Continuum of Care, MAT, Telehealth: Limelight Interview

continuum of care

Katie Vokes working with Residential Treatment staff at John Street


The “continuum of care” in addiction treatment describes a system in which individuals enter treatment at a level appropriate to their needs. As monitoring progresses, they step up to more intense treatment or down to less intense treatment as needed. Care is individualized and incorporates the following, no matter the level in which a person enters the continuum (SAMHSA):

  • Treatment Engagement
  • Early Recovery
  • Maintenance
  • Community/Family Support


continuum of care graph

The Continuum of Care – Sanford


Continuum of Care, MAT, Telehealth

The subject of our Limelight Interview, Katie Vokes, is Sanford’s Director of Outpatient Services, Medical Manager. In this role, she supports the clinical, medical and administrative teams. Additionally, she coordinates medication-assisted treatment (MAT), telehealth, and the smooth transfer of Sanford clients between levels of care in the continuum.


Continuum of care Katie at desk

Katie Vokes at the Sanford Outpatient Center


I work with all levels of care at Sanford. Excellent internal communication, and a thorough understanding of all the concepts improves processes and efficiencies. From admissions through the whole continuum, we want things to run smoothly.

Katie Vokes, Director of Outpatient Services, Medical Manager

Limelight Interview – Katie Vokes

SH – Please talk about your job at Sanford.

Katie Vokes – My title is Director of Outpatient Services, Medical Manager. That means I support the outpatient team – clinical, medical and administrative. My position has evolved over time. I work closely with the residential houses as well as outpatient to provide resources, technical support and staffing help. Coordinating all levels of care makes for smooth, efficient processes and communication.


SH – As Medical Manager, you work closely with Medication-Assisted Treatment (MAT) protocols. What is MAT?

Katie Vokes – MAT is the use of anti-craving medications together with psychotherapy. Our medical and clinical teams determine if MAT is appropriate for each individual in our care. This depends on the individual’s drug use, drug of choice, and where they are in the recovery process.

There is still stigma when it comes to MAT, even though research shows it can help sustain recovery. People argue it is substituting one drug for another. But if you have a broken arm, you get a cast, right? I think of it as one tool in the recovery tool box. Addiction is defined by behavior. And if you are receiving Vivitrol once a month, going to counseling and your drug-seeking behaviors are gone … your relationships have improved … MAT is a good thing for your recovery.


SH – Has the pandemic impacted MAT?

Katie Vokes – If anything, I think we’ve been able to serve more people with virtual treatment/telehealth. We still provide the assessments, structure and accountability, and counseling. Clients are still drug screened. And as much as possible we provide in-person connection.


SH – Speaking of telehealth, how has COVID-19 impacted your job?

Katie Vokes – We had a huge program shift in March of 2020. We transitioned to virtual programming – fast. The forced growth meant we had to learn to be flexible, pivot and find a new way of providing addiction treatment. We were also impacted by the real concerns for access to PPE. And the need to up our game with an influx of more acute clients seeking help. I like to use the word “unstoppable” when describing our team in a crisis. We met the challenges with resilience!


SH – You see people in recovery every day. What do you think is the key to recovery success?

Katie Vokes – Having the appropriate support system in place – educated about addiction as a chronic disease. Likewise, a commitment to recovery. A full continuum of care, one-year plus, and MAT can be successful.


SH – The pitfalls?

Katie Vokes – Isolation. Also, dealing with stigma can make access to care more difficult. Relapse might happen, but it should not stop the recovery process or negate prior hard work. You have to get back at it. Develop resilliance.


SH – What is the fun part of your job?

Katie Vokes – Working with the Sanford team. I work with the most supportive, passionate, and flexible people. We are all growing in our roles and meeting the challenges – doing good work. It is a joy to come to Sanford Outpatient Center every day and watch these talented people help our clients.


SH – You’ve already mentioned some of them, but what about the challenges?

Katie Vokes – Dealing with the pandemic. The high need for nurses. The quickly changing regulations from the CDC. Having said that, the growth and the challenges at Sanford are exciting!


SH – What books do you read (other than work-related)?

Katie Vokes – (Laughs) with an 11-month old at home, I don’t have as much time to read. When I do read for pleasure, I like mystery fiction. But, the most recent book I read was Over the Top, by Jonathan Van Ness. It’s an honest, readable book about overcoming trauma, addiction, family strife, etc. Great book!


SH – What makes Sanford unique?

Katie Vokes – Two things: our staff and the environment. Our staff truly wants to help our clients. And the environment relieves our clients’ stress. When I walk into a Sanford facility and see a dining room, a chair, hear music – it feels non-institutional and healing.


SH – What is your favorite journey?

Katie Vokes – Personally, it is becoming a mom. Professionally, I have worked in a number of health organizations, but there was something missing. Coming to Sanford and the behavioral health field filled the void. This feels like important work.


SH – Finally, do you have a phrase you use a lot (or even overuse)?

Katie Vokes – Not a phrase, but I do have a thing I do with gratitude. I practice this at home (it annoys my husband) and at work. When things get tense or people begin to get upset or negative, I say, “Let’s pause.” Then I say, “Tell me three things you are grateful for.” There might be grumbling at first, but it helps to reset the moment and remind us how lucky we are.


SH – Anything else you’d like to say?

Katie Vokes – Healthcare as a whole has been changed forever by the pandemic and telehealth. And Sanford has implemented virtual programs for all types of therapy and education. Telehealth allows us to provide treatment to those with geographic or physical restrictions. To enhance our Residential Treatment with remote “visits” to 12-step meetings outside of Grand Rapids/Michigan. And to augment long-term care with easy connection to Sanford from remote locations. But the day we can shake hands again. Give hugs again … I say bring it on!


Great thoughts to end with.  Virtual hug. Thanks Katie!

Sanford Behavioral Health is licensed and accredited as an addiction, eating disorder, and co-occurring mental health treatment facility, serving all of Michigan and beyond. Each of Sanford’s facilities in Greater Grand Rapids is carefully and diligently crafted to create a welcoming and comforting environment. Sanford is led by a psychiatrist-led team of medical, clinical, and support personnel providing medication-assisted, evidenced-based treatment to residential, outpatient, and telehealth patients. For more information, visit