MAX: A unique intervention program from Catholic Charities Cleveland
By Tara McMullen
A patient awakens in a hospital room. Bright lights. Beeping monitors. A nurse enters and informs them they’ve been revived from an opiate overdose. They were lucky this time. Would they like to speak with someone about recovery?
Here in this hospital room is where the Max Kolbe Program (MAX), a unique intervention program launched by Catholic Charities, Diocese of Cleveland (CC Cleveland), first intervenes.
In 2020, CC Cleveland won the large member agency category in Catholic Charities USA’s Innovation Challenge. One of three winners, CC Cleveland was recognized by CCUSA for their inception of MAX and its novel approach to tackling the opioid epidemic and its entangled relationship with poverty.
“Poverty, in its most pure sense, is not just lacking money, it is lacking resources,” explains Fredy Robles, the Chief Program Officer for CC Cleveland and a licensed therapist specializing in mental health and substance abuse. “Someone lost in active addiction may have excluded themselves from their support system so they’re lacking that resource. They have oftentimes burned bridges and disconnected themselves from the people who would be most important to them in every sense — financially, emotionally.” He details that as addiction progresses, it’s difficult to maintain employment, which further strains financial resources, and can lead to criminal activity and a self-perpetuating cycle of poverty.
To halt that slide, recovery is critical. In Cleveland, Catholic Charities already manages three residential treatment programs for addiction, in addition to outpatient and psychiatric services, but MAX offers a new approach. David Monter, a program administrator and social worker with the group, explains that the first innovative element of MAX is having peer support specialists reach out to users in nontraditional settings to create efficacies.
What this program aims to do is connect with people authentically at the bedside in the emergency department when they’re vulnerable, when they’re motivated to change and capture that motivation…and then develop a plan right there.
For some, they need someone to talk to that first day. They might need a place to sleep once they are discharged. They might need a hot meal. Or they may be ready to commit to sobriety. Whatever they need, the coach meets them with all the resources CC Cleveland can provide, ranging from mental health services to housing options, and from case management to a bed in a residential treatment program. And if they’re not ready yet, the coach hands him or her his cell phone number and promises to follow-up in a few days.
What’s more, the peer recovery coaches are all people with the lived experience of addiction and are uniquely positioned to walk alongside a patient with compassion and hope. They are walking testaments to the power of recovery.
Monter has worked as a substance abuse counselor for nearly a decade. He is also a person with the experience of recovery. “I’ve been in active recovery for a long time. It doesn’t matter how good I am at my job, the second I tell somebody that I am also a person in recovery they start looking to me… they start connecting with me because that’s an experience that we’ve shared.” He continues, “So being able to sit in there and tell somebody I know what it’s like to lay in the hospital bed, because you know 10 or 12 years ago I did the same thing…I was laying right there and I can tell you that it sucks. And I know what you’re feeling. And I know how scared you are. And I know how I can help you get out of this. Being able to connect with somebody with shared experiences has been a key component to this.”
Monter explains that at most hospitals, people with substance use disorders are given a brochure with instructions to schedule an assessment, but it can take days or weeks for an appointment. This can feel like an eternity to someone trying to sober up. With MAX, because the coach is immediately present to create a personalized plan, almost 80 percent connect with CC Cleveland after discharge. Monter underscores that a component of that success is recognizing there are limitless paths to recovery, and the key is finding the one that works for each individual.
To call the work of CC Cleveland impactful is an understatement. Since launching in 2019, the group has already served more than 300 people and is on track to meet its goal of helping 1,000 people in its first three years. They also plan to train 100 peer support recovery coaches, which gives those in recovery an opportunity for employment. Robles notes the more than 50 hours of required training for recovery certification can launch the new coaches into meaningful work both with CC Cleveland and beyond.
Patrick Gareau, President and CEO of CC Cleveland, says that the employment portion is one of the most valuable components of MAX. He explains, “It’s important that this program is not only reaching out to those who are in recovery, but is providing a career path for those who, because of their addiction and all the damage that it caused, have difficulty securing gainful employment. This turns their experience into a positive one so they can reach out to those who are continuing to suffer and bring them to the road of recovery.
The idea for the program, named for the patron saint of drug addiction, came about as part of brainstorming sessions led by Gareau. Though there were several other valuable proposals, Robles notes the group was searching for a program that could impact every community, and addiction, he somberly notes, doesn’t discriminate based on race, wealth, age or gender. Addiction is present everywhere, especially in the wake of the Covid-19 pandemic. In July, the U.S. Centers for Disease Control and Prevention reported drug overdose deaths increased by nearly 30 percent in 2020, with more than 93,000 lives lost.
Though MAX briefly had to suspend its hospital visits during the height of the pandemic, its success has been undeterred. The program recently signed new contracts with additional health systems in several counties, including a NICU for babies born to addicted mothers. It also aims to make the program replicable elsewhere, says Robles. As the team considers the needs of different populations — urban versus rural and affluent versus impoverished, one thing doesn’t change: the need to recognize the dignity of each person they serve.
“Our faith tells us there’s no distinction, that we’re all made in the image of God and that every single human being has dignity and every person is worthy of respect. As Catholics, this should be part of our faith to serve people, regardless of where they are, regardless of their struggle,” Robles says. “We can bring a sense of hope. That is the Gospel…to share hope with people.”