Project Grant H79TI084198

EXPANDING ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) AND PSYCHOSOCIAL SERVICES FOR HOMELESS AND VETERANS WITH OPIOD USE DISORDER IN RURAL TENNESSEE - PROJECT TITLE: EXPANDING ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) AND PSYCHOSOCIAL SERVICES FOR HOMELESS AND VETERANS WITH OPIOID USE DISORDER IN RURAL TENNESSEE MEDICATION-ASSISTED TREATMENT - PRESCRIPTION DRUG AND OPIOID ADDICTION (MAT-PDOA), NO. TI-21-006 (2021-2026) THIS PROJECT WILL ADDRESS THE OPIOID ABUSE CRISIS IN TENNESSEE BY EXPANDING ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) AND PSYCHOSOCIAL SERVICES FOR 450 RURAL HOMELESS AND VETERANS WITH OPIOID USE DISORDER (OUD) IN A 24-COUNTY CATCHMENT AREA IN PRIMARILY RURAL TENNESSEE. THE PROJECT WILL INCORPORATE A NOVEL, COMPREHENSIVE CARE MODEL THAT INTEGRATES A VARIETY OF EVIDENCE-BASED APPROACHES, COMPRISING OF MEDICATION, PSYCHOSOCIAL THERAPIES, COUNSELING, AND RECOVERY SUPPORT SERVICES TO FACILITATE FULL RECOVERY FOR THIS UNDERSERVED POPULATION. THIS PROJECT WILL ADDRESS A CRITICAL GAP IN TREATMENT SERVICES IN RURAL AREAS FOR HOMELESS AND VETERANS WHO HAVE BEEN SEVERELY IMPACTED BY THE OPIOID CRISIS IN THIS REGION BUT HAVE LIMITED ACCESS TO MAT SERVICES FOR OUD. IN 2019, AMONG THE 2,089 TN RESIDENTS, WHO DIED OF A DRUG OVERDOSE, NEARLY 75% (1,543) WERE A RESULT OF OPIOIDS COMPARED TO 1,304 IN 2018. THE NUMBER OF OVERDOSE DEATHS INVOLVING FENTANYL INCREASED BY 945% WHILE DEATHS ATTRIBUTED TO HEROIN OVERDOSE ROSE BY MORE THAN 145%. THERE HAS BEEN A 350% INCREASE (300 IN 2013 TO 1,482 IN 2020) IN OVERDOSE-RELATED ED VISITS IN REGION V, WHICH INCLUDES THE POPULATION OF FOCUS (POF) FOR THIS PROJECT. IN THE 24-COUNTY CATCHMENT AREA, NON-FATAL OVERDOSES INCREASED FROM 1,594 IN 2015 TO 3,364 IN 2018; FATAL OVERDOSES INCREASED FROM 498 IN 2015 TO 750 IN 2018. HOMELESS PEOPLE ARE PARTICULARLY VULNERABLE WITH OVER 30% FACING SUBSTANCE ABUSE (SUD), OUD, AND CO-OCCURRING DISORDERS (COD). THE HOMELESS ARE NINE TIMES MORE LIKELY TO FACE MORTALITY FROM AN OVERDOSE. MOREOVER, VETERANS ARE AT A SIX-FOLD RISK OF REPORTING SUD, FOUR-FOLD RISK OF REPORTING COD, AND TWICE THE RISK FOR AN ER VISIT COMPARED TO NONVETERANS. TO ACHIEVE THESE GOALS, OUR INTEGRATED CARE DELIVERY MODEL WILL PROVIDE ASSESSMENT FOR OUD, ILLICIT DRUG USE, AND ALCOHOL DEPENDENCE, CO-OCCURRING MENTAL HEALTH, AND PHYSICAL HEALTH; AND DELIVER A FULL CONTINUUM OF SERVICES, INCLUDING INTEGRATED MAT WITH MENTAL AND PHYSICAL HEALTH CARE, PSYCHOTHERAPY, RECOVERY SUPPORT SERVICES (RSS), CASE MANAGEMENT, AND TRANSITIONAL AND PERMANENT HOUSING ACROSS MIDDLE TENNESSEE. CLIENTS WILL BE OFFERED DETOX, MAT, INPATIENT AND OUTPATIENT TREATMENT, RELAPSE PREVENTION, PEER SUPPORT, VOCATIONAL TRAINING, AND TRANSPORTATION SERVICES. IN ORDER TO PROVIDE A BROAD SPECTRUM OF SERVICES, BUFFALO VALLEY, INC. WILL PARTNER WITH OTHER SERVICE PROVIDERS: HOSPITALS, ERS, LAW ENFORCEMENT, FAITH-BASED ENTITIES, AND EMPLOYMENT AGENCIES. WITH OUR LARGE TREATMENT INFRASTRUCTURE IN HOHENWALD, TN, 6 SATELLITE FACILITIES, AND 603 HOUSING UNITS IN SURROUNDING AREAS, WE ARE WELL-POSITIONED TO SERVE THIS HARD-TO-REACH RURAL POPULATION IN MIDDLE TENNESSEE. THE SPECIFIC GOALS OF THE PROJECT ARE: 1. GOAL 1: TO DEVELOP OUTREACH AND ENGAGEMENT STRATEGIES FOR RECRUITMENT OF 450 PRIMARILY RURAL HOMELESS AND VETERANS WITH OUD (90 PER YEAR); 2. GOAL 2: TO CONDUCT SCREENING AND ASSESSMENTS FOR PRESCRIPTION OPIOID MISUSE, ILLICIT OPIOID USE, AND ILLICIT DRUG USE FOR 450 PRIMARILY RURAL HOMELESS AND VETERAN CLIENTS (90 PER YEAR); 3. GOAL 3: TO EXPAND ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) AND EVIDENCE-BASED PSYCHOSOCIAL AND RECOVERY SUPPORT SERVICES TO 450 PRIMARILY RURAL HOMELESS AND VETERANS WITH OUD (90 PER YEAR); AND 4. TO DECREASE PRESCRIPTION OPIOID MISUSE, ILLICIT OPIOID DRUG USE, AND ILLICIT DRUGS AND ALCOHOL USE AT SIX-MONTH FOLLOW-UP FOR 450 OUD CLIENTS IN THE CATCHMENT AREA.