Louise Howell, PhD, has served as director of Kentucky River Community Care (KRCC) for nearly two decades. KRCC includes 40 sites in 8 rural counties in the Appalachian Region of southeastern Kentucky. In each of the counties comprising its service region, KRCC operates an eight-bed adult and a two-bed youth residential detoxification program, an intensive outpatient program for women, and an outpatient clinic, among other programs. The population served at KRCC has an average age range of 25–35 years and is predominantly male. The most common addictions for which people seek treatment include nicotine, alcohol, marijuana, and opioids.
Becoming a member of NIATx has been a system-changing experience, says Dr. Howell, now the Executive Sponsor for KRCC's change projects. "Decision-making and problem-solving have been delegated to the change teams," she explains. "They have become a forum for problem solving." Dr. Howell adds that the NIATx model has changed the way KRCC staff view their jobs. "By going through this experience, staff have learned a lot about their programs, and how to think strategically to improve them. It's influenced their interactions with other staff and with the clients we serve."