Delivery of Care

Investing in human infrastructure

A new mobile medical van is launched in Rhode Island, while the state plans to sell off a building in Woonsocket rather than repurpose it

Photo by Richard Asinof

The CODAC mobile medical vehicle in operation from the parking lot of Community Care Alliance in Woonsocket.

By Richard Asinof
Posted 7/25/22
The ability of the state to repurpose buildings it owns keeps falling short in providing the necessary support for community infrastructure to support community behavioral health investments in Woonsocket.
Why is the state determined to sell off the building at 181 Cumberland St. in Woonsocket, instead of repurposing it? Who is making the decisions at the R.I. Department of Administration? Has Gov. McKee signed off on the decision to sell the building? Will any of the candidates running for Governor be wiling to tour the building at 181 Cumberland St.?
While Rhode Island has received numerous mentions in the national press for its willingness to invest in the establishment of a harm reduction center pilot program, the continuing efforts by CODAC to expand its ability to serve clientele in the distribution of methadone is an equally important function of the actively engaged recovery community in the state.
It is the kind of national story that should be championed by the state’s elected leaders – as much as the state’s low unemployment rate is being championed.

WOONSOCKET – Benedict “Ben” Lessing, Jr., is a tilter at windmills. He is unapologetic about his role as a modern-day Don Quixote. He believes that the arc of history will bend toward justice.

For three decades, Lessing has been fighting on behalf of many who have lost their voices in the convoluted community behavioral health system in Rhode Island, advocating for the homeless, the mentally ill, and those ravaged by the opioid epidemic.

When fully engaged in fighting the good fight, Lessing will occasionally slip into the lingo from his Louisiana heritage and respond to a question by saying: “True, dat!”

It is with purpose that Lessing has attached a quote from Nelson Mandela at the end of every email he sends: “Overcoming poverty is not a gesture of charity, it is an act of justice. Like slavery and apartheid, poverty is man-made and can be corrected by the actions of human beings. Every human being has a fundamental right to dignity and a decent life.”

Lessing, the president and CEO of the Community Care Alliance, has been undaunted and unafraid to challenge the powers that be – including the R.I. Department of Administration under both Gov. Gina Raimondo and Gov. Dan McKee – seeking to preserve the capability of the state-owned building at 181 Cumberland St. to serve his agency’s clients.

In March of 2020, ConvergenceRI published an exclusive, investigative report, detailing how the state’s neglect as a landlord had forced the Community Care Alliance to abandon its building because of the state’s failure to repair a leak in the roof at the 181 Cumberland St. [See link below to ConvergenceRI story, “Is the state guilty of neglect with its community assets in Woonsocket?”]

Because of Lessing’s continued advocacy, for the last two years, the basement at 181 Cumberland St., still functioned as a working kitchen, preparing approximately 2,500 meals weekly for individuals served in psychiatric residences, substance-use residential facilities, individuals receiving shelter and a few hundred youth that participate in the Boys and Girls Club locally.

[Editor’s Note: Since November of 2021, Lessing has also been in negotiations with Richard Charest, the director of the R.I. Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, to develop a commitment from the state to create a shelter for the homeless in Woonsocket, utilizing another state-owned property on Putnam Pike. See link below to ConvergenceRI story, “No shelter from the storm.”]

Working within the system, Lessing has also been willing to negotiate with those at the highest levels in government to achieve better outcomes, including Gov. McKee. Lessing met with stakeholders this past spring, in an unpublicized gathering convened by Neil Steinberg, president and CEO of the R.I. Foundation, to try and reach consensus on how best to address the homeless situation in Rhode Island.

What happens to a dream deferred?
On Thursday, July 21, the dream to repair and repurpose the property at 181 Cumberland St. apparently finally fell apart, when R.I. BHDDH Director Charest informed Lessing that the state of Rhode Island was now intent on selling the building – despite advocacy by Charest himself, who had argued that the building be repaired and returned to service, giving the Community Care Alliance a long-term lease, according to Lessing.

The villain in this story appears to be the Division of Capital Asset Management and Maintenance, or DCAMM, a division of the R.I. Department of Administration, which is now seeking to sell the building.

[Editor’s Note: Because Lessing believes it is his role to engage with all members of the news media, readers can expect that reporters Lynn Arditi from The Public’s Radio and G. Wayne Miller from The Providence Journal will also be producing stories about the decision by the R.I. Department of Administration to sell 181 Cumberland St. The question is: Will either Arditi or Miller cite the original story written by ConvergenceRI in March of 2020, which was provided to them by Lessing?]

Goin’ mobile
Once again, ConvergenceRI admits to burying the lede. This story was originally supposed to focus on the decision by Community Care Alliance, in partnership with CODAC, to allow the CODAC’s mobile outreach medical van to service clients in CCA’s parking lot at 80 Clinton St. in Woonsocket, Monday through Saturday, 6:30 a.m. through 10 a.m.

“Woonsocket has been and continues to be ravaged by opioid overdoses,” Lessing wrote to ConvergenceRI, explaining his support for the collaboration. “We are grateful for the addition of CODAC's Mobile Van to work with Community Care Alliance to address this crisis. Our hope is that their presence and collaboration will increase the capacity and access of life saving medical resources for a marginalized population.”

In a comprehensive story by Boston Globe reporter Brian Amaral, following up on a news release from CODAC, Amaral provided the import of the groundbreaking presence of a mobile unit that can dispense methadone in Rhode Island, one of the first such operations in the nation, tied to the ever-increasing rates of opioid-related overdose deaths in the state. [See link below to story, “R.I. provider to launch mobile opioid treatment as state faces record-high overdoses.”]

As Amaral reported: More Rhode Islanders died of accidental drug overdoses in 2021 than any year on record, and the trend into 2022 shows no signs of abating. The state’s largest outpatient provider for drug treatment announced [on July 18] that it’s launching a new treatment option to help turn that tide: an RV-like mobile unit that will dispense medication to treat people who want to stop using drugs.

The story continued: “Access to care is more important than ever amid our soaring overdose rates,” Linda Hurley, the president and CEO of CODAC Behavioral Healthcare, said in a news release. “This mobile medical unit will allow us to face that challenge, both geographically and demographically.”

In his story, Amaral provided a bit of the background: how the mobile medical unit was funded with a grant from the Champlin Foundation: The 27-foot vehicle, was funded through a grant by the Champlin Foundation. It has a dispensary, examination and treatment room, a counseling room, a waiting area, a bathroom, and a security system. It will be able to dispense medication for opioid use disorder including methadone, as well as treatment with buprenorphine and naltrexone. Taken together with counseling, these medication-assisted treatments can reduce cravings and block some of the effects of short-acting opioids like heroin.

The backstory
What Amaral missed was the backstory about the mobile medical van was almost derailed by funding cuts by R.I. BHDDH. Nearly a year ago, in August of 2021, the R.I. Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, let community agencies know that they were cutting more than $2 million in funding for recovery programs. [See link below to ConvergenceRI story, “BHDDH cuts more than $2 million in funding for recovery programs.”]

ConvergenceRI’s reporting led to an intervention by the recovery community members at the Governor’s Task Force on Overdose Prevention and Intervention, which led to the cuts being rescinded – although Gov. McKee maintained that these were not cuts but the result of federal programs being sunset.

One of the programs that had been slated to lose funds was CODAC’s mobile medical unit. As ConvergeneRI reported:

• CODAC, which is slated to lose more than $1.3 million beginning Oct. 1, including $755,791 to provide medication-assisted treatment “induction” opportunities at BH/Link on a 24/7 basis.

In addition, the story continued: CODAC, the largest nonprofit outpatient provider for opioid treatment in Rhode Island, also received a $333,313 cut in funding for its efforts to develop its mobile treatment capacity [emphasis added].

The program was first developed as a shared mobile treatment unit for the opioid epidemic. It was then redeployed as a mobile COVID testing unit during the coronavirus pandemic.

Further, the story reported: Because of the challenges created in sharing the mobile unit, CODAC applied and received funding from the Champlin Foundation to purchase its own mobile unit. Now, just as the mobile unit was about to be deployed, CODAC lost the funding for staffing through the cuts in state opioid response dollars from R.I. BHDDH.

Translated, through the perseverance of the recovery community, working in partnership with other community agencies, CODAC’s mobile medical unit is now serving Rhode Islanders, dispensing methadone, one of the first such programs in the nation to do so – reaching out to people where they are.

While efforts are underway to create a harm reduction pilot program in Rhode Island to serve as a safe-injection site, with money – reportedly $2.5 million allocated through the legal settlement funds won by the R.I. Attorney General’s office, the ability to dispense methadone fro the mobile medical unit is up and running in Woonsocket.

On the mean streets, shelter from the storm
Early Friday morning, July 22, ConvergenceRI drove to Woonsocket to check out the new mobile medical unit operating out of the Community Care Alliance parking lot. In the New England vernacular, the day was turning into a “scorcha,” with temperatures already in the mid-80s on their way to the mid-90s, the air hazy, and several male pedestrians observed walking around without any shirts on.

There was nothing remarkable to report on from the CCA parking lot. The CODAC mobile was open for business. Some days, no news is good news.

Changes

John J. Tassoni, Jr. will step up to serve as the new president and CEO of the Substance Use and Mental Health Ledership Council of RI on August 20, replacing Susan Storti. ConvergenceRI asked Tassoni to provide his views of the changing landscape in Rhode Island when it comes to the recovery community.. His responses were pithy.

ConvergenceRI: What are the challenges confronting the state in combatting substance use issues?
TASSONI: Access to care, rates;  not enough beds for residential care; the number of different substances coming into the state and treatment options; and workforce.

ConvergenceRI: What are the shortfalls in the current budget?
TASSONI: Funding for the providers. They did girls residential, but not boys. Development of all levels of care
 
ConvergenceRI:  Is the state willing to engage with providers as partners?
TASSONI: That decision has been made. This a team effort; there is no I in team.

ConvergenceRI: What kind of data do you think the state should be producing to create a better understanding of the current epidemic?
TASSONI: Quicker turnaround of hospital OD stats. [Hiring] a chief medical examiner - has not been filled in years due to funding and more staff. Alcohol poisoning data or all age groups

ConvergenceRI: What questions would you ask of the candidates running for Governor?
TASSONI: Their commitment to the issue, and to have someone dedicated to their office to report back on issues and concerns.

ConvergenceRI: What kinds of new investments would you like to see in community-based mental health and behavioral services?
TASSONI: Higher rates.  Higher rates for the providers
Uncompensated care to be paid for, similar to what the hospitals receive. Residential care for young boys - to keep them in state. [A girls' unit is in budget ]
 
ConvergenceRI: Is the state suffering from what is known as compassion fatigue?
TASSONI: All of us are, due to COVID,

ConvergenceRI: Can you describe the value of Recovery TV?
TASSONI: Hope in recovery, brought by some of my guests, including providers showcasing their agencies
 
ConvergenceRI: What questions haven’t I asked, should I have asked, that you would like to talk about?
TASSONI: Will the state stay focused on the problem?




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