more personal experience. I think we all do a great job making them feel at home and that provides the best environment for healthy growth.”

To join the MRHC team, visit www.mrhcia.com/careers or call (712) 655-2072 for more information on current job openings.

Recovery Center Works to Prevent Overdose Deaths

overdose

In 2020, 91,799 people died from a drug overdose in the United States, increasing by 31% from the year prior, according to the CDC. And nearly 75% of those deaths involved opioids, making August 31st, Overdose Awareness Day, more important than ever.

“Overdose is something everyone should be aware of,” shared Recovery Center Director, Taya Vonnahme, MSN, RN, ARNP, tCADC. “Not only is overdose a concern in the addiction world but also in general practice. We see overdoses all the time for various reasons – alcohol, opiates, and drug related. Some are unintentional from prescription pain medications that were accidentally taken incorrectly.”

The Recovery Center at Manning Regional Healthcare Center is dedicated to raising awareness of drug overdose and helping prevent future deaths caused by an overdose.

“Everyone should educate themselves on the signs of a possible overdose and know what to do if it is suspected,” Vonnahme recommended.

Typical signs of an overdose can include one or several of the following:

  • Unconsciousness
  • Seizure
  • Severe headache
  • Chest pain
  • Breathing difficulties
  • Extremely paranoid, agitated, and/or confused
  • Snoring or gurgling

Seek emergency help by calling 911 if someone is exhibiting these symptoms. Prior to emergency personnel arriving, follow these steps:

  • Administer *Naloxone if available
  • Support breathing by ensuring their airway is clear and giving breaths
  • Monitor their response
  • Do not forcefully try to awake them
  • Don’t try to make them vomit

When help arrives, it is vital to provide as much information as possible about the overdose. Information such as what type of drug and how much was taken and how long ago it was taken can help save a life.

“One of the best things I have seen that can assist someone who has overdosed is Naloxone,” Vonnahme said. “It saves lives every day and anyone can learn how to use it. It is also available to anyone who may need it no matter the reason. If you know someone who uses any type of opiate, prescription, or recreational drug they should know about this and learn how to use it.”

*Naloxone is a non-addictive, life-saving medication that can reverse an opioid overdose. Given as a nasal spray, auto-injector, or injectable, naloxone can be purchased from most pharmacies without a prescription. If you or someone you know is at increased risk for opioid overdose, you should carry naloxone and keep it at home. People who are taking high-dose opioid medications (>50 morphine milligram equivalents per day) prescribed by a doctor and people who use opioids and benzodiazepines together should also carry naloxone, according to the CDC.

Opioid Education

To help educate about the dangers of substance abuse, MRHC will be hosting a variety of trainings in partnership with New Opportunities of Carroll in the upcoming weeks. The first training will be held on Monday, August 29th from 6-7pm in MRHC Conference Room 1. The first half hour will teach about common misused drugs, how drugs impact the body and brain, and the risk factors of a substance use disorder. The second half hour will focus on the “Stigma Associated with Substance Use Disorder”, in which participants will learn what stigma is, the consequences of stigma, and what you can do to change stigma.

The next training will take place on Monday, September 26th from 6-7pm. It will teach what an opioid is, types of opioids (licit and illicit), consequences of opioid misuse, and what resources are available to address opioid misuse in your community. Participants will also learn about the effects of opioid and stimulant polysubstance use on individuals, the intentional and unintentional reasons for polysubstance use, and the community level strategies to reduce the risks associated with polysubstance use.

Recovery Center Services

If you or someone you care about has problems with substance abuse, help is available. The sooner a person can get help, the better the long-term chance for recovery. If you feel that you need help or guidance, contact the Recovery Center at (712) 655-2300.

The Recovery Center is a 16-bed, co-ed chemical dependency facility located in Manning. Services include detoxification, residential treatment, outpatient treatment and consultations or evaluations. Recovery Center staff have adapted treatments to meet addiction issues, from alcoholism to meth to the abuse of prescription painkillers. For four decades, staff have helped clients take their first step toward healthy, drug and alcohol-free lifestyles. For more information, visit www.manningrecoverycenter.com.

The Past, Present, and Future of the Recovery Center

Recovery Center 40th

The Recovery Center at Manning Regional Healthcare Center has been providing substance abuse recovery services in western Iowa for 40 years. To celebrate, all friends of recovery are invited to join The Recovery Center staff on August 6, 2022, at the Manning Hausbarn-Heritage Park Konferenz Center from 11:00 am – 3:00 pm. This free event will include a luncheon, welcome from the Recovery Center Director, testimonials of recovery, and networking among all in attendance.

Before the Recovery Center celebrates this milestone with the community, we wanted to reflect on the center’s history to see how far it has come, share what the Recovery Center is like now, and see what is in store for the future of substance abuse services in Manning.

The SAT Unit

In 1982, the Substance Abuse Treatment Unit, known as the SAT Unit, was established at Manning General Hospital after it became evident that substance abuse recovery services would fill an unmet need in the area. Since state funding was not an option, Health Resources, Inc. of Chattanooga, Tennessee worked with Manning General Hospital to establish the SAT Unit and an agreement was made for Health Resources to develop and manage the SAT Unit. The Iowa Department of Health issued the center a Certificate of Need, and clients were first accepted for residential treatment on January 17, 1983.

“The SAT Unit was the only hospital-based program fully functional with residential, outpatient, and support groups in Iowa at that time,” shared Denny Garvis, the Recovery Center director from 1990-2007. “We were also the first hospital-based program in Iowa to get a three-year licensure and 100% in licensure review. And those achievements had nothing to do with me, it was all the staff. Staff is key, and I had a tremendous team,” Garvis reflected.

Dr. Myer & Dr. McNerney were the beginning medical directors for the 12-bed SAT Unit. They initially started off with five staff members and provided residential and outpatient services. They also provided dual diagnosis/co-occurring disorder mental health services with Dr. Jerry Catron – treatment services that were groundbreaking at that time. The center was also able to host DMACC nursing students for 15 years through a DMACC nursing professor, Pam Garvis, so they could get a background in substance abuse and addictions, which was unheard of at the time. These experiences are still rarely offered in nursing education programs.

The Recovery Center eventually established outreach EAP and SAP programs in Atlantic, Carroll, Ida Grove, and Denison. When it came to outpatient services, Medicaid played a big role since they would only pay for outpatient services if the treatment center was within the hospital.

Eventually, many programs around the state started switching to strictly outpatient treatment based on low census, and the SAT Unit soon faced the same crisis. The numbers were very low for both kinds of treatment and at the time, the MRHC hospital board was questioning whether to keep the SAT Unit doors open.

“My philosophy was that if we do the right thing, we’ll get patients and that will keep the doors open. I argued that if we could sustain one year of operating in the red, we could survive, and the board went along with it,” Garvis said. “As other similar programs went to just outpatient, we remained residential, and thankfully it worked because a year and a half later our numbers started to improve. Bill Ohde was a strong hospital board supporter for us to get the one-year probationary program, and without his input & support, I don’t think the Recovery Center would be here today.”

The SAT Unit’s name was later changed to “Manning Family Recovery Center” to draw attention to the expansive family support program.

“The name SAT was always cold to me,” Garvis explained. “When we decided to change the name, we had a contest for the staff and that’s how we came up with Manning Family Recovery Center. It best identified what we did because the family component is key to recovery.”

After 33 years in a historic hospital on Main Street in Manning, the Center moved to its present location at 1550 6th Street in 2014 when Manning Regional Healthcare Center moved. The new space allowed for more natural light in patient rooms and space for indoor and outdoor recreation. Finally, to simplify outreach efforts, the center shortened its name to the Recovery Center in 2018.

As Garvis reflected on how the Recovery Center operated in the 80s, 90’s and 2000’s, he shared a few key takeaways:

“We are very proud of what has happened here over the years, but if there was anything in treatment that we could have improved on back then, it would have been working harder to help clients understand that you can still have fun and not drink and use. We always struggled with that,” Garvis said. “We tried to have as many social functions as we could to introduce people to the ‘real world.’ Our intent was to help them understand that 90% of the population drinks and uses, and that’s the world they’re going to function in when they leave treatment.”

While many things have changed and evolved within the Recovery Center, one thing that has unfortunately not changed is the stigma associated with substance abuse.

“To say that low income or minorities are the ones that need treatment is false,” Garvis said. “We have treated politicians, several mayors, doctors, lots of nurses, lawyers, administrators, ministers, priests, and paramedics,” – the number one profession of individuals the center currently treats.

Garvis went on to explain how the stigma and embarrassment that goes with addiction can deter people from seeking treatment services. He also points out the advantages of receiving treatment services at The Recovery Center in Manning.

“The credit to this place is that it is very private and secluded. Once clients get here, they understand that nothing is going to leave here without their approval,” Garvis shared.

The Recovery Center Now

The Recovery Center’s staff now consists of 11 full-time staff and five as-needed staff. The multi-disciplinary team includes the medical director, an administrative assistant, 24-hour nursing services, four licensed substance abuse counselors, two full-time and four part-time counselor techs, a nurse care coordinator, family therapist, licensed clinical coordinator, psychologist, and a director. The center also has a 16-bed capacity but can overflow into the hospital if needed. There are two people to a room and each room has their own bathroom and shower.

“We have never been empty, and we always have a significant waitlist. The average wait time right now is four weeks,” said Recovery Center Director, Taya Vonnahme, MSN, RN, ARNP, tCADC. “But if someone were to walk in right now, we’d find a bed for them. We’ll overflow as much as we have to. I won’t turn anyone away.”

Other than having additional space if needed, another main factor that differentiates Manning’s treatment program from others in Iowa is the fact that the Recovery Center is a department within MRHC, a critical access hospital.

“Being connected to the hospital allows us to easily access all possible modalities of care from lab, radiology, nursing, specialty clinic services, and more,” shared Vonnahme.

It also allows the Recovery Center to take patients who have extenuating medical backgrounds and several who have significant medical issues as they can be seen by specialty providers at MRHC during their stay.

The co-ed chemical dependency facility offers services such as detoxification, residential treatment, outpatient treatment and consultations or evaluations.

“Our services continue to change and grow,” shared Vonnahme. “Currently, we provide treatment at four levels of care from detox, residential, and three options of outpatient treatment. Everyone can benefit from one of the types of services and most clients follow a steppingstone path and will work their way down through their specific treatment plan.”

The Recovery Center bases treatment plans on evidence-based practices, incorporating therapies and strategies proven to have successful recovery outcomes for previous addicts. The 12-step framework and other therapies and services are utilized to facilitate the recovery process. The licensed counselors follow best practices by individualizing each treatment plan, so they are specific to each client’s needs and goals.

“For example, outpatient services can be varied based on how many hours a week someone needs,” explained Vonnahme. “We mostly focus on intensive and extended outpatient treatment each week. These levels are usually completed by someone after they finish a residential stay, but it does not have to be that way. There are outpatient clients who never complete residential treatment and that is sufficient for them.”

Recovery Center staff have adapted treatments to meet the most pressing or newly emergent addiction issues, from alcoholism to the influx of meth to the abuse of prescription painkillers. The main goal for clients is to take their first step toward healthy, drug and alcohol-free lifestyles.

The Future of the Recovery Center

As the Recovery Center continues to grow and evolve, they have big goals for the future of recovery services.

“Our team continues to grow in many ways. We have started offering problem gambling and prime for life services (Iowa OWI course) and are working to add additional services, but it takes time,” Vonnahme said. “I hope to be able to dedicate much-needed time to a prevention program. This work is greatly needed, and we are striving to bring it back.”

While it is a top priority to expand prevention and outpatient services, they also want to emphasize the importance of mental health education.

“There are not enough services out there for mental health or addiction so we are trying to do the best we can in the short amount of time we have with the people that come in for treatment,” Vonnahme said.

Fortunately, the Recovery Center has an overwhelming amount of support and assistance within the hospital. MRHC administration and the board of directors recognize that that the Recovery Center is a key service line and part of the long-term vision and strategy of MRHC.

“I have a very good administration backing me who trusts and helps me,” Vonnahme shared. “That makes a huge difference being able to do this job because my administration team is pretty understanding of some of the issues with insurance and realizing that we’re doing the best we can with what we’ve got. They’re supportive when I want to take a risk and will let me try new things.”

In addition to a supportive administration, board of directors, and a determined Recovery Center staff, the Manning community is also a strong advocate for the center.

“We are fortunate for the support we get and always have as well as the community we’re in,” Vonnahme shared. “I’m very lucky with the staff, volunteers and support we have. The only reason I can do this job is because of the team, not only my staff in the Recovery Center, but hospital wide with billing and financial, administration, and others. It’s amazing how many people it takes to keep something like this afloat and the communication and skills you have to bring together.”

To learn more about substance abuse services at the Recovery Center and celebrate the 40th anniversary, RSVP to the August 6th event by calling (712) 655-2300. For more information about the Recovery Center, visit www.manningrecoverycenter.com.

What is Considered Alcohol Abuse?

Brad Madsen

By Bradley Madsen, Recovery Clinical Coordinator  

Summer is here and that means more people are out socializing and enjoying a beverage or two. However, have you ever wondered what constitutes drinking too much? Alcohol abuse is defined as “the habitual misuse of alcohol”, meaning that a person consumes excessive amounts of alcohol.

Here is a pop quiz. For each question you answer “yes,” give yourself a point.

1. Have you ever set out to have ‘a quick drink or two’ but ended up having more drinks than you intended? Or did you stay at the bar drinking past the time you said you’d be home for dinner?
2. Have you ever thought “I really want/need to cut down on my drinking”, but struggled to do so?
3. Have you ever spent more time drinking alcohol or recovering from drinking than you would like?
4. Do you ever crave or have a strong desire to have a drink?
5. Have you missed major role obligations (work, school, or home) more than once because you were impaired or busy drinking?
6. Do you continue to use alcohol despite persistent or recurrent social (or interpersonal) problems caused or made worse by drinking alcohol?
7. Have you continued to drink despite knowing you have persistent, or recurrent mental or physical health problems caused or made worse by alcohol use?
8. Have you given up or reduced social, occupational, or recreational activities because of alcohol use?
9. Have you used alcohol when it was dangerous to do so? (Drinking and driving or drinking despite liver problems).
10. Have you noticed that you have developed a tolerance to alcohol? (It takes more alcohol to feel buzzed than it did in the past. Or you notice you can drink more now without feeling as impaired as you might have in the past).
11. Do you ever feel ill when you don’t drink for a couple of days?

These questions represent the diagnostic criteria for alcohol use disorders as defined by the DSM-5 (Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition)

Scoring:
2-3 “yes” answers – You may have a mild alcohol use disorder.
4-5 “yes” answers – You likely have a moderate alcohol use disorder.
6+ “yes” answers – You likely have a severe alcohol use disorder.

If you (or someone you know) meet the criteria for an alcohol use disorder, you aren’t alone. According to the NIH, one in eight Americans meet the criteria for alcohol use disorder. Does this mean you are an ‘alcoholic’? Not necessarily, but it does mean that you are putting yourself at risk to develop alcoholism.

If you or someone you care about has problems with alcohol (or other substances), help is available locally. The sooner a person can get help, the better the long-term chance for recovery. Alcoholism is a disease, not a moral failing, a choice, or weakness. If you feel that you need help or guidance, reach out to your physician, or contact the Recovery Center at (712) 655-2300.

The Recovery Center at MRHC is a 16-bed, co-ed chemical dependency facility located in Manning. Services include detoxification, residential treatment, outpatient treatment and consultations or evaluations. Recovery Center staff have adapted treatments to meet the most pressing or newly emergent addiction issues, from alcoholism to the influx of meth to the abuse of prescription painkillers. For nearly four decades, staff have consistently helped clients take their first step toward healthy, drug and alcohol-free lifestyles.

For more information about the Recovery Center in Manning, visit www.manningrecoverycenter.com.