Project Grant H79TI084388

MAT EXPANSION AND RETENTION THROUGH OUTREACH AND ENGAGEMENT TEAMS - CODAC, INC'S PROPOSED MAT-PDOA PROGRAM SEEKS TO EXPAND ACCESS TO EFFECTIVE MEDICATION-ASSISTED TREATMENT (MAT) SERVICES FOR PERSONS WITH AN OPIOID USE DISORDER (OUD) SEEKING OR RECEIVING MAT. THE DESIRED OUTCOMES FOR THIS PROGRAM ARE: 1) AN INCREASE IN THE NUMBER OF INDIVIDUALS WITH OUD RECEIVING MAT; 2) AN IMPROVEMENT IN THE 6 MONTH AND 1 YEAR RETENTION RATES FOR INDIVIDUALS NEWLY ADMITTED TO MAT; AND 3) AN INCREASE IN THE NUMBER OF INCARCERATED INDIVIDUALS WHO RECEIVE SUBLOCADE AND ENGAGE IN FOLLOW UP CARE IN THE C5637OMMUNITY. PROJECT GOALS AND OBJECTIVES: ONE OBJECTIVE OF THIS PROPOSAL IS TO EXPAND MOBILE OUTREACH TEAMS IN AREAS OF IDENTIFIED NEED. THESE TEAMS INCLUDE CLINICIANS, PEER SPECIALISTS AND NURSES TO CO-LOCATE WITH COMMUNITY BASED ORGANIZATIONS SERVING AT RISK INDIVIDUALS INCLUDING THOSE WITH OUD; LIVING WITH OR AT HIGH RISK FOR HIV/ HEPATITIS C; HOMELESS; NEWLY RELEASED FROM INCARCERATION; OTHER SUBSTANCE USE DISORDERS (SUD); RESIDENTS IN HEALTH POVERTY AREAS. SERVICES: SERVICES PROVIDED AT MOBILE OUTREACH CLINICS INCLUDE: CRISIS STABILIZATION AND ASSESSMENT; PATIENT-CENTERED MEDICAL SCREENING AND EDUCATION; MAT FOR OUD VIA BUPRENORPHINE/ NALTREXONE; MEDICATIONS FOR OTHER SUD; SUBSTANCE USE COUNSELING; CASE MANAGEMENT; OPT-OUT RAPID HIV AND HEPATITIS C TESTING; SEXUALLY TRANSMITTED INFECTION SCREENING; INSURANCE INITIATION; BI-DIRECTIONAL LINKAGES TO MEDICAL, BEHAVIORAL, AND SOCIAL SERVICES. COMMUNITY-BASED OUTREACH SERVICES WILL INCREASE THE OPPORTUNITY TO ENGAGE INDIVIDUALS IN DISCUSSIONS ABOUT THEIR SUBSTANCE USE AND THE BENEFITS OF MAT. PROVIDING THESE SERVICES WITH NON-SUD RELATED SERVICES SUCH AS MEDICAL SCREENINGS INCREASE ENGAGEMENT AND REDUCE THE STIGMATIZATION OF SEEKING MAT. THIS NO WRONG DOOR APPROACH STREAMLINES ACCESS TO PATIENT-CENTERED QUALITY CARE. TO IMPROVE CLIENT RETENTION, INDIVIDUALS ADMITTED TO MAT WILL BE LINKED TO ENHANCED ENGAGEMENT TEAMS THAT WILL ADDRESS THE NEEDS OF INDIVIDUALS NEWLY INDUCTED ON METHADONE, BUPRENORPHINE, OR NALOXONE. THE TEAMS WILL BE HOUSED IN CODAC'S PROVIDENCE, PAWTUCKET, CRANSTON AND WARWICK LOCATIONS, TO MEET THE NEEDS OF THE CITIES HARDEST HIT BY OPIOID OVERDOSE. SERVICES WILL BE EXPANDED BEYOND TREATMENT AS USUAL TO INCLUDE COMPREHENSIVE CASE MANAGEMENT, FAMILY ENGAGEMENT AND OTHER SUPPORT SYSTEMS, CONNECTION TO NECESSARY COMMUNITY BASED RESOURCES, AND PEER SUPPORT. CODAC WILL ALSO INCREASE THE CONNECTION TO COMMUNITY BASED CARE FOR INCARCERATED INDIVIDUALS WHO ARE PRESCRIBED BUPRENORPHINE TO TREAT OPIOID USE DISORDER. INCREASING THE USE OF THE LONG-ACTING INJECTABLE FORM OF BUPRENORPHINE WILL DECREASE THE RISK OF MEDICATION DIVERSION IN THE CORRECTIONAL SETTING AND PATIENTS WILL BE MORE LIKELY TO ENGAGE IN CONTINUED TREATMENT POST RELEASE. OUTCOMES: INCREASED ACCESS TO AND RETENTION IN MAT FOR A HIGH-RISK POPULATION WILL LEAD TO THE FOLLOWING OUTCOMES: AN INCREASE IN INDIVIDUALS ENROLLED IN MAT AND INTEGRATED CARE SERVICES, IMPROVEMENT IN TREATMENT RETENTION RATES, A REDUCTION IN ILLICIT OPIOID USE, A REDUCTION IN THE USE OF PRESCRIPTION OPIOIDS IN A NON-PRESCRIBED MANNER, AND A REDUCTION IN RE-INCARCERATION OF INDIVIDUALS. THE GEOGRAPHIC REGION SERVED BY THE PROPOSED PROGRAM ENCOMPASSES THE ENTIRE STATE OF RHODE ISLAND. THE PROJECT WILL SERVE A TOTAL OF 1,007 UNDUPLICATED INDIVIDUALS DURING YEAR 1 AND A TOTAL OF 5,637 OVER THE 5 YEAR PROGRAM PERIOD.