When a person struggling with addiction steps into Front Range Clinic's Mobile Health Unit, Tonja Jimenez greets them with a warm smile.
"They check in right here, this is our check-in desk," she pointed out. "This is our waiting area."
Jimenez, 38, is in recovery for methamphetamine use disorder. About 12 years ago, her addiction landed her in jail for a month. Within 36 hours of her release, Jimenez was using again.
"It just all hit me that, 'Oh my Lord, I am an addict. I couldn't stop. I couldn't say no,'" she said.
But Jimenez did say no. She went to treatment, got sober and continued her education. Last May, Jimenez earned a psychology degree from the University of Northern Colorado and is now the Mobile Health Unit's peer specialist.
"I just usually start off with small talk and if they need help finding resources for, let's say, homelessness, food, clothing, whatever it is that they might need help with," she said. "That's what I'm here for."
The Mobile Health Unit is housed in a 34-foot Winnebago coach RV. It's small but fits a counseling room, a bathroom for a urine sample and an exam room. These are the necessary equipment and resources to treat opioid use disorder.
The unit provides medication-assisted treatment (MAT) to those addicted to opioids. MAT combines behavioral therapy with medications like buprenorphine or naltrexone, which reduce cravings and withdrawal symptoms. The Mobile Health Unit also treats people with other substance use disorders.
Jimenez is part of a three-person, on-the-ground team that includes a nurse and licensed addiction counselor. Doctors are also available to meet with patients and write prescriptions via telehealth.
Far Reaching Addiction Treatment
In 2018, Colorado received a federal opioid grant and used some of the funds to build six Mobile Health Units. They will serve 25 rural and frontier counties that were chosen for several reasons, including high opioid overdose death rates and lack of treatment facilities. The goal is to serve 300 people a week.
"What we plan to do is start in these communities. But while we're in these communities, we also want to get other providers to become medication-assistant treatment certified," said Robert Werthwein, director of the Office of Behavioral Health. "Then hoping we build a capacity, then we can move on to the next community."
Front Range Clinic was awarded three of the Mobile Health Units. The health care company provides MAT services at 19 brick and mortar locations and is embedded in more than a dozen community-based programs around the state.
"That's been part of the mission from the very beginning that we want to provide this low barrier, high access to care," said Jeremy Dubin, medical director at Front Range Clinic.
Two of Front Range Clinic's Mobile Health Units are currently in operation. They are based in Pueblo and Greeley and serve the Eastern Plains.
The Greeley unit covers the northeast and serves patients in Sedgwick, Logan, Phillips, Lincoln and Kit Carson counties. In 2017, only two of the counties had a facility that provided medication-assisted treatment and, according to state data, didn't take Medicaid.
The Mobile Health Unit goes to the same six locations every week, including a café, museum, hospital, pharmacy and community center. The providers will treat anyone regardless of insurance and patients can make appointments or walk in.
Before the Mobile Health Unit, people had to travel to bigger Front Range cities for services.
"We saw someone in a very remote town who was taking an entire day off work every month just to get their medicine," said Donna Goldstrom, clinical director of behavioral health services at Front Range Clinic. "Now since we're in his town he literally comes to the mobile unit over his lunch break to get treatment."
Community Participation
Before the units were ready, Front Range Clinic met with hundreds of people around the state to learn more about their community's needs. Shaun Wilson, executive director of Hope House, a transitional housing facility in Sterling, attended a presentation and got concerned because no one with a substance use disorder was there.
"If we plan on addressing our opiate addiction, then I think what we need to be doing is listening to the voices of the individuals who are struggling with that addiction," Wilson said.
Wilson asked her residents to share their drug treatment experiences with Front Range Clinic. They said long wait lists and lack of services made it difficult to access treatment.
Front Range Clinic listened to Hope House residents and other individuals who attended their meetings. The company prioritized their needs, according to Dayna DeHerrera-Smith, marketing and outreach coordinator, and made community members active participants and stakeholders in the project.
The Mobile Health Unit parks at Hope House when it's in Sterling.
"That's why we really enjoy the mobile unit," Wilson said. "We can send individuals directly there and all of their needs are immediately met."
Help In Any Way
The Mobile Health Units are required to see 50 patients a week. The Greeley-based unit is not there yet, but according to Goldstrom, more patients visit every week and are receiving treatment for more than just opioid addiction.
"We're seeing a lot of folks who have alcohol use disorder, people who have methamphetamine use disorder," she said. "We want to help all of them, in anyway that we can."
The Greeley unit has served patients in northeast Colorado for about two months. Jimenez said she's mainly talked to people who come in for alcohol abuse but is looking forward to helping everyone.
"I understand it looks like there's no way out. But look at where I've been. Look at what I've accomplished. Look where I am today, there is a chance," Jimenez said. "There is light at the end of that tunnel. You can make it."
Front Range Clinic will own the Mobile Health Units after the grant ends and plans to continue the service. The long-term goal is to create lasting change by training local providers so they too can offer medication-assisted treatment in their own communities.
