Editor’s note: This article is part of a joint editorial initiative between the National Association of Community Health Centers and Direct Relief.

In Colorado, a federally qualified health center has provided access to healthcare and quality housing for decades. Now, the health center’s Fort Lyon location is celebrating a decade of successful substance use recovery, too.

The Denver-based health center, the Colorado Coalition for the Homeless, began offering healthcare services to those experiencing homelessness 40 years ago. The founders realized that housing was a critical part of maintaining overall health needs and began purchasing property so patients could have a place to call home.

Now, the Coalition owns over 2,000 affordable, supportive housing units for individuals and families and has repurposed a Veterans Hospital-turned-correctional facility for those with substance use disorders to live while in recovery.

Health, housing, and flexibility are the secrets to the program’s success. According to Fort Lyon, over 40% of their participants exited the program and moved into permanent housing. When transitional, long-term care was included, 58% of participants moved into permanent housing. Last year, 93% of participants said they were satisfied with their experience at Fort Lyon.

“It’s amazing what can be done here,” said Vincent Orzweiler, a current participant in the Fort Lyon program. The 62-year-old said he has struggled with alcohol dependency for 30 years. He’s tried other recovery programs in the past but said many are expensive and only allow participants to stay in recovery over strict timelines.

November marked 19 months at Fort Lyon for Orzweiler, who says he has taken a deep dive into his mental and behavioral health to better understand the reasons he consumes alcohol.

“Mentally, it’s about filling a void, the spiritual intersection of addiction,” he said. “There are mental problems that we all go through, and there are reasons that we became addicts.”

Before moving to Fort Lyon, Orzweiler had a new job and said that life was going well.

“I thought I could go back and maybe use a little here and there because my life was better,” he said. “But that addiction took control again, and I ended up losing almost everything again.”

Frustrated, his friends and family encouraged Orzweiler to seek out social services. He completed an application and was referred to Fort Lyon.

No Place for Isolation

There are few rules at Fort Lyon, other than joining at least one of the many recovery groups on site. Isolation is not an option, and enrolled participants are at Fort Lyon because they want to be there.

The program can accept up to 225 applicants at a time through referrals from social services across the state. The program is free to participants, at a cost of $18,800 per person per year for the state. Participants can stay at the facility for up to three years while working on their mental and behavioral health needs. The participants are predominantly male, at 80%. About 68% of participants are from counties outside of Denver, and most participants are between the ages of 45 and 54.

Fort Lyon is located in Colorado’s Bent County, a rural area with less than 6,000 residents and the program has been home to over 2,200 people in the past decade. Patients have access to the on-site health clinic, can choose from dozens of workgroups to participate in, go to school to gain certifications and become employed to begin rebuilding their lives. They are housed across three dormitories and 10 single-family homes across the campus.

That community has been key to Orzweiler’s recovery. He said that he is prioritizing his mental health and has learned that he needs a supportive network around him. When he leaves, he’ll return home and plans to find a therapist to continue working on his mental and behavioral health needs.

“I had to change a lot of behaviors, and it’s not just the using part,” he said. “It’s the things that I would say made me a better human being. A better citizen…Why did I cheat? Why did I steal? Why do I lie? It’s all part of the addiction, and those issues have to be addressed.”

Orzweiler said that he and many others felt “beaten down” by life tolls when they arrived to the facility. After months of therapy, he says he can’t overstate how important the mental health side of his recovery has been at Fort Lyon.

Patients expressing their own desire for recovery is also why Fort Lyon has been successful, said Lisa Trigilio, operations director. Trigilio has worked at Fort Lyon since its inception as a recovery facility. She said the “loose program” doesn’t have a lot of requirements, thus increasing the chance for patient success.

“For me, it’s the phenomenal amount of people that you meet,” she said about why she enjoys working at Fort Lyon. “We have so many wonderful people that come through here, and it just excites me to see when people are changing.”

Participants can choose whether their recovery is faith-based, medically assisted, involves group therapy, or a myriad of other options. They’re allowed to leave campus to explore the town, often to eat and find local employment. Fort Lyon is also not a closed facility—those seeking help for substance use disorders are welcome to join the on-site group discussions.

Trigilio said many have arrived at Fort Lyon feeling “very broken” and that they leave feeling “excited about life again.”

“You can’t find that anywhere else that I know of,” she said.

Fort Lyon’s health center is a satellite center to the Denver location. A physician is available two days a week, as well as a licensed professional counselor and a psychiatric nurse practitioner. They offer in-person and telehealth options. The medical services are free for participants through the state’s Medicaid program. All staff are trained to administer Naloxone, and if comfortable, carry it with them while at work.

“Taking a comprehensive history is important. Many of the patients I work with not only have addiction but also mental health concerns, co-occurring disorders,” Vickie Lucero, an on-site behavioral health provider, told Direct Relief in an email.

Lucero said that she asks patients about previous trauma, treatments and outcomes. Lucero teaches healthy boundaries, and talks to her patients about how to communicate and prioritize self-care. Many arrive at Fort Lyon with unaddressed medical issues, which can affect their overall treatment plan.

“Addressing addiction requires addressing the whole person,” Lucero wrote. “Trauma, pain, grief, education, employment (and more). They all impact how an individual copes with the challenges of life. At FLHC, we work to address all those things with care and compassion, taking care of the whole person.”

Direct Relief has supported the Colorado Coalition for the Homeless with medical aid and financial support, including a $100,000 emergency operating grant to continue work during the Covid-19 pandemic.