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Department of Behavioral and Community Health Presents Budget to County Legislature Continued addiction, mental health services among initiatives planned for 2019

Published: 11/16/2018

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Colleen Pillus

Poughkeepsie … The Dutchess County Department of Behavioral and Community Health (DBCH) met with members of the Dutchess County Legislature’s Budget, Finance and Personnel Committee this afternoon, presenting information and answering questions about DBCH’s 2019 budget as part of the ongoing Legislative review of County Executive Marcus J. Molinaro’s 2019 County Budget proposal.    DBCH highlighted initiatives and plans for the coming year, providing details about, among other efforts, the County’s ongoing “Breaking Through” initiative, which eliminates the stigma surrounding substance abuse and mental illness, encouraging individuals living with those issues to take part in the County’s myriad services and programs, leading them toward recovery.

In addition to continuing the County’s life-saving “Breaking Through” initiative, other DBCH initiatives Commissioner A.K. Vaidian, MD, MPH outlined for legislators included: increased Citizen’s Preparedness and “Stop the Bleed” training sessions, presented by the Medical Reserve Corps of Dutchess County; the creation of a coalition of local schools, community-based organizations and public health providers to formulate effective ways to reduce the rates of sexually transmitted diseases; and outreach, education and provider training to maintain and improve measles vaccination rates to prevent outbreaks seen in neighboring counties.

County Executive Molinaro said, “The health and safety of Dutchess County residents is our top priority, and safeguarding our residents’ health – both their physical and mental well-being – is a grave task our Department of Behavioral and Community Health takes seriously. The opioid epidemic is unlike any other public health crisis seen in our lifetime, and Dutchess County must continue ‘Breaking Through’ the stigma of addiction and providing services and programs that save lives. We must also maintain the high-quality services that keep County residents as healthy as possible, while continuing to create innovative programs that combat emerging public health threats.”

County Executive Molinaro’s 2019 budget proposal looks to continue the unique and inventive services and programs Dutchess County offers those living with addiction.

Dutchess County Stabilization Center
The County’s Stabilization Center, a voluntary walk-in facility located at 230 North Road in Poughkeepsie and open 24/7/365, provides a single point of service where individuals can receive crisis counseling, mental health assessments, supervised outpatient withdrawal services, addiction, substance abuse counseling and peer advocacy and support. Dutchess County’s 24/7 intervention model, anchored by the Stabilization Center, is drawing interest from communities throughout New York State and the nation interested in replicating the County’s success.   DBCH has hosted site visits from interested officials from, among others:

  • the New York City Department of Health;
  • the Long Island field office for the New York State Office of Mental Health;
  • Westchester County;
  • Tompkins County;
  • Oneida County;
  • Monroe County; and
  • Suffolk County.

Staff at the Center connect individuals to drug rehabilitation providers, mental health and substance use treatment providers, housing services and faith-based community support. Since the Stabilization Center’s opening in February 2017, more than 2,600 individuals and their families have made over 4,400 visits to the center. To build on its success and to increase its utility, the Stabilization Center has taken on new roles, including offering training in Narcan, the life-saving medication that can reverse the effects of an opioid overdose, and distribution of Narcan kits on a walk-in basis.   In 2019, the Stabilization Center will also be able to initiate patients on Medication Assisted Treatment (MAT) thanks to state funding for a licensed prescriber.

Recovery Coach 
The 2019 Executive Budget also provides permanency for the Recovery Coach position created in 2018. The Recovery Coach aids individuals in maintaining their recovery by providing motivational coaching, mentoring, lifestyle consulting, recovery planning and resource guidance from someone who has lived through recovery themselves. To date, the Recovery Coach has served 167 individuals with referrals coming from all of DBCH’s outpatient programs, including the Stabilization Center, Intensive Treatment Alternative Program (ITAP), Partial Hospital program and services based at the Dutchess County Jail.

Dutchess County’s new recovery coach is in addition to numerous recovery coaches currently serving with various community agency partners including the Council for Addiction and Prevention (CAPE), PEOPLE, Inc., and Lexington Center for Recovery. 

Medication Assisted Treatment 
The Medication Assisted Treatment (MAT) program has expanded with a new medication dispensary center to meet the growing need for this highly effective program. In the past year, the County has doubled the number of participants in the Lexington Center for Recovery’s Methadone program at its 230 North Road mental health services campus; this has increased the capacity of the Methadone Maintenance Treatment Program (MMTP) to a maximum of 500 patients and expanded its offering of clinical services to enhance rehabilitative and psychosocial interventions that are available for individuals receiving Methadone.  Of those in the MAT program, 85 percent have discontinued illegal opioid use; and more than 60 percent have maintained or improved their employment, successfully managing their addiction and living quality lives. 

Further, DBCH is working to expand MAT offerings throughout the community by engaging with physicians, pharmacists, emergency departments by assessing needs, providing MAT waiver training, guiding individuals through the various regulations, and connecting them with state programs.
The County also continues to connect those released from the Dutchess County Jail with these treatment programs as a tool to maintain ongoing recovery.

ReSTART program
Criminal justice patients are particularly vulnerable to fatal opioid overdoses, which is why the County works hard to connect these individuals with supports and treatments upon their release from the county jail. While the individuals are incarcerated, the County offers a host of jail-based services in an effort to reduce recidivism including ReSTART, an evidence-based program designed to provide treatment and reentry services to inmates, to address numerous issues, including chemical dependency. Further, Vivitrol – a type of MAT – is offered at the jail in addition to the provision of Narcan kits and training to all opioid-involved inmates leaving the jail.

U.S. Department of Justice Grant Award
The U.S. Department of Justice recently recognized Dutchess County’s efforts in tracking and conducting data analysis on local opioid use, awarding the County a grant of nearly $1 million to “lead an effort to prevent overdose fatalities through timely, comprehensive information sharing within a community-wide collaborative that includes public safety, public and behavioral health, and other vested partners.” This award will allow DBCH to: 

  • create a Data-Driven Opioid Response Collaborative (DDORC) – increasing the capabilities of the Opioid Task Force;
  • enhance overdose surveillance and monitoring; and
  • undertake comprehensive capacity building initiatives aimed at integrating harm reduction principles into existing service delivery models and identify and address disparities in access to behavioral health services. 
  • Education and Outreach

Dutchess County’s Opioid Educator, which is made a permanent position in the 2019 Executive Budget, assists with the coordination of the County’s Opioid Overdose Prevention Program, the planning of the County’s response to the opioid epidemic, and provides relevant trainings, education and outreach to all interested parties.   The Opioid Educator has been instrumental in the expanded distribution of Narcan kits and the training that accompanies it.  DBCH routinely hosts eight to 10 Narcan trainings each month throughout the community, distributing some 200-300 Narcan kits at these trainings. 

In addition, DBCH provides numerous ongoing outreaches, educational training and preventions throughout the community, including:

  • Second Step, an evidence-based program that teaches social emotional skills and concepts, designed to help children be more successful in school and develop skills that last through adulthood. This curriculum is aggressively promoted by DBCH and currently utilized throughout local schools with few exceptions.
  • Mental Health First Aid and Youth Mental Health First Aid, universal evidence-based educational courses that seek to inform the public about the earliest signs of substance use and mental health challenges.
  • Screening, Brief Intervention and Referral to Treatment (SBIRT), an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. The SBIRT model encourages community-based screening for health risk behaviors, including substance use. DBCH trains medical facilities and community providers in the development and implementation of such protocols.

Moreover, County Executive Molinaro’s budget proposal continues funding for and the provision of Crisis Intervention Training (CIT) for county law enforcement, first responders and other criminal justice related professionals to ensure we have resources who can help de-escalate incidents and divert individuals to a safe and therapeutic environment.  As a result of the County’s efforts, every community in Dutchess County boasts a cohort of Narcan- and CIT-trained law enforcement officers.

County Executive Molinaro said, “Make no mistake: Dutchess County’s radical and innovative approach to combatting the opioid crisis is making a difference in our community – saving the lives of many battling substance abuse and reaching others before they take their first step on the road to addiction. Still, there is much more work to be done. Moving forward, we look to build on our successes and innovate to create new strategies, all with the ultimate goal of preventing as many Dutchess County deaths as possible. I hope the legislative members will share our vision and support our life-saving mission.”

The full Dutchess County 2019 Executive Budget proposal, including the Department of Behavioral and Community Health, is available online.