Project Grant H79TI084451

ACCESS MAT EXPANSION - ACCESS, AN FQHC, SERVES MORE THAN 175,000 LOW INCOME PATIENTS ANNUALLY IN THE CHICAGO REGION-AN AREA WITH SOME OF THE HIGHEST OPIOID-RELATED DEATH RATES IN THE NATION. THIS PROJECT WILL IMPROVE ACCESS TO TRAUMA-INFORMED MAT SERVICES THROUGH EXPANDED PARTNERSHIPS, THE ADDITION OF A 15TH SITE TO OUR PROGRAM, AND ENHANCED RECOVERY SERVICES. OVER FIVE YEARS WE PLAN TO INCREASE OUR MAT CAPACITY BY 26 PERCENT AND SERVE A TOTAL OF 1,988 UNIQUE PATIENTS. POPULATIONS TO BE SERVED: ACCESS WILL EXPAND AND STRENGTHEN OUR MAT PROGRAM MODEL FOR OUR LOW INCOME, PREDOMINATELY MINORITY PATIENTS IN THE CITY OF CHICAGO, SUBURBAN COOK COUNTY AND DUPAGE COUNTY. SOME COMMUNITIES IN THE TARGET AREA HAVE AN OPIOID-RELATED OVERDOSE DEATH RATE NEARLY FOUR TIMES THAT OF THE NATION OVERALL, WITH EVEN HIGHER RATES SEEN AMONG BLACK INDIVIDUALS AGED 45 TO 64 YEARS. THE COVID-19 PANDEMIC HAS FURTHER EXACERBATED THE OPIOID EPIDEMIC IN THE CHICAGO REGION. THERE WAS A 20 PERCENT INCREASE IN OPIOID-RELATED OVERDOSES IN 2020 BUT A DECREASE IN THE AVAILABILITY OF TREATMENT AND RECOVERY RESOURCES. THE COMMUNITIES IMPACTED ARE HIGHLY IMPOVERISHED WITH SIGNIFICANT HEALTH INEQUITIES AND HIGH RATES OF TRAUMA AND VIOLENCE. PROJECT GOALS: 1. ENSURE CONTINUED ACCESS TO MAT SERVICES DURING THE COVID-19 PANDEMIC; 2. EXPAND ACCESS TO MAT SERVICES IN THE HARDEST HIT COMMUNITIES; 3. LOWER THE RISK OF FENTANYL-RELATED OVERDOSES; 4. EXPAND PARTNERSHIPS TO ENSURE SEAMLESS TRANSITIONS OF CARE FROM INSTITUTIONAL SETTINGS SUCH AS HOSPITALS AND THE CRIMINAL JUSTICE SYSTEM; 5. ENSURE PATIENTS RECEIVE THE RIGHT LEVEL OF CARE AT THE RIGHT TIME AT ACCESS, INCLUDING ACTIVE TREATMENT, INTENSIVE OUTPATIENT PROGRAMS, AND RECOVERY SERVICES; 6. STRENGTHEN THE INFRASTRUCTURE OF THE PROGRAM AT ACCESS TO INCLUDE DEDICATED PROGRAM OVERSIGHT AND EVALUATION TO SUSTAIN HIGH QUALITY CARE. PROJECT STRATEGIES: THESE GOALS WILL BE ACHIEVED BY: (A) EXPANDING TELEHEALTH TO INCLUDE GROUP THERAPY AND INTRODUCE INJECTABLE BUPRENORPHINE; (B) OPENING A NEW MAT PROGRAM AT AN ACCESS HEALTH CENTER WHICH IS CO-LOCATED WITH A SAFETY NET HOSPITAL IN A COMMUNITY WITH ONE OF THE HIGHEST OPIOID-MORTALITY RATES IN THE NATION; (C) UPDATING PROVIDER EDUCATION ON OVERDOSE PREVENTION AND INCREASING THE AVAILABILITY OF NALTREXONE TO ALL ACCESS SITES; (D) EXPANDING PARTNERSHIPS WITH HOSPITAL SYSTEMS AND COMMUNITY PARTNERS; (E) INTEGRATING PEER RECOVERY SPECIALISTS, CHAPLAINCY, AND LEVEL TWO SERVICES INTO THE PROGRAM AND EXPANDING GROUP SERVICES TO SPECIAL POPULATIONS SUCH AS WOMEN; AND (F) HIRING A DEDICATED MANAGER AND EVALUATION STAFF. NUMBER OF PEOPLE TO BE SERVED: THE PROJECTED UNDUPLICATED NUMBER OF PATIENTS SERVED WILL BE: YEAR 1: 725; YEAR 2: 755; YEAR 3: 785; YEAR 4: 835; AND YEAR 5; 875-A TOTAL OF 1,988 PATIENTS OVER THE FIVE-YEAR PROJECT PERIOD, WHICH ASSUMES SOME PATIENTS WILL STAY IN THE PROGRAM FOR MORE THAN ONE YEAR. PATIENTS WILL RECEIVE PATIENT-CENTERED, TRAUMA-INFORMED, EVIDENCE-BASED INTERVENTIONS WITHIN THE PRIMARY CARE SETTING. USING A HARM REDUCTION APPROACH THAT ADDRESSES PATIENTS' INDIVIDUAL CIRCUMSTANCES, WE WILL REDUCE OPIOID USE AND IMPROVE OVERALL HEALTH OUTCOMES.