Advancing Equity

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Purpose and Target Population

  • The Franklin County Syringe Services Program (FCSSP) is the only syringe services program in Maine embedded within a rural healthcare system and delivered through a Mobile Health Unit.

  • The FCSSP is dedicated to;

    • Integrating evidence-based harm reduction into Maine Health Franklin’s continuum of care, positioning syringe services as a gateway to healthcare rather than a stand-alone service.

    • Reducing barriers to care created by transportation, geographic isolation, stigma, and limited healthcare access in rural communities.

    • Bringing services directly to individuals through a Mobile Health Unit, meeting people where they are rather than requiring travel to a fixed location.

    • Reducing transmission of HIV, hepatitis C, and other infectious diseases through safer injection supplies, education, and prevention strategies.

    • Connecting participants to primary care, behavioral health, substance use treatment, recovery supports, housing resources, infectious disease prevention, and other community services.

    • Demonstrating that harm reduction is not separate from healthcare, rather an essential entry point to healthcare in rural communities.

  • The FCSSP serves individuals who use drugs, individuals at risk for overdose or infectious disease, and others who may not otherwise engage with traditional healthcare settings.

Best Practices

  • The FCSSP integrates harm reduction within a healthcare system to create seamless pathways to primary care, behavioral health services, substance use treatment, recovery supports, and preventive healthcare.

  • The program uses a hybrid service model that combines fixed-site healthcare access with mobile outreach to reduce barriers and increase accessibility.

  • Services are delivered through a compassionate, low-barrier, person-centered approach that meets individuals where they are.

  • The FCSSP builds trust through consistency, relationship-building, confidentiality, and respect for each individual’s goals and readiness for change.

  • Each participant interaction serves as an opportunity to provide education, support prevention efforts, navigate healthcare services, and connect individuals with additional services.

  • The program develops strong partnerships across healthcare, public health, emergency response, recovery organizations, law enforcement, and community agencies to strengthen the rural continuum of care.

  • The FCSSP continuously assesses community needs and adapts service delivery to respond to evolving healthcare challenges.

Challenges and Solutions

  • Transportation barriers and geographic isolation limit access to harm reduction and healthcare services. The FCSSP addresses these challenges by providing services through both a fixed healthcare location and a Mobile Health Unit, reducing travel barriers and expanding access across rural communities.

  • Stigma prevents some individuals from accessing traditional healthcare services. The FCSSP responds by providing confidential, nonjudgmental, person-centered services that build trust, reduce stigma, and create opportunities for ongoing healthcare engagement.

  • Limited resources and fragmented service systems can make it difficult for individuals in rural communities to access coordinated care. The FCSSP addresses this challenge by operating within MaineHealth Franklin, creating coordinated pathways that connect participants to primary care, behavioral health, substance use treatment, recovery supports, infectious disease prevention, and other community resources.

  • Individuals with the greatest need often have limited connections to healthcare services. The FCSSP uses harm reduction as a trusted entry point by offering low-barrier services, building relationships over time, and connecting participants to healthcare, treatment, recovery, and community resources based on their individual needs and readiness.

Resources and Tools

Contact

Beyond Syringes: A Rural Integrated Harm Reduction Model for Healthcare Access

Franklin County, Maine

Planning and Implementation

  • As part of MaineHealth, Healthy Community Coalition developed the Franklin County Syringe Services Program (FCSSP) as an integrated program within the local Franklin Community Health Network, embedding evidence-based harm reduction services into an established rural healthcare system.

  • The program leveraged existing clinical infrastructure and a Mobile Health Unit, while strategically planning service locations and outreach to address community needs, transportation barriers, geographical considerations, and gaps in access to healthcare resources across Franklin County.

  • The FCSSP has built a collaborative network of healthcare providers, behavioral health agencies, recovery organizations, public health partners, emergency responders, law enforcement, and community organizations to strengthen referral pathways, while trained care team members deliver evidence-based harm reduction services and connect participants with healthcare and community resources.

  • The program maintains consistent service locations, hours, and outreach efforts to build trust, strengthen community relationships, and encourage ongoing member engagement.

  • The FCSSP uses participant feedback, program data, and continuous quality improvement processes to evaluate program effectiveness and refine services in response to evolving rural community needs.