(Photo by Flickr user John Sonderman, used via a Creative Commons license)
When it comes to treating those dealing with opioid use disorders and addiction, there is unfortunately no one easy solution.
Mayor Jim Kenney’s Task Force to Combat the Opioid Epidemic in Philadelphia released a report in May detailing 18 recommendations for the city to consider when addressing the issue, and even one of the more promising solutions of possibly opening a safe injection site in Philly has its own complications to think about beyond whether or not it’s legal.
But this crisis, which is leading to more and more deaths nationally, is first and foremost a health issue. One community health center in Camden, Project H.O.P.E., provides an example of the more locally focused work that is being done to treat those suffering from opioid addiction.
Here’s some context as to what the opioid epidemic looks like in Camden, with its population of 76,000 and reputation as one of the United States’ poorest cities:
- The Wall Street Journal reported in June that fatal overdoses in the city had at that time already passed the total number of overdoses in all of 2016.
- Lsst month, NBC reported that medics in Camden had to revive 16 people from overdoses in one hour, a spike that was caused after some dealers gave away some free heroin.
At Project H.O.P.E., a nonprofit that was established in 1993 to help those dealing with homelessness in the Camden area, Brian Colangelo, the director of the mental health program there and a clinical social worker, meets with patients regularly and said many of those who are homeless are also struggling with opioid addiction.
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For Colangelo, what makes a healthcare provider like Project H.O.P.E. unique is its ability to provide immediate and comprehensive access to people who want to start getting better — and that means being able to treat the medical issues, mental health issues and substance use disorder issues all in one place.
This could include individual or group counseling by certified alcohol and drug counselors or medication-assisted treatment via drugs like Suboxone. The organization is one of few in the Camden area that can steadily prescribe it, and Colangelo said Project H.O.P.E. has prescribed Suboxone to more than 650 patients in the past four years.
"Treatment 'is a conversation I have with them, not for them.'"
From the moment Colangelo meets with a patient to conduct a health assessment, he said it’s about making it a “partnership.”
“That’s a conversation I have with them, not for them,” he said. “I could have lots of great ideas, but if it’s not what the patient needs or wants at that time, it’s gonna be a waste of everyone’s time.”
And their desires, such as wanting to get their life back into shape, are “realistic,” he added, but he’s seen firsthand how hard it can be for these folks when Camden is facing the reality that it’s dealt with when it comes to poverty, affordable housing, lack of jobs that pay a liveable wage, et cetera.
That’s where Pat DeShields, CEO of Project H.O.P.E., sees something like her organization and its dedicated staff members intervening to take up the responsibility of being a true-to-its-name community health center.
“They’re called community health centers because they are obligated to respond to the communities they’re situated in and address the health needs as defined by the community,” DeShields said.
One key way the organization is able to stay true to this mission has been by completing a community needs assessment, coming up with a strategic plan for the next consecutive three years and designing its programming around that. The last assessment completed in 2016 determined the need for more behavioral health and addiction services, but DeShields said it was around three years ago that Project H.O.P.E.’s physicians really started to take notice of opioid addiction being a prominent issue.
Those assessments are required of Project H.O.P.E. through its categorization as a federally qualified health center (FQHC), a designation the U.S. Health Resources and Services Administration (HRSA) grants to community healthcare providers that also earns them federal funding.
(According to 2015 data from the Henry J. Kaiser Family Foundation, there were 23 in the state of New Jersey. Philadelphia has about 40 FQHCs.)
It was thanks to a $4.7 million grant from the Affordable Health Care Act that allowed the org to build out a new healthcare center back in October 2015, which helped provide a whole slew of new exam rooms as well as enable the administrative and clinical staff to be housed in one space. The federal funding also allows Project H.O.P.E. to not have to turn anyone away because of lack of insurance.
Project H.O.P.E. stands to lose 70 percent of its funding.
But the horizon at this point in time looks a bit cloudy for Project H.O.P.E.: After Sept. 30, DeShields said there’s a “funding cliff” all FQHCs across the U.S. will face unless funding is renewed by Congress. Without that funding, Project H.O.P.E. would face a loss of 70 percent of all its funds.
Brandy Bones, board president for Project H.O.P.E., is aware of the precarious situation and has set goals for finding new sources of funding regardless. More than funding, though, the Philadelphia-based Bones, who is involved professionally in affordable housing and community development, said an ultimate goal of hers is to build out Project H.O.P.E. as an organization that is integral to the Camden community.
That vision will be bolstered by the additional support and backbone provided by the 20 partner organizations working alongside Project H.O.P.E. in its missions. But when it comes to the board, which Bones said requires more invested members who are aware of the regulations put in place by the HRSA, Bones said she is “trying to recruit a board that’s more representative of the community we’re serving.”
“My vision for the board is that I’m no longer on it and it’s full of Camden-based community leaders,” she said.
Bones hopes things will be on the up-and-up for the “disinvested neighborhood” that is Camden — something she said she’s already seeing, even if the perception is that the city is one of hopelessness.
“Things are bad, but there are things happening that are very good,” she said, “and as long as we continue to care for the community, we can do this right.”