Local providers describe walk-in care, mobile units and SUBLOCADE access as hubs expand services

Representatives from five health engagement hubs described what hub funding enabled and the operational challenges they continue to face.

Mary Truit, a registered nurse with HealthPoint's WholeCare program, said hub funding allowed HealthPoint to offer low-barrier, walk-in primary care, long-acting injectable buprenorphine induction (LAIB) on a walk-in basis and street-medicine outreach across shelters and encampments. "Our longest patient who's been in sustained recovery is now coming up on his 2 year anniversary," she said.

Everett Maroon, executive director of Blue Mountain Heart to Heart, described mobile units, street medicine and billing difficulties. He told the committee a woman who previously used heroin accessed SUBLOCADE as a walk-in at his site, later completed a nursing program and now works at the local hospital. "SUBLOCADE was like a miracle drug for her," he said.

Shannon Goforth (Sound Pathways) described an integrated nonprofit/for-profit model that added a mobile medical van, consolidated services into a single building and implemented same-day hepatitis C testing and treatment. Tribal partners (Yakama Nation and Lummi Nation) emphasized culturally informed harm-reduction kits, peer outreach, and trust-building in communities with historical distrust of Western medicine.

Panelists uniformly cited billing mismatches with managed-care organizations, insufficient fee-for-service revenue to cover trauma-informed care time, workforce retention issues and a shortage of local housing or specialty services as limits on what hubs can accomplish without additional funding or infrastructure improvements.