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TI-15-007 Individual Grant Awards 2015MAT-PDOA
|Award Number||Organization||Grantee State Sort descending||City||Funding amount|
|1 H79 TI026143-01||
The Iowa Department of Public Health (IDPH) proposes to broaden treatment infrastructure for evidence-based medication assisted treatment (MAT) services, integrate care and prevention activities to achieve the following: 1) coordinate expansion and enhancement of MAT services; 2) increase the number of individuals receiving MAT services; and 3) decrease illicit drug use and improve client outcomes. Iowa intends to serve 340 new clients. The MAT program, led by IDPH will begin with block grant funded substance abuse treatment providers in the highest need counties. Contracts will be awarded to providers in four of the ten highest need counties to implement a comprehensive MAT program that includes: treatment provision to all eligible Iowans; training/workforce development; integrated care coordination; prescriber recruitment; outreach to underserved populations and improved access. Emphasis will be on the following strategies, goals and measureable outcomes as follows: IDPH will hire a full time MAT Iowa Project Director to manage program implementation; statewide outreach; advance overdose prevention; secure training in MAT evidence-based practices including Collaborative Opioid Prescribing Education (COPE), motivational Interviewing; and increase the number of individuals receiving MAT services by contracting four providers in counties with demonstrated high need for opioid treatment enhancement and expansion. These providers will increase Iowa's MAT capacity and knowledge to provide a broad array of best practices and integrated care services that will decrease illicit drug use and improve client outcomes. Measurable outcomes goals include increasing MAT and integrated care, decreasing illicit drug use at 6-month follow-up's, and reducing service disparities for women and other minorities through ongoing analysis of treatment outcomes among sub-population groups.
|1 H79 TI026149-01||
The Indiana Division of Mental Health and Addiction proposes to implement the Indiana Medication Assisted Treatment Project (IMAP) to expand outreach and engagement services and increase access to treatment in the communities surrounding South Bend and Austin. IMAP will target veterans, pregnant women, individuals with lower income, and those at-risk for HIV, Hepatitis C (HEP C) and other communicable diseases as a result of opioid addiction. The above target populations and communities are most in need of expanded capacity for access to treatment. IMAP will serve 500 individuals over the life of the grant. According to the Indiana Veterans Health Administration (VHA), almost 500,000 veterans reside in Indiana. It is estimated that 2% or more are challenged by opioid addiction. Nationally, women who are pregnant between ages 15-44 are estimated to have a 5% prevalence of an opioid use disorder. Utilizing this national prevalence rate, Indiana can estimate that over 4,000 births would be identified as high-risk pregnancies due to opioid addiction in 2014. It is estimated in 2013 that over 743,000 people in Indiana of all ages were living in poverty; low income individuals have a much higher prevalence of opioid use disorder. Finally, it is estimated that approximately 150 individuals in Austin, Indiana have tested positive for HIV since January 2015 primarily due to intravenous drug use. South Bend reports 22 positive HIV cases in 2014. IMAP will fund outreach projects, provide recovery supports to remove barriers to treatment, and case managers to assist patients with referrals for mental health services at partnering Community Mental Health Centers (CMHC), medical services, vocational rehabilitation services, and educational services. The IMAP will target increased access to medication-assisted treatment in the first year using the Opioid Treatment Program at Victory Clinical Services in South Bend and the Southern Indiana Treatment Center in Charlestown, Indiana.
|1 H79 TI026147-01||
Kentucky has experienced an increase in opiate use over the past decade. Pregnant and postpartum women are at risk since the impact of opioid abuse and dependence can have detrimental effects on both the mother and infant. Evidence suggests that early identification and a comprehensive integrated approach to treatment and recovery supports, including medication-assisted treatment (MAT), can improve maternal and infant outcomes. The KDBHDID proposes to implement infrastructure and service delivery elements to promote maternal and child outcomes among pregnant and postpartum women with opioid use disorders in two high-risk areas of Kentucky. Through a partnership with mental health centers, Cumberland River Behavioral Health in the southeastern portion of the state and Bluegrass.org serving central Kentucky, the Supporting Mothers to Achieve Recovery through Treatment and Supports (SMARTS) Initiative seeks to promote community partnerships, enhance technology infrastructure to support service delivery, support the creation of state guidelines for MAT for pregnant and postpartum women, and provide extensive training and workforce development opportunities for the medical and behavioral health workforce. Through implementation of evidence-based strategies, to promote early identification of opioid abuse among pregnant and postpartum women and Hazelden Betty Ford Foundation's Comprehensive Opioid Response - Twelve Steps (COR-12) approach, these communities will serve 500 pregnant and postpartum women with opioid abuse. A comprehensive evaluation will support ongoing performance assessment against proposed goals, objective, and activities and guide continuous quality improvement activities. The goal is to enhance the system of care for pregnant and postpartum women and their families in these high-risk communities and to support expansion into other high-risk areas of the Commonwealth to improve maternal and infant outcomes.
|1 H79 TI026154-01||
The Massachusetts Department of Public Health will expand service systems capacity to engage and retain pregnant and postpartum women in integrated Medication Assisted Treatment services (MAT) and coordinated delivery of health care, addiction and recovery support services. The Moms Do Care Project (MDCP) is requesting $1 million in funding to expand and enhance MAT services. MDCP is a collaborative effort with several agencies. The population of focus is pregnant women with opioid use disorders in which 225 women are expected to be served during the grant period. The MDCP will link women to comprehensive coordinated services and recovery support which will include trauma informed care integrated with pre- and post-natal primary, mental health and addiction services. The treatment teams will include physician prescribers, nurse care managers and Recovery Moms with a multidisciplinary team approach. Its purpose is to expand medical and behavioral health service systems capacity to engage and retain pregnant and post-partum women in integrated MAT and coordinated delivery of health care, addiction and recovery support services. The objective is to support recovering mothers receiving MAT with individualized services that support sustained recovery, choices about continuing medication, and support efforts to maintain custody or contact with their children. System capacity is expanded through integration of MAT and specialized health service for pregnancy and addiction. Outcomes include increased access and engagement in MAT concurrent with pre-and post-natal care; reduced illicit drug use; and improved health, recovery and functioning status at the individual level. Systems level outcomes include an increased number of waivered buprenorphine prescribers; increased workforce understanding of opioid dependency in women specific to the needs of pregnant women and improved integration of primary care and behavioral health services.
|1 H79 TI026148-01||
The Maryland Behavioral Health Administration (BHA) proposes to increase enrollment in medication assisted treatment (MAT) by 271 individuals per year in two high risk communities by outreach to overdose survivors in emergency rooms, increasing use of Interim Methadone Maintenance (IM), and increasing induction in Level 3.7 facilities. Baltimore City and Anne Arundel County have high rates of opioid-related emergency room visits and this proposal utilizes direct outreach to that population to recruit them into MAT. When an opioid overdose patient is admitted to the emergency room, an "outreach peer" or someone with who has life experience with opioid addiction and treatment, along with specialized training, will meet with the patient and encourage them to enter medication assisted treatment which can lead to more people entering treatment, resulting in decreased illicit drug use and overdose deaths. IM services will be used as a strategy to increase access to MAT in these survivors and bridge any gaps between overdose experience and entry into a standard MAT program. Another strategy to expand access to MAT is to increase the number of individuals in Level 3.7 residential treatment services receiving buprenorphine or buprenorphine/naloxone induction treatment (as opposed to detoxification). Induction opportunities in these facilities will motivate residents to enter MAT programs upon discharge. Participants will receive new services provided by peers specially trained by, and part of, the Medication Assisted Recovery Services (MARS) project which offers psychoeducation, social activities and skill building. Beneficiaries of MAT will also be provided care coordination to connect them to available "wrap-around" support services, such as housing, transportation, and employment assistance. Such services are expected to increase retention in effective MAT programs, and to increase adherence in BHA's high-risk communities.
|1 H79 TI026157-01||
Missouri's Medication Assisted Treatment-Prescription Drug and Opioid Addiction project will expand access to integrated treatment for individuals with opioid use disorders in urban/suburban St. Louis and eight rural counties in Southeast Missouri which had the highest rates of opioid treatment admissions in 2014. High poverty, lack of health coverage and lack of transportation, make it difficult for individuals with opioid use disorders to obtain treatment and other needed healthcare. Additional funding will enable the state to fill an unmet need for medication assisted treatment (MAT) and integrated care in both geographic locations. Missouri will partner with two experienced, community-based providers to achieve four goals: 1) increase utilization of MAT for consumers with opioid use disorders; 2) increase the number of consumers with opioid use disorders who receive coordinated and integrated care, including recovery support services; 3) improve behavioral health outcomes for consumers with opioid use disorders; and 4) improve overall health outcomes for consumers with opioid use disorders. The state's existing disease management model of care will be implemented by the partnering providers to coordinate the provision of primary healthcare; behavioral healthcare, including MAT; and recovery supports for non-Medicaid eligible adults with opioid use disorders. Multidisciplinary teams will ensure that each consumer's physical and behavioral healthcare needs are coordinated to help them achieve their recovery goals and improve their overall health. Missouri established MAT in its service delivery system in 2007. Various restrictions have impacted the state's ability to expand MAT such as funding restrictions and lack of trained physicians. Funds will also be used to support additional training for provider staff and certification for additional medical personnel. The project will serve an additional 607 individuals with opioid use disorders by the end of the grant.
|1 H79 TI026153-01||
The New Jersey Division of Mental Health and Addiction Services' (DMHAS) Medication Assisted Treatment Outreach Program (MATOP) seeks to provide accessible, comprehensive and integrated care, using evidence-based programs such as medication assisted treatment (MAT), mindfulness based recovery maintenance, smoking cessation and other recovery support services for individuals with an opioid use disorder. Three New Jersey licensed Opioid Treatment Programs (OTPs) will provide outreach to populations at risk such as incarcerated individuals, pregnant and parenting women, veterans, parents and caregivers involved with the child welfare system, opioid overdose reversals and syringe access program participants. New Jersey will focus efforts on Ocean, Essex, and Monmouth which demonstrated the highest number of opioid treatment admissions in 2013. The goals of MATOP are to: 1) increase individuals receiving MAT; 2) increase the individuals receiving integrated care and; 3) decrease illicit drug use at six-month follow-up. Specifically, MATOP seeks to: 1) increase understanding of MAT and address misunderstandings regarding the use of MAT among individuals and providers; 2) increase treatment admissions in New Jersey utilizing MAT; 3) demonstrate an increase in the rate of MAT patients who complete treatment; 4) demonstrate better outcomes through the use of MAT and additional supportive therapies and services; and 5) increase outreach to historically underserved populations. MATOP services to be provided include, but are not limited to: medical assessment, clinical assessment, physician visits, and wraparound/recovery support services. In addition, DMHAS will partner with other entities to provide trainings and webinar series for OTP providers, patients and their families. New Jersey's project will serve 390 unduplicated individuals total. Anticipated outcomes include but are not limited to a reduction/abstinence from drugs and alcohol and an increase in employment.
|1 H79 TI026146-01||
Vermont's increase in opioid treatment admissions across health care sectors has been addressed in the Governor's 2014 state-of-the-state address and has been declared "the opioid epidemic" and Vermont's top priority and will institute a "Hub and Spoke" model that will serve as a blue print to combat the problem. Hubs are regional specialty treatment centers that coordinate the care for individuals with opioid use disorders and other co-occurring addiction and mental health problems. Hubs are opioid treatment programs, licensed to prescribe methadone, but expanded to provide buprenorphine. Spokes are office-based opioid treatment providers, mostly primary care or family practice physicians, waived to prescribe buprenorphine for opioid use disorders. Concern exists for potential high risk populations, such as: 1) active offenders and those in the community; 2) parents and those involved in the child welfare system; and 3) motivated individuals seeking medication-assisted treatment (MAT), but due to limited capacity are put on wait-lists. Rutland/Addison Counties and Franklin/Chittenden Counties are the highest communities at risk. MAT will be expanded using a targeted and multi-faceted strategy by utilizing four primary approaches: 1) organize a multi-disciplinary community-based team within each patient-centered medical home/neighborhood; 2) offer the option of naltrexone in the Hubs and Spokes; 3) implement evidence-based integrated psychosocial treatments in the specialty addiction treatment agencies; and 4) build recovery capital by engaging peer recovery support guides at the outset of treatment. The project will engage 375 persons with opioid addiction from the high risk categories and closely monitor their recovery course and outcomes. The goal is to improve MAT for all Vermonters and tracking the required outcomes at the patient-level (n=375), gather services and implementation level performance measures during this 3-year project.
|1 H79 TI026138-01||
The Washington State Medication Assisted Treatment-Prescription Drug and Opioid Addiction Project (WA-MAT-PDOA) will expand access to integrated medication assisted treatment (MAT) with buprenorphine for individuals with opioid addiction. An office-based opioid treatment (OBOT) model that serves a predominantly rural population will provide new tools to replicate integrated MAT statewide. The WA-MAT-PDOA collaborates with others to address the rising rates of opioid-related problems, including overdose deaths and addiction treatment admissions. Adults with an opioid use disorder (OUD) for prescription opioids or heroin in the following high risk communities will be served: King County and five predominantly rural counties in southwest Washington (Grays Harbor, Lewis, Mason, Pacific and Thurston). Strategies and interventions will include three evidence-based/informed practices including; 1) MAT with buprenorphine/ naloxone (Bup/Nx); 2) the Massachusetts Office-Based Opioid Treatment with Buprenorphine (OBOT-B) model, and 3) a non-EBP, The Johns Hopkins School of Medicine Collaborative Opioid Prescribing model of Opiate Treatment Program (OTP)-OBOT will be used. The goals are to: increase the number of patients receiving MAT by increasing capacity in primary care office based settings and OTPs; enhance the integrated care that MAT-PDOA patients receive; improve retention rates for MAT-PDOA enrollees; decrease drug and alcohol use rates six months after treatment admission; and reduce adverse outcomes related to OUD. Objectives include, but are not limited to: 1) serve 776 patients over a three-year period, 2) train clinical staff in the use of EBPs, 3) serve patients in a culturally competent, patient-centered care manner, 4) reduce opioid related deaths, and 5) seek sustainable program financing. This project includes a collaboration with various agencies that will provide technical support, ongoing evaluation, policy support, and pursuit of model sustainability.
|1 H79 TI026150-01||
The Wisconsin Targeted Capacity Expansion: Medication Assisted Treatment (MAT) - Prescription Drug and Opioid Addition (PDOA): Community Activated Recovery Enhancement (C.A.R.E) Grant (MAT-PDOA C.A.R.E) will focus on enhancing and expanding treatment service delivery systems to increase community capacity and provide accessible, effective, comprehensive, coordinated/integrated and evidence-based MAT and recovery support services for individuals with opioid use disorders. Evidence-based efforts for engaging and retaining individuals with opioid use disorders into an integrated service delivery system will be funded in Sauk and Columbia Counties, with possible expansion to Richland County in grant year three. Service expansion, oversight, training and technical assistance will be provided by the Sauk County Department Health Services (SCDHS) in collaboration with Comprehensive Community Services (CCS) and the C.A.R.E. program of Sauk City, Wisconsin. The Wisconsin Department of Health Services will contract with SCDHS and its CCS program along with the grassroots C.A.R.E. program to connect the formal infrastructure of community behavioral health services with the grassroots MAT efforts of the C.A.R.E. CCS points of service access are available to all eligible consumers across the lifespan with diagnosis of mental health, substance abuse or co-occurring conditions. An evidence-based treatment service delivery approach focusing on four goals will: 1) increase the individuals receiving MAT services, with pharmacotherapies approved by the FDA, for the treatment of opioid use disorders in identified high-risk communities; 2) increase the individuals receiving integrated care, increase retention in services, improve quality of life and reduce relapse; 3) decrease illicit drug use at 6- months follow-up; and 4) reach out to untreated opioid use disorder sub-population groups, incarcerated individuals within four months of release, gap group populations and pregnant women.
|1 H79 TI026151-01||
The Targeted Capacity Expansion: Medication Assisted Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) is a grant program with a length of up to three years. Medication assisted treatment (MAT) is defined as the use of Food Drug Administration (FDA) approved opioid agonist medications (e.g., methadone, buprenorphine products including buprenorphine/naloxone combination formulations and buprenorphine monoproduct formulations) for the maintenance treatment of opioid use disorder and opioid antagonist medication to prevent relapse to opioid use. The number of people to be served by this project annually is approximately 137. Throughout the lifetime of this grant approximately 441 people will be served. Through this grant application Wyoming will expand its treatment service system, increase capacity and provide accessible, effective, comprehensive, coordinated /integrated, and evidence-based MAT and other recovery support services to individuals with opioid use disorders seeking or receiving MAT. Two sub-awards will be provided to Central Wyoming Counseling Center and Southwest Counseling Services. These agencies already have the infrastructure in place to provide these services. In addition, the geographic locations are based on high risk communities within the state. The agencies have been carefully evaluated and selected by the state. Agencies will be required to use evidence-based practices for all screening, assessment and interventions.