Here’s the second installment of the Green Hill playbook for navigating COVID-19 and a recessionary economy. While our last post was sent as programs around the country were responding to a rapidly changing situation, this post is focused on embracing the ‘new normal’ – the environment in which we’re all operating. We will be addressing items according to our established framework below. 

1. Family Communications 
2. Policies & Procedures 
3. Programming Changes 
4. Family Financial Considerations 
5. Leadership and Staff Management 
6. Recession Planning

If you would like to see more details regarding anything you see in this post, such as our parent communications or detailed procedures, please reach out. We would also welcome any feedback or further suggestions. 

Family Communications

Communication with families has pivoted from a focus on easing fears towards more of an acceptance of the ‘new normal.’ Thus, we’ve launched a weekly newsletter for our transitional living families.

Elements for an Effective Newsletter 

1. Highlight changes to policies and procedures in response to COVID-19.
2. Demonstrate the importance of remaining focused on treating mental health and substance use. 
3. Focus on the positive elements of your programming and how it’s evolved. 
4. Reassure families that they are part of the treatment alliance. 
5. Acknowledge anxiety surrounding public health AND the economy. 

Policies & Procedures 

We are continuing to build on our previous changes to our day-to-day operations and admissions procedures, while practicing strict enforcement of any COVID related policies we have adopted. We have continued to communicate ongoing changes to parents and residents and have held updated training for all staff. 

Stay at home: Wake County has issued a mandatory stay at home order. We are requiring all staff to abide by the order during non-working hours and are modifying treatment plans to abide by the order. We are considered an essential business, and thus, we will remain fully operational. However, we are taking all necessary precautions to ensure the safety and welfare of our community. 

Updates to our list of procedures have been underlined.

Admissions: 

• Added screening questionnaire criteria for COVID 19
• Quarantine policies for new residents, if necessary
• Medical assessment upon arrival
• Requiring new admissions to avoid flying

Operations:  

• Continued to update our program schedule to facilitate a wider range of active and engaging programming within Green Hill’s facilities:
  • In-house 12-step, Recovery Dharma, and SMART meetings 
  • In-house workout and fitness sessions 
  • Peer planned and facilitated activities
  • Outdoor experiential programming 
• Restricted all non-essential community activities, outings, and programming 
• Cancelled all non-essential resident travel 
• Provided further education and training to our staff and residents on social distancing practices and healthy community living procedures
• Conducted early refills of all resident medication 
• Initiated updated academic schedules to ensure structure and support for residents transitioning to remote learning
• Updated twice daily cleaning protocol 
• Updated staffing model for potential time away for illness
• Switched community outpatient to full telehealth
• Established relationship with local PCP for testing, COVID screening
• Introduced grocery store pickups, with residents now ordering groceries online, and staff picking them up. 
• Nightly temperature checks

Program Updates

Maintaining milieu is our chief concern for residents. We have also had to practice a healthy dose of self-forgiveness, as there is no formula for how to operate within these constraints. Our main programming effort continues to be the Van Dyke Olympiad, with events being added each day. Our biggest success for the olympiad is staff engagement. This creative solution to our current predicament has allowed our clinical team to engage with residents in an entirely new and more natural way. As most of our program staff is in recovery, increased staff involvement at the house has also given a unique opportunity for our team members with more significant time in sobriety to show residents that this pandemic is difficult for everyone in recovery. 

Last Week’s Highlights: 

• Favorite event: Spike ball tournament
• Looking forward to: Iron Chef (Apocalypse Edition), Trivia 
• Made us laugh: Ryan coming in on his day off just to compete

We have also placed a greater emphasis on physical health and well-being by starting a peer-led workout program at the house and yoga & meditation sessions being led by Tripp. Our goal has been to provide a safe quarantine environment that is both structured and stimulating. We have also asked for the help of the local 12 step community in maintaining a connection with Green Hill. We have continued to develop a more robust in-house meeting format, bringing speakers for in-house meetings over Zoom. We are also participating in Zoom meetings with our resident’s home groups and favorite local meetings. 

Financial Considerations for Families

Our strategy of proactive family communications regarding finances has helped us to protect our revenue and keep our clients engaged in the program. While we had no formal financial communications in the last week, we have had a number of calls with parents to discuss their updated financial situations. We can say we would have had 2-3 clients leave almost overnight if we were not willing to provide financial support to families. 

While we have done a great job of working with existing clients and families, we are worried that extended care options will be less appealing simply due to financial uncertainty. Our next goal is to more proactively communicate this information to incoming admissions and potential clients. Green Hill has scholarships available, and we would hate for motivated candidates for extended care to head home after primary treatment simply because of finances. We are a purpose driven organization, and we believe extended care is even more important in this environment. We would urge other programs to make necessary accommodations in an effort to prove to the world that we will always put quality care above financial motivations.

Leadership: Combatting Fatigue 

We continue to place an emphasis on combating the mental fatigue associated with our current circumstances. The 15 minute daily pulse calls for the leadership team have been vital in keeping the team focused and motivated, but also as a barometer for our collective wellness. On the first few calls this week, it was clear that fatigue was setting in. These calls give us an opportunity as owners to hear our people and figure out which members of our leadership team are running out of gas and need some extra recognition or attention. 

The Green Hill leadership team has a dedicated ‘war room’ where Tripp is working around the clock. These uncertain times have an impact on our residents, their families, and our staff. To combat the quarantine fatigue, our leadership team has developed a check-in roster to ensure that our team is functioning at 100%. 

• Dedicated space and staff to monitoring and adapting to COVID-19 news
• Updating our team on best practices on a daily basis 
• Embracing our core value of ‘unity’ during trying times
• Continuing 15 minute daily pulse calls
• Continuing the use of our weekly check in trees

Recession Planning 

SBA / Federal Aid: We have spent a significant amount of time this week on the phone with bankers and accountants trying to make sense of the support offered by the SBA. The main applicable offering is the SBA Payroll Protection Program (PPP). While the details of this program have yet to be finalized, and rollout may be slow, we are in the process of finishing our application. We were recommended by our banker to ‘get in the queue,’ even if we didn’t need the funds right away.  At Green Hill, our staff is our biggest asset, and having the means to retain them is vital. This will also simultaneously show our staff that we are committed to keeping them, and their jobs are not in jeopardy. The PPP program gives low interest loans for payroll and rent, and includes forgiveness for payroll taxes. The plan allows businesses to receive 2.5x monthly payroll, but as we said, the details keep changing. 

Not out of the woods: The Federal Reserve and Congress have started to implement the largest ‘bailout’ package in the history of the nation. In the face of a national credit crunch, the Federal Reserve issued a sweeping implicit guarantee for bond markets, while Congress gave much needed aid to small businesses and citizens. These measures calmed markets, and brought peace of mind to the nation, but we are by no means through the worst of this in an economic sense. We are continuing to monitor our financial situation and planning for the worst. We are urging program directors and owners to continue to proceed with caution, and use this time to prepare their business for a recessionary environment. 

Just to reiterate, please contact us if you would wish any more detail regarding any of the topics we covered above. Acting quickly in this environment and staying collaborative may save us all. 

Mindfully,