FY 2024 behavioral health service expansion - king county, WA is experiencing a growing opioid addiction epidemic and a record number of deaths from opioid-related overdose, yet there continues to…

FY 2024 behavioral health service expansion - king county, WA is experiencing a growing opioid addiction epidemic and a record number of deaths from opioid-related overdose, yet there continues to be unmet demand for treatment services. The king county behavioral health expansion project (KCBHEP) will serve seattle and the greater king county area, expanding access to mental health and substance use disorder (SUD) treatment including medication for opioid use disorder (MOUD) for individuals who are experiencing homelessness. In order to increase the number of clients receiving these services, KCBHEP will partner with reach to fund 2 FTE SUD harm reduction specialists and 1 FTE behavioral health specialist who will provide direct street outreach to engage with people who live outside and use drugs, prioritizing encampments and communities most impacted by overdose and incarceration. Funding will also be used to start contingency management services within the outpatient opioid treatment network (OTN) program, a clinic-based and field-based harm reduction-oriented MOUD team run by the downtown emergency services center (DESC), in compliance with hrsa requirements for contingency management. We anticipate that KCBHEP will yield 200 additional clients receiving mental health services and 500 additional clients receiving SUD services, as well as 120 additional clients receiving MOUD. The goal of KCBHEP is to find and help the most vulnerable, least capable individuals who would not otherwise access services. KCBHEP staff will initiate contact with people living homeless in greenbelts, encampments, vehicles and RVS, and at social services such as meal programs. The team will repeatedly visit people wherever they are to develop relationships over time, utilizing their knowledge of local landscapes and relationships with unsheltered communities help them to locate individuals when they voluntarily move or are involuntarily displaced. Services are implemented from a harm reduction orientation in which practical strategies are aimed at reducing the harmful consequences of substance use and homelessness, rather than abstinence. These methods have proven successful by our health center in engaging the most disenfranchised individuals into essential support services. KCBHEP staff will assess the nature and severity of clients' SUD and mental health needs and match their clinical interventions to each individual's stage of change. They will provide mental health services in the field, provide SUD treatment for individuals who are ready and able to enroll in treatment, and facilitate warm handoffs to ensure clients enroll in longer term services. To more effectively engage new individuals into care, they will also provide drug user health resources, including overdose prevention/reversal kits, drug checking services, syringes, safe smoking kits, and sharps containers. Contingency management is an evidence-based behavioral approach whereby users of substances receive tangible positive reinforcement for achieving self-identified goals. Contingency management will be provided in two ways: 1) for clients who have already started on a long-acting injectable buprenorphine medication, clients will be offered incentives for each subsequent injection administered in the clinic; and 2) for clients who are interested in starting long-acting injectable buprenorphine, and progressing through the buprenorphine initiation process that precedes the first injection, clients will be provided with incentives for meeting with an OTN team member during each day of the multi-day initiation process. Contingency management has been shown to improve retention in MOUD care, and we anticipate that this offering will make the MOUD services offered even more appealing and will drive a significant increase in new clients starting MOUD.