Organization Name: MaineGeneral Community Care

Program Name: Integrated Harm Reduction Program

Program Contact: Shane Gallagher, Program Manager
Email: shane.gallagher@mainegeneral.org     Phone: (207) 861-5253

UWMM has funded this program for 2 years.

Amount Requested: $5000
Is this an increase from what your program received for the current funding cycle? 
No

Twenty-five word summary of this program’s purpose:

This program aims to reduce the negative effects of substance use by providing HIV and Hepatitis harm reduction education, anonymous testing and needle exchange services.

How your program is uniquely important to the community:

The Harm Reduction Program provides free and anonymous harm reduction education, HIV and Hepatitis C testing, condom dispensing, and clean syringe exchange in a safe, non-judgmental environment. The program is the only State of Maine Certified Syringe Exchange Program in serving the area. The program is located at 9 Green Street in Augusta and 149 North Street in Waterville. The Green Street location has walk-in hours on Tuesdays 2:30-4:30pm and Wednesdays 12:30-4:30pm. The Waterville location has walk-in hours on Fridays 10:00am-2:00pm.  Anyone can voluntarily access all of the Harm Reduction Program’s services.  

Trained health educators offer free rapid and confidential HIV and Hepatitis C testing to high-risk individuals, with no appointment necessary during open hours. Testing is also offered once per month at the Discovery House treatment center and at Blue Sky Counseling.  Each 30-minute testing session provides staff the opportunity to offer risk reduction education, counseling, and use motivational interviewing to determine clients’ readiness to consider substance use recovery, treatment or other support. Clients receive their test results on site and staff can immediately link clients to treatment. Our clients are regularly linked with Primary Care providers, treatment services, counseling, housing and food assistance. 

The Harm Reduction Program delivers education and outreach throughout Kennebec County, through a partnership with the MaineGeneral Overdose Prevention Program.  This program focuses on overdose prevention through education of people who are incarcerated, people who are in treatment for recovery, and staff members of agencies working with individuals who may be at risk for overdose.

Program Updates

Since last report (or in past two years):

There have been four major changes since the last review. First, Shane Gallagher is the new Program Manager for the MaineGeneral Harm Reduction Program. Shane received a Master’s of Science in Health Policy from the Edmund S. Muskie School of Public Service at the University of Southern Maine and is a Certified Health Education Specialist. Shane has ten years of public health experience and spent the previous two years working as a health educator in the Overdose Prevention and Harm Reduction Program. Second, the program received several grants including state grant to deliver overdose prevention education, grant funds from Stephen and Tabitha King Foundation to expand harm reduction program services, and a federal grant from the Health Resources and Services Administration (HRSA) to address stigma associated with substance use and medication assisted treatment capacity across Kennebec and Somerset counties. Third, the program successfully opened a second harm reduction office in Waterville with support from the United Way of Mid Maine and the Stephen and Tabitha King Foundation. This second location offers all the same harm reduction services as the Augusta location, including HIV and Hepatitis C testing.  Finally, a grant that assisted the program to acquire testing supplies and partially reimburse the program was not renewed by the funding agent. The program decided to continue providing these services despite the loss of funding.

 

Expected in the coming year:

The Harm Reduction Program’s overdose prevention projects continue to receive strong support.  However, the need for clean syringe access, HIV and Hepatitis C testing, and referral to treatment continues to grow.   This year’s work will focus on expanding harm reduction services and outreach to increase awareness among community partners. Two additional staff will receive training from the State to perform rapid HIV and Hepatitis testing, which will greatly expand our capacity to provide testing at offsite locations.

Outcome your program most contributes to:
Health: All individuals in Mid-Maine are in safe and healthy environments with access to health supports and services.

How program contributes:
Provides a direct service in behavioral and/or physical health areas, Increases access/reduces barriers to direct services, Advocates for behavioral and/or physical health, Collaborates with other programs/services in behavioral and/or physical health

Define your year: July 1 – Jun 30

How much did we do? 132 (Total number served)

How well did we do it?

Performance measure: Percent of returning clients
Most recent year’s data: 66%
Previous year’s data: 67%

What was the difference made?

Performance measure: Percent of clients whose basic needs are met
Most recent year’s data: 100%
Previous year’s data: 100%

Action Plan

Objectives for current year:

The primary goal of the Integrated Harm Reduction Program for the current year is to continue to expand services in Waterville to better serve the Mid-Maine area.

  • Disposed of 124,000 used needles.
  • Serve 40 new members.
  • Administer 30 total HIV test and 20 total HCV tests.
  • Deliver materials, outreach, and education to individuals and partner organizations through the Mid-Maine area.
  • Distribute 1,000 condoms.
  • Distribute Narcan kits directly from the Harm Reduction offices to high risk individuals.
  • Track all activities completed and services delivered on a monthly basis.

Objectives and results from last year:

  • Continue to deliver harm reduction services at the program’s Waterville location.
  • Expand Partnerships to better facilitate linkages across organizations spanning the Mid-Maine service area.
  • Continue to track all activities, services, delivered, referrals made, supplies distributed, tests completed, and member input/feedback and review monthly to identify area for quality improvement.
  •  

    Further, the program tracked the following performance measures:

    • Number of Syringes Disposed (Goal 130,000).
    • Percent of members provided supplies (Goal 100%).
    • Percent of members enrolled that year (Goal 50%).
    • Number of HIV Rapid Tests completed (Goal 30).
    • Number of Hepatitis C Rapid Tests completed (Goal 30).

    Overall, the program’s objectives were completed. However, of the five performance measures, the program met only one goal (percent of members provided supplies). A combination of factors led to this result.

    First, the program experienced staff turnover. This left the program understaffed for several months. One health educator covered both exchange sites in addition to their normal duties. Despite being understaffed, the program performed 27 HIV tests and 22 HIV tests and disposed of 121,988 used needles.

    Second, membership data showed a decrease in the number of active exchange members. The surge in fentanyl and heroin use in 2017 is one possible factor in this decrease either due to members passing away from overdose or seeking treatment on their own. In 2017, over half of all overdose deaths in Maine had fentanyl or a fentanyl analogues in their system. Due to the anonymous nature of the program, we cannot be sure; however, anecdotal evidence from members points toward these factors.

    Third, stigma associated with substance use likely played a role in the number of new members accessing services. Reviewing new member data from 2004 and 2005 indicated a slow, gradual growth in the program at the Augusta location. We anticipate the Waterville location will experience a similar growth, as word spreads through the community of the services availability.

    Success Stories

    “I have been a member of the exchange for about 5 years. I appreciate all of the help that they have given me throughout the years. I could not afford to get HIV or Hepatitis testing on my own and being able to get that done here has benefited me and others by known that I test negative. I have also always been able to use clean supplies and not shared any needles or equipment with others. They have helped me very much with reducing the risk to myself and/or others. Thank you.”

    Previous Year Actual Income and Expenditures

    Government Funding UWMM Funding Other UWs Funding Fees/Dues Funding Other Sources Funding Total Income
    0 3000 3000 0 14047 20047

    Total Actual Expenditures: $19491

    Current Year Budgeted Income and Expenditures

    Government Funding UWMM Funding Other UWs Funding Fees/Dues Funding Other Sources Funding Total Income
    8986 5000 3000 0 12105 29091

    Total Budgeted Expenditures: $29091

    Anything remarkable about your program’s budget:

    As mentioned earlier, the Integrated Harm Reduction Program’s budget is largely dedicated to the purchasing of supplies. The State of Maine dollars were approved by the state Legislature in the spring of 2018. These dollars are scheduled to be distributed February 2019 through June 2019. It is unknown, at this time, if this is one time funding from the State or if there will be future investments. These state dollars may only be used for the purchases of supplies. 

    The other category of funding includes Syringe Access Funding received from the Health Equity Alliance of Maine and discretionary money from the CEO of MaineGeneral Health. In both cases these funds are for purchasing of supplies for the operation of the exchange. 

    The program submitted an application to the United Way of Kennbec Valley for $3,000 dollars. The program has not received an award letter at this time and considers these funds unconfirmed. 

    The previous fiscal year had a small surplus due to carry over from a previous fiscal year. This carryover was the result of slow payment by a funder.

     
    What else you’d like reviewers to know:

    Due to the anonymous nature of our services, we do not collect residence data below the county level. In calendar year 2018, 90% of clients resided in Kennebec County.  

    We identify the basic needs of our clients as access to safe, clean supplies, testing services, and referrals to other resources as needed. 

     

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