Taking time to sit for a conversation in our agency’s conference room, PSNNY’s Care Coordinator, Ashley Morris, exudes serenity and quiet focus. Ashley is a first generation American. Her parents immigrated to New York from Jamaica and settled on Long Island where they purchased a home in Brentwood. Attending Brentwood High School and completing her undergraduate degree from SUNY Old Westbury, Long Island has always been Ashley’s home. Ashley began working as a HARP Care Coordinator within PSNNY’s Health Homes Department right out of college. HARP, Health and Recovery Plan, is a special initiative within New York State’s Medicaid Managed Care System that provides an integrated set of physical, mental health and substance use services for clients with a history of repeated stays at hospital and treatment centers. Ashley explains PSNNY’s public-health approach to working with such individuals:
Over the past year, Ashley and Dylan partnered to get Ben medical care and mental health treatment. They were able to secure him an apartment which he could pay for using his disability benefits. Ashley notes that while she considers Ben a success story, she must strive to ensure that Ben maintains his sobriety and develop the practical skills needed to adapt to his new living arrangement. After spending ten years in prison and five years on the streets, he needs ongoing assistance to maintain his health plan while adjusting to a new lifestyle, one day at a time.
These past six months were particularly challenging for those Ashley serves:
By the end of March, the gyms closed; all the colleges shut down their campuses; there were no viable jobs on the horizon; recovery meetings and healthy outside activity were extremely limited. All of the things Jim expected he could rely upon to support his recovery disappeared as quickly as the pandemic hit our region. What’s worse, he no longer had access to in-person contact with Ashley. During the height of the shut-down this spring, care coordinators throughout agencies on Long Island were not able to make personal visits to treatment centers and sober houses and were forced to rely solely on phone calls. Ashley sighs as she expresses feelings of grief mingled with a sense of helplessness around Jim’s misfortune. She explains that she was unable to detect the signs of Jim’s decline, and was surprised to learn from his wife in early June that his lifeless body was found by the staff at the sober house: “The last time I spoke to Jim was the end of May. He said he was doing well and he was happy, but clearly he was not. What bothers me is that if I could have made personal contact with him, I might have seen with my eyes what I could not detect over the phone. Maybe his expression or affect or body language could have revealed something about the crisis he was in.” Ashley is convinced that if Jim had been able to work on his recovery plan, he would still be alive. He was yet another casualty of this pandemic. While Jim may not be counted in the official COVID-19 death toll, he died from a pervasive despair brought about by the fallout around this pandemic on Long Island.
The ability to respond effectively to clients with acute needs requires a high level of skill, notes Ashley. She explains that accurate assessment and meaningful relationship building enable clients to develop the self-efficacy they need to navigate the dauntingly complex systems of services aimed at keeping them well:
When asked what the tragedy of this pandemic has taught her, Ashley returns to thoughts of Jim. She explains how his death reminds her that she cannot simply take a client’s word at face value during a crisis. Despite all her efforts to remain responsive and in close contact with Jim, phone outreach ultimately proved inadequate:
While the challenges around COVID-19 may be new, lack of resources is not. Ashley points out that she is grateful to work with a responsive and skilled team of professionals committed to solving problems. They will continue to work together to find solutions to support their clients. This is an ongoing process that never ends, but it is fused with a hopeful collaborative effort that will continue.