Milestone has long believed that a collaborative approach to substance use disorders treatment is more effective in improving health outcomes than a siloed approach to care. Last year, Milestone joined the Greater Portland Addiction Collaborative (GPAC), a new and unique collaboration, spearheaded by Mercy Hospital, focused on improving outcomes by optimizing existing services and capacity. GPAC aims to create a comprehensive treatment model, focusing on four key goals: effectively using existing resources, lowering cost while increasing the availability of high quality treatment, filling the gaps by expanding the continuum of care, and ensuring accountability for services delivered. GPAC members include local hospitals, the City of Portland, Portland Police Department, treatment and crisis providers, and housing and employment providers.

As part of GPAC, Milestone will work to enhance some of its critical areas of service. Our goals for 2017 are to expand the Homeless Outreach & Mobile Engagement (HOME) Team from one to two teams. Our collaboration with GPAC will also help us build capacity for treatment in our Detox Program. We will enhance both our physical space and nursing staff, and the implementation of an electronic medical records system will help us improve the efficiency of the program.

What should be the most important area of focus in 2017, if we are to be successful in combating the current opioid crisis in Maine?
Our primary focus for combating this deadly crisis from a statewide perspective continues to be a comprehensive approach that acknowledges the lifesaving value of working the problem from a preventative, treatment, and enforcement angle. We must realize that a singular focus on just one of these areas will result in long-term failure and, with our family members’ lives on the line, we can't allow that to happen. 

What are some important steps each of us needs to take?
We must realize as human beings that this new "war" on the disease of addiction, rather than those who suffer from it, will be long and hard fought. It is imperative that we stay engaged and, as we lose a loved one a day in this state to a fatal overdose, we must hold each other accountable for change. We must hold our elected officials accountable while demanding that they act with common sense and dignity. MaineCare expansion is a necessity in this fight and, as citizens, we should refuse to allow it to be held hostage by political ideology.

Where do you see Milestone's role in the opioid crisis moving into 2017?
I continue to see Milestone as a statewide leader in the movement to fight this crisis. That role will be further enhanced as the Greater Portland Addiction Collaborative (GPAC) continues to pick up momentum from various funding sources. GPAC is a game-changing initiative that will save lives while serving as a national model for others to follow. 

According to a recent study conducted by the National Health Care for the Homeless Council, homeless people are three to six times more likely to become ill than housed people. But, due to a variety of factors such as lack of health insurance, many homeless people who are ill and need treatment do not receive medical care. As a result, many homeless individuals utilize hospital emergency rooms as their primary source of health care. This is an ineffective form of care and very expensive for the emergency medical system. This spring, Milestone’s Homeless Outreach & Mobile Engagement (HOME) Team will seek to expand its services by adding a medical outreach component to the Team. Currently, the HOME Team provides street outreach, intervention, referrals and transportation to homeless individuals experiencing chronic health and substance use disorders in Portland. Medical outreach will help improve health outcomes for homeless individuals by alleviating their substantial unmet medical needs. Through this innovative approach, the HOME Team will provide a necessary community resource for people in need that will improve services and focus on prevention rather than emergency services.
 

Milestone’s detox clients are all too often discharged with no housing or treatment options due to lack of insurance and affordable sober housing options, which inevitably results in high rates of recidivism and relapse. In an effort to increase capacity and coordinate care at discharge, the Greater Portland Addiction Collaborative (GPAC) has initiated the opening of a new, structured sober living facility in Westbrook, which will house 12 women. The facility will be operated by Community Housing of Maine (CHOM), with services provided by Amistad, and with Milestone’s Detox Program as one of its primary referrals. GPAC hopes to continue developing additional structured sober living facilities by possibly opening three additional new sober houses by the end of year. Milestone is also actively exploring opening one of its current houses on the Old Orchard Beach Extended Care Campus to sober housing programs not affiliated with Milestone services.