Before the COVID-19 pandemic, Turning Point Counseling Services in Fairbanks, Alaska, had no experience with remote care models. Like many small behavioral health providers, the organization had relied entirely on in-person treatment. But when stay-at-home orders hit and patients still needed access to mental health and substance use treatment, the team at Turning Point had to adapt quickly. That adaptation became a “trial by fire,” turning telehealth from an emergency response into a sustainable, long-term tool that continues to shape the organization’s future.
Shifting Overnight to Virtual Care
For Turning Point, the transition to telehealth was not gradual. According to Nick Kraska, the agency’s chief operating officer and CFO, the team had to act swiftly when it became clear that in-person sessions would no longer be possible. With thousands of active patients depending on their care, they needed an immediate solution to maintain treatment continuity.
Fortunately, the provider’s electronic health record (EHR) from InSync Healthcare Solutions already had telehealth functionality built in. While other providers were scrambling to adopt platforms and learn new systems, Turning Point was able to launch its virtual care program within 24 hours by working directly with its vendor. What started as a quick fix soon proved to be a workable, sustainable approach to delivering behavioral health services.
A Growing Patient Base in Alaska
Turning Point Counseling Services is a full-service behavioral health and substance use outpatient provider, offering everything from individual and family counseling to intensive outpatient programs for substance abuse. The organization serves approximately 2,000 active patients annually, with 13 counselors handling as many as 400 visits in the busiest weeks.
When the pandemic forced rapid changes, all of these services had to move online. What could have been a major disruption instead turned into a breakthrough moment. Patients embraced telehealth as a lifeline, and many continued to prefer it even after restrictions eased.
Telehealth Becomes the Norm
Six months after implementation, telehealth still accounted for 90% of Turning Point’s outpatient visits and 100% of its substance abuse intensive outpatient program (IOP) sessions. The adoption rate was far higher than expected. While some patients returned to in-person treatment, many found virtual care more convenient and less intimidating.
Telehealth even improved outcomes in some cases. The agency’s substance abuse program, for example, saw near-perfect attendance and unusually high graduation rates after transitioning online. Trauma patients also responded positively, as telehealth allowed them to feel safe in their own environments while participating in therapy.
Overcoming the Biggest Challenges
Despite the success, moving to telehealth was not without its challenges. One of the biggest concerns early on was whether Turning Point’s highly personalized, patient-centered care could translate effectively into a virtual model. Would counselors be able to build rapport through a screen? Would patients remain engaged?
To the surprise of leadership, patients were willing to adapt quickly. They valued continuity of care and accepted the new format. Counselors also discovered that the telehealth platform was user-friendly and conducive to real conversations.
The more difficult hurdles turned out to be administrative rather than clinical. Reimbursement for telehealth services proved complicated, requiring individualized handling of each claim depending on the insurance payer. Kraska noted that administrative workloads doubled, as providers and payers alike adjusted to new processes. Billing errors, denials, and uncertainty about payer requirements were all part of the learning curve.
Technical Barriers and Connectivity
Another challenge, particularly relevant in Alaska, was connectivity. While most of Turning Point’s patients lived in areas with stable internet, some from rural locations faced difficulties. The team had to adapt by shifting sessions to phone calls when possible or recommending in-person care if connectivity issues made telehealth impractical. For patients too remote to travel, Turning Point sometimes helped them connect with other local providers who could meet their needs.
Though connectivity was an issue, it did not significantly impact the majority of Turning Point’s patient base. The provider set clear expectations that patients would need reliable internet to participate fully in telehealth sessions.
Telehealth and the Loss of Warm Hand-Offs
One limitation Turning Point identified was the challenge of networking and care coordination. Traditionally, the agency prided itself on its personal touch and warm hand-offs when referring patients to other providers. In a virtual environment, these hand-offs became more difficult. While patients benefited from continuity of care, telehealth reduced the sense of close community connections that in-person interactions naturally supported.
Sustainability Beyond the Pandemic
Despite these obstacles, Turning Point believes telehealth is here to stay. The infrastructure is already in place, and the provider has integrated telehealth seamlessly into its existing EHR system. Patient notes are automatically stored in the same records, eliminating duplication of work and making telehealth a natural extension of traditional care.
Looking ahead, the agency sees telehealth as a way to reach underserved populations in Alaska. With vast geographic distances and limited access to behavioral health providers, telehealth offers a practical way to bridge the gap. Expanding these services to remote communities will be a long-term strategic priority for Turning Point.
The Role of Insurance in Telehealth’s Future
While the clinical and patient experience of telehealth has been positive, its long-term sustainability hinges on payer support. Kraska emphasized that private insurance companies play a critical role in keeping telehealth viable. Some payers have been reluctant to reimburse virtual care at the same level as in-person sessions, despite the fact that the work is identical.
If telehealth eventually fails, Kraska believes it will be due to insurance reimbursement restrictions rather than patient demand or provider reluctance. For now, providers like Turning Point are working closely with payers to prove the effectiveness and value of telehealth services. Continued advocacy will be essential to ensure its place in the behavioral health landscape.
A New Era of Behavioral Health Delivery
Turning Point’s experience illustrates how a crisis can accelerate innovation in health care. What started as a trial-by-fire adaptation quickly revealed itself to be a sustainable, even advantageous, approach to care delivery. With higher attendance, better program outcomes, and widespread patient acceptance, telehealth is reshaping how behavioral health providers think about the future of care.
As the behavioral health industry continues to adapt post-pandemic, telehealth will likely remain central to service delivery. Providers who can integrate it effectively, advocate for ongoing reimbursement, and balance virtual and in-person care will be best positioned to meet patient needs in a changing world. For Turning Point Counseling Services, the lessons learned through fire have forged a path forward—one where telehealth is not just a temporary fix but a permanent part of its care model.
