Project Grant H79TI086027

EXPANDING ACCESS TO MEDICATION-ASSISTED TREATMENT ? PRESCRIPTION DRUG AND OPIOID ADDICTION (MAT-PDOA) AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH IN THE CHARLOTTE METROPOLITAN AREA OF NORTH CAROLINA - SUMMARY: AMITY MEDICAL GROUP, INC. (AMG) IS A NON-PROFIT MEDICAL PRACTICE WITH EXTENSIVE EXPERIENCE PROVIDING AFFORDABLE, CULTURALLY COMPETENT, INTEGRATED MEDICAL SERVICES, HIV SERVICES, OPIOID USE DISORDER (OUD) SERVICES, INCLUDING MEDICATION-ASSISTED TREATMENT (MAT) SERVICES, AND MENTAL HEALTH SERVICES TO VULNERABLE RESIDENTS. AMG IS PROPOSING TO USE GRANT FUNDING TO EXPAND AND ENHANCE ACCESS TO MEDICATIONS FOR OPIOID USE DISORDER (MOUD) IN THE CHARLOTTE AREA OF NORTH CAROLINA, REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. PROJECT NAME: EXPANDING ACCESS TO MEDICATION-ASSISTED TREATMENT - PRESCRIPTION DRUG AND OPIOID ADDICTION (MAT-PDOA) AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH IN THE CHARLOTTE METROPOLITAN AREA OF NORTH CAROLINA POPULATIONS TO BE SERVED: ANY INDIVIDUALS WITH OUD, INCLUDING INDIVIDUALS FROM DIVERSE RACIAL, ETHNIC, SEXUAL AND GENDER MINORITY COMMUNITIES. THERE IS A STRONG NEED FOR IMPROVED ACCESS TO THESE SERVICES IN THE CHARLOTTE AREA WHERE ACCORDING TO THE UNIFORM DATA SYSTEM MAPPER REPORT, 29% OF THE POPULATION (315,436 RESIDENTS) ARE BELOW 200% OF THE FEDERAL POVERTY LEVEL, 12% LIVE IN POVERTY, AND 12% ARE UNINSURED. ACCORDING TO THE NC INJURY & VIOLENCE PREVENTION BRANCH, IN MECKLENBURG COUNTY, THERE WERE 44 OPIOID POISONING DEATHS IN 2010, AND THIS NUMBER ESCALATED BY 300% TO 176 OPIOID POISONING DEATHS IN 2020. ALSO, THE NUMBER OF OPIOID POISONING EMERGENCY DEPARTMENT VISITS DRASTICALLY INCREASED BY 566% FROM 116 IN 2010 TO 772 IN 2020. STRATEGIES & INTERVENTIONS: AMG WILL UTILIZE EXISTING STAFF, HIRE STAFF, AND COLLABORATE WITH PARTNERS TO PROVIDE MOUD SERVICES IN COMBINATION WITH COMPREHENSIVE PSYCHOSOCIAL SERVICES, COUNSELING, BEHAVIORAL THERAPIES, RECOVERY SUPPORT SERVICES, AND HARM REDUCTION SERVICES. AMG WILL ALSO CONDUCT SCREENINGS AND ASSESSMENTS; DEVELOP AND IMPLEMENT OUTREACH AND ENGAGEMENT STRATEGIES TO INCREASE ACCESS TO MOUD AND RELATED SERVICES FOR DIVERSE POPULATIONS WITH OUD; BUILD FUNDING MECHANISMS AND SERVICE DELIVERY MODELS WITH ORGANIZATIONS TO EFFECTIVELY IDENTIFY, ENGAGE, AND RETAIN INDIVIDUALS IN OUD TREATMENT AND FACILITATE LONG-TERM RECOVERY; USE TELEHEALTH SERVICES TO REACH, ENGAGE, AND RETAIN PATIENTS IN TREATMENT; PROVIDE DE-ESCALATION/CRISIS PREVENTION AND TRAUMA-INFORMED CARE TRAINING TO STAFF; AND ASSESS INDIVIDUALS AND FAMILIES WHO ARE AT RISK FOR OR EXPERIENCING HOMELESSNESS AND REFER THEM FOR SERVICES. GOALS & OBJECTIVES GOAL 1: TO EXPAND AND ENHANCE ACCESS TO MOUD FOR INDIVIDUALS WITH OUD IN THE CHARLOTTE AREA OF NORTH CAROLINA. OBJECTIVES: 1) PROVIDE MOUD TO 600 NEW UNDUPLICATED INDIVIDUALS IN YEAR 1; 2) PROVIDE MOUD TO 350 NEW UNDUPLICATED INDIVIDUALS IN EACH ADDITIONAL YEAR; 3) BY THE END OF YEAR 5, AMG WILL HAVE PROVIDED MOUD TO 2,000 UNDUPLICATED INDIVIDUALS TOTAL. GOAL 2: TO DECREASE ILLICIT OPIOID USE AND PRESCRIPTION OPIOID MISUSE IN THE CHARLOTTE AREA OF NORTH CAROLINA. OBJECTIVES: 1) BY THE END OF EACH PROGRAM YEAR, 80% OF PROGRAM PARTICIPANTS WILL HAVE SELF-REPORTED A REDUCTION IN RECREATIONAL OPIOID USE AND PRESCRIPTION OPIOID MISUSE SINCE STARTING THE PROGRAM; 2) BY THE END OF EACH PROGRAM YEAR, 95% OF PARTICIPANTS WILL HAVE RECEIVED A PSYCHOSOCIAL ASSESSMENT; 3) BY THE END OF EACH PROGRAM YEAR, 80% OF PROGRAM PARTICIPANTS WILL HAVE CONTINUED THEIR RETENTION IN SERVICES; 4) BY THE END OF EACH PROGRAM YEAR, THE NUMBER OF ER VISITS AND HOSPITALIZATIONS FOR PROGRAM PARTICIPANTS WILL HAVE DECREASED BY 75% FROM THEIR YEAR PRIOR TO PROGRAM ENTRY; 5) BY THE END OF EACH PROGRAM YEAR, 80% OF PARTICIPANTS WILL BE ENGAGED IN PRIMARY CARE VIA VISITING A PRIMARY CARE PROVIDER AT LEAST ONCE IN THE PAST YEAR; 6) BY THE END OF EACH PROGRAM YEAR, 80% OF PARTICIPANTS THAT HAD SCORES OF 10 OR GREATER ON THE PHQ-9/GAD7 PRIOR TO PROGRAM ENTRY WILL SHOW IMPROVEMENT IN THESE SCORES; AND 7) BY THE END OF EACH PROGRAM YEAR, 80% OF PARTICIPANTS WILL HAVE REPORTED AN INCREASE IN THE QUALITY OF THEIR LIFE COMPARED TO SURVEYS CONDUCTED PRIOR TO ENTRY IN THE PROGRAM.