Support Wellness is an innovative program at the South End Community Health Center that provides patients suffering from OUD with medication assisted treatment in an integrated primary care setting that the program also includes extensive mental health treatment and case management co-located with medical services. Support Wellness was initiated in October 2016 as a HRSA funded harm reduction program and has expanded its services to provide STI screening, including HCV and HIV, as well as treatment, for all patients receiving primary care and OUD treatment. With an understanding of the high prevalence of chronic health problems impacting individuals suffering from OUD and mental illness, Support Wellness ensures that patients receive comprehensive treatment for all chronic conditions including COPD, asthma, diabetes, heart disease, and chronic pain. The program was designed as a nursing-led multidisciplinary model offering individualized community-based care to a growing number of patients (now 170) living with SUD. The program and its patients are located in a dense urban area where homelessness, drug use and drug dealing are extensive. Within the first year of its inception, the program grew to capacity with respect to the size of its staff and the number of patients.
Currently the staff includes two registered nurses, a nurse practitioner, a medical director who is a board certified physician in both Internal Medicine and Psychiatry and Neurology, a psychologist, a licensed social worker, a navigator/case manager, and a program coordinator. A physician with HCV and OUD expertise has recently joined the team and is dedicating 12 hours a week to provide comprehensive primary care to our patients exclusively. The location of the program, as well as its excellent reputation and open capacity has resulted in a high number of referrals. Support Wellness grows by an average of three new patients a week. The program is designed to have the flexibility to see patients for same day appointments and to see existing patients in the same week should they miss their scheduled appointments. As a result of open access and same day treatment, as well as the program’s popularity, the team nurses are seeing a large number of patients daily and are in need of support from additional nursing staff to be available to continue to deliver high level and flexible care. SAMHSA funding would support the department’s rapid growth and expansion of care to successfully meet the urgent needs of patients with OUD and thus prevent the number of overdoses in this community.
As part of its ongoing expansion and innovation, the Support Wellness team visits the Suffolk County House of Correction on a weekly basis to provide education directly to female and male inmates regarding health issues, including primary care, HCV and HIV treatment, medication assisted treatment, and overdose prevention, The team also provides pre-release treatment planning to ensure that incarcerated individuals are connected directly to medical services upon release. Support Wellness proudly offers its services to everyone regardless of race, sexual orientation, gender identity, or socio economic status and cultivates a safe space for all of those enrolled in the program.