Mind and Body

A constituency of consequence

The political fight for the heart and soul of the city of Providence was played out at a recent mayoral forum, sponsored by the recovery community

Photo by Richard Asinof

Nirva LaFortune, center, responding to a question at the Aug. 4 forum sponsored by RICAREs. Gonzalo Cuervo, left, and Brett Smiley, right, listen.

By Richard Asinof
Posted 8/8/22
To move forward with harm reduction, it will require leadership and good communication by the Mayor’s office – and a willingness to include those with lived experiences in recovery to have their voices heard and to serve as decision-makers.
What is the potential to have CODAC’s mobile medical van expand its operations to dispense methadone to a wider number of communities? What are the opportunities for the city of Providence to work collaboratively with the health equity zones in the city to expand opportunities for affordable housing and recovery services? What kind of advertising campaign should be developed to push for community acceptance of harm reduction centers?
The format for the Mayoral forum, with community members asking questions of the candidates, providing opportunities for a more honest dialogue in how the candidates answered the questions. It will be fascinating to see if and when those conducting polling include specific questions about health care policies, broken down by gender and by demographics. Further, if pollsters would be willing to ask questions about recovery and harm reduction centers.

PROVIDENCE – When Jim Gillen and Tom Coderre were busy improvising ways to develop the recovery community into a political force, they developed the idea of a “constituency of consequence.”

The concept envisioned that large numbers of Rhode Islanders who were now living in long-term recovery would step out of the shadows of stigma and become organized participants in the state’s electoral politics, a force that could do the work to change the landscape.

Indeed, in 2014, Gillen introduced himself as a moderator at a gubernatorial forum at the then Rhode Island Communities for Addiction and Recovery Efforts [RICARES] headquarters in Pawtucket, saying: “My name is Jim Gillen, I am in long-term recovery, and I vote.”

Fast forward eight years to 2022, and RICARES was sponsoring a mayoral forum on Aug. 4 at the Jim Gillen Teen Center on North Main Street in Providence, named in honor of the late Jim Gillen, who passed away in 2015. [See links below to ConvergenceRI stories, “The best way to honor Jim Gillen,” and “The recovery community according to Jim Gillen.”]

The forum featured Channel 10’s Alison Bologna as the moderator, with candidates Brett Smiley, Gonzalo Cuervo, and Nirva La Fortune answering questions. Despite steamy temperatures in the 90s, nearly 100 people attended.

The questions to the candidates were asked not by journalists but rather by recovery community members, often accompanied by the stories of their own narratives. As a result, what was created was a level of honest dialogue far too often missing from other candidate forums and debates.

There was a tangible urgency to many of the questions being asked, which were not focused on abstract inquiries about future policies if elected, or economic worries about inflation and recession, but rather on heartfelt matters, on survival, on challenges where life and death hung in the balance.

The candidates responded in earnest to the challenge, offering the kind of answers that seemed to cut through the typical sloganeering. It was a very different view of the world than the one presented by banking CEO Jamie Dimon of JPMorgan Chase during his recent media tour of Providence.

Translated, the candidates and the audience shared a sense of connectedness in their lives, across the economic strata of Providence.

That sense of connectedness was best captured by Jennifer Hawkins, executive director of ONE Neighborhood Builders, in a series of tweets last week, focused on why housing is so expensive: “If we don’t massively increase wages, and/or massively increase permanent rental subsidies, we will never address yawning affordability gap. We can’t build our way out of this problem. Yes, we must produce at high rate, high density, and high compact living space.”

And, Hawkins continued: “If wages are persistently inadequate to cover the minimum cost for operating even a modest rental apartment, our poorest neighbors will continue to be shut out.”

[In terms of palpable, human drama, the forum had everything – candor, openness, media participation – that was missing from the fundraising visit this weekend between Allan Fung, running as the Republican candidate for Congress, and Republican House Minority Leader Kevin McCarthy, a Trump acolyte, with its staged photograph and the friendly interview with McCarthy conducted by WPRO’s Gene Valicenti – avoiding contact with any other news media.]

The dialogue between the mayoral candidates at the forum was, in many ways, a battle for the soul of Providence, with a focus on the people who live and work here, rather than the buildings and edifices and corporate structures in the city.

Here is PART One of the extended coverage by ConvergenceRI of the Aug. 4 Mayoral forum, sponsored by RICARES.

BOLOGNA: All the event partners here tonight view recovery through a social justice lens. And believe that people in recovery should have an influence on the policies that affect them and that of the city’s policies, too.

And, that it should be based on science and evidence, not fear and emotion. And, that all are working together to ensure that our families and friends have access to health care, access to appropriate treatment, because treatment is different for everyone, and safeguards against legal overdoses, so our family members and friends can attain [recovery].

The objective here tonight is to inform you of the candidates’ positions here, if they become your next mayor in Providence, on the issues that are important to all of you and why you are showing up here tonight, and to encourage electorate participation.

The questions you are about to hear from tonight were created, over a month-long process, speaking to wide range of communities within Providence.

The planning committee then researched how our city government works, identifying where solutions and decisions can be made that address these issues.

I was very good friends with Jim Gillen, whom a lot of you people knew as well, who started the first peer-to-peer recovery center in the country, in Pawtucket, and it branched out through the support of the Providence Center and other organizations.

This community really does work together in a collaborative way, and we can build upon that.

MEKO LINCOLN: [the men’s transition program coordinator at Amos House] Good evening. Thank you very much for meeting with us. I think it is an enormous responsibility to be mayor of a city, particularly my city, the city of Providence.

I am a lifelong resident of Rhode Island. I am a lifelong resident of Providence. I was born on the South Side. I currently reside in the Eighth Ward. I am also employed at the Amos House as a certified peer recovery specialist. I am also a person who was formerly incarcerated, and living in long-term recovery.

Recovery is the avenue for many Providence residents, and there are many pathways to recovery. Individuals who are starting recovery for themselves have to face many barriers, challenges, and many traumas. Those experiences should be respected, understood and accepted.

Question: How will you ensure that people with lived experience in recovery from substances and mental health disorders, have decision-making and meaningful participation around policies?

SMILEY: Thank you everyone for coming out tonight. My name is Brett Smiley and I delighted to be here tonight. And I am delighted to be here tonight specifically because I was a friend of Jimmy’s. I have been here before. I am a former board member of RICARES. I am a person in long-term recovery from alcoholism. Last year I celebrated 20 years of continued recovery [applause]

I was fortunate enough to find a program of recovery that worked for me, and it made the man that I am today. To answer your question very directly, I will include people in recovery in the highest levels of government, starting hopefully, in the Mayor’s office.

As someone who has spoken openly about my own recovery, I had the opportunity to serve as Gov. Raimondo’s chief of staff, and the state’s director of administration. I’ve had the opportunity to serve on the Governor’s Opioid Task Force, to be a part of many of the policy accomplishments that have saved lives in our state, particularly for people in our community.

The creation of BH/Link. The certification of recovery housing in Rhode Island. I’ve had a chance to help fund and start the Recovery Friendly Workplace initiative in the state of Rhode Island, housed at Rhode Island College. And I’ve hired people in long-term recovery in various positions in my career, both in state government and in my former small business. And so, this is a deeply personal issue for me.

I think it’s a powerful example that all of us have the opportunity to recover, and to excel in whatever field we choose to excel in. And, if I have the chance to serve as Mayor of Providence, I can assure you that there will be meaningful opportunities in city government at the highest levels, not just in the recovery space, There are many people in our community who are highly effective and passionate advocates for recovery.

But we also have talented people who want to serve as tax administrators or economic development professionals or in other areas of city government, and those positions should be open as well.

LaFORTUNE: First, I want to say thank you for sharing your story. Thank you. My sister and both my brothers have experienced mental and behavioral health issues. In fact, both of my sisters experienced trauma at a very young age. And one sister also overdosed twice on drugs. Luckily, her life was saved. And, back then, there wasn’t a program like this. She was lucky to be accepted into [a recovery program], which was a program that really helped her, because she was at risk of dropping out of middle school.

It really helped to navigate a lot of those challenges. And then, later on in life, she finally got the assistance that she needed, but it is something that families have to navigate together. But, as an immigrant, as someone who grew up mostly in the West End and the South Side neighborhoods, substance abuse and mental health was stigmatized.

It was actually quite difficult for my family to have that conversation. And, it wasn’t until my little brother was rushed to Butler Hospital; we had a family meeting with him, and he said: “I suffer from mental health illness, and I use drugs.”

And so, for me, it’s personal. That’s why I worked on the first behavioral health crisis response task force in the city of Providence. Many of you were part of that discussion. We wanted to model it on the similar programs to other initiatives throughout the nation, but it’s not only to intervene, but also to connect people to services.

Because if you live in a fancy house, people may not know; many people, many people have to navigate these types of challenges. But some people are more stigmatized than others, so it is about creating initiatives to support everyone. Thank you.

CUERVO: So, I am running for Mayor for a fundamental reason, which is to cclose the opportunities gap that has impacted so much of our city’s population.

That opportunity gap manifests itself in many ways. And it creates the divisions that lead to a lot of challenges that we face, in turns of folks who are going through long-term recovery, and have had substance abuse challenges.

I think it would be hard to find a family or an individual in our city who doesn’t have a story that they can connect with, either themselves or family member, or a loved one.

And, you know, life offers up a variety of paths to get to where we are right now, to the present. And I think, to get back to your original question, I think it is imperative that whomever is in a position of power, regardless of what that position is, need to surround themselves with a diversity of viewpoints and opinions – and that includes people who have lived that experience, particularly, if the person in  this case, who would be Mayor, may not have lived experience themselves.

They need to be surrounded by people – and not just in token community relations positions, but in positions  where the decisions are being made about research, about budgets, and about policy objectives. Thank you.

LINCOLN: [follow-up question] How do you view the role of the Providence Healthy Communities Office and the city’s Behavioral Health Task Force?

SMILEY: The Mayor’s Healthy Communities Office and the Behavioral Health Task Force are important opportunities for the city to lead in its response to the overdose crisis. But also to lead the other mental health social and emotional health challenges that we are hearing about from residents of the city.

It is an important venue to bring together stakeholders and important community partners, so that community partners, many of whom are in the room today, feel like they have a voice, that they have a voice in not just making sure the city is meeting those needs and listening to the right folks, but also in resource allocation – in the city budget, in the opioid settlement money that has now started to flow into the city, to have a say over how that money should be spent, and to fill the gaps. Because we know that in Providence, we are disproportionately hit through the overdose crisis and through addiction in general.

And so, the state has its role to play, but the mayor’s opioid substance abuse task force and Healthy Communities office have direct purview over the city’s response.

Addiction and recovery is central to it for me, but it needs to be a bit broader to include social and emotional health, particularly post pandemic. We know that addiction is a disease of isolation; it [was made] worse during COVID 19, and the isolation that came from the pandemic.

It has been so hard on our community; it’s hit other people, too, Older residents, and other communities that suffer from emotional and mental health challenges. And so, I intend to use that office to try and meet those needs, and to be the lead policymaker and [in charge of] resource allocation, to try to meet the overwhelming need in our community.

LaFORTUNE: I work very closely with the head of the Healthy Communities office. In fact, I think it needs to be a part of the cabinet level within City Hall, within the Mayor’s office. It is an important office, if you want to create healthy communities and safe communities.

I worked to develop the framework for the task force. We brought people from the community, people who are working with folks, people who themselves are still navigating. As Mayor, whatever policy or initiative that I create, or that I work with my team to create, it has to be informed by the voice of the community. That will always be a priority.

Because, it’s the community who knows first-hand, who has that lived experience, and it’s important for us to hear their voices – but also to ensure that we are allocating the funding to support not only these initiatives but also the many organizations that provide the various services.

Because they are bursting at the seams. You have BH/Link, you have to transport someone to East Providence, and then, if they don’t have a [detox] bed, they might go the hospitals. And then, once they are at the hospitals, they may be let go, and they may not be able to get services.

We need to support our social service centers and entities, and to ensure that Healthy Communities is part of the decision-making process. And, it is at the executive level, but more importantly, that the voices of the community are serving on these committees – and that they inform the policies that we [create].

CUERVO: I would agree with both assessments. I think that the Healthy Communities office has done a good job at providing information and serving as a resource. But it is kind of very surface level. And, I think there is an opportunity to elevate the work that they do and give that office more teeth and authority.

And also, to integrate more input from the community – the kind from folks who have lived that reality and who can inform policies. And not just have an office that is providing information, that  is kind of an inch deep and a mile wide.

MICHELLE MCKENZIE: [a public health researcher] Thank you all for being here tonight. My name is Michelle McKenzie. I live in Ward 10. And I am a person in long-term recovery. I am board chair of RICARES. It has been an honor to be a part of RICARES for many years now.

I have, as almost everybody in this room has, lost friends, family colleagues to substance use disorder. And overdose.

I have seen first hand. And I been a part, first hand, in all the efforts that the state and the communities have put into addressing overdose. And there are amazing efforts, but we continue to lose people. Last year, we lost over 435 people to overdose. An area that needs expansion is harm reduction. Last year, 94 folks from Providence died from overdose.

QUESTION: How would your administration specifically support overdose prevention initiatives, such as the harm reduction centers, in your first term?

CUERVO: When the harm reduction centers [came up], I was very supportive. I think that it is a necessary tool. It has been proven to be very effective. We need to save lives in many ways. It is something we need to do.

We need to think about [harm reduction centers] as a bar and nightclub, where people go to drink in a social setting. We need to look at it that way, to look at it as a public health mechanism to save lives.

LaFORTUNE: I actually had the opportunity to visit VICTA, to see some of the work that they are doing on Elmwood Avenue. This is my ward, the Jim Gillen Youth Center is right in our Ward Three. And, one of the things that VICTA is looking to do is to expand –and looking at perhaps North Main Street as being an area for them to expand some of their services.

What we can do to one, create a safe space for individuals, and two, also create a space where they can be linked to services where they don’t feel ashamed going in. It’s important.

I am fully supportive of not only working with Victa as an organization but also identifying other programs throughout the city and state to support our community, who are navigating substance abuse, as well as mental and behavioral health [issues].

SMILEY: Thank you for the question. I’ve gone to funerals and lost friends. I think probably most of us in the audience have. Harm reduction needs to be a priority.

We need to keep people alive. And, hopefully, keep people alive long enough that they do find recovery. It may not happen but we will never have that chance if we don’t keep people alive.

With respect to harm reduction centers, I do support them. I have been supportive, on the record, and publicly supported them. I think we know that the rubber is going to hit the road when we actually get close to finding a space and opening the doors. We know that there is going to be NIMBYism and community pushback, because of stigma and fear and concern.

I am prepared, hopefully as Mayor, to lead through that moment, to help address those concerns, to de-stigmatize, to provide the necessary forward motion to make sure that we don’t get stopped in our tracks when the moment comes to actually open that center. And I am committed to that.

But the harm reduction center is only one piece of a harm reduction strategy. And so, I think that the Providence Safe Stations initiative is excellent and should be expanded. And, the partnership and the leadership that our Fire Department has provided is something that we should continue.

I know housing is going to come up tonight, and that we still have a shortage of detox beds in this state. A lot of that will require state funding and state leadership. But the city has incredible power to advocate at the state level. We have a large delegation that can push on city priorities. That is a direct concern to our city and our community. And so, I am committed to harm reduction above and beyond the harm reduction centers,

BOLOGNA: How many hits [of Narcan], if you will, does it take to keep somebody alive, if you will, because of fentanyl on the streets?

McKENZIE: It is not unusual for people to need two to three doses in order to have a response.

BOLOGNA: How do we get more doses of naloxone, or Narcan, out on the street?

SMILEY: I think there is an opportunity to find state and the federal government resources.

BOLOGNA: Some money is coming down from the Opioid Settlement, but the question is, that’s going to run out at some point. What do we do? Nirva?

LaFORTUNE: We need to work with the public health department. This is a public health crisis. And, we have to look at resources that are coming from the state level, as well as looking at resources from the city level.

It should be available, especially as it is going to save lives. And so, I would work with the state, with public health within the state of Rhode Island. But also work with our state legislators to ensure that we have some sort of line item within our state budget, to ensure that every city has funding to buy enough [Narcan] to save someone’s life from an overdose.

SMILEY: I would just add that I was part of another administration when we actually passed a surcharge on prescription drugs that has provided us with sustainable funding stream for this life-saving drug.

And I think that there is more education that can be done, not just with making sure that public health professionals and public safety professionals know how to administer it, but also storage, because we have had waste of naloxone going bad because of improper storage.

So, there is more education to be done, and naloxone is an important part of the solution. But, with the rise of amphetamines and other overdose issues right now that are not addressed by naloxone.

McKENZIE: If you’re trying to open a opioid treatment center, if you’re trying to open a recovery center, if you’re trying to open low-income housing, for that matter, there is a lot of push back, a lot of NIMBYism. QUESTION: And, certainly, for a harm reduction center, I would like to hear from you guys, what specifically can the Mayor’s office do to be a champion? [Look at] the years it took for CODAC to be able to purchase their new place.

SMILEY: I think it’s a combination of education. We’ve got leaders in the community, we are so lucky to have leaders like Brandon Marshall, and Dr. Jim McDonald, who has now left, but who is an excellent communicator. We’ve got real research, real experience in other communities, where this has saved lives. Some of it is information, some of it is communication, so neighbors and communities don’t feel surprised.

But finally, it comes down to leadership, where, I believe, it is going to come to a moment, where it is going to require the Mayor, in this instance, the public hief executive, to just push through some of the push back. Because I don’t think we are ever going to get everybody comfortable and we need to get to the other side of that discomfort, to ensure that we are saving lives.

LaFORTUNE: It is not an easy process. I don’t want to pretend that it is. You have communities that have been historically disenfranchised, [who are saying,] do not bring it into my community. Every time you want to bring a homeless shelter, or a harm reduction center, in concentrated areas.

Then you have communities who are like, I don’t wan it here. Yes, I agree, it’s about education, but we also have to change the culture, about how we see addiction, and how we are serving people.

When I talk about creating a city government that works for all people, that means that it is a city government that is inclusive of every single resident, whether you are a resident who lives in a house or you are unhoused, or you lay your bed every night in a homeless shelter.

It’s still education. It’s also pushing back. Working with our community leaders, folks who are doing the work.

But it is bringing everyone to the table to have conversations, but also to de-stigmatize and demystify all these assumptions,

It shouldn’t be concentrated in one area; it should be acceptable to all people. Because transportation is an issue. Housing is an issue. Affordability is an issue in the city of Providence. So, inclusiveness also means accessibility, and accessibility means that it is available in every single neighborhood

So we have to get buy-in. It’s going to take time. And, there’s pressure that comes form the community.

As Mayor, it’s about informing the community and also being able to push back with data. With quantitative and qualitative data, which shows the benefits of these centers.

CUERVO: There are multiple factors. There are neighborhoods in Providence where the residents firmly feel that they have been excessively burdened with agencies that provide a variety of things. And, they’re right, to a certain degree, [because] those neighborhoods [are the ones] which offer the path of least political resistance That’s where the NIMBYists have the least amount of power.

So, we have to change that reality, and we change that reality through education. I think the way you remove the stigma is not from data. Nobody cares about data. Particularly NIMBYists, they don’t care about data.

We have an opportunity to work with organizations to tell the story, and use the power of the bully pulpit that the Mayor has to get those stories through the media, throughout the city.

And, if that is not helpful, then it is about leadership, it is about saying, we’re going to do this. And, I’m willing to take the hit, because it is the right thing to do.


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