How people suffering from behavioral health issues are getting COVID-19 vaccinations, with Natasha Hennessey, Chief Pharmacy Officer for Genoa Healthcare.
Some people remain unvaccinated against COVID-19 because they are hesitant or hard to reach. People suffering from behavioral health issues are especially challenging to vaccinate -- and the Delta Variant makes vaccinations more critical than ever. In this episode, Natasha Hennessey, Chief Pharmacy Officer Clinical Services with Genoa Healthcare, details her organization's efforts to vaccinate people who suffer from behavioral health issues.
Ira Apfel 00:06
Hello and welcome to UnitedHealth Group’s Weekly Dose Podcast, where we'll get you up to speed on the latest trends shaping the future of health care. I'm your host Ira Apfel. The nation's COVID-19 vaccination rate continues to rise, but some people remain unvaccinated because they are hesitant or hard to reach. In particular, people with behavioral health issues are especially challenging to vaccinate. People suffering from behavioral health issues and substance use disorders face a higher risk of severe illness from COVID-19 infection due to poor general health and factors such as lack of access to health care, and permanent housing. And the Delta Variant only makes matters worse. However, finding show that providing vaccination clinics parallel to mental health services can increase vaccination rates by up to 25%. To learn more about efforts to vaccinate people who suffer from behavioral health issues, we're going to talk to Natasha Hennessey. She's the Chief Pharmacy Officer Clinical Services with Genoa Healthcare. Natasha, welcome to the podcast.
Natasha Hennessy 01:11
Thank you. I'm happy to be here.
Ira Apfel 01:13
So let's talk about Genoa Healthcare. Who are its customers and how does it fit into the larger UnitedHealthcare picture?
Natasha Hennessy 01:20
Yeah, so Genoa was one of OptumRx's pharmacy care services lines of business, we have almost 600 locations we actually opened number 582. Today, in Connecticut, we have those 600 locations are located within 47 states and the District of Columbia. And generally they are co located with Ana community mental health center. General is the largest behavioral health care pharmacy in the United States. And we really focus on specializing and serving the needs of those with behavioral health addiction and complex chronic issues.
Ira Apfel 01:52
So there, there are almost 600 locations now. How long has it been with UHC?
Natasha Hennessy 01:58
So we were acquired back in October of 2018. So coming up on three years.
Ira Apfel 02:04
Okay, and what are some of the services that Genoa provides. And is vaccinating patients, typically one of them? Or is this kind of a new service that you're trying out?
Natasha Hennessy 02:14
Yeah, so it really is a natural add on service, given the services we've already provided to date. So we are located on site within the clinic, which really allows our pharmacists to be a part of that clinics care team. So we're able to help with therapy optimization, we fill in synchronize all medication, so they're filled at one time each month, we're making proactive outreach for refill dues for the patients, we have a range of medication packaging, and deciding on which one fits best for the patient's needs. We offer free medication delivery, and we have historically offered flu vaccinations and things like pneumonia and shingles. And so COVID was just a natural addition to that. I will say, however, that COVID has really put a magnifying glass on the impact we can make as you think about immunizations in the behavioral health population.
Ira Apfel 02:58
So I would also imagine that there wasn't that much training to do in the sense of it's just a different type of vaccination to give out, is that correct?
Natasha Hennessy 03:06
Yeah, that is correct. There's some you know, specifics around, you know, monitoring after vaccination and some reporting requirements that were a little bit different. But in general, it was a very, you know, a custom activity that we'd already been doing.
Ira Apfel 03:19
I'm curious, how did the covid 19 pandemic affect Genoa and its patients, particularly at the beginning, where everybody was scrambling?
Natasha Hennessy 03:26
Yeah, great question. Um, definitely a huge impact. I mean, as you think about those community mental health centers that we are co located within, it was nearly nine out of 10, after the pandemic hit, that had shifted to telehealth. And so they're providing the majority of their care to their patients telephonically or via a video platform. And so we were able to keep the doors of our pharmacies open in most cases to ensure that our patients got their medications. And we really focused on ensuring that they had the access that they needed. And what we found out is that we were really that bridge between the provider and at the CMHC and our patients, and how
Ira Apfel 04:03
are you able to keep the doors open? Because that sounds like something that was potentially really fraught for a lot of reasons.
Natasha Hennessy 04:10
Yeah. So huge, huge kudos and appreciation to our frontline staff, that were able to show up every day to ensure that the medications were filled for their patients. You know, we were able to accommodate social distancing guidelines, and that really shifted telehealth by increasing, you know, Home Delivery that we had already offered prior to the pandemic and of course, then offering curbside pickup as well just to ensure that the consumers are receiving their medications where they felt safe.
Ira Apfel 04:38
How did you manage to communicate all this to your patients, because they're probably also hearing in the news, and they have to stay at home. And they don't have any opportunity to go in for appointments because no one's really allowed outside at the height of the pandemic. And yet for COVID-19 vaccinations and for testing. They had to come in and wow Communicate all that to them?
Natasha Hennessy 05:02
Yeah, that's a great question. And you know, one thing to point out is it was a continual engagement for our staff. And what I mean by that is we made a huge effort once the pandemic hit to maintain those connections with our consumers. So the manual outreach phone calls that we were doing just continued and even enhanced to ensure that our consumers were doing okay, amongst a very uncertain time, I'd love to share with you an example, we have one of our consumer medication. We have one of our consumer medication coordinators, who was contacting a consumer for a routine refill reminder call. It talked about this gentleman's medication for a minute or two. And then he shared with her that it was nice to hear from someone. It turned out he hadn't talked to anyone in over two weeks. He said that he was feeling overwhelmed that he was anxious about COVID, he had canceled all of his appointments with any health care provider that he already had scheduled. And he mostly stayed in his room in a shelter. Their call ended up lasting about 2020 minutes or so. And he said it made him feel like somebody cared about his wellbeing. And critically, it also meant that his prescriptions were refilled. And he was staying on his medication therapy.
Ira Apfel 06:07
That's pretty amazing. And I imagine that it was like that for a lot of patients. Is that correct?
Natasha Hennessy 06:11
It really is. Yes, it was just I mean, it was a continual connection point with our patients. But again, a more enhanced conversation around how are they doing through throughout everything that was going on?
Ira Apfel 06:21
And how normal is it for Genoa to manually call all of its patients? Is that a normal tactic?
Natasha Hennessy 06:27
Yeah, it really is. So we pride ourselves on providing high touch pharmacy care services, to you know, generally underserved or vulnerable population. And so that manual outreach, where, you know, our pharmacist or pharmacy technician is picking up the phone and manually dying and having a conversation is extremely important in their care journey.
Ira Apfel 06:47
I'm wondering, why did you decide to do COVID vaccinations? I'm thinking maybe someone else could have said, you know, that's not really what we're here for. It's not really what we do. It's too much of a challenge. And we're just trying to do our other daily tasks and other our other daily services, what made you decide to go forward? And do the vaccinations?
Natasha Hennessy 07:12
Yeah, so I think for us, it wasn't even really a decision. It was, hey, here's a solution. And we knew that we were going to be part of that solution. I mean, as you think about pharmacy providers throughout the country, and how we were always able to increase access to immunization. This was just another example of that. And I think to call out as we think about our clinic partners that were co located on site with, and most importantly, our consumers that are challenged to have access to, you know, immunizations, it was just the right thing to do. We knew we had opportunity support the population we serve. Primarily, those are people with mental illness and substance use disorder. And it really was in an unprecedented time when things were so uncertain, but people with behavioral health issues tend to be underserved and overlooked in terms of primary care and other social services. And so they don't have permanent housing, they may not have the strong, strong support networks. And they often depend on our pharmacies, and our behavioral health clinic partners for services and support. So just given all of that we knew it was the right thing to do. And it was something that we were going to make every effort to happen.
Ira Apfel 08:13
And I imagined way back in January 2020, when people are already talking about the idea of vaccinations, you probably were thinking, what does all that mean for genuine? What are we going to do? How are we going to start preparing for it? Is that how things worked out?
Natasha Hennessy 08:28
Yeah, it really was, is what did we have to put in place? You know, as those vaccines were developed to ensure that when they became available, and we were able to receive them in our pharmacies, we were ready to go and provide those vaccinations in a timely fashion. And so it was ensuring that the proper procedures were outlined that we had the right storage requirements checked off, and that we really had a proper end to end process from start to finish for the administration,
Ira Apfel 08:55
So, what a vaccination rates look like for patients with behavioral health issues. Are they higher or lower than the general population?
Natasha Hennessy 09:04
So if you just think about broadly, vaccinations, they are generally lower, we've seen limited studies where they may be as low as 25% of a population receiving a flu shot, for example. And so you know, as it relates to COVID, specifically, I haven't seen any specific details on that come out, but as you think about you know, there being a 55% vaccination completion rate today. I would say the anecdotally the severe mental illness population is much lower.
Ira Apfel 09:30
What did you learn, as you were developing your protocols for vaccinating patients against the Coronavirus?
Natasha Hennessy 09:38
Yeah, I think there's a couple of different things. I think that what we have, you know, talked to our pharmacy staff about and what they have been really great at is that every touchpoint that they have with our patients, and even with our clinic partners, as they've engaged with the patients, as services have come back online, is having that conversation about the COVID vaccination have they had the vaccination already? If they haven't, why can we talk about Where your hesitancy is coming from or why are you concerned? We have one example. Our pharmacist who resides in Marshall, Minnesota, she's given just over 800 immunizations herself. And she had a couple that are both patients of ours at the pharmacy and the mental health center where we are located. And they're really nervous about the vaccine had a lot of questions. Shannon, our pharmacists was able to talk to them address their fears and give them information to consider. They took that information away; they call back the next day and made an appointment which they kept. And they came back for the second shot. So huge success story there.
Ira Apfel 10:35
So what did you and your colleagues learn overall from the vaccine project?
Natasha Hennessy 10:40
So as I think about, you know, US historically, providing immunizations we've done so kind of as a Hey, we're a pharmacy, we provide immunizations, but as we think about COVID, and all the efforts that we have put into processes and supporting our pharmacists and pharmacy technicians, I think as we move into the flu season, we are very well positioned to continue to provide that care to our patients maybe in a way that we haven't historically been. I do think there's other opportunities to think about expanding other types of services, when you think about point of care testing will always obviously or fall back on and offer our traditional pharmacy services. But how do we expand the scope of what our pharmacists and pharmacy technicians can provide to our clinic consumers?
Ira Apfel 11:21
Well, Natasha Hennessy, thank you so much for joining us in the podcast today.
Natasha Hennessy 11:25
Thank you. It's been my pleasure.
Ira Apfel 11:27
That's it for this episode of UnitedHealth Group’s Weekly Dose Podcast. Thanks for listening and have a great rest of your week.