All Joshua

All Joshua Medical Staff The All Joshua medical staff includes family practice specialists Robert J. Ball, M.D., (also certified in addiction medicine), Stella Jefferies, CRNP, and Debra Vereen, M.D. Ball, a native of Jamaica, is a graduate of Howard University College of Medicine who completed his residency at George Washington University. Jefferies graduated from the University of Maryland, Baltimore in 2003 and earned her Masters at the Catholic University of America, Washington DC in 2008. Jefferies is an Adult Practitioner that works with adults with multiple co-morbidities, psychiatric illnesses and other primary care health conditions. She is a Vivitrol Provider as well as a Licensed Marijuana Provider for Georgetown University School of Medicine in 1996, and completed a residency at George Washington University Hospital. She is affiliated with Southern Maryland Hospital Center. Support personnel include head medical assistant and office manager Rosemary Porter, and medical assistants Nicole Winston and Dashawn James. the State of Maryland. Vereen graduated from

Medication plus counseling The development of drugs like suboxone and vivitrol have been one of the most important advances in addiction treatment, Ball notes. All Joshua clients who receive medication-assisted treatment begin to taper the dose off after one year, based on the judgment of their physicians. Others continue to receive it longer; the average duration of medicated- assisted treatment for opiate addiction is about two years. The fact that All Joshua is equipped to provide on-site counseling to clients who are receiving medication-assisted treatment is important, Ball says. “It’s a big-time advantage that our clients can get counseling while they are waiting [to receive suboxone or vivitrol.]” Sometimes, even when health care professionals have the tools to give people the help they need, their ability to deliver care is limited by external factors, like location, and differences in the reimbursement policies of public and private payers. That is the case with addiction treatment, Ball says. In treating opiate addiction, the number one problem is insurance coverage, he believes. Some physicians take advantage of recovering opiate addicts who need the medication to help them recover, overcharging them for office visits. “For instance, if somebody without insurance comes to Maryland from Pennsylvania or West Virginia, some docs will charge several hundred dollars just to see them.” Other challenges that limit the number of people who can access suboxone as a recovery tool are a shortage of physicians accredited to prescribe the medication, and an inadequate supply of the medication in some locales, Ball says. He’d like to see more resources being committed to provide treatment. “There have been several announcements about billions of (federal) dollars being poured into the problem, but not much of it has been reaching the local level. One problem is that if I prescribe suboxone for someone who is not from the D.C. area, their state’s (Medicaid) insurance may not cover them; so, they will have to pay cash to receive treatment.” “If I prescribe suboxone for someone who is not from the D.C. area, their state’s Medicaid may not cover them.” -Robert J. Ball

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