Tuesday, July 16, 2024

Coastal Horizons cuts down wait times for MAT patients, tackles capital projects in 2023

Coastal Horizons has capital projects slated for the coming year with funds from the New Hanover County Endowment; one of which is to add a fourth window for patients receiving daily medication-assisted treatment. (Port City Daily/Amy Passaretti)

WILMINGTON — Every morning at 615 Shipyard Blvd., roughly 350 people line up at Coastal Horizons Center to wait for medication.

There are more than 600 clients in its medication-assisted treatment program. Currently, the facility has three windows to serve patients, who check in daily to receive prescriptions.

READ MORE: Commissioners to consider preliminary spending of $68.5M from hospital sale funds and opioid settlement money

It takes 4.39 minutes to get to the dosing window from the waiting room. Coastal Horizons wants to add a fourth window — a move that could reduce wait times by 25%, or save six hours a day, for the nearly 400 recipients of methadone or buprenorphine.

To keep up with its growing outreach, the New Hanover facility — a campus consisting of its main Shipyard Boulevard facility, Clinica Latina, community-based programs, Horizons Health Services, Outdoor Adventure, Prevention Services, Rape Crisis Center and Wilmington Health Access for Teens — has a long wish list of upgrades.

With its newly awarded New Hanover County Endowment Grant — Coastal Horizons was one of five organizations out of 110 to receive the maximum amount of $250,000 — it plans to use funds on four capital projects, including the new window.

“That will enable us to get more people in and out and get back to work and back to their lives,” development director Elizabeth Redenbaugh said. “We’re thrilled about that.”

The nonprofit’s substance use disorder and health treatment center began operating in 1970. In its 2021-2022 annual report, it noted more than 2,600 patients came through its doors for mental health and substance use disorders. The facility is admitting on average 182 new patients per month. 

Coastal Horizons, founded by Flo Stein-Bolton, first launched the Crisis Line Open House, still in existence today, with $14,000 received from the county commissioners. Fifty years later, the nonprofit has ballooned with a budget that exceeds $40 million dollars and 600 staff members. 

Now serving 57 counties statewide, the nonprofit has grown its programs to include more than 20 services, including re-entry and recidivism reduction, rape crisis center, housing, and mental health.

One that started more than 20 years ago is the Open House Youth Shelter, approved by the state in 2010 as a residential foster care facility. It serves on average 70 individuals annually. Also with the endowment grant, Coastal Horizons will be revamping the facility.

The nine-bed homeless shelter serves children ages 6 to 18 who don’t have a safe place to live. Its kitchen is in need of a complete remodel, as it’s “dangerously close” to being non-compliant with current health codes, Redenbaugh said. The common areas also need upgrades, as do the three bedrooms, each outfitted for three individuals, with an attached bath.

“It needs a fresh look,” Redenbaugh said. “Children live with us for several days, some for as many as two years. It’s their home and it needs to be a place welcoming for them.”

The waiting area of Coastal Horizons’ main facility will receive new seating as construction will get underway to expand the room. A partial wall will come down to eliminate the “small hallway” feel for when the hundreds of patients enter the building daily.

“It’s more about flow and feel than it is about added square footage,” Redenbaugh said. “The feel of the area doesn’t reflect the value of dignity and respect toward patients coming through.”

Two other projects are located off-site; the first being at Wilmington’s Health Access for Teens. Coastal Horizons provides mental health, substance use and prevention services in several schools throughout the county and primary care services on four high school campuses — Ashley, Hoggard, Laney and New Hanover High.

Its main office is at 4005 Oleander Drive, and a first-floor conference is slated to be closed off. The children’s waiting area on the second floor opens to a large meeting room below and therefore conversations are easily overheard.

“Because of that, we are not able to use the conference space for teen meetings or perhaps for conversations about what is the best treatment plan,” Redenbaugh said. “It cannot occur while others are in the building for confidentiality.”

A new shelter is also on the docket to be built at the Castle Hayne Outdoor Adventure Program, a ropes course used for team-building exercises. Coastal Horizons had a shelter there in the past but it was destroyed by hurricanes. The nonprofit hasn’t had the funds until now to rebuild.  

Located at 3807 Juvenile Center Drive, the plan is to add picnic tables and an open-air pavilion so groups can engage in sit-down activities aside from the ropes course. The course is used by other agencies, such as the New Hanover County Gang Task Force and New Hanover County Schools.

Coastal Horizons engaged Big Sky Design to create estimates of each project and Buckner Building will carry out all the work, except the outdoor shelter. Construction is anticipated to start next month and must be done in 2023, per rules of the New Hanover County Endowment grant. The money received has to be spent in the calendar year.

“We hope at least by the end of the second quarter we will be done,” Redenbaugh said, “barring any supply chain disruptions.”

While crews are working, operations will run as “normal as possible.” Coastal Horizons may have to secure alternative housing for youth at the shelter during construction, but the hope is to provide the least disruptive timeline.

The improved structures will be of long-term value for growth as the nonprofit has already accepted, as of 2022, more than double the number of clients it serves since 2016. 

New Hanover County is ranked the fifth-highest for opioid use, at 45% according to the Carolina Center for Recovery. The county saw a drastic increase in overdose deaths from 2014 to 2017, based on N.C. Department of Health and Human Services’ 2021 data. There was a decrease until 2020 when numbers spiked to the highest in 20 years, at 42.6 deaths per 100 residents.

“We have different treatment modalities we didn’t have 30 years ago,” Coastal Horizons President and CEO Margaret Weller-Stargell said in a YouTube interview in 2020 for Coastal Horizons’ 50-year anniversary. “One person who walks in our door might not need the same as the one behind them. How we might treat them and help them get better might be two different methods of treatment.”

One is Coastal Horizons’ use of MAT, considered the gold standard in treatment. Yet, another facility soon to open, the county-owned Healing Place, will be centered on a peer-led abstinence-based approach. Though it will not offer drugs as a form of treatment at its 200-bed facility, The Healing Place will not turn anyone away who utilizes medication-assisted treatment, according to previous PCD reporting.

“It is certainly anticipated some of the patients we currently serve will seek housing at The Healing Place, and we will make those referrals when needed,” Weller-Stargell told PCD. “We would anticipate referrals coming to us for those patients needing MAT who don’t currently receive our services.” 

Aside from facing criticism for not employing MAT, The Healing Place faced controversy when it was chosen in 2020 to operate the county facility. Coastal Horizons had anticipated being the service providers. Yet, leadership from both organizations met in August to discuss how to work together, Weller-Stargell confirmed.

She said she assured executive director Brian Mingia her staff will do whatever is in the best interest of the clients, including referrals.

“We would expect the Healing Place to refer patients to Coastal Horizons or any other MAT provider, for patients with an opioid use dependency whose treatment is medically and clinically determined to have the best outcome with a combination of medication and therapy (MAT),” Weller-Stargell said.

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