Pathways Autumn 2016 Secret File

V O L U M E 20 I S S U E 3

PATHWAYS

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Published by Evergreen Health Services

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PRESIDENT & CEO / Ronald T. Silverio EDITOR/ART DIRECTOR / John Carocci EDITOR / Martha Sawicki COPY EDITOR / Theresa Woehrel CONTRIBUTING WRITERS Martha Sawicki, Christopher Reybrouck CONTRIBUTING PHOTOGRAPHER John Carocci __________________________________________________

EDITORIAL & ADVERTISING / 716-847-0212 FACSIMILE / 716-847-0418 EMAIL / publications@evergreenhs.org ON THE WEB / www.evergreenhs.org _________________________________________________

Copyright 2016 by Pathways, all rights reserved.

Published by Evergreen Health Services, 206 South Elmwood Avenue, Buffalo, New York 14201. Pathways circulation is 5,000. Pathways is received by request by donors and supporters. Distribution is by mailing list and placement. Views expressed herein are not necessarily the views of the publisher. Publication of any person or organization in articles, advertising or listings in Pathways is not to be construed as any indication of the sexual orientation or HIV status of such person or members of such organizations.

Pathways cannot acknowledge or return unsolicited manuscripts unless they are accompanied by a selfaddressed stamped envelope. Pathways’ mailing list is never shared. Pathways urges readers to consult their medical practitioners about any therapies or treatment strategies in this publication. To be put on the Pathways Magazine mailing list, call 847-0212, or email ssciandra@evergreenhs.org. _________________________________________________

inside this issue From the President / 1 CAS Fights Health Disparities / 2 Meet Amanda Jackson-Jacobs / 3 The Opioid Epidemic and Evergreen / 4 Governor Cuomo Visits Evergreen / 5 DOFL: Our Compliments to the Chefs / 6 Block Club: Guided by Vision / 10 SCOUT Helps a New Generation Face HIV / 12 Evergreen Lofts Opens / 14

on the cover

Black Sheep's Steve and Ellen Gedra will Co-Chair Buffalo's Dining Out for Life 2016.

Photo by John Carocci.

Mission and Change as Always Last year, over 13,000 individuals came through Evergreen’s doors to receive one or more of our services. These individuals come from all walks of life, socioeconomic levels, racial and cultural backgrounds, and a variety of gender and sexual orientations. What all of them received was a welcome and total acceptance of where they are on their earthly journeys.

For over thirty years we have opened our doors and hearts to folks facing multiple challenges. It started with individuals and communities struggling to understand and cope with the AIDS epidemic. Our commitment to serve them and their families required us to develop multiple services including medical, housing, mental health, substance abuse, and various prevention strategies. We supported those living with HIV and AIDS, we provided a safe and nurturing environment for them to interact with caregivers, did our best to be present and resourceful in assisting them in their struggle, and we were often asked to celebrate their lives when they passed.

Moving ahead several decades, we still provide those services and support to over 1,200 HIV+ individuals and their families. Happily, there are treatments available that provide healthier and longer lives than ever imagined 30 years ago.

And now we are confronted with a vicious new epidemic — characterized by frequent overdoses and life-threatening episodes. The epidemic of substance abuse, like HIV and AIDS, cuts across all walks of life, socio-economic levels, racial and ethnic backgrounds, and various genders and sexual orientations. We serve well over 4,000 individuals who use unprescribed substances. With our once highly unorthodox, and now standard of care Syringe Exchange Program, we provide a safe and nurturing environment for substance users to remain healthy and open to use less but to always use safely. We provide counseling, medical care, mental health support, nutrition, and housing services. We engage our clients in a Harm Reduction process that encourages thoughtful and measured responses to maintaining a healthy and balanced life for substance users, always with an eye towards sobriety.

Every epidemic is different, but responses to epidemics have much in common.

We — our staff, volunteers, and Trustees — strive to provide a compassionate, professional, safe, and accepting environment for individuals, families and communities challenged by a variety of health and social challenges. Epidemics come and go — the mission of being present and supportive to those most affected by epidemics is what we do.

Warmly,

Ronald Silverio and Joy Feldman

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Many of the people we serve are unfamiliar with, or even afraid of, the healthcare system

- Christina Turner

Buffalo is not unique when it comes to health disparities. Racial minorities face a disproportionate number of health disparities when compared to their white counterparts. Black people, in particular, have shorter life expectancy, higher infant mortality rates, and a higher prevalence of chronic health conditions, like HIV and diabetes, than white people do. Heart disease occurs twice as often in black people as it does in white people, and the death rate for breast cancer among black women is 40% higher than among white women. The causes of these disparities are complex and varied. Some of the most common causes are socioeconomic and cultural barriers, lack of access to or mistrust of the healthcare system, and healthcare providers’ bias toward and uncertainty of how to care for minority patients most effectively. For minority people, these health disparities can be devastating, leading to lost earning potential, lower quality of life, and even premature death.

A Tackling Disparities, Empowering People Buffalo is unique, however, in that we have Community Access Services (CAS), an Evergreen

affiliate that fights health disparities in minority communities through comprehensive prevention and treatment services. CAS offers an array of programs designed to reduce health disparities and improve health outcomes for minority people.

Services include HIV and Hepatitis C testing, STI prevention, and harm reduction counseling, as well as support groups, and linkage/navigation services. CAS also serves as a portal to wraparound services, like medical care, mental health or substance use counseling, or care coordination through Evergreen.

A Building Trust, Changing Lives Community Access Services staff members spend a lot of their time out in the community, meeting people where they are.

“It’s easier that way,” says Christina Turner, Program Manager at CAS. “Many of the people we serve are unfamiliar with, or even afraid of, the healthcare system. They don’t understand it.

They’re not going to come to us, so we go to them; we walk them through the process, at their pace.”

The first step is building a rapport with potential

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clients; but Turner notes this can take time. “It’s a fine line,” she says. “If you rush the process, you’ll see their wall go up.”

The wait is worth it. A new marketing campaign features success stories from clients who have made long-lasting, positive changes in their lives through CAS. Each client’s story is unique, but they’ve all overcome incredible obstacles which were keeping them from a healthy life.

A Bringing Services to People CAS has also developed partnerships with a variety of other community organizations, like the Matt Urban Hope Center and the CRUCIAL Center. These alliances help CAS bring services directly to people who would otherwise be unable — or unwilling — to access them. CAS will soon announce new partnerships with community-based providers that will allow CAS to bring HIV and STI testing to people who desperately need it.

Turner sees more of these collaborations in the future, as CAS continues to expand its reach into areas where the greatest need is, and help make health disparities a thing of the past.

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Meet Amanda Jackson-Jacobs Amanda Jackson-Jacobs serves as a board member for Community Access Services, an affiliate of Evergreen Health. Jackson-Jacobs is the CEO of Trace Cyber Solutions, LLC, a start-up, minority-owned information technology business. Jackson-Jacobs is dedicated to helping communities of color achieve their best health, and is sharing her years of professional experience and expertise with CAS. “My heart for service is keenly aligned with the mission of CAS,” Jackson-Jacobs says. “I have a personal passion for community initiatives that transform lives.”

Jackson-Jacobs is dedicated to removing barriers to healthcare for people of color, and wants to help Community Access Services expand their reach and impact. “CAS is an integral part of Evergreen. As the agency expands its East Side services, CAS will be at the forefront, addressing the critical health needs of people of color in the community,” Jackson-Jacobs says. She believes that CAS employees have the leadership and skills needed to build commitment in the community, and to reduce healthcare disparities for people of color. “I am proud and honored to serve as a member of the Community Access Services board,” Jackson-Jacobs says.

And, we’re proud and honored to have her!

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THE OPIOID EPIDEMIC & EVERGREEN A C O N V E R S AT I O N W IT H E M M A A N D J E S S I C A |

THE

Opioid Epidemic in Western New York is a serious issue — and one that Evergreen talks about a lot.

For the past few years, opioid use, overdose, and death tolls have been climbing. This year, it’s predicted that the City of Buffalo will see almost 600 opioid overdose-related deaths.

But, there’s hope. In June, Evergreen was proud to host Governor Andrew Cuomo as he signed proactive legislation to help providers like us combat this challenging epidemic.

Pathways sat down with Emma Fabian, Director of Substance User Health Policy, and Jessica (photo above), an SEP and SUI client, to talk about opioid use, the overdose epidemic, and how Evergreen and our supporters can take action to save lives.

Jessica, your addiction to opioids started with prescription pills. Was it is a huge leap to start buying street drugs, or using heroin?

Jessica: It really wasn’t. I started misusing my medication, and needed more than I was prescribed. I knew someone who sold Lortabs sometimes, and I didn’t think buying pills was a problem. It felt normal. Then, when I was in

the hospital, I met a patient who got me to try heroin. She shot me up. The rest is history.

When you started misusing drugs, your doctor abruptly cut you off from your pain medication. At that point, was it hard to find an alternative?

Jessica: No, it was easy. I could get drugs easily through certain people. I preferred to use in private, but you can definitely find heroin at parties or social settings. It’s not hard to find opioids these days.

Emma: And heroin is a lot cheaper than pills, isn’t it?

Jessica: Definitely. You can get heroin as cheap as $60 for a gram. It might not be good, but you can get it.

Your story sounds like a lot of people’s.

Especially clients who use Evergreen’s programs. How is Evergreen responding to the Opioid Epidemic?

Emma: I don’t know if there are any solutions to this epidemic yet, but Evergreen is working to find them. Evergreen does a great job of bringing people in, and meeting them where they are. I think our priority right now

BY MARTHA SAWICKI

is keeping people alive. We’re not interested in pushing people toward one kind of treatment or medical care. Evergreen is unconditionally helping people survive this epidemic; that’s a real strength.

Jessica: As a drug user, Evergreen’s approach has been so helpful. I used for like a year before I started coming here because I didn’t know about it. I would go to a pharmacy for needles, even though I always found the experience very stressful and stigmatizing. It’s tough. I went through a lot of needles; I had to suck it up to get them. When I was introduced to Evergreen, I thought it was like magic. I like how Evergreen draws people in, but tries to do what works for each person. Evergreen has the tools for safe using, keeping people alive, and support and treatment, when they’re ready.

Emma: At its core, syringe exchanges provide safe equipment to stop the spread of HIV and Hepatitis C. Evergreen is so much more than that, though. So many of our clients are getting harm reduction counseling and safe injection help, talking to staff about what treatment and the next level of care will look

like, and connecting with our staff socially, in a humane way.

Jessica: Treating people with humanity when they come for their needles is an incentive to come back, and use clean equipment. It’s how you get people to come back, and consider sobriety options.

So, the way that the Exchange provides their services is a key to helping drug users open up and get care?

Emma: We don’t know exactly what causes all opioid addictions. But, from my experience, I think it’s related to social isolation; a loss of meaningful connection to the outside world and other people. At Evergreen, we can provide a little bit of what people need intellectually, socially, emotionally…

Jessica: …and trust. Creating more transparency about addiction struggles helps.

I’ve gone from living in a shoebox to a glass house. It’s a significant difference. I’m happier now. I think people need to be able to talk to a counselor or someone that they can be completely honest with in order to meet their sobriety goals.

Jessica, now that you’re so open about your opioid use, do people treat you differently?

Jessica: At first, I kept it a secret. I think that people knew something was going on with me, but I also have a lot of mental illness. I was really sick, and people couldn’t tell what was what. I decided to become more transparent about using opioids, and a bunch of my friends cut me off. My mom always reminds me to tell people that I got started in heroin because my doctor prescribed pills. But, I’m a heroin addict; I don’t think it matters how I got started.

Emma: A lot of people in our community talk about drug use like it’s a moral failing, which I think is why we make a bold distinction between people who got hooked experimentally versus people who started using at a doctor’s office. It’s important to give addiction a human face.

How can everyday people do that?

Emma: Help change how we talk about addiction. Treat this epidemic like the public health issue that it is. Talk about people like they’re human beings, and not statistics. I think that more people will seek help if their personhood is preserved, and they aren’t made to feel ashamed. It sounds simple, but it’s hard to do. Evergreen’s trying to help our community shift its perspective.

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(photo by Darren McGee)

Evergreen was proud to host Governor Andrew Cuomo as he signed legislation designed to fight the heroin and opioid overdose epidemic in New York State into law. This new law is an important step in increasing access to treatment, but, as Evergreen's Director of Substance User Health Policy Emma Fabian notes, the real significance is a move toward speaking about drug use as a public health issue rather than a moral failure.

"Because of our harm reduction approach to the services we provide, Evergreen is well positioned to play a significant role in discourse about substance use," says Fabian. "There is a lot more work to be done. It will do us good to speak compassionately and thoughtfully about public health issues like drug use instead of falling back into traditional stigmatizing rhetoric."

Evergreen is a leader in offering comprehensive, compassionate health and treatment services to people who use drugs. For over ten years, Evergreen has operated one of the largest syringe exchange programs in the state, providing resources to prevent disease transmission and a non-judgmental “point-of-entry” into health care or drug treatment for those who are ready. We also provide hundreds of Narcan kits — the lifesaving opiate antidote — and overdose prevention training each month to people who use drugs, their loved ones and the general public. Evergreen offers mental health and substance use counseling based in the harm reduction model, a client-centered approach focused on realistic goals and achieving success through incremental steps. Primary and specialty medical care, along with case management, housing, employment, and wellness services are other components of the agency’s wrap-around model for people who use drugs. Rooting all of our programs in a harm reduction approach is vital to engaging with the drug using community and keeping them alive. Evergreen recognizes that to end the current epidemic, we must be able to engage meaningfully with drug users even if they are not ready or able to abstain from drugs, and to fight the stigma of drug use by affirming the dignity and value of every person who enters our doors.

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Emma Fabian

Emma Fabian is Evergreen’s first Director of Substance User Health Policy. In this role, Emma will direct the development of Western New York’s only Substance User Health Hub, a pilot program managed by the New York State Department of Health’s AIDS Institute that emphasizes engaging with drug users using a harm reduction, nonjudgement approach.

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very year, Evergreen looks forward to Dining Out For Life, our most unique and widespread fundraiser. It’s such a treat to reconnect with the local restauranteurs and chefs who support the event and our mission. These eateries (91 of them, to be exact) are committed to making our community a better place to live. They care about their customers and neighbors, and help out where they can. For the weeks leading up to Dining Out For Life, they donate space in their menus and windows and even their front lawns to promote the event.

The night of, Dining Out For Life restaurants welcome our volunteer ambassadors, treating them like royalty, as they help us spread the word about our cause. And, at the end of the night, the restaurants donate at least 25% of that night’s earnings to Evergreen so that we can continue to provide highquality medical care — and specialty HIV care — for the people in our community who need it the most.

Put simply, our restaurants are incredible — fostering a healthier community just by serving us delicious meals and drinks! We couldn’t love them more.

But, this year, one special restaurant has stepped up to chair the event. Chefs Steve and Ellen Gedra, owners and operators of The Black Sheep Restaurant

and Bar happily took on the roles of event co-chairs for 2016’s Dinging Out For Life Event. “You can’t put a price on saving lives,” Steve said. “Whatever we can do to help each other — help eradicate HIV and AIDS — that’s what our community needs to do.”

Steve means it. Before opening The Black Sheep, the Gedras operated Bistro Europa, and have been participating in Dining Out For Life since the start.

To date, they are the single largest donor, donating 50% of their food and alcohol sales from the night of the event. One step further, their pour staff donates a portion of their tips.

“Great strides have been made in HIV treatment,” Steve said. “If we can eliminate HIV completely — and we’re closer every day — then we need to support events like Dining Out For Life. It’s so important.”

Steve and Ellen have created an intimate farmto-table dining atmosphere at Black Sheep, and they are committed to serving locally-sourced produce and sustainably-raised meats. If you haven’t already checked it out, you should! Although Dining Out For Life only happens once a year, our restaurants and chefs, like the Gedras, are Evergreen’s friends all year round. They share our passion for ending HIV in our community, and helping Western New Yorkers to feel well. That tastes pretty good to us!

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Story by Christopher Reybrouck and Martha Sawicki. Photos by John Carocci.

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Evergreen Association Board of Trustees Janice P. Barrett Joy A. Feldman Thomas J. Foels Sharon Hanson Brian L. Kawaler Kirsten Moysich Kevin F. O'Leary Thomas H. Owen Ronald T. Silverio

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Evergreen Health Services Board of Trustees Broderick Cason

Natalie Dunklin Joy A. Feldman Matthew Feldman Jeffrey Fick Nancy A. Hammond Coralia J. Hetzner Donald R. Letta Joel G. Mahakian Melissa Neal Mark Nowak Neil Pawlowski Ronald T. Silverio Matthew J. Weigand

Evergreen Health Services helps to foster healthy communities by providing medical, supportive and behavioral services to individuals and families in WNY, especially those in marginalized populations and/or challenged by chronic or life threatening diseases.

Pride Center of Western New York Board of Trustees James Bower

Javier Bustillos David W. Cyr Jennifer Dunning David F. Granville Christina Holdsworth Patricia Jones Roy Olsen David C. Scott William Sherlock Ronald T. Silverio Martin D. Steck

The mission of PCWNY is to work with the community to make Western New York a safe, healthy, and satisfying place for lesbians, gay men, bisexuals, transgender and queer people to live, work, and establish their families.

Community Access Services Board of Trustrees Broderick Cason

Gilbert Hernandez Coralia J. Hetzner Amanda Jackson Wyleia S. Miller Esmeralda Sierra Ronald T. Silverio

Community Access Services is a not-for-profit communitybased organization committed to addressing the epidemic of HIV and AIDS and other diseases that challenge the health and welfare of urban communities in Buffalo and Erie County by assuring the availability of comprehensive care services including prevention education and treatment.

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Block Club Is Helping Evergreen Make Change

by John Carocci

Block Club

has quickly become one of the most admired design and branding agencies in Western New York. They’ve created distinctive identities for Buffalo’s top restaurants and retail outlets, along with innovative, award-winning marketing campaigns for a variety of organizations, including Evergreen.

Partners Brandon Davis and Patrick Finan started Block Club in 2007. Finan cites timing as a key factor in their decision. “Buffalo's resurgence was just getting started,” recalls Finan. “The time was right for us to start this business; change was in the air.” Block Club has accomplished remarkable things since 2007, including a magazine (Block Club), two spin-off companies (Loupe and IfThen), and a reputation for excellent design with visual and social impact.

“We’re guided by a vision,” says Finan. “To be a great place to work, to make meaningful work, and, most importantly, to work with clients who share our values. That’s why we love Evergreen!”

We want to lead by example, an

materials from the PrEP campaign in action

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Many of Block Club’s clients are non-profits. Some are well-known national brands, like TED Conferences or the United Nations, but most are Buffalo-area businesses. “Partnering with Western New York businesses gives us all more power to create change in our community and for our neighbors,” says Finan.

Like any block club (note lower case), Finan and his team are committed to making Buffalo a better place to live. “We want to lead by example, and make a positive impact,” says Finan. “Evergreen does very important work for Western New York,” he continues. “When we work with Evergreen, we’re helping people be healthy, and feel valued.

Evergreen’s success is good for all of us.”

Block Club and Evergreen recently collaborated on a high-profile marketing campaign to introduce PrEP, a daily pill for HIV prevention, to at-risk communities in Buffalo. The campaign’s billboards, bus shelters, and print ads were viewed over 22,000,000 times, and the campaign’s social media components were viewed over 3,400,000 times. As a result, over 100 people began taking PrEP for HIV prevention through Evergreen. Block Club and Evergreen’s collaboration was recognized by the Ad Club of Buffalo with the 2016 Silver ADDY Award for Integrated Media Public Service Campaign.

As Block Club gets ready to celebrate 10 years in business, Finan is planning for the future, not looking back.

“Block Club is owned by two gay men. Half of our staff is gay.

Knowing that we’re working with an organization that helps everyone — no matter your sexual orientation, the color of your skin, your gender, or whatever it is — feel safe, respected, and cared for, without judgment: that’s something awesome. That should be the norm everywhere.

Evergreen is a role model for organizations here in Buffalo and beyond.

We’re proud to work with Evergreen.”

Finan also sees a long relationship ahead between Evergreen and Block Club. “We’re so excited to be partnered with such an important, impactful organization. "We couldn’t be happier about Evergreen’s explosive growth and success. We’ll be there every step of the way to support the needs of the organization, any way that we can.” PATHWAYS

nd make a positive impact - Patrick Finan

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a new generation faces HIV

Pride Center Engages Young Men in Education & Healthcare HIV Back on the Rise | HIV was once a death sentence, but thanks to advances in prevention, early detection, and treatment, HIV has become a manageable chronic health condition. Many people who have HIV lead long, healthy lives in which their HIV status is a footnote, not the headline. But, despite all of our advances, recent trends show that HIV is back on the rise. There’s been a particularly sharp increase in HIV diagnoses among young gay and bisexual men of color. In 2014, more than 20% of new HIV diagnoses were among youth aged 13-24. Of those, 80% were gay or bisexual males; Black (55%) and Hispanic/Latino (23%) men are disproportionately represented in this group. v New Healthcare Needs | It’s tempting to be complacent about these numbers in an era when treatment can be as simple as one daily pill. But nearly half (45%) of youth aged 18-24 who are HIV+ don’t know their status. Worse, HIV+ youth are less likely than any other age group to be connected to healthcare.

Young gay and bisexual men who are unaware of their HIV+ status and not connected to healthcare are at higher risk of spreading HIV, and less likely to start treatment early, when it’s most effective. Those who are connected to healthcare may have providers who aren’t informed about current prevention options such as PrEP, or who make value judgments based on risk behaviors or sexual orientation. v The Pride Center Responds | SCOUT is a new Pride Center program designed to reach young gay and bisexual men with innovative sexual health prevention messages and tools, screening programs, education, and advocacy. Pride Center Senior Director Matthew Crehan Higgins says, “SCOUT is about knowledge, both of what is going on with one’s body, and what options are available in addressing one’s sexual health”. SCOUT will address questions young gay and bisexual men may have about prevention, and will also help link them to medical care regardless of their HIV status. SCOUT will also acknowledge the stigma and judgment that continue to surround sexual activity and HIV; stigma that prevents many from talking frankly about their health or seeking the care they need. SCOUT is not about judging or slut-shaming. SCOUT is about keeping young gay and bisexual men informed and healthy. v For more information about SCOUT visit the Pride Center website at www.PrideCenterWNY.org. - John Carocci

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Years of careful planning and hard work have came to fruition — the Evergreen Lofts project is complete! This former factory has been transformed into a beautiful residential complex, with 56 loft-style apartments for individuals and families in desperate need of safe, affordable housing. The building features amenities such as laundry rooms on each floor, a computer lab, community spaces, and easy access to Evergreen's programs and services for residents.

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