Project Grant H79TI086423

TTC'S OVERDOSE TREATMENT ACCESS (OD-TA) PROJECT - TARZANA TREATMENT CENTERS, INC. (TTC) WILL EXPAND ACCESS TO OPIOID OVERDOSE (OO) EDUCATION AND NALOXONE DISTRIBUTION (OEND) IN LOS ANGELES COUNTY (LAC) THROUGH THE DEVELOPMENT AND IMPLEMENTATION OF TWO SCALABLE TRAINING OF TRAINERS (TOT) PROGRAMS: 1) OEND BEST PRACTICES FOR FQHCS, COMMUNITY CLINCS AND PHARMACIES TOT PROGRAM (OENDCCP); AND 2) OEND BEST PRACTICES FOR COLLEGE CAMPUSES TOT PROGRAM (OEND CC). THE OENDCCP WILL RECRUIT HEALTHCARE "CHAMPIONS" OR PROVIDERS (DOCTORS, PHYSICIAN ASSISTANTS, NURSE-PRACTITIONERS, NURSES, MEDICAL ASSISTANTS, COMMUNITY HEALTH WORKERS, ETC.) AND PHARMACISTS FOR A HALF-DAY, IN-PERSON TRAINING ON INNOVATIVE PRACTICES, POLICIES, PROCEDURES, AND MODELS OF CARE FOR PRESCRIBING/CO-PRESCRIBING AND OTHERWISE EXPANDING ACCESS TO NALOXONE IN COMMUNITIES WITH HIGH RATES OF OO DEATHS. PARTICULAR FOCUS WILL BE PLACED ON CULTURALLY INFORMED APPROACHES THAT ADDRESS SOCIAL STIGMA, MEDICAL MISTRUST, AND OTHER BARRIERS TO NALOXONE ACCESS IN THE PREDOMINANTLY RACIAL/ETHNIC MINORITY POPULATIONS SERVED BY THE TRAINEES. OEND "CHAMPIONS" WILL THEN RETURN TO THEIR SITE TO TRAIN OTHER STAFF AND BUILD SITE-SPECIFIC CAPACITY TO PROVIDE EFFECTIVE OEND SERVICES THAT ARE CULTURALLY RESPONSIVE TO THE POPULATION SERVED. AT LEAST TWO (2) TRAININGS WILL BE HELD EACH YEAR (1 DURING YEAR ONE) WITH 30-40 PROVIDERS EACH FOR A MINIMUM OF 270 OEND CHAMPIONS TRAINED DURING THE 5-YEAR PROJECT. THE OEND CC WILL RECRUIT "COLLEGE AMBASSADORS" OR STUDENT LEADERS AND CAMPUS HEALTH CENTER PERSONNEL FROM LOCAL COMMUNITY COLLEGES AND UNIVERSITIES THROUGHOUT LAC FOR A HALF-DAY, IN-PERSON TRAINING ON INNOVATIVE PRACTICES, POLICIES, PROCEDURES, AND MODELS OF ENGAGEMENT FOR INCREASING ACCESS TO OEND ON COLLEGE CAMPUSES. FOCUS WILL BE PLACED ON CULTURALLY INFORMED APPROACHES FOR HISPANIC-SERVING INSTITUTIONS (HSIS) WHERE THE SAME CULTURAL BARRIERS TO NALOXONE ACCESS MAY PREVAIL AS IN PREDOMINANTLY LATINX COMMUNITIES. AT LEAST TWO (2) TRAININGS WILL BE HELD EACH YEAR (1 DURING YEAR ONE) WITH APPROXIMATELY 25 TRAINEES EACH FOR A TOTAL OF 225 OEND COLLEGE AMBASSADORS OR TRAINERS TRAINED DURING THE 5-YEAR PROJECT. BETWEEN THE TWO TOT PROGRAMS, A TOTAL OF 495 UNDUPLICATED INDIVIDUALS WILL BE TRAINED AS TRAINERS WITH AWARD FUNDS. EACH OEND CHAMPION OR TRAINER COMPLETING THE TOT PROGRAM WILL COMMIT TO TRAINING A MINIMUM OF 5 PROVIDERS AT THEIR SITE FOR A TOTAL OF 150-200 INDIVIDUALS TRAINED IN YEAR 1 AND 300-400 TRAINED ANNUALLY IN YEARS 2-5 FOR A TOTAL OF 1,350-1,800 INDIVIDUALS TRAINED IN OEND BEST PRACTICES FOR FQHCS, COMMUNITY CLINICS, & PHARMACIES BY THE END OF YEAR 5. MEANWHILE, EACH OEND COLLEGE AMBASSADOR COMPLETING THE TOT PROGRAM WILL TRAIN A MINIMUM OF 5-10 STUDENTS/HEALTH CENTER STAFF AT THEIR CAMPUS FOR A TOTAL OF 125-250 INDIVIDUALS TRAINED IN YEAR 1 AND 250-500 TRAINED DURING YEARS 2-5 FOR A TOTAL OF 1,125-2,250 INDIVIDUALS TRAINED BY THE END OF YEAR 5. TTC'S TOT PROGRAMS WILL ADDRESS SERVICE GAPS IN LAC WHERE HIGHER RATES OF AREA POVERTY WERE ASSOCIATED WITH HIGHER OO DEATH RATES. THE SPECIFIC GOALS OF THE TOT PROGRAMS ARE TO: 1) INCREASE CAPACITY OF LOCAL FQHCS, COMMUNITY CLINICS, AND PHARMACIES TO DEVELOP EFFECTIVE OEND PROGRAMS, INCLUDING INNOVATIVE AND CULTURALLY RESPONSIVE PRACTICES, IN HIGH-NEED COMMUNITIES; AND 2) INCREASE CAPACITY OF LOCAL HIS COMMUNITY COLLEGES AND STATE UNIVERSITIES TO DEVELOP EFFECTIVE AND INNOVATIVE OEND PROGRAMS, INCLUDING CULTURALLY RESPONSIVE PRACTICES, AMONG DIVERSE STUDENT POPULATIONS. BY THE END OF YEAR 5, THE RATE OF ED VISITS AND HOSPITALIZATIONS DUE TO OO WILL BE REDUCED BY AT LEAST 25% FROM BASELINE (2022). ANNUALLY DURING YEARS 1-5, AT LEAST 533 NALOXONE NASAL SPRAY KITS WILL BE DISTRIBUTED TO OEND CHAMPIONS FOR DISTRIBUTION TO PATIENTS AT HIGHEST RISK FOR OO, AND APPROXIMATELY 5-10 PATIENTS WHO HAVE EXPERIENCED AN OO WILL BE LINKED TO OUD TREATMENT EACH YEAR THROUGH AN ENHANCEMENT OF LINKAGE TO TREATMENT PROTOCOLS WITH PARTICIPATING FQHCS AND COMMUNITY CLINICS.