On The Move To Eliminate Social Determinant of Health Barriers
By Lydia Bernatovicz
A large, unassuming RV is parked in a garage, just off Sheridan Drive.
Instead of a queen bed and a camp stove, inside is a miniature doctor’s office. Step through the door and you’ll find a desk and chairs, where patients interface with a peer counselor or social worker. A slim bench acts as a waiting area, across from the small restroom that allows the nurse to take samples. In the back room, separated with a door, is a nurse’s station. Tools to check patient’s vitals line the wall behind an examination table. There’s a slim flat screen monitor to allow the nurse and patient to communicate with a doctor off-site, to provide recommendations and treatment plans.
Welcome to BestSelf’s Recovery Connections Mobile Team.
BestSelf is the largest community-based behavioral health organization serving children and adults of all ages in Western New York. BestSelf offers a comprehensive array of treatment and rehabilitation services to promote self-sufficiency, wellness and recovery, and an enhanced quality of life for children and adults with mental health and substance use disorders. They provide residents of Western New York with easy access to a full continuum of person-centered, trauma-informed behavioral health treatment and recovery services. The Recovery Connections Mobile Team is just one of their substance abuse programs.
“We’re a clinic on wheels,” said Tylica Pope, Program Director of Recovery Connections Mobile Treatment Team and the MRT OASAS and CTI Housing Programs. “Everything a traditional clinic has, we have—except for group counseling.”
According to Tylica, patients don’t need to have insurance or transportation to access the clinic, (often barriers for other treatment options). The team comes to them. They even transport patients to other appointments in the community, until Medicaid transportation is arranged.
“There was a big debate when the program started, on whether we should have a logo or branding on the van,” said Jenifer Seib, Director of SUD Treatment Services at BestSelf. “In the end, we decided against it. We want patients to feel comfortable with the service, and that includes giving them privacy. When you see the van parked outside someone’s house, you’re not thinking, ‘Oh, that person has a drug problem’ because the side of the van says, ‘Best Self Mobile Recovery Connections Team.’ It makes patients more comfortable getting treatment.”
A typical day for the Recovery Connections Mobile Team?
With the flexibility of a mobile team, there’s infinite variety. Usually, they start with scheduled follow up appointments for patients, and will dispatch the van for new assessments. For example, the van frequently parks outside Opioid Court to meet with referred patients and create linkages. They’ll also do outreach to other areas as well.
The Recovery Connections Mobile Team also works with jails to get inmates the care they need inside the facility, as well as linking them with care providers post release. They provide buprenorphine which is used to treat opioid addiction once withdrawal has begun. The goal is to facilitate rapid access to medically assisted treatment for those who need it.
“We’ve been able to get people linked to medical assistance within 24 to 48 hours, which is huge,” added Jenifer Seib. “The mobile team has done a great job with that.”
Another useful aspect of the Recovery Connections Team are the peer advocates. “We send peers out to see patients who aren’t ready to go into treatment to talk with them and encourage them to get help. It helps to have someone who’s been through it, who can relate to their struggles, and show them that treatment works,” explained Jennifer.
The Recovery Connections Team is innovating to help overcome barriers they’re finding in the program. One challenge was linking clients to another provider in the community for ongoing treatment. Most clinics weren’t providing rapid access and the medication needed to treat the client’s addiction. “For most providers treating this population, it’s common to require clients come to counselling and support groups to demonstrate how serious they were about recovery. It could take weeks or months to continue their medication,” says Kelly Whitman, Vice President of Substance Use Disorders Treatment and Housing.
BestSelf spoke to treatment providers in the community about their methods, and how individuals were being assessed by a prescriber within 48 hours of referral to the Recovery Connections Van.
“Those conversations went over extremely well, and we are now able to transfer clients to their preferred provider within the community, without disrupting their medication,” Kelly Whitman explains.
“We want people to see us as a long-term solution, and the go-to source of support for these communities,” says Tylica Pope. She explained that as the program continues, BestSelf is looking to expand into more communities that are lacking treatment options for patients. The Mobile Recovery Connections Team is working to increase the program’s use of telemedicine, so patients in rural areas can access treatment without long travel times.
A visit to the BestSelf Recovery Connections Van clearly demonstrates how it addresses social determinant of health barriers for recovery from opioid addiction—transportation, insurance, and access. Patients can sign up for the program while meeting with one of the peers.
“We’re trying to make it as easy as possible for patients to get treatment,” concluded Tylica Pope.
For more information on the Recovery Connections Mobile Team, please visit BestSelf’s website www.bestselfwny.org, or contact the team directly at 716-566-7771.