Generating systemic change along the addiction recovery continuum
Leading a team of Community Health Workers in one of the most populated cities in the U.S. while implementing a new overdose tracking tool may be daunting, but Kevin Fox, Program Manager at the North Texas Behavioral Health Authority (NTBHA) is taking on these challenges and thriving.
In 2020, NTBHA received a grant from Texas Health and Human Services to bring the core competencies of the community health worker field to the substance use and mental health field in Dallas and surrounding areas housed within NTBHA. At the time, Fox served as a community health worker instructor, focusing on teaching and helping prospective CHW applicants get certified. He was brought on to oversee the CHW program at NTBHA. Fox was excited to help bring this program to the community and focus on helping those dealing with substance use disorders in his community.
“This was something that was not done before, primarily community health workers were people with physical health conditions such as diabetes, high blood pressure, that kind of thing. So this was a new endeavor. It turned out to be a wonderful partnership,” Fox said.
Since the early 2000’s Fox has focused his career around healthcare, due in part to his wife’s career in social work, he wanted to focus on helping those around him.
“We moved here from Chicago,” Fox said. “That is when I embarked on my career as a pharmacy technician, in health care, working over at GE Healthcare, which is a very rewarding career. I learned so much about what it actually means to contribute and help and produce to help produce positive health outcomes in the community. I knew that I was making a difference. But I knew that there was so much more that I felt that I was called to do.”
Looking to deepen his connection with community outreach, Fox was introduced to Dr. Joe Powell, current CEO of Associate of Persons Affected by Addiction (APAA) who brought on Fox as a mental health specialist before then transitioning into the Community Health Worker field in Texas.
Now, Fox serves as the Program Manager of the Substance Use Disorder Community Health Worker program at NTBHA, championing a team of six CHWs who are using TxCOPE, ARI’s overdose tracking tool in their efforts as front-line workers in the opioid crisis.
“I see myself as a community bridge builder, a collaborative partner,” Fox said. “I provide working linkage with a network of community and social service agencies.” Fox provides resources, and referrals, and works to connect persons with a substance use disorder with providers and additional agencies. “We are building capacity for the community.”
NTBHA focuses on creating a collaborative system of care for those who are experiencing mental illness or afflicted by substance use disorders. Fox said that health literacy remains a constant in their practice but by addressing it, NTBHA and Fox help to reduce health disparities in the community.
As a leader in outreach and healthcare, Fox attributes his ability to lead by being an active listener, focusing on creating an understanding to foster relationships.
“Listening is a skill, it’s an art,” Fox said. “When you’re engaged with someone, and there’s conflict, [people] don’t listen to understand. Active listening is one of my skills that I use as a leader, I practice what is called the 80/20 rule; I listen 80% and I talk only 20%. This helps me to build those relationships and to lead my team.”
On par with his leadership, Fox sought after TxCOPE in wanting to his program’s efforts in tackling harm reduction with those they serve.
“Since the inception of the program back in 2020 we’ve been seeking to develop partnerships, to strengthen our Harm Reduction Program. The one piece that we are not able to really get a handle on was just tracking, being able to track overdoses,” Fox said.
With the ability to track overdoses quickly, TxCOPE was as Fox called it, ‘a no-brainer.’ He reached out to the TxCOPE engagement team in the spring of 2023, shortly after the official launch of TxCOPE and after years of gathering data from pilot programs.
“Once we heard about what TxCOPE does, as far as their ability to provide those tracking tools, and that ability to believe, for us to determine where those hotspots would be, it was a no brainer, it was like ‘Boom, that was something that we want to jump on.’ We got our staff on board with the TxCOPE app,” Fox said.
Fox said that the ability to track and then identify hotspots in real-time has helped in the distribution of Narcan, the life-saving opioid antagonist.
“We do a lot of encounters and visits with our clinics are our methadone clinics. And so in our homeless encampments, where we’re boots on the ground, this is where we can get that raw data to log on and put on our TxCOPE app, it helps us to define and find those hotspots,” Fox said.
The partnership with TxCOPE has also helped to strengthen their efforts with Housing Forward, which provides permanent housing for homeless community members. In August 2023, Dallas County proposed $3 million to begin the decommissioning encampment project where city officials and elected organizations will remove and close the homeless encampment while providing resources and temporary housing.
“It’s been mandated that these canvases be closed. But you can’t do that without offering resources and referrals to the people that are there. That’s where we come in. CHWs are able to provide those much-needed resources using the TxCOPE app to track and find out if there are any recent overdoses.” Along with tracking, NTBHA plans on providing resources to provide housing and see what benefits they are eligible for. “Our ability to provide those critical documents that keep track of any possible opioid fentanyl overdoses is making a huge difference in how Housing Forward operates and being more effective.”
The work Fox and his team are doing on the ground is helping to combat the overdose epidemic and focus on recovery housing one step at a time. By utilizing TxCOPE in their program, CHWs can focus on providing quick, efficient care and equip overdose hotspots with life-saving supplies.
“What I see over the three years since we started the program [is that] we’ve been able to break down the health information processing barrier because health literacy is an issue,” Fox recalled. “Our six community health workers have a lived experience – they’ve had substance use issues, they’re in recovery themselves, so they know what recovery looks like. When they’re out, they make that instant connection. And when we see that [health literacy] capacity, increase. The light comes on, you can see the body language changes, their eyes light up, they become more confident and their self-efficacy increases. That is so rewarding. That provides me hope.”