Taking the term “meeting patients where they're at” to another level, a leading provider of opioid use disorder (OUD) treatment in Rhode Island is using a 37-foot mobile medical unit to visit underserved areas of the state with high numbers of overdose and HIV cases.
In operation since July, the mobile unit staffed by CODAC Behavioral Healthcare is making weekly trips to seven communities during weekday hours. The unit, which is owned by the University of Rhode Island and was originally acquired by the state through federal Ryan White CARE Act dollars, offers medical and counseling services and referrals to follow-up care.
“This is taking what people want to the people when they need it,” CODAC president and CEO Linda Hurley tells Addiction Professional.
The effort is being conducted as a pilot with state funding through next March, as those involved in the project examine what they will need in order to ensure the effort's long-term sustainability.
Hurley says the project involves a collaboration among CODAC, the state university and the state's Executive Office of Health and Human Services. The mobile unit is being parked at locations such as public safety department parking lots and church lots, as organizers have tried to limit the amount of community pushback these types of operations can unleash.
“It brings 'not in my back yard” to a whole new level,” Hurley says of the reaction these services can receive.
She adds, “We reached out to public safety departments and city councils, and had people tour the vehicle.”
The unit, an upscale RV with a popout that allows a person waiting for service to sit outdoors in the shade, is staffed by a physician assistant, a nurse care manager and a counselor, Hurley says. Everyone in the operation is oriented to health care delivery, as the vehicle's driver is a certified peer recovery specialist, she says. The vehicle also is set up for the capacity to offer telehealth services when a participating provider is not available.
Hurley says CODAC has been looking at offering mobile services for the past few years. The organization hired a physician assistant who had experience in establishing a mobile unit in Connecticut, she says.
Linkages to ongoing care
Some of the patients seen in the unit will be referred to ongoing services from CODAC, while others could be referred to another opioid treatment program (OTP) or to an office-based provider of buprenorphine treatment, Hurley says. CODAC is Rhode Island's largest OTP.
“This connects people to anything that might meet their needs,” she says.
In the second week of operation, two individuals who were seen in the mobile unit were initiated to buprenorphine treatment. The volume of services so far has been in line with expectations, Hurley says.
The service has the capacity to identify previously unmet needs. Hurley recalls the case of a man who dropped in because he had twisted his ankle while mowing a lawn. As he waited for transportation, he started talking to the nurse manager and it became clear that he needed ongoing care for an opioid use issue.
Hurley believes that by the time the pilot period ends next spring, the participating communities will have become reliant on the mobile service. “I don't want that to go away,” she says.