Liberty Resources’ longtime CEO on the role agency plays in Central New York, the impact of COVID-19 on the delivery of services and the organization’s new 8,000-square-foot facility in Fulton
By Mary Beth Roach
‘We’re actively emerging into the autism arena. We started this recently in conducting comprehensive, diagnostic evaluations for children who may be assessed as being on the autism spectrum. There is a significant backlog of children needing diagnostic assessment from Binghamton to the Canadian border. We are receiving referrals from as far as the Adirondacks and beyond.’
Carl Coyle has served as chief executive officer for 31 years for Liberty Resources, a health and human services organization in New York state and Texas. In this interview, Coyle focuses on the agency’s work in Central New York, discusses the impact of COVID-19 on the delivery of services, and talks about the organization’s new 8,000-square-foot facility in Fulton.
Q: Can you outline some of the specific services that Liberty Resources offers?
A: Liberty Resources operates six service domains or areas of practice which we focus on. We started out as a mental health organization. That was our genesis in 1979. We still operate mental health and behavioral health services today. The second area we started growing into was developmental disabilities.
We then moved into child welfare services, providing foster care and preventative services. Oswego County was an instrumental county when we started expanding, particularly in foster care. A fourth area is now care coordination as a health home under the Affordable Care Act for children and adults; providing care management and care coordination throughout CNY. As a fifth sector we break out our clinics – both our behavioral health and primary care clinics into its own division. We have a vice president who oversees our clinics due to their size, scope and geography [Syracuse Fulton, Rochester and 42 schools].
The recently constructed building in Fulton at Crossroads Park provides both primary care and behavioral health, including substance abuse treatment. The sixth area is early intervention and autism treatment services. We are providing services for children who are developmentally delayed or have a cognitive, developmental or physical limitation for children birth to three. That encompasses following them as they transition into school age, 3 to 5. This predominantly consists of the disciplines of physical therapy, occupational therapy, speech language therapy and special education. We’re actively emerging into the autism arena. We started this recently in conducting comprehensive, diagnostic evaluations for children who may be assessed as being on the autism spectrum.
There is a significant backlog of children needing diagnostic assessment from Binghamton to the Canadian border. We are receiving referrals from as far as the Adirondacks and beyond.
Q: You cover such a broad spectrum of issues and care. What was the impetus for growing?
A: I can illustrate that very well when we expanded into Oswego County. It was community need. For example, around 1990-91, I was having a conversation with the regional director of [the state’s] Office of Children and Family Services, and he said, ‘I’d like to introduce you to the DSS commissioner in Oswego County because they’re placing a significant number of children out-of-county into institutions.’ It’s very expensive and it’s not always optimal separating children from their families. There was a community need. We responded to that.
The new building [in Fulton] is an example of community need. By most measures, [Oswego County] is substantially more service poor and service needy. Statistics indicate it’s the second most impoverished county in the state. Of the top 20 reasons for death in the county, five of them are related to behavioral health issues — suicide, overdoses and other conditions that are behavioral in nature. We saw a tremendous need for mental health services in Oswego County and that’s why we constructed that building and expanded our services.
Q: What counties do you serve?
A: The five primary counties of Central New York — Onondaga, Madison, Oswego, Cayuga and Cortland. We also go down into Tompkins, Tioga, Chenango, and we’re now in Monroe. We’re also across NYS and in Texas, but CNY is our home and our largest service geography.
Q: What is your agency’s budget?
A: Pre-COVID, it was about $82 million. In Central New York, that’s about 70% to 75% of that. Our early intervention program is down due to school closures but that will return to normal levels post-COVID.
Q: How are you funded?
A: We’re funded by Medicaid, county-based contracts and commercial insurance.
Q: How many employees does Liberty Resources have in this area?
A: In this area, about 1,100 to 1,200; overall about 1,600. The rest are distributed throughout the state and in Texas.
Q: As CEO, what do you see as the accomplishments of your job?
A: It was the fact that we’ve expanded so much and met so much community need.
Q: What are some of the challenges?
A: Obviously, COVID is a challenge right now. I would say the larger challenge that’s more systemic is the complexity of operating multiple services. The regulatory environment underneath that is really challenging.
Q: How has the pandemic impacted services?
A: For our residential programs — group homes for people with developmental disabilities, mental health; kids in foster care with foster parents; halfway houses for people experiencing substance abuse — obviously it’s still face-to-face. We had early-on challenges of availability of PPE, hazard pay issues, and how to keep staff and patients safe. On the ambulatory side, we moved very, very quickly to telehealth. The impact on the mental health delivery system is just through the roof. We’re operating at about 125 percent of normal capacity, maybe a little bit greater.
However, in our early intervention program, telehealth was not authorized prior to COVID. So there had to be regulatory change, emergency orders from the governor’s office, for children to receive services via tele. We’re doing that, but when you have to do physical therapy, it’s not fully effective. The children still need it in person. They have developmental milestones they really need to try to achieve, and services were significantly interrupted. The only option we had was tele because the state mandated that we could not go into the homes and do the services in a natural environment.
That’s probably serving around 3200 children pre-COVID. We’re treating about 65% now. There’s concern that the children that aren’t getting services are going to backslide and lose momentum. Then there are the children that aren’t getting into the system. A lot of these kids get referred when they are 2-3 because they’re preschool eligible. So, if they have a known condition or known diagnosis and not getting services, they are missing those developmental milestones. We’re not seeing typical levels of new referrals because the schools are so disrupted. The districts are going to see, over a period of time, more challenging kids because they’re not treated early. There’s also some evidence starting to emerge for children’s mental health that the level of trauma the children are experiencing is going to have long-term residual effects. The pandemic is really taking a toll societally on so many levels.
Q: What are some of your future goals for Liberty Resources?
A: We are seeing great opportunity to consolidate in the health care delivery space and the mental health delivery space. What we’re doing is a significant amount of mergers and acquisitions and expect that to continue over the next several years.