Project Grant H79TI084094

HOPE CENTER MAT-PDOA PROJECT - THE HOPE CENTER MAT-PDOA PROJECT WILL SERVE 45 PARTICIPANTS ANNUALLY (225 OVER THE 5-YEAR PROJECT PERIOD) BY EXPANDING ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) FOR PERSONS WITH AN OPIOID USE DISORDER (OUD) WHO ARE SEEKING OR RECEIVING MAT AND WHO ARE EXPERIENCING HOMELESSNESS AND/OR REENTERING FROM THE CRIMINAL JUSTICE SYSTEM AND SEEKING OR RECEIVING RESIDENTIAL RECOVERY SERVICES AT HC. THE OPIOID CRISIS HAS LED TO SHARP INCREASES IN OPIOID-RELATED CRIME AND ARRESTS NATIONWIDE. KY HAS THE 7TH HIGHEST OVERALL INCARCERATION RATE AND THE 3RD HIGHEST FEMALE INCARCERATION RATE IN THE NATION (U.S. DEPT. OF JUSTICE, PRISONERS IN 2019, 10/2020). ADULTS EXPERIENCING HOMELESSNESS ARE MOSTLY WHITE (49%), AND NON-HISPANIC (75%). MOST (69%) ARE OVER AGE 24, WITH UNACCOMPANIED ADULTS 70% OF THE HOMELESS POPULATION, AND 60% ARE MALES (HOMELESS RESEARCH INSTITUTE, 2018). ADULTS INCARCERATED IN KY PRISONS ARE MOSTLY WHITE (76%), WITH 21% BLACK; AND IN JAILS, 72% WHITE AND 22% BLACK (VERA INST. 2019). 35% OF ADULTS IN JAIL AND 22% IN PRISON ARE THERE FOR DRUG OFFENSES (2016 KYDOC ANNUAL REPORT). ABOUT 10% OF PEOPLE LEAVING PRISON EXPERIENCE HOMELESSNESS FOR SOME PERIOD AFTER RELEASE (NAT'L REENTRY RESOURCE CENTER). MORE THAN HALF OF THOSE INCARCERATED HAVE A MENTAL ILLNESS: 56% OF STATE PRISONERS AND 64% OF JAIL INMATES. MOST (75%) HAVE CO-OCCURRING SUBSTANCE USE DISORDER (NRRC). HOPE CENTER WILL COORDINATE SERVICES WITH BLUEGRASS COMMUNITY HEALTH CENTER TO PROVIDE SERVICES TO THE TARGET POPULATION, INCLUDING MAT IN COMBINATION WITH COMPREHENSIVE OUD PSYCHOSOCIAL SERVICES. EVIDENCE-BASED PRACTICES WHICH WILL BE USED TO ACHIEVE PROJECT GOALS AND OBJECTIVES INCLUDE LONG-ACTING NALTREXONE, MOTIVATIONAL INTERVIEWING, AND COGNITIVE BEHAVIORAL TREATMENT. THE PROJECTS GOALS ARE 1) INCREASE THE NUMBER OF ADULTS WHO ARE REENTERING AND/OR HOMELESS IN FAYETTE COUNTY WITH OUD RECEIVING MAT BY IMPLEMENTING A CONTINUUM OF SERVICES TO PROVIDE AWARENESS, EDUCATION, OUTREACH, LINKAGE WITH HEALTHCARE, MAT ASSESSMENT, INITIATION OF MAT, AND ONGOING MAT, PRIMARY CARE, AND BEHAVIORAL HEALTHCARE; 2) DECREASE ILLICIT OPIOID DRUG USE AND PRESCRIPTION OPIOID MISUSE AMONG REENTERING AND/OR HOMELESS ADULTS WITH OUD AT SIX-MONTH FOLLOW-UP BY PROVIDING MAT IN COMBINATION WITH COMPREHENSIVE OUD PSYCHOSOCIAL SERVICES; AND 3) IMPROVE EFFECTIVE PROJECT IMPLEMENTATION AND EVALUATION BY CONDUCTING CONTINUOUS QUALITY IMPROVEMENT ACTIVITIES. OBJECTIVES INCLUDE: 225 PROGRAM PARTICIPANTS INITIATING MAT DURING THE PROJECT PERIOD; 100% OF PROGRAM PARTICIPANTS HAVING ACCESS TO MAT THROUGH ASSISTANCE IN OBTAINING AND RETAINING MEDICAID OR OTHER HEALTH INSURANCE AND ESTABLISHING A MEDICAL HOME FOR PRIMARY AND/OR BEHAVIORAL HEALTHCARE IN CONJUNCTION WITH MAT; A DECREASE IN ILLICIT OPIOID USE/ PRESCRIPTION OPIOID MISUSE IN AT LEAST 75% OF PROGRAM PARTICIPANTS AS MEASURED BY GPRA; AND THAT 100% OF PROGRAM PARTICIPANTS RECEIVE COMPREHENSIVE OUD PSYCHOSOCIAL SERVICES PROVIDED BY HC AS PART OF RESIDENTIAL RECOVERY AND BY BCHC AS PART OF MAT SERVICES.