The Center Of Treatment Innovation (COTI) Program is a mobile peer support, harm reduction, and treatment program that goes out and reaches individuals wherever they are in Cortland County. It is a program of Family & Children’s Counseling Services (FCCS).

Alexandra Mikowski is an Outreach Therapist for the COTI Program, and a passionate advocate for increasing opioid overdose prevention services in Cortland County. Healing Cortland sat down with Alex to learn more about the COTI Program. 

First of all, COTI Programs exist across New York State. They are OASAS certified providers focused on engaging people in treatment through: 

• Mobile clinic services: bringing treatment staff into under/unserved areas – The FCCS COTI has two vans that go and meet folks at their home, a park, or wherever the client feels comfortable meeting.
• Expanding tele-practice sites; and 
• Enhanced peer outreach and engagement within the community. 

The COTI Program is about breaking down barriers and meeting clients where they are at.

Some examples of work the COTI Program does involves transporting clients to treatment services. Alex has brought clients to Detox and other treatment options, including REACH Medical, a low-threshold treatment provider, on various occasions. Likewise, COTI staff prioritizes outreach after receiving overdose information from local law enforcement. Whenever possible, within days of a reported overdose, COTI staff will go to the overdose site and neighboring houses/apartments to see if anyone is in need of support, services, or Narcan. 

We first asked Alex to describe the COTI Program:

Alex: “So, COTI is about bringing the clinic outside the four walls of the clinic. Our goal is to innovate, and to try doing not the normal. That was the mandate from the state. It looks like doing an evaluation from a park, or taking someone to Detox from a garage. It’s less agency-centered, so you don’t have to go to the agency, and do what the agency says, and can really focus on the needs of the client. We have found it to be really helpful.”

“We do a lot of door to door outreach. We may get referrals from other agencies, and we can self-refer. For example, the Wishing Wellness Center of Catholic Charities can send someone over, and they may have done the referral with them. We get some referrals where the client is not asking for help. In some cases, maybe they’ve gone to the DSS seeking help, or maybe the police have had an encounter.”

How can clients reach the COTI Program?

“Clients can call us, they can go into the agency, they can email us, etc. There are a lot of ways for people to reach us.”

What do you enjoy about working for the COTI Program?

“Meet them where they’re at” is a phrase used constantly in trainings and in the treatment world. For me, I love jobs where you literally ‘meet them where they’re at.’ We don’t judge if we think they should, or shouldn’t be using however much. We don’t judge what they should do in their life. We can just physically go to them, and can offer harm reduction, services, and just let them know what’s available. If they aren’t ready, that’s okay. We just tell them if and when they are ready they can give us a call. But if they are ready we can work with them right away.”

For more information about the COTI Program or to access Narcan training or kits, contact the FCCS Main Office at (607) 753-0234 or the COTI Outreach Therapist Cell at (607)749-0014 during normal business hours. You can also reach COTI staff by email at COTI@fcscortland.org.