Project Grant H79TI086180

SAMHSA MAT-PDOA - NORTHWEST HEALTH SERVICES, INC. (NHS), LOCATED IN RURAL NORTHWEST MISSOURI, PROPOSES TO DRAMATICALLY EXPAND MEDICATIONS FOR OPIOID USE DISORDER (MOUD) SERVICES ACROSS 15 COUNTIES IN NORTHWEST MISSOURI. THE "NORTHWEST MISSOURI MOUD EXPANSION" PROJECT WILL ENGAGE 375 - 450 INDIVIDUALS WITH AN OPIOID USE DISORDER ANNUALLY IN MOUD, INCREASING THE NUMBER OF UNIQUE PATIENTS SERVED GRADUALLY OVER FIVE YEARS, TO ULTIMATELY REACH 2,100 INDIVIDUALS. NHS IS REQUESTING $744,938 IN YEAR 1 TO INITIATE THE PROJECT. PATIENTS WILL BE RECRUITED ACROSS A MIXTURE OF RURAL, SUBURBAN, AND URBAN COMMUNITIES. DEMOGRAPHICS ARE EXPECTED TO BE SIMILAR TO NHS'S PATIENT POOL: ASIAN - 0.71%, NATIVE HAWAIIAN/PACIFIC ISLANDER - 0.3%, BLACK - 3.95%, AMERICAN INDIAN/ALASKA NATIVE - 1.15%, WHITE - 86.2%, MORE THAN ONE RACE - 3.37%, AND UNREPORTED - 4.32%. OF PATIENTS ACCESSING NHS FOR SUBSTANCE USE LAST YEAR, OVER 8% WERE UNINSURED INITIALLY. APPROXIMATELY 16% ARE EXPECTED TO HAVE CO-OCCURRING CONDITIONS ALONGSIDE AN OUD DIAGNOSIS. STRATEGIES AND INTERVENTIONS FOR THE PROJECT INCLUDE ALL REQUIRED ACTIVITIES WITHIN THE SAMHSA MAT-PDOA SCOPE OF WORK. THESE INCLUDE PROVIDING MOUD WITH FDA-APPROVED MEDICATIONS, CONDUCTING DSM-5 DIAGNOSTIC CRITERIA SCREENINGS TO IDENTIFY CARE LEVEL AND TREATMENT, CHECKING THE STATE PRESCRIPTION DRUG MONITORING PROGRAM (PDMP), CONDUCTING SCREENINGS FOR CO-OCCURRING DISORDERS, IMPLEMENTING OUTREACH STRATEGIES TO ENGAGE DIVERSE POPULATIONS, ENSURING ALL PRACTITIONERS HAVE DATA WAIVERS TO PRESCRIBE MOUD TO AT LEAST 30 PATIENTS, AND BUILDING FUNDING MODELS AND A COLLABORATIVE CARE MODEL (COCM) TO DELIVER QUALITY SERVICES ACROSS RESOURCE-LIMITED COMMUNITIES. THE PROJECT WILL ALSO USE TELEHEALTH SERVICES, EXPAND FORMAL PARTNERSHIPS TO DELIVER RECOVERY SUPPORT SERVICES, AND PROVIDE HARM REDUCTION SERVICES. SAMHSA ALLOWABLE ACTIVITIES WILL INCLUDE LINKAGE TO TWO HRSA FUNDED INITIATIVES ADMINISTERED BY NHS-INTEGRATING MOUD WITHIN A PRIMARY CARE MOBILE UNIT, COORDINATING CLOSELY WITH SERVICES SUPPORTING POPULATIONS WITH OR AT-RISK FOR HIV/AIDS/INFECTIOUS DISEASES, ENHANCING CARE TO NHS' HOMELESS POPULATION, AND IMPROVING ORAL HEALTH CARE FOR ALL PARTICIPANTS. GOAL 1: EXPAND ACCESS TO MOUD IN NORTHWEST MISSOURI BY (A) INCREASING THE NUMBER OF UNIQUE SERVICE DELIVERY SITES AND (B) INCREASING THE STAFF OVERSEEING COORDINATED RESPONSE. PRIMARY OBJECTIVES: (A) INCREASE FROM ONE (1) TO TEN (10) PRIMARY CARE CLINIC SITES PROVIDING MOUD; (B) EXPANDING FROM ONE (1) TO SEVEN (7) COUNTIES); (C) INTEGRATE MOUD EVIDENCE-BASED SERVICES INTO THE RECENTLY LAUNCHED PRIMARY CARE MOBILE UNIT; (D) LAUNCH A TELEHEALTH COUNSELING PROGRAM WITH BEHAVIORAL HEALTH STUDENT PROVIDERS (OVERSEEN BY A PRECEPTOR) TO ADDRESS STAFFING SHORTAGES IN THE CATCHMENT AREA; AND (E) INCREASE REGIONAL AWARENESS OF THE AVAILABILITY OF MOUD SERVICES AND ACCESS POINTS THROUGH TARGETED MEDIA MESSAGING TO REACH A MINIMUM OF 20,000 VIEWS. GOAL 2: ENHANCE MOUD SERVICE QUALITY THROUGH TEAM-BASED AND EVIDENCE-BASED CARE IN PRIMARY CARE CLINICS. PRIMARY OBJECTIVES: (A) ENGAGE THE PI/BEHAVIORAL HEALTH COORDINATOR AS THE DEDICATED STAFF "HUB" TO COORDINATE THE COLLABORATIVE CARE MODEL SERVING PATIENTS WITH OUD; (B) ADD TWO COMMUNITY HEALTH WORKER/NAVIGATORS THAT HOLISTICALLY SUPPORT MOUD SERVICES; (C) ADD 1.0 PEER SUPPORT SPECIALIST (PSS) TO COLLABORATE WITH SCHOOLS AND COMMUNITY PARTNERS IN OUD RESPONSE; (D) PROVIDE TECHNICAL ASSISTANCE TRAINING TO 40 NHS STAFF ON EVIDENCE BASED PRACTICES AND TECHNICAL NEEDS TO IMPROVE MOUD SERVICES; (E) INTRODUCE FINANCIAL ASSISTANCE FOR PATIENTS TO REDUCE SOCIAL DETERMINANT OF HEALTH BARRIERS (E.G., TRANSPORTATION, FOOD, CLOTHING); (F) ANNUALLY DISTRIBUTE 200 UNITS OF NALOXONE TO PATIENTS AND ALSO TO COMMUNITY MEMBERS SUPPORTING FRIENDS AND/OR FAMILY MEMBERS WITH OUD; AND (G) ENSURE AT LEAST 80% OF PATIENTS BEGINNING MOUD SERVICES PERSIST IN TREATMENT FOR AT LEAST SIX MONTHS.