Codman Co-Hosts Conference on HIV and Substance Use Disorder: Lessons Learned

Denise Croken, NP, CARN-NP, with former Codman staff member Pooja Raval, MC, and Raphael Apter, LMHC.

This winter, Codman staff joined forces with the National Aids Education and Training Center to host a full-day conference in Boston titled “35 Years of HIV and SUD Lessons Learned and Shared Experiences.” The conference was organized and kicked off by Codman’s Dr. Jonathan Pincus, MD, who has worked in HIV care for more than 25 years.

“When I started working with HIV patients in the 90s, they faced serious stigma, complex treatment needs, housing issues, and other challenges,” says Dr. Pincus “We are seeing patients with addiction facing many of those same issues, so we believe there is great value in getting those involved together to talk about what we’ve learned and the best ways to move forward.”

At the conference, experts in the fields gathered together and shared information, broke into discussion groups, and heard from experts in topics such as community engagement, peer/patient engagement, legal support, and more. Like HIV, harm reduction practices in addiction use can save lives, and providers see that up close.

In addition to Dr. Pincus’ contributions, Codman’s Ian Huntington, MD, and Denise Croken, NP, spoke about advanced clinical issues in substance use health and wellness. They presented on a cutting-edge treatment that is a long-acting injectable for opioid disorder. Instead of a pill every day, patients can get an injection once a month. “Codman was one of the first community health centers in the state to offer this injectable, so we were happy to share our experiences,” says Denise Croken, MSN, NP, CARN-NP, a substance use health and wellness nurse practitioner.

Meet Codman’s Newest Board Member: Desiree Otenti

Desiree Otenti, MSN, MPH, recently joined Codman’s Board of Directors and brings with her advanced practice nursing experience, deep knowledge of vulnerable populations, and management and insurance expertise.  Her unique experience and perspective will be a valuable addition to the board, which is comprised of patients, community members, and experts in the health care field.

Otenti studied biology in college, but it was an early experience that drove her to want to help others. She recalls when she was 8 years old her father, born in India, took her on a trip to visit family in his home country. While shocked by the poverty in general, she was particularly moved by an elderly man sitting in the hot sun begging for money. Her father wondered aloud why no one helped move the man to the shade. Desiree remembered thinking “Why don’t we help him?” That memory and the feeling of wanting to help people in need remains with her today.Once she graduated, she decided to combine her passion for science with her life-long desire to help people.

Desiree continued her education and became a nurse practitioner.   She started to practice  at our fellow community health center – Boston Health Care for the Homeless. Here she gained a lot of medical experience, and also  got to know a very vulnerable population of patients.  She later went back to school to study Public Health, focusing on policy and management. “I realized that helping patients one-on-one was meaningful, but using the knowledge I gained from patient care to help create patient-centered policies would be more impactful. I wanted to help a population of people all at once,” she says.

She has served as the director of case management at Boston Health Care for the Homeless, and eventually became a senior clinical manager at Blue Cross Blue Shield of Massachusetts where she is now their senior director of medical policy. “It’s been eye opening to see the health care system from this bigger-picture view. Health care resources are limited, so it’s increasingly important to make sure the right patients are getting the right treatments that will actually improve their health outcomes.”

In this current role, Desiree oversees the review of medical literature that examines which new medical devices, drugs, and procedures are most effective for which patients. With that information, BCBSMA can create criteria about which patients receive certain services. “We look at the studies product manufacturers conduct to get FDA approval and ask – does this study prove that this device actually makes the patient have a better health outcome?” she says.

Desiree also volunteers for BCBS’s Women’s Inclusion Network. As a past  president, she continues to organize programs and events for the female BCBS staff.

In the summer of 2019, Desiree learned about the opportunity to serve on the Board of Directors of Codman, and was happy to become a part of team Codman. “Between my ongoing work as a nurse practitioner taking care of vulnerable patients and my work on the payer side, I have a unique perspective of the health care field – the forest and the trees,” she says. “I hope to use this knowledge to help continue to position CSHC as a leader in the heaLth care industry, not only as a model for other community health centers, but as a beacon for the industry as a whole. CSHC has a holistic view of health that goes beyond the stethoscope and clinic door, which complements her talents..

Desiree says that she is still trying to learn as much as possible about the health center, its staff, board, and aspirations.  She is committed to working with Codman in its role of keeping the community healthy. She says she doesn’t think that the current status quo of health care delivery does that, but is impressed with Codman’s work thus far in making positive change.

“CSHC has a history of exploring outside of the box ways to bring health and wellness beyond the clinic doors. I want to continue to explore new models of care delivery, new ideas around what actually makes a community healthy, and new partnerships to deepen CSHC’s impact for the people we serve.”

After Struggling to Get Healthy, This DotRx Coach Now Helps Others

Annette BartleyAs soon as Annette Bartley heard about the opportunity to become a DotRx  coach, she knew that it was something she wanted to do. Bartley, a Codman patient , knew that as someone who struggled to get healthy and succeed with lifestyle changes, she wanted to help others do the same.

Bartley was one of the first  coaches , in Codman’s DotRx healthy prescription program and loves it. DotRx is a no-cost, prescription-based program for Dorchester residents who are patients at Codman. With the support of Blue Cross Blue Shield of Ma and our community partners The Daily Table, Healthworks, Outdoors Rx and the Dorchester YMCA, our providers write “prescriptions with the goal to connect families to experiences that promote healthier lives, including opportunities to eat healthy, get outside, and be active. A key component to the program is that patients are connected with a  peer coach – a resident from our community   who can help them eat healthier and engage in more activity – outdoors and indoors.

Bartley, now in her second year, finds helping families rewarding and fun. She recollected that her first DotRx  family was introduced to the program by their Codman provider.  prescribed DotRx because their 12-year-old was struggling with weight issues.  Bartley reached out to the family and met them at Franklin Park for a walk, through the Outdoors Rx program.

While the youth was reluctant at first, Bartley stressed “try everything once and see if you like it,” and the boy ended up having a good time while he got some exercise. Another day they went to the Roxbury Y so the mom could take a Zumba class and the son could play basketball.

She has inspired several families with her gentle but persistent outreach, and keeps up with them by texting frequently, asking them to shoot a quick picture of them being active or enjoying a healthy meal, and generally giving support and advice. She also shares her own journey with DotRx patients, texting back photos of herself being active.

She reads a lot of health information and talks with friends who are fitness enthusiasts. “Even though we are not experts in everything, people see that you lost weight and will do the same things you did,” Annette says.

At one point, in her life, Bartley struggled to lose weight.  As a high school swimmer, getting to the YMCA to swim for exercise was a natural step. However, when swimming alone wasn’t accomplishing what she wanted, she knew she needed to add something new to her fitness routine. She realized it was challenging to step into the gym and to try something new, but she put herself out there and encourages DotRx families to do the same.

When it comes to healthy eating, Annette sings the praises of The Daily Table, a low-cost grocery store in Codman’s Health and Wellness Center at 450 Washington St. Dorchester, whose mission is to sell healthy and tasty food at fast food prices.

“You can have a ‘hungry horror’ day and go into Daily Table and grab a quick, healthy, and affordable snack. How much damage can you do at Daily Table? Most of their products are healthy,” she says. She gives clients tips based on her own experience there, such as going in at night and buying two salads – one for dinner and one for lunch the next day.

When she talks about exercise, she talks about the Dorchester YMCA pool for families, and was thrilled to see one client who had a particularly difficult time because of pain and inflammation do well in the pool. “She couldn’t believe what she could do in the water that she couldn’t do on land — squats, kicks, jumping jacks.” She also talks about the benefits of working out at healthworks Fitness at 450 Washington Street.  Annette stressed that having a  coach is what got this particular client to try the pool in the first place.

Bartley, like the other DotRx coaches, has a full-time job. She knows the challenges of making time for a healthy lifestyle when your schedule is tight. She has had a lot of success with the clients she has worked in the program, and loves being able to work with members of her community and show them the resources they have here in the neighborhood.

Boston Medical Center Opens Pharmacy at Codman Square Health Center

 

On Dec. 30th, Boston Medical Center opened the BMC Pharmacy at Codman Square Health Center, BMC’s  first offsite pharmacy. The pharmacy, located on the ground floor of the Health Center, has dramatically improved service, as it offers a seamless link between BMC and Codman’s electronic medical records. Many of Codman’s patients are also patients at BMC.

BMC Pharmacists are nationally certified, in addition to being registered health providers with the commonwealth. In addition, the pharmacy has added a new state-of-the-art automation device, as well as other technology upgrades.

The BMC Pharmacy at Codman easily accesses interpreters in 240 languages so that patients can communicate in the language in which they feel most comfortable. Patients can also use the mobile app called Pocket Rx, where they can check their profile and request refills without having to make any phone calls. (The app is available at on iTunes, or Google Play.)