Project Grant T6249321

INTEGRATED SUBSTANCE USE DISORDER (SUD) TRAINING PROGRAM - PROJECT TITLE: THUNDERMIST HEALTH CENTER INTEGRATED SUBSTANCE USE DISORDER TRAINING PROGRAM (ISTP) APPLICANT ORGANIZATION: THUNDERMIST HEALTH CENTER HEALTH CENTER PROGRAM GRANT NUMBER: H80CS00454 ADDRESS: ADMINISTRATIVE OFFICE, 171 SERVICE AVENUE, BUILDING 1, WARWICK, RI 02886 PROJECT DIRECTOR: CARA ZIMMERMAN, MD, MBA CONTACT PHONE NUMBER: VOICE: (716) - 866 - 6866 E-MAIL ADDRESS: CARAZ@THUNDERMISTHEALTH.ORG WEB SITE ADDRESS: WWW.THUNDERMISTHEALTH.ORG FUNDS REQUESTED: $452,012.27 THUNDERMIST HEALTH CENTER (THC) BEGAN ITS MISSION OF REMOVING BARRIERS TO HEALTH CARE IN 1969. WHAT STARTED AS A VOLUNTEER-RUN HEALTH CENTER, HAS GROWN INTO AN NCQA-RECOGNIZED PATIENT-CENTERED MEDICAL HOME WITH BEHAVIORAL HEALTH DISTINCTION. THC SERVES PRIMARILY LOW-INCOME, MEDICALLY UNDERSERVED CHILDREN AND ADULTS, INCLUDING PEOPLE EXPERIENCING HOMELESSNESS. PATIENTS PRIMARILY RESIDE IN WOONSOCKET, WEST WARWICK, WARWICK, AND WASHINGTON COUNTY, RHODE ISLAND. NEARLY 50% OF THC PATIENTS ARE PUBLICLY INSURED, AND 10% ARE UNINSURED. THC REQUESTS $452,012.27 TO SUPPORT THE DEVELOPMENT OF AN INTEGRATED SUBSTANCE USE TRAINING PROGRAM AT OUR HEALTH CENTERS. THE GOAL OF THIS PROGRAM IS TO PROVIDE ENHANCED CLINICAL TRAINING TO FULL-TIME NURSE PRACTITIONERS AND NURSES WORKING IN OUR HEALTH CENTER LOCATIONS. CLINICAL TRAINING WILL FOCUS ON ENHANCING PARTICIPANTS' EXPERTISE WITH ADDICTION TREATMENT INCLUDING CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER, HARM REDUCTION BEHAVIOR CHANGE TECHNIQUES AND PROVISION OF HIGHLY EFFECTIVE COORDINATED MULTI-DISCIPLINARY CARE. THE PROGRAM WILL BE A FULL-TIME, YEAR-LONG PROGRAM AND WILL TRAIN PRIMARY CARE NURSE PRACTITIONERS, PSYCHIATRIC NURSE PRACTITIONERS, AND NURSES. L FELLOWS ARE FULL-TIME, THC EMPLOYEES. ALL FELLOWS SIGN EVERGREEN CONTRACTS, AND MANY REMAIN EMPLOYED AT THUNDERMIST FOLLOWING THEIR RESIDENCY. CURRENTLY, THUNDERMIST TREATS PEOPLE WITH SUBSTANCE USE DISORDERS (SUD) AND OPIOID USE DISORDER (OUD) IN OUR HEALTH CENTERS, INTEGRATED IN THE PRIMARY CARE SETTING WITH MULTIDISCIPLINARY CARE TEAMS. CURRENTLY, 1,559 THUNDERMIST PATIENTS HAVE AN IDENTIFIED OPIOID USE DISORDER. OVER THE LAST YEAR, THUNDERMIST PROVIDERS PRESCRIBED SUBOXNONE, VIVITROL, NALTREXONE, OR BUPRENORPHINE TO 1,211 PATIENTS. THERE HAS BEEN A NEARLY 900% INCREASE OF PATIENTS WITH AN IDENTIFIED SUD OVER THE LAST FIVE YEARS. THERE HAS ALSO BEEN A 105% PERCENT INCREASE IN BEHAVIORAL HEALTH PATIENTS, EXCLUDING PATIENTS BEING TREATED FOR SUD, OVER THE LAST FIVE YEARS, CLEARLY INDICATING THE NEED FOR THIS CARE IN OUR COMMUNITIES. THE COVID-19 PANDEMIC HIGHLIGHTED AND EXACERBATED BEHAVIORAL HEALTH CRISIS, PARTICULARLY IN UNDERSERVED COMMUNITIES INCLUDING COMMUNITIES WE SERVE. WE ANTICIPATE TRAINING APPROXIMATELY 70 PARTICIPANTS ANNUALLY, THIS WORK WILL BE INTEGRATED INTO THE ONBOARDING FOR ALL NURSES AND BECOME PART OF THEIR ANNUAL TRAINING REQUIREMENTS. THE PROGRAM WILL BE COMPRISED OF BOTH CLINICAL EXPERIENCE AND DIDACTIC EDUCATION, IN ADDICTION MEDICINE AND MENTAL HEALTH. THE PROGRAM WILL BE SUPPORTED BY THE ISTP CLINICAL DIRECTOR, CLINICAL NURSE EDUCATOR, AND OTHER CLINICAL CHAMPIONS AT THUNDERMIST WHO CARE FOR PATIENTS WITH SUDS AND/OR OUDS. THE DIDACTIC COMPONENT WILL INCLUDE SEVERAL COMPONENTS INCLUDING PROVIDERS CLINICAL SUPPORT SYSTEM (PCSS) CONTENT, AND DIDACTIC CONTENT CONTRACTED VIA COMMUNITY-BASED CLINICAL AND ACADEMIC PARTNERS. A COMPREHENSIVE NUMBER OF TOPICS THAT WOULD BE REVIEWED DURING THIS PART OF THE TRAINING PROGRAM FROM THE EPISTEMOLOGY OF SUBSTANCE USE DISORDERS, TRANSFORMATIVE CHANGE AND MOTIVATIONAL INTERVIEWING, AND CO-OCCURRING PSYCHIATRIC DISORDERS. THE CLINICAL ELEMENT OF THIS TRAINING PROGRAM WILL CONSIST OF COLLABORATION WITH A COMMUNITY PARTNER IN SPECIALTY CLINICAL ROTATIONS AND HANDS-ON TRAINING WITH CLINICAL CHAMPIONS AT THUNDERMIST. COLLABORATION WITH A CLINICAL PARTNER WILL GIVE PROGRAM PARTICIPANTS A DEEPER UNDERSTANDING OF ADDICTION MEDICINE IN SPECIAL POPULATIONS, INCLUDI NG ADOLESCENTS.