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Desert Companion

Health: ‘Housing is healthcare’


Well Care CEO Marce Casal in a room at New Hope Motel
Photography by Brent Holmes

A local company has a novel idea for improving healthcare for the poor: putting disconnected services under one roof

You wouldn’t normally think of a motel on Fremont Street as a beacon of optimism, but then there’s the New Hope. It blends in with Fremont’s southward stretch of used car lots, weekly apartments and locals casinos, but it’s anything but another flop. The rooms have newly painted walls, new laminate floors and IKEA furniture. But beyond good looks, this modest halfway house, which opened in June, is aiming to solve some big problems in healthcare and mental health services for the poor.

“Housing is a form of healthcare,” says Marce Casal on a recent morning as he gives a tour of the renovated motel (formerly the Lamplighter). Casal is president and CEO of The Well Care Group, which owns and operates New Hope. “Until you fix that basic human need for shelter and food, all the other health services become a challenge. That’s what this facility can do — provide short-term transitional housing so we can provide people time to work on their social-service needs.”

It’s a simple idea with a lot of moving parts. More than just running a transitional home, Well Care has plugged into the New Hope Motel all the other services that, say, a recovering alcoholic or mental health patient might be told to take advantage of but never follow through on — and thus fall right back into their addiction or depression. At New Hope, for example, a case manager makes sure members get rides to doctor appointments, and schedules therapists for on-site group sessions. Medications are delivered to the motel, made possible by the fact that Well Care also has a pharmacy arm. There’s no excuse for anyone to miss a doctor visit, a therapy session, a pill, a job interview. It’s those seemingly minor cracks and gaps — a forgotten medication or follow-up physician appointment — that cause many a patient to veer off the precarious path to recovery.

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“The key is reducing fragmentation,” Casal says. “It’s very challenging to get resources, especially if you’re indigent and homeless. How do you get around? How do you get to go see a bunch of different professionals and make your appointments when you don’t have a home? What we ended up developing was a comprehensive program where we could provide all lines of services under one umbrella for one person.” One goal is to keep the poor and homeless struggling with addiction and mental health problems out of local emergency rooms. Unnecessary emergency room visits add $4.4 billion annually to the nation’s healthcare costs, according to a widely cited 2010 RAND Corporation study.

Well Care, which began in 2007 as a pharmacy but sold most of that off in 2013, got into the behavioral healthcare business after it was approached by Amerigroup, a company that serves Medicaid and Medicare recipients in 12 states. Amerigroup wanted to save money; with its pharmacy programs, Well Care had already earned a reputation for trimming healthcare costs by reducing hospital readmissions. The company operates two behavioral healthcare clinics in Las Vegas and began operating one in Reno in December. Most of Well Care’s clients live in transitional homes dotted throughout the valley, but Casal hopes that the more centralized and efficient New Hope Motel model catches on. So far, Casal estimates, more than 3,000 clients have gone through Well Care’s 30- to 45-day program.

Johnn Ventimiglia“Without Marce, I’d be either dead, drunk or stoned out of my mind,” says Johnn Ventimiglia, a former client. Ventimiglia says the death of his wife in 2014 from breast cancer, and the death of his oldest daughter in 2015 by a drunk driver, sent him into a tailspin. “I was clinically depressed, emotionally wrecked, spiritually bankrupt.” He lost his job as a chef on the Strip, and eventually entered the Well Care program in March 2016. “It’s a one-stop shop,” he says. “You can get your medical, your psychiatric, your therapy.” Today, he’s an executive for a trucking company he founded with a friend. “Marce and Well Care literally saved my life.”

Whether the company will continue to save lives is up in the air, given the cloudy future of the Affordable Care Act; all of Well Care’s clients are Medicare or Medicaid recipients. Casal is loath to speculate about what will happen to New Hope and Well Care’s behavioral clinics if the ACA is repealed. “I believe it’s going to be a little bit of time before anything will be done, but no one’s certain on how that will impact us.”

Annabella SilvaMeanwhile, the program continues to impact lives. Annabella Sliva, 62, is a current client. In January, Sliva, a retired card dealer, ran out of money and was facing eviction. She fell into a depression and attempted suicide by stabbing herself in the stomach. After a stay in Montevista Hospital, she was introduced to Well Care’s services.

“If I only knew about Well Care, I would have never, ever tried to take my life. Never,” she says. “I was so blown away when the case manager asked me what kind of help I needed. I’ve never asked for help. But you know what? It was about time to learn it was okay to ask for help. There’s nothing wrong with it. You could ask for help.” 

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