Trying To Work Out A Solution To The Opioid Crisis

Trying something new:

In late February 2019, Nikki was in a meeting with hospital administrators when one said, in an offhand way, that Medicaid wouldn’t reimburse the hospital for the CADS program, because it was housed at the courthouse and not in a medical facility. He proposed that they shelve the program, and Nikki felt her composure slipping. Maybe they could use a hospital-owned practice in Batesville, someone else suggested. But that was half an hour from the courthouse, too far for many patients. Another practice was closer, just 10 minutes away. Maybe they could co-opt the break room, move a refrigerator around.

That was when Nikki lost it, right there in front of the administrators—all of whom were at least two decades her senior. Housing a medical program inside the courthouse had been the whole point, the key to finally making the medical and legal systems mesh. It was the heretofore-missing component, a way to coordinate the carrot and the stick. The fact that people like Gessendorf and Schmaltz knew each other so well now—their quirks, their backstories, the names of each other’s spouses—those relationships, Nikki argued, were what made the program work.

But then she had an idea.

“Why can’t I just buy part of the courthouse?” Nikki asked. They could wall off one side of the conference room they were already using and the hospital could rent it for $25 a month. The county commissioners would have to sign off, as would the judges and Schmaltz, who worried, initially, about the appearance of spending taxpayer money to convert the space. But he was supportive. For the first time in some people’s lives, the cycle of jail to probation to relapse and back was coming to a close.