City extends Consistent Care contract and highlights outcomes from opioid‑funded high‑utilizer program

Maggie Yates and Consistent Care's physician‑leader, Dr. Nevin, told the committee the city will extend and amend a contract to continue a high‑utilizer intervention funded by opioid settlement dollars.

Dr. Nevin summarized the model bluntly: “We have a model where we offer people treatment or we offer them consequences,” he said, describing referrals from community court and law enforcement that give chronically high‑need individuals a path into treatment or legal consequences when they decline help.

City staff and Consistent Care staff said the program worked with roughly 176 patients through the contract period; about 70% self‑reported opioid use disorder and about 73% had a mental‑health diagnosis. Program reporting indicated that more than half of clients were enrolled in medication‑assisted treatment (MAT) and that about 43% engaged in outpatient or residential treatment. Staff also highlighted the use of long‑acting injectable antipsychotics and low‑barrier methadone or buprenorphine initiation as effective interventions for people with co‑occurring psychosis and substance use.

Council members probed consent and coercion concerns, noting that many enrollments arise from community court referrals where individuals face alternatives to traditional prosecution. Staff said the program operates with assessments and offers; participation in the therapeutic community‑court pathway remains voluntary in the sense that defendants can choose regular court outcomes instead of the treatment track, though court participation provides leverage to engage reluctant clients.

Council members also emphasized upstream investments — housing options after treatment, sustained recovery housing and capacity for post‑residential placements — and asked for continued data refinement through merged datasets (municipal court, first‑responder and program data) to better track outcomes.

The committee discussed and supported the contract amendment presentation; staff will return with updated data and the proposed contract paperwork for council action.