Editor’s note: This story is adapted from the Sept. 16 issue.
Individuals with substance-abuse disorders seeking medication-assisted treatment and behavioral health care can now get both under one roof, thanks to a collaboration by The Providence Center and CODAC Inc.
TPC, which affiliated with Care New England in 2014, provides full-service primary and mental health care, treatment for substance-abuse disorders and wraparound services and supports. CODAC administers comprehensive outpatient behavioral health services and a full range of medication-assisted treatment.
With opioid addiction a problem affecting every Rhode Island community, the state must work in a more integrated way to increase treatment options, said Owen Heleen, chief strategy officer for TPC.
“Health care needs to become more efficient; there’s no need to reinvent the wheel if … a perfectly good wheel can do the job,” he said.
The collaboration – a new clinic at TPC headquarters at 528 N. Main St., Providence – furthers the goals of Gov. Gina M. Raimondo’s Overdose Prevention and Intervention Task Force. They include reducing opioid overdose deaths by one-third within three years.
Accessing all the services and supports patients need under one roof is most beneficial, said CODAC President and CEO Linda Hurley.
Before the program’s mid-August soft opening, many individuals received medication-assisted treatment at one of CODAC’s five offices, and primary care and mental health services and supports at TPC, which has 15 treatment centers and 15 residential facilities in Rhode Island. Now, CODAC’s clinic dispenses medication-assisted treatment at TPC’s headquarters, where patients also can receive services and supports from TPC.
The stigma around illegal drug use and treatment is insidious, yet slowly abating, said Hurley. TPC and CODAC belong to Recovery Works RI, a coalition of business and health care entities striving to change addiction and recovery conversations. It’s more effective, said Heleen, to view addiction as just another chronic disease, like diabetes. Successfully treating patients with any chronic condition requires not only medication, but also addressing the social determinants of health, such as housing, employment, primary care and wellness.
Individuals with addiction have “a chronic relapsing disease of the brain,” according to the American Medical Association, said Hurley, and community providers must recognize that. TPC’s Anchor Recovery Community Center program provides peer-recovery support services, which TPC considers essential to patients’ ongoing recovery.
Before CODAC – a Cranston-based behaviorial health nonprofit – could open the clinic, which dispenses methadone, buprenorphine and naltrexone, it had to clear several hurdles.
Construction reconfigured the office space leased from TPC, and CODAC needed approvals or licensures from several entities.
Five employees – with nursing, counseling and administrative expertise – staff the new clinic. With each entity providing separate, unduplicated services, licensing and billing are straightforward, said Hurley. Medicaid insures most patients of TPC and CODAC.
Noting that any collaboration involves culture changes, Heleen said, “If Linda and I can get out of the way and have collaboration built around the people who deliver the services on the front line to the people who need them, it works pretty well.”
The new clinic can serve 200 patients. If demand requires, CODAC could offer additional clinic hours to serve 200 more patients, said Hurley. In the first 18 business days of the clinic’s opening – from Aug. 8 to Aug. 31 – 43 patients were receiving treatment.
The clinic had its official opening on Sept. 28.
The need for such health care collaboration is greater than ever, said Hurley, with fentanyl (a synthetic opioid) and fentanyl-laced cocaine showing up with increased frequency locally. Citing data from the state’s Department of Health and the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, Hurley said that of the 258 deaths from drug overdoses in Rhode Island in 2015, 74 were attributed to fentanyl.
“We can’t work in the same way and expect different results. We can’t incarcerate or prosecute our way out of this,” said Heleen. He’d like to see supports and services available on every community’s Main Street, and more open, honest conversations about addiction and recovery.
“There’s lots of potential for this kind of collaboration to build a more consumer-friendly, efficient health care system,” he said. •
