Linda Hurley
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The significance of investing more in mobile methadone services compared to traditional brick-and-mortar facilities
Linda Hurley, the CEO of CODAC Behavioral Healthcare in Rhode Island, discusses the advantages of traditional opioid treatment programs (OTPs) alongside mobile services, highlighting why providing care through mobile units can incur higher costs than standard facilities. She emphasizes that both forms of treatment are essential.
CODAC introduced the first mobile medical unit compliant with updated Drug Enforcement Administration (DEA) regulations.
Considering redundancy is crucial: “What happens to patients if there’s only one mobile unit in your area and it breaks down? Or if there’s an issue with the electrical system?” Hurley questions. “There are countless things that could go wrong. Mobile vans face a significantly higher number of physical barriers to care compared to traditional facilities.”
Expertise requirements: The staff in mobile units need more experience than their counterparts in fixed locations, given the limited space and potential isolation. During emergencies or urgent situations, these staff must have access to supervision. “You can’t deploy entry-level staff in a mobile van,” Hurley states.
Cultural competency: To be most effective, staff should resonate culturally with the communities they serve, asserts Hurley. “If staff are engaging with Latino or Cape Verdean populations, it’s essential they can communicate in those languages,” she explains. “Hiring bilingual or multilingual staff comes at a higher cost.”
Maintenance necessities: The mobile units require a dispensary that meets DEA standards, Hurley points out. “These aren’t just recreational vehicles,” she clarifies. “They aren’t built for the rigorous demands of mobile methadone treatment. They weren’t designed for full-day, everyday operation. There’s an expensive, heavy safe, the generator can fail, and the hydraulic systems can break down.”
Additionally, CODAC funds peer support and community care managers who use their own vehicles to accompany the mobile unit, adding to the overall expenses.
As a prominent figure in the methadone treatment arena, Hurley believes that patients should have easier access to treatment. “Ethically, we have a responsibility to do more regarding transportation and related services,” she expresses. “A mobile unit provides deeper connections for care, understanding that it reaches individuals unable to visit a traditional facility. Therefore, wraparound services are crucial.”
However, it is a misconception to think that mobile methadone services are cheaper than traditional facilities. They aren’t, and one does not replace the other. Both services are essential.