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Schenectady's Hometown Health to expand addiction treatment with Conifer Park partnership

Schenectady's Hometown Health to expand addiction treatment with Conifer Park partnership

Partnership with Conifer Park will offer multilayers approach to substane use
Schenectady's Hometown Health to expand addiction treatment with Conifer Park partnership
Dr. Cristine Espinosa holds a box of Suboxane Friday that is prescribed to heroin addicts to help their addiction.
Photographer: PETER R. BARBER/GAZETTE PHOTOGRAPHER

SCHENECTADY — Hometown Health will be expanding its drug and alcohol abuse treatment options through a collaboration with Conifer Park and with the help of a $350,000 state grant.

The goal is not to make Hometown another provider of comprehensive services but to make it a portal to such treatment, and to better serve the patients who rely on Hometown for their health care needs.

“There’s a need in the community,” said CEO Joe Gambino. “We can certainly help them with their addiction on the medical side but there’s also a great deal of counseling that needs to go along with that.

“We’re really not doing any substance abuse counseling. New Choices does it and Conifer Park does it, they do a great job.

We want to provide substantive bridge to those services.”

Dr. Cristine Espinosa, chief medical officer at Hometown, said: “For us currently, our medical providers … have had limited  training in substance use disorders.

“Opiates such as heroin would be the big one we need help with.”

Hometown Health currently has medical and behavioral health personnel. It wants to add a counseling component because addiction has so many potential causes and impacts that an integrated approach to treatment is likely to be more effective.

“What we find, and this goes beyond substance use disorder, is people really want to be taken care of by their primary care doctors,” Espinosa said. “And we want to be able to provide that service along with behavioral health, in addressing all the needs of that individual.”

Justin Reimenschneider, behavioral health director at Hometown, said another benefit will be allowing drug-dependent patients to receive treatment at a full-service health facility, rather than at a site that treats only addiction, because some patients don’t want to go to an addiction treatment center.

“The main point I’m seeing it as is hopefully taking away some of the stigma and just allowing people to come for what might be a regular doctor visit,” Reimenschneider said.

Hometown Health, which also has an Amsterdam clinic, is headquartered at 1044 State St., on the edge of the Hamilton Hill neighborhood. It is a Federally Qualified Health Center, a designation that provides it with increased federal funding because it serves a low-income population.

One would be mistaken, Espinosa said, to assume that Hometown Health’s patient population is more prone to drug abuse because of income.

“We are finding nationally not just in Schenectady that heroin is not discriminatory in far as who its affecting,” Espinosa said. “Do patients in poverty have more risk factors that would lead to substance use disorder? You might think so.”

But the risk cuts across all regions, she said.

That said … she doesn’t have a good handle on how many of the 22,000 people Hometown Health treats each year have a drug or alcohol dependency. Some show obvious signs, some do not. But only about 6 or 7 percent volunteer the information or admit it when asked.

“We think that’s a gross underestimate,” Espinosa said. “We think that in the future as we’re developing our ability to treat substance use disorder, people will become much more forthcoming, and we’ll have a better understanding in about a year from now.”

Hometown Health is expanding its treatment offerings through an initiative of the state Office of Alcoholism and Substance Abuse Services, which is providing $5.25 million to expand access to medication-assisted treatment at primary care clinics and hospital emergency rooms across the state. Hometown was awarded $350,000, but must partner with an OASAS-certified facility to claim reimbursement under that grant.

Conifer Park is certified. It runs an inpatient facility in Glenville and outpatient clinics in Schenectady and five other upstate cities.

Michael Kettle, vice president of business development at Conifer, said the integrated treatment model envisioned through the partnership with Hometown is important to effective care. And it’s seen as a two-way street, with Hometown providing medical care or an outpatient setting for counseling.

For many people suffering through addictions, health care is a secondary, tertiary or even non-existent priority after feeding their habit, Kettle said.

“This is not just a fix by taking a pill,” Kettle said. “We’ve said for decades this a chronic progressive illness.”

The specifics of the partnership with Hometown are still being worked out. Kettle expects telemedicine will play some role in the package. He hopes there will be Conifer counselors on site at Hometown, doing evaluations and follow-up assessments, perhaps running a group therapy session. Such a setting would be ideal for the inpatient who is transitioning to outpatient followup care, he added.

Addiction to alcohol, synthetic opioids, benzo drugs and (less commonly) methamphetamine are seen in Schenectady-area patients, said Kettle, a 30-year Conifer employee. But the addiction hitting hardest now is heroin.

“We still really are in the middle of an opiate crisis and I don’t see that abating for years,” he said.

The medication-assisted treatment model being pursued by Hometown and Conifer is the standard of care for opioid use disorder in New York state.

“Access to the appropriate treatment is life-changing and critical in achieving recovery,” OASAS Commissioner Arlene Gonzalez-Sanchez said in a news release. “These awards will expand access to important care and enable those who are fighting addiction to receive the medication needed to help them succeed and live happy and productive lives.”

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