Photos From the Keepin' It Real Block Party

On Saturday August 9, 2008, the BCI Outreach Team created a fun and enjoyable block party atmosphere to motivate our community members to consider the importance of their health and their individual HIV status. Free rapid HIV testing was provided along with information tables, a DJ, educational games, free food and give-a-ways.

Click here to view our album of photos from a fun event for a good cause.

The Most At Risk Are The Hardest To Reach

The News Journal details the extent of our challenge in reaching a hidden and mistrustful population with the needle exchange. Though blacks remain hesitant to access the services, it's important to note our successes and how far we've come.

Before Wilmington got a needle-exchange program of its own, some addicts went to Philadelphia to get clean syringes from the exchange program there. In addition to needles, they brought back stories about police harassment near the vans that distribute them.

Those experiences make it hard to trust the Wilmington program, even though the relationship between its workers and police here has gone better than anyone could have expected, officials say.

...

"It's a fact that a needle-exchange program cannot reach the people it's trying to if there is not cooperation from the police department," Silverman said. "The cooperation we've had here has been outstanding. They're not using our vans as a mouse trap. No one has been arrested near the vans and no one has been followed and arrested down the block."

...

The program has exceeded its goals for clients and getting people into drug treatment centers.

And we have new strategies to reach those most at risk.

Silverman said she is formulating a plan, which she hopes to implement in the fall, that would get the program's current clients to go to shooting galleries and drug houses to recruit new members.

"Our team of workers are former addicts, former sex workers or have some connection to the communities we serve, but there are still places we can't go," she said.

Volunteer Spotlight: Walter Frazier, Outreach Support

Walter Frazier came to Brandywine Counseling as a volunteer with the Outreach Department in July 2008, and quickly became someone we could depend on to help out. In the first of a series of volunteer spotlights, Walter tells us about his experience in his own words:

I relocated to Wilmington a few months ago and decided that while I am seeking full-time employment I would volunteer at a non-profit agency. I learned about BCI by word of mouth and called to see if my skills might be needed.

In the past 10 years I have served on Boards and committees and even worked for the American Red Cross for 3 years as a program director in Bloomington, Indiana. These experiences have given me the opportunity to learn how important the work of non-profits is to a community.

Just based on the name, I assumed this organization most likely provided substance abuse counseling. Although this counseling is part of Brandywine’s activities, I had no clue there was an outreach department that provides free HIV testing and treatment if necessary, nor did I know of the methadone program for heroin users.

I have spent my time raising funds for the annual HIV Testing Event, which is held this year on August 9. I have found this project to be very fulfilling and relevant to me since I have lost 3 close friends to this wretched disease.

I have been surprised by how BCI approaches its endeavors. BCI provides its professional services without prejudice and blame. I have seen how quickly BCI drops everything when a client walks through the door for help. It has been inspiring.

What I have done while volunteering is very small compared to the activities of the whole organization. I feel gratified thinking one person might be tested for HIV, receive early intervention and live a longer life as a result of my efforts.

Outreach Workers Become Visible

From delawareonline.com, some video of our outreach team in action as they prepared for last Saturday's educational block party.

This Saturday - 1st Annual Keepin' It Real Block Party

1st Annual Keepin' It Real Block Party
Saturday, August 9, 2008
3 PM - 7 PM
L.A.C.C. (Latin American Community Center) Parking Lot
4th and Van Buren Streets, Wilmington

This Saturday is our 1st Annual Keepin' It Real Block Party event! We invite you to join us and have a good time.

The purpose of this event is to raise awareness, educate, and motivate people to get screened for HIV. We are targeting the adult community members who reside in the Hilltop/Westside neighborhoods in the 19805 zip code. We will be providing Free and Rapid HIV testing, Free Food, Games, Prizes, Gifts, and activities for the kids. Please consider joining us to spread an important message and create a fun and enjoyable atmosphere that will motivate our community members to consider the importance of their health and their individual HIV status.

Don't forget, this HIV Awareness event will feature information tables, a DJ, educational games, free food and give-a-ways! This is an excellent opportunity for your agency to promote its mission and services. Be sure to invite your co-workers, clients, family and friends!

New AIDS Infection Estimate Is A "Wake-Up Call"

About 55,000 Americans are infected with HIV each year, according to the Centers for Disease Control and Prevention. This number had been thought to be 40,000 a year, until a new, more accurate blood test was introduced. The new test can tell how long ago an infection occurred.

The CDC report also found that HIV infections are falling among injection drug users. Some experts are giving the credit to prevention efforts including syringe exchange, while at the same time calling for additional funding to expand them. Many populations continue to be at high risk, including gay and bisexual men, those under 30, and African Americans.

Whether more funding comes or not, the revised estimate clearly is a "wake-up call to scale things up," said Dr. Kevin Fenton, who oversees CDC's prevention efforts for HIV/AIDS.

For more information, see:
The full article
CDC HIV Fact Sheets

5 Questions for Dianna Dorsey, Outreach Worker

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Dianna Dorsey
Job: Outreach Worker, HIV Prevention and Needle Exchange
Time with BCI: 5 years

1. What is your job at BCI?
I work in the Outreach Department as an HIV Prevention Specialist, and the NEP program. And what we do is, we go out in the community, and pass out condoms, educate individuals on the street about HIV, the spread of HIV and Hep C, and different STDs. We also try to get them to come and do an HIV test, and let them know how important it is to learn their status. A typical workday is being out on the streets, going all across town, educating them, just letting them know how important HIV is, and how important it is to not to be sharing your works.

And the needle exchange, we have the van, and the clients come out and exchange their dirty syringes for clean ones to prevent the spread of HIV and prevent sharing. So when we’re in the community and we’re doing our outreach, that’s another target. We go and hand out flyers, and let them know we have the needle exchange, and we’re also doing HIV testing out on the street at this location and this time, and different locations that we have throughout the week.

2. What got you interested in doing this kind of work?
I actually had family members who went through the struggle of addiction. And just seeing them inspired me to understand addiction, to find out the triggers, and everything that comes along with that. So that was my main reason. As far as working with HIV, I just wanted to be more educated about it. And once I got the proper education, I just fell in love with it, and that’s my goal. I love what I do.

3. What is your biggest challenge in doing your job?
My biggest challenge is not having [clients] come through, as far as getting tested. Or, on the streets, trying to really really really educate these people out there, and they’re still saying no. So, we have to come from different angles at times, and that’s a challenge. Because you have some people that are out there that say, “Well, I don’t want to get tested.”

“Well, have you ever been tested?”

“No.”

“Tell us the reason you don’t want to be tested.”

“I don’t.”

“Do you understand the importance of being tested?”

So, when they tell us no, they don’t want to be tested, that’s a very big challenge to me, because I’m not accomplishing what I’m out here to do.

4. What would people be surprised to know about your work?
I think they would be surprised to know that I really care. And caring for the individuals on the streets, that’s a plus. That’s number one. Because if you’re in this addiction - and you have individuals that are out there that don’t have loved ones – [and] you really show them that you’re there, and that you’re supporting them regardless of what decisions they make, I think that surprises them a lot also. Because if you just go out and say, “Here, take this condom,” or, “Come to the exchange,” they’re going to feel some type of way about that, because they’re not feeling the love at all from us. So in order for us to engage with these clients, we have to show them that we care. We have to show them that we love them, and I think that surprises a lot of them.

5. What advice do you have for someone who would like to do the job you do?
Come with it with your heart. Don’t just do it for a paycheck, have it in your heart that this is what you want to do.

5 Questions for Jeremy Zane, Therapeutic Supervisor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Jeremy Zane
Job: Therapeutic Supervisor, Lancaster Center
Time with BCI: 4 years

1. Safety Net Services is one of the BCI programs you’re involved in. How are you addressing an unmet need for substance abuse treatment and HIV/AIDS services in Wilmington?
Our main focus is getting people into treatment. The [Christiana Care] infectious disease clinic, who is the largest HIV treatment provider in the city, was referring a lot of people to Brandywine, and a lot of people weren’t making it. The first thing that we’re doing is the seamless transition. A lot of times we get referrals from the infectious disease clinic the day people find out they’re HIV positive. In fact, in the first five months, there’s already been 4 or 5 where we were at the infectious disease clinic the moment they found out that they were positive. So from day one, we’re linking up these two services. We want people to understand that HIV is treatable, that it’s not a death sentence anymore, as long as a person takes care of their body, and takes their medication. Also, substance abuse treatment can coincide with HIV.

We’re talking about a population that is probably taking the bus everywhere, or needing to get rides. Transportation can be a very significant barrier in itself. We’re talking about a person who could be going, in one day, from substance abuse counseling, get on the bus, go downtown, go out to the infectious disease clinic, sit all day out there, get the things that they need to get done, and then go back into the middle of town to Connections or Community Mental Health for their mental health services. That’s a lot of running around. And if the person is in a lot of need, and needs services every week, the chances they will get those services consistently, decreases greatly, having to run around town that much.

Having Christiana Care’s remote site here, a person can come in, get their substance abuse treatment, see the nurse practitioner, get their HIV meds, and they’re able to do it all under one roof. The mental health component also can be contained here. A person with mental health issues can have their evaluation done here, can have their medication management done here, can get their prescription through here. Everything that person needs is contained under one roof.

2. You also helped start Recovery Counts for people who weren’t succeeding in the usual track of treatment. What is this program and how did it come about?
I remember the day, there was a particular client who came over and said, “They’re discharging me off the clinic, but right now, I’m clean. I can give a clean urine right now, but I’m being discharged.” And from that moment, Basha [Silverman] and I kind of looked at each other and thought, “I wonder how many other people there are like that, who are being told they’re discharged, and now, this is when they’re going to decide to make that change?” And after looking at it, we found it to be quite common. So what we wanted to do was to come up with a program that, we say in a very concrete way: This is your last chance at treatment. If you do not demonstrate changes now, you’re going to be referred to a higher level of care, and you’re going to be discharged from the opioid treatment program.

We started a pilot program of about a dozen people. And what we were able to do was, really offer them more intensive services. We’re going to have a couple of groups a week, we’re going to be meeting for an individual session every single week, until we get through this and over this hump. And from that point, it started to grow. And then what we started to realize was that, maybe we should start working with people at the beginning. Anybody who’s on contract at all is then going to go into this program.

The reason they’re not succeeding in treatment is because, maybe we’re not offering intensive enough services. This person needs to be seen more than once a month, and they need a case manager, they need to be coming to group. And the same person running the group needs to be running their individual counseling sessions, so they can incorporate what’s going on in group back in the individual session, in a seamless way.

We also look at an outcome questionnaire. By decreasing incarceration risk, housing need, [and increasing] interpersonal relationship skills, education and employment, it has a correlation with their urine screens. As negative urine screens go up, these factors improve.

3. Recovery Counts and Safety Net Services could both be described as harm reduction approaches to addiction treatment. Do you have an opinion of whether harm reduction or traditional treatment is more effective for clients?
I personally believe that a harm reduction model is more effective. Now, you have to really define what harm reduction means, because it means different things to different people. Some people who are on the liberal side of the harm reduction model say that no one should ever be penalized for urine screens, ever. That a person should never have negative consequences, should never have hard holds. I’m certainly much more on the conservative side than that. I believe that a person needs time to change. They’re going to be positive while they’re in treatment, and the day they walk in the door, you can’t possibly expect them to just, all of a sudden, start submitting negative urine screens. So where is that point? Is it two months into treatment, eight months into treatment? And from my point of view, that’s going to be different for everybody. That toleration, that acceptance that a person’s going to be positive while they’re beginning treatment here, in my opinion, is still part of the harm reduction model.

I also believe, however, that there’s also some point where, if we’re not demonstrating changes at this level of care, and allowing the person to continue their behaviors at this level of care, it’s more detrimental than it is helpful. And we need to make efforts to get a person into a higher level of care, which can be perceived as punishment. If we’re discharging a person because we believe they can’t succeed at this level of care, and they don’t want to go inpatient, then that person’s probably going to perceive what we’re doing as punishment, and I think some of the purest harm reduction model thinkers would also think that that’s punishment as well.

4. How did you get into the field of addiction treatment?
I got introduced to Brandywine when I was at Wilmington College with my undergrad degree. Basha had come in and was doing a presentation about the outreach services that Brandywine had to offer. And at that point, I really didn’t know what I was going to do with an undergraduate degree in psychology. And that was the first time that I became interested in outreach in general, and in getting into the substance abuse field. So I came in for an interview, and there was a project they had just gotten some funding for, and I just kind of fell into it that way.

And once I’d gotten involved and started working with the population… you grow into it. It became something that was very interesting to me. The substance abusing population has mental health issues, they have medical issues, and counseling people with substance use disorders, you get a little piece of everything. So, as opposed to just working with people with depression, or just working with people with post-traumatic stress, you get all that here, but the common thread is, everybody’s also abusing substances. So you get a more complete package, and a more dynamic caseload, in my opinion.

5. What is rewarding about your work at BCI?
I think everybody says that they’ve got a couple of clients who’ve really made changes, and with some of the clients that I’ve had now for 2-3 years, you see them struggle and struggle and struggle, and then finally get to this ultimate goal. The first time a particular client gets travel bottles. When somebody is detoxed successfully who was about to be kicked off the clinic a year ago. Everybody’s got those two or three clients that they’re always going to keep with them. That type of satisfaction, that type of reward and internal satisfaction that you get, I don’t see how you could possibly get that at any other job.

Denise Kitson Receives Guardian Angel Award

Brandywine Counseling congratulates Denise Kitson, Program Director of The Lighthouse Program, on receiving the Guardian Angel Award at the Delaware HIV Consortium's 2008 WOW Awards Gala.

Pictured at right, Denise receives her award from Peter Houle, Executive Director of the HIV Consortium. Arlene Bincsik, President of the HIV Consortium Board of Directors and head of the Christiana Care HIV Program, gave the following speech:

"It is said that a guardian angel sits on your shoulder and protects you and comforts you in times of need. This year’s Guardian Angel Awardee is Denise Kitson of Brandywine Counseling and the new director of The Lighthouse Program in Sussex County.

"Whether it is feeding the hungry, supplying clients with street kits of tooth brushes, soap and other necessities, helping them access healthcare, finding shelter, HIV testing or entering rehab, Denise has always gone above and beyond the call of duty to help her clients and the marginalized populations.

"When others said no, Denise has always said 'How can I help you, help yourself?' She is a program manager, a case manager, a counselor, a confidant, a shoulder to lean on, an ear that listens, a compassionate volunteer all rolled up in one incredible woman. But most of all…she has been a Guardian Angel to hundreds of people when no one else cared! She strives to empower clients rather than enable them. The Delaware HIV Consortium proudly bestows the Guardian Angel Award to Denise Kitson. Congratulations!”

Linda DeShields, A Pioneer of Addiction Treatment in Delaware, Dies at 63

Linda DeShields, a steadfast advocate for Delaware's most disadvantaged citizens who helped build programs for treatment, prevention, and rehabilitation, died on Tuesday in Wilmington, Delaware. She was 63.

Linda was one of the pioneering black females in Delaware’s treatment services. She opened the doors for people of color to enter this field, and is thought of as “the Harriet Tubman of treatment” for the state’s African American women and men. This legacy continues today, as many of the outreach workers she hired have ascended to supervisory positions. Her daughter, Rochelle Booker, is the supervisor of Delaware’s first needle exchange program.

In the late 1980’s, Linda started her career at Brandywine Counseling, Inc. (BCI) as Delaware's first HIV/AIDS outreach worker. Later, as Director of Outreach Services, she hired a team of indigenous outreach workers who were in recovery themselves, and often recently released ex-offenders. She had a strong work ethic, often working 10-12 hours a day when it was necessary to get the job done. She passed on these values to her team, many of whom had never held a job. Throughout her career, she became the voice for her clients in the community and diligently worked on behalf of them to ensure better access to the services they needed.

Linda recognized that addicted persons face interrelated challenges such as housing, crime, and domestic violence. In addition to her full-time job, she worked with numerous community organizations that dealt with these social ills. She was a liaison with the Wilmington Housing Authority for drug and alcohol services, a position that was the impetus for the creation of the NSAFE HIV case management program at BCI. She also worked with Mayor Sills’ administration as a community liaison focusing on substance abuse and related problems. Linda also appeared on the cable TV show “Women 2 Women” on channel 28 to interview women on women’s issues. She highlighted successful business owners, struggling domestic violence victims, as well as those addicted to drugs, and offenders.

One of the populations Linda was most passionate about was inmates, particularly women. For nearly 20 years, she volunteered at the Women’s Correctional Institution. She would go to WCI on a daily basis, meet with inmates about to be released, and prepare them for what to expect and to meet important goals like rejoining the workforce. She was also a very dear friend to the staff and often called to just check in on them. The staff remembers her as “an inspiration [who] always had a listening ear, and never turned away.” The way she touched the lives of the offenders and so many officers was like “being touched by an angel.”

Linda also volunteered at the Plummer Center, coming to the dining hall to have lunch with ladies who did not get family visits or any money. Her heart was in this work and she genuinely cared for the inmates. She continued her visits even after suffering a stroke that left her in a wheelchair.

Linda was also a member of the Police Advisory Board, and went to many parole board hearings to advocate for ex-offenders. She did substance abuse evaluations on offenders who had been referred to the Public Defenders office, and made recommendations for treatment as well as for pre-sentencing investigation.

Another passion of Linda’s was children in at-risk situations. She did weekly prevention and education interventions with arrested youth at Bridge House and Ferris School. She also worked with organizations seeking mentors, such as Eighth Street Baptist Church’s "Magic and Minds Together," which developed therapeutic drama skits for kids. The program was the result of a faith-based partnership with Brandywine Counseling, a connection Linda initiated before such partnerships were mainstream.

Rev. Ty Johnson recalls that Linda “was way before her time. She made the connection between the power of spirituality and power of recovery and knew it was vital to success and healing.” She knew that once she connected Eighth Street Baptist, whose board members were ex-offenders in recovery, to the recovery community that had resources, that things could change.

Linda DeShields was an inspirational and influential figure at BCI. She laid the groundwork for many of the services we provide today, and positively affected the lives of countless Delawareans. She will be greatly missed.

Funeral services will be held Monday July 14 at 12 Noon at Ebenezer Baptist Church, 2300 N. Claymont Street, Wilmington, 19802, with viewing from 10 am - 12 pm only.

Support Delaware's 10 Year Plan to End Chronic Homelessness

John Baker of AIDS Delaware has written an editorial to draw attention to the need for more housing for people with HIV/AIDS in our state. "A Wealthy State Fails to House Its Sick" describes how we could fill the need for hundreds of beds if the state would fund a plan that has been brought before the legislature. The cost of this plan would be offset by reducing the burden on our emergency rooms and hospitals. Studies show that the stability that comes with housing enables patients to improve their health.

Your help is needed for this plan to become law.

The state of Delaware has a responsibility to invest the money needed to house people with AIDS and others who are chronically ill. Right now, we are all paying far too much.

Please contact your legislators and ask them to support and fund the "10-Year Plan to End Chronic Homelessness."

2nd Annual Old Skool Outreach

Hi, this is Brandy Rodgers from the Outreach department.

It was a warm and bright afternoon on June 3, 2008 when Brandywine Counseling's Outreach team celebrated its 2nd Annual Old Skool Outreach event. It was a great time of fellowship and outreach as the NEP team and other staff at Brandywine such as our site supervisor James Harrison, and Chris Zebley and Joyce Bunkley who are nurse practitioners that work with HIV positive clients, joined us for the occasion. Last year’s event was such a success that we had to do it again, but this time Bigger and Better.

The NEP team, along with some of the staff at Brandywine Counseling’s HIV prevention programs, walked throughout Wilmington neighborhoods accompanied by some friends and family spreading knowledge about HIV prevention, rapid HIV testing, and ways to join the needle exchange program. We had a nice turn out at the event as the crowd enjoyed music while eating some wonderful BBQ done by Demitrius Bullock of the NEP team before going out into the neighborhood. The normal outreach team, which includes eight, grew to about seventeen people.

We had a great time spreading knowledge and interacting with the community. We would like to thank everyone who came out and showed their support for the event and we hope to see more next year!

More photos from the event

Join Us May 31 for "Old Skool" Outreach

Volunteer your time to save lives! It's our 2nd Annual "Old Skool" Outreach Blitz!

Please join BCI Saturday, May 31, 2008 from 11 am - 3 pm for a Mega Outreach Blitz in the City of Wilmington to promote the Needle Exchange Program. We need former outreach workers and people who have never done it before but want to give back. Walk through the city spreading a message of hope, recovery, health, and safety. Encourage drug users to enter treatment, enroll in the needle exchange program and most importantly get tested for HIV.

Refreshments will be provided.

Last year's event was a big success and we can't wait to do it again.

If interested please sign up with Rochelle Booker at 757-3821 or apply online.

Needle Exchange: 200 Enrolled!

The Needle Exchange team has enrolled our 200th client in the program. We now stand at 3,482 needles exchanged during 698 different exchange events. Over 80 referrals have been made, including 12 to methadone treatment. Five HIV positive clients have been identified on the needle exchange van.

Well done, team!

5 Questions for Claudette Bell, Outreach Worker

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Claudette Bell
Job: Outreach Worker, HIV Prevention and Needle Exchange
Time with BCI: 5 years

1. What makes community outreach different from seeing clients in a treatment center?
Every part of BCI is important, but actually going out in the community, when you go out in [drug users’] environment and see what they have to deal with on a daily basis, that makes it just a little bit different. It brings it more to life how people are actually living. When they come up to the clinic, you might see them for an hour if they have groups, or if they’re coming to get dosed, they’re no more than ten or fifteen minutes. But when you go out in the community and actually see how our clients are living, it brings a whole different light and more respect for them. It’s a struggle out there, it’s no joke. It’s rough out there.

2. What are the challenges involved in doing outreach?
We’re just like the postal service with outreach, we work in all kinds of weather. I think we have a good team. Even when we’re out there in the rain, people be like, “Y’all be passin’ out condoms and stuff in the rain?” I’ll be like, “Yo, we just like the postal service - we’re out there in all weather!”

Some of the communities that we go into are bad. We’re always told never to put ourselves at risk. But you never know what can happen, you could just be walking down the street and people start shooting or something. We don’t go out there putting ourselves at risk, but we know that, like they say, stuff happens.

3. What is it about this job that makes it worthwhile for you?
Some clients are here actually to get their lives together, and others are just here so they won’t be out on the street, trying to find dope. Sometimes when they come in, their intentions will be, “Well okay, I’m just going up there so I won’t have to be out on the street.” But something within the program, or something that somebody might have said to them, will turn them around, and then their purpose of being here is to be clean.

A couple clients, I was here when they came, I was doing their case management work, and now they actually work for BCI. And being able to instill in them that there is hope. Just because of where they were as addicts, you don’t have to always be an addict, because you can always turn your life around. It’s just a matter of, if that’s the road that you want to go, and how willing you are to fight for it.

And to me, that’s the joy of it, when you see clients get clean and become productive members of society. It’s just helping people. It’s not that you’re doing it to look for a reward or something like that, it’s doing it because it’s in your heart and that’s what you want to do.

4. You can tell a lot about a person by what they have in their office – tell us what you have in your office.
Oh Lord, I have everything! When I was over at the main building, they used to call me MacGyver. Anything they needed, I had it. Screwdrivers, plates, forks, napkins, feminine products. Anything they needed, I had it in my office. Like I said, it’s about helping people, so you never know what people may need. I go to the store and I’ll be like, oh, okay, here’s some safety pins, get a pack of safety pins. Never know, somebody’s button might pop, they need a safety pin.

5. What is the most fun thing you’ve done with your clients?
Oh, wow. When I was with the Hope program [as an Intervention Specialist], I used to do a lot of fundraisers and stuff, and cookouts, and barbeques. The funnest thing was when we went to Dorney Park. They had so much fun! Because I know, when I went into recovery, that was one of the first things that I’d done, and I’m like, “I haven’t been to an amusement park in so long!” So I kept on asking clients, “Well, when was the last time that you’ve been to an amusement park?” And a lot of them couldn’t remember. So to me, to take them to an amusement park and just to see how much fun they had. They was kids. They had a ball. So, to me that was great.

Celebrating 1 Year of Needle Exchange

Today is the first anniversary of Delaware’s pilot Needle Exchange Program in Wilmington. Some stats courtesy of John Kennedy from the Division of Public Health:

180 clients are enrolled in the program. We’ve exchanged over 2,700 dirty needles for sterile ones and we’ve referred 79 clients to treatment. We’ve identified three new HIV positives who hopefully won’t infect anyone else.

BCI has been using the new spacious van since November, and it now goes to 9 sites, including evening and weekend hours. Community and police support continues to be outstanding. New clients are being referred by word of mouth, from community members, political leaders, and the police.

Congratulations to our NEP team and DPH on a successful first year!

5 Questions for Chris Zebley, Nurse Practitioner

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Chris Zebley
Job: Nurse Practitioner
Time with BCI: 4 years

1. What is your job at BCI?
I’m a board certified adult nurse practitioner and HIV specialist. I actually work for Christiana Care Health System. My department is the Community HIV Program. I collaborate with Dr. Szabo, who’s an infectious disease physician, and we run an HIV clinic here at the Lancaster site every Tuesday morning. The whole idea was to allow a one stop shop to get your mental health, your substance abuse treatment, and if you’re HIV positive, to get your HIV medical care under one roof. We call it “nested services.”

2. What services do you provide to BCI clients?
A nurse practitioner can treat acute and chronic illnesses throughout the lifespan, along with having prescribing privileges. I can practice independently, whereas a physician assistant must have supervision.

The services I provide include case management and treating acute illnesses. The clients who come in to see me generally present with maybe a tooth abscess, bronchitis, a skin infection, sprains or strains. The client may be unable to see their primary care physician, or worse yet, because of their addiction, might not see it to be a priority to take care of their health. I make referrals to dentists, PCP’s, foot and eye appointments. On occasion I’ll refer them to the ER, and I can call people that I know in the emergency room. There’s many, many things that I’ve done for people as part of referrals and such.

In my HIV clinic I have around 35 clients. I get referrals from my department, from NSAFE upstairs, Outreach, or by word of mouth. The medical management of these clients is very intense, because the majority have “advanced disease,” so it’s my duty to assist them in maintaining optimal health. We treat patients with very, very heavy co-morbid conditions - Hepatitis C, heart failure, vascular problems. I may do pill planners to aid in the adherence of their medicines, treat any acute illnesses that may arise, and also provide health maintenance by making sure they have their necessary screenings, such as a colonoscopy, Pap smear, or mammogram.

On Fridays I usually do annual physicals for Dr. Glick, as well as intake physicals for methadone, Suboxone or Revia. I do part time work with the Medical Maintenance Level 2 program at Newark where the people come in once a month for their methadone.

I’ll be working hand in hand with Outreach on Safety Net Services. I’ll be providing case management, HIV medical care, and psychotropic medication management.

3. What drew you into a career in the addiction treatment field?
This is something that I grew into. In the hospital we’d always have people that were disadvantaged, and stigmatized in society - IV drug users, the homeless, HIV infected individuals. These were real people with real illnesses who never asked for anything, and were very appreciative of the care they received. And I always thought, I’d like to work with these individuals, because they had a lot of needs, simple needs, that could be fulfilled.

This was a job posting with Christiana Care. I was working in employee health as a nurse practitioner at the time. I happened to see this posting, and it was for the Riverfront. An HIV clinic, but you would be working in a methadone clinic. I didn’t even know what a methadone clinic was, really. I didn’t realize how many people actually go to these places.

There were many people telling me, “You’re not gonna like it. You’re gonna regret taking that job.” You can’t go on hearsay. If I’d really listened to people, I might not be here today. I would not even have taken the position. I had to experience that for myself. And from day one, it was fine, it was nothing like what people told me it was going to be. I enjoyed it from day one. Because we’re able to meet the people’s needs, that’s a big thing.

4. If you had $30,000 to donate to BCI, what would you do with it?
Certainly the Outreach. They’re the ones that get people in here. They do so much good, whether it’s the food closet, or the clothes closet, and to help for that needle exchange to grow. As we see the research and the data come down, I’m sure the federal government and the state will allow us to expand. But that’s been a plus here for Brandywine Counseling. I’ve done intakes and I asked them, “Well, how did you know to come here?” And they said, “Well, it was the needle exchange.” That’s an indicator that it’s working.

I’d also open more transitional housing, because recently the CDC announced that homelessness is now the single largest contributor to HIV infectivity.

5. What is it like to work with these clients?
You’ve really got to like people in their worst condition, and in their good condition. And that’s what nursing is about, the human response to illness.

These people are survivors. They’re very, very smart. They could be executives if they could put their mind to more positive things. Some of these people could have been very, very wealthy and rich, the way they’ve been able to hustle, to get money for drugs. People have written about, if we could only find out how these people, the disenfranchised, tick, and how they’ve been able to survive these harsh illnesses, without a lot of medicine, then we could treat a lot of other illnesses cost effectively without using medications.

My first patient that I ever saw [now] comes here for take-homes twice a week, so they’ve been drug free for almost two years. I have them come in for support, and they’re part of my HIV clinic too. To me that’s a success story, because they know that they can come in at any time, whether they can see their counselor or not. To really see this person get out of the deepest, darkest abyss, where they were constantly using, and she’s not now, so she’ll continue in her recovery. That was pretty cool, to actually see that.

Project Hope: 5 Years of Serving the Triply Diagnosed

Brandywine Counseling, Inc. (BCI) recently wrapped up Project Hope, a 5 year CSAT-funded project that provided integrated substance abuse treatment, mental health treatment, and medical care to substance abusers with or at risk for HIV/AIDS in Wilmington, Delaware. Project Hope was successful on many levels.

Project Hope continued BCI’s partnership with Christiana Care Health Services to provide integrated nested services. Also known as a “one stop shop,” this approach proved very effective for a chronically ill population with multiple needs. Nesting services in a single clinical home within our on-site infectious disease clinic increased communication among clinicians, increased the comfort and safety of patients, and strengthened confidentiality. We first used this model in 1999 as part of the Aegis program for minority women. In 2002, Project Hope expanded the approach to serve both men and women.

Most Project Hope clients were between 35 and 45 years old with no employment history, little education, and multiple treatment failures. Half of the client population was triply diagnosed with substance abuse, mental health and HIV diagnoses. With this in mind, Project Hope’s achievements are impressive.

• We treated 151 clients, our target capacity.
• 75% of clients remained in treatment for six months or longer. The average length of treatment, regardless of discharge status, was 10 months.
• While in the project, 36% achieved and maintained sobriety.
• Clients complied with mental health and HIV medications. Many (44%) improved their income and many (40%) reduced their risk of HIV by participating in the program.

These achievements may seem modest for many substance abuse programs, but they are remarkable for a program treating the triply diagnosed. In sum, Project Hope demonstrated the effectiveness of integrated nested services for the dually and triply diagnosed.

Though Project Hope has now ended, all clients continue to receive appropriate treatment from other BCI programs. In 2007, BCI received a new CSAT grant to provide treatment and pre-treatment services. Safety Net Services will continue the engagement, linkage activities, and case management found effective with Project Hope.

On a personal note, Project Hope was one of the first federal grant proposals I wrote for BCI. I remember working with Shay Lipshitz to put it together, and trying to translate her vision for the program into a coherent written plan. We knew that if we were successful, we could make a difference for people who really needed these services. As a grant writer, it’s especially gratifying to see a project through from conception to reality. So to the staff who provided these services, I say thanks for a job well done.

World AIDS Day: Stop AIDS. Keep The Promise.

Delaware will observe World AIDS Day tomorrow, December 1.

Currently, there are 3,320 Delawareans living with HIV/AIDS. Since 1981, when the HIV/AIDS case tracking began, 1,853 HIV/AIDS deaths have been reported through 2006.

The Delaware Division of Public Health invites you to get involved by volunteering for a local HIV organization, confronting discrimination, getting tested for HIV, and protecting yourself and your partners.

For more information, including a list of local events, click here.

Needle Exchange Van Ribbon Cutting Ceremony

Today Delaware dedicated a new needle exchange van fully equipped to serve injection drug users at risk in the City of Wilmington.

Since February, Brandywine Counseling, the contracted vendor for the Division of Public Health, has been using two small vans, including an ambulance donated from Wilmington’s Public Safety Department. Now, with the new 2007 Ford E450 van with a "Utilimaster" body, we'll be able to carry more supplies, and offer people more privacy and more services.

A client who wants to exchange needles will come to the door of the van. Inside the door is a container where they can drop their used needles. Staff will sit inside the door to dispense syringes and first aid kits. If the client wants to get tested or wants counseling, they will step into the back of the van, where there is seating and a table. Supply cabinets give us ample space to store first aid kits, personal sharps containers for clients, safe sex kits, and HIV testing materials. There are also restroom facilities. We expect that with this better privacy and safety, we will now see even more participants, and greater willingness to access more services like HIV testing.

At today’s dedication ceremony at Delaware Health and Social Services’ Herman Holloway Campus, several key figures spoke about the program. Director of Public Health Dr. Jaime Rivera called the program “incredibly successful. It’s the result of ten years of planning and pushing to make this happen, and we finally got it done.” Senator Margaret Rose Henry, who was primarily responsible for getting the bill passed, thanked everyone who helped convince the community it needed to happen. “Our goal is to have the best five years ever so that we can show the rest of the state this is a good thing, we need to do it statewide,” she said.

BCI Director of HIV Prevention Basha Closic recognized her Needle Exchange team: Rochelle Booker, Sharon Brown, Claudette Bell, Dianna Dorsey, Morris Gardner, and Lolisa Gibson. “Day in and day out they sit with people and they counsel them about the importance of taking a HIV test and knowing their status, and if they are positive, not infecting another person and taking responsibility. Those conversations are really hard to have, especially with strangers. These people have really, really amazing personalities and spirits. This who you hired to carry out the job.”

Delaware HIV Consortium Executive Director Peter Houle reminded us of how AIDS has left an indelible mark on Delaware and on the world over the past 25 years. He described how Delaware has become a model for other states in HIV service delivery, and now this pilot program has enhanced our already nationally acclaimed continuum of care.

The van was dedicated to the late Dr. Robert Jackson of the Division of Public Health, who was recognized at the ceremony for his strong support of needle exchange and advocacy for HIV prevention. The ribbon was cut by Senator Henry. Participants then had the chance to tour the van.

The van makes weekly stops to four sites in Wilmington, with more soon to be added. Since startup, we've enrolled over 140 clients, and they have exchanged over 1,800 needles. We've referred 31 clients to alcohol, mental health, or drug treatment centers for further treatment. Our goal is to enroll 200 clients by February 2008.

To view more pictures of the van and the dedication ceremony, click here.

BCI is truly grateful to have this van. We will continue to provide high quality, safe services for this five year pilot program and beyond. What a long way we've come in ten years!

Delaware Adopts New Rapid HIV Test

Delaware's Division of Public Health has announced they are adopting a new finger prick HIV test. The Unigold test will replace the OraQuick oral swab due to its quicker results, longer shelf life, and cost savings.

Click here to read the full press release.

5 Questions for Edna Maldonado, Case Manager

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Edna Maldonado
Job: Case Manager, NSAFE
Time with BCI: 1 year

1. Tell us about your job at BCI.
I’m a case manager. I help clients that are HIV/AIDS positive remain healthy and live productive lives. Clients may come to our office very depressed after learning they are HIV positive or diagnosed with AIDS. The diagnosis alone can devastate a client. Some think they have received a “death sentence;” for others it may lead to feelings of suicide. I have to reassure them this is not the case because of today’s advances in medicine. So part of my job is to educate the clients about their disease.

In order to have a successful relationship with my clients, I must first develop a trusting relationship. I allow them to know they are in a safe environment where all conversations are confidential. Once the clients are stable, I develop an individualized care plan to prioritize their needs. I will then provide advocacy and linkages to a wide array of community services like food, shelter, and clothing.

I am also bilingual. My caseload consists of Hispanic HIV infected clients and the general population as well. Frequently, I have to accompany my clients to their medical, dental, or social security appointments to assist them with the language barrier. On many instances, they bring me letters to translate into Spanish from other agencies, including from immigration services. It does take much physical and mental energy switching from one language to another, but I love what I do. I enjoy helping my clients and providing these culturally competent services.

2. What drew you to a career in social services?
In my heart I always wanted to be a social worker, even though my degree is in Education. When residing in Connecticut, ten years ago, I was given the opportunity to work with the homeless population. This was an experience of a lifetime. To be able to help the most unfortunate people you can find and making a difference in their lives, that is what drew me to continue working in social services, so here I am.

3. What advice do you have for someone who would like to do the job you do?
I believe a case manager’s most important characteristic is to be compassionate and caring for others. Many people are afraid to work with the problem of HIV. I believe that we have to face the problem and be willing to help it, and be compassionate.

4. If you had $30,000 to donate to BCI, what would you do with it?
I would like to have a job training center for our clients who have difficulty getting jobs because of their histories. To give these people an opportunity to get some training, learn something, and at the same time, in that place, being able to employ them. I believe that would be a great empowerment tool for our clients.

5. What is rewarding about your work?
Since I have been here, the most rewarding thing for me is to be able to reach these clients that otherwise have no one else to help them. The fact that I can help these clients to become very productive, and empower them to live a successful life, that’s a big satisfaction for me.

A Supervised Shooting Gallery?

This interesting article was passed along to me yesterday. It's about supervised drug injection centers, where users bring their drugs, shoot up in a sterile booth, and leave without fear of arrest. The goal is to prevent overdose and infectious disease. Such a facility already exists in Vancouver, and some benefits have been seen. San Francisco is now looking at establishing the first facility in the U.S.

What do you think about this approach? Is it a logical progression of the harm reduction philosophy, or is it going too far? Would you like to see a supervised shooting gallery in our area someday?

5 Questions for Evelyn Handley, Receptionist

Welcome to a new feature on the BCI Blog called 5 Questions. Here, we’ll introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Evelyn Handley
Job: Receptionist, Alpha program
Time at BCI: 12 years

1. What is something people would be surprised to know about your job?
How much I do! From the time I open the door at 7:00, it’s on. There’s work to be done. People are sometimes lined up outside to come in. Anyone that walks in to the front door, I’m the first person they see. So I more or less help them out, getting their name, their information, showing them how to fill out their packet. A lot of people aren’t capable of reading or writing. I help them with that. I get the packet to the assessor, I chart, I discharge, run the machines, whatever needs to be done, I take care of it.

I hear as much about a person’s problem coming in the door as the counselor they sit down with. I talk to people every day about rape issues, divorces, DFS, people coming into their home, taking their children, the drug and alcohol, a little bit of everything. When they’re done talking to me and they end up coming back, “The information you gave me was wonderful, it was so helpful, I enjoyed talking to you,” I know what I do at the front desk makes a big difference.

2. What advice do you have for someone who would like to do the job you do?
You have to be a people person, for real. You really do. Everyone’s not capable of sitting at that front desk. It can become overwhelming, because your clients come in the door. Some people have good days and bad days. If they’re having a good day, you know it, if they’re having a bad day, you definitely know it because they give you all their stuff. You have to be able to swallow that, keep smiling, and be able to help them at the same time. Also, you have some people that are very aggressive. You need to know how to back them down professionally and with a caring heart, and if that doesn’t work you need to know what next step to take.

3. What has been the most rewarding moment for you since you’ve been at BCI?
When you see a person come in the door crying, and their children have been taken from them, and they admit that they’re on drugs and alcohol, and they stay here for 9 months to a year, and within that time, DFS and Family Court have given their children back to them, you know that our work is really important, that we’ve done all we could to help them build up their self esteem and put them on the right road to recovery. When you see a person that doesn’t have a job, they’re homeless, 9 months from now, they have it all or they’re on their way to getting it, that’s rewarding.

4. If you had $30,000 to donate to Brandywine Counseling, what would you do with it?
It would have to go to two different places, I would split it. Our Bridge Perinatal, and our HIV [Outreach]. I started out with the HIV department. Street outreach is important - that was said to me maybe my second year by [Executive Director] Sara Allshouse. I didn’t know just how important it was. I knew the job I was doing, I went out on