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DATA Waiver Training for Medical Students

Providers Clinical Support System at ISMMS

Translating Training into Practice: Enhancing Medical Student and Resident Education on Buprenorphine for the Treatment of Opioid Disorder

Increasing the Pipeline of MAT Prescribers: DATA Waiver Training for All Vermont Medical Students at The Larner College of Medicine

Provider’s Clinical Support System – Universities Grants (PCSS-Universities)

UI-TEAM: Utilizing Interdisciplinary Training to Educate and increase Access to MAT

Ursuline College Breen School of Nursing Medication Assisted Treatment Training Integration Program

Interprofessional Clinical Opioid Use Disorder (I-CLOUD) Curriculum Proposal

Preparing the new generation of providers to tackle the opioid epidemic through enhanced training and support

SUNY Downstate Medical Center MAT Waiver Training Project

Maine Providers Clinical Support System-University (Maine PCSS U)

Increasing Access to MAT in South Dakota

Implementation of Initiatives in Medical Student and Resident Education for Improved Access to Medication-assisted Treatments for Opioid Use Disorder

Education in Medical and Pharmacological Addiction Treatments

Data Waiver training across the education continuum

Provider Clinical Support System-PCSS Training focused on MAT preparedness for Nurse Practitioner Students and Field Preceptor Community Health Sites to address Opioid Use Issues

University of Missouri Kansas City PCSS Universities Project

Wright MAT

Physician Assistant Student Training-Medication Assisted Treatment (PAST-MAT)

Urgency to implement DATA waiver training at University of Alabama at Birmingham

This application, entitled “Provider Clinical Support System-PCSS Training focused on MAT preparedness for Nurse Practitioner Students and Field Preceptor Community Health Sites to address Opioid Use Issues: Enhancing a Faith-Based SBIRT Practice Model” seeks to enhance the curriculum and training protocol of nurse practitioner (NP) students and field preceptor (FP) community sites to ensure Medication Assisted Treatment (MAT) preparedness by equipping students and sites with the necessary skills to address Opioid Use Issues, including the implementation of evidence-based strategies for identifying patients at risk for opioid use disorders (OUDs) and triaging risk (i.e., use of Screening, Brief Intervention and Referral to Treatment (SBIRT) and MAT protocols). The goal of the training grant is to expand an effective provider clinical support system for addressing OUDs within the field of NPs to address gaps in knowledge and practice that currently exist in the larger systems of care. The efficient and effective implementation of evidence based practices for addressing OUDs in community health care settings by NPs will help reduce the current and significant public health issues that are devastating local communities, including overdose, death, infectious disease transmission, crime, and other medical and mental health consequences. For sustainability, we will build upon a current web-based learning management system (LMS) that houses an effective SAMHSA-supported, faith-integrated SBIRT training currently implemented in nursing curricula and expand it to include a MAT training component that meets the required 24-hours of training under the Comprehensive Addiction and Recovery Act (CARA). In addition, this project will train FP community health sites and develop partnerships with local substance use coalitions and providers in Los Angeles County to ensure availability and linkage to the necessary substance use disorder (SUD) treatment and community recovery resources associated with MAT. This project responds to the national priority of implementing effective and sustainable system-wide efforts aimed at preventing and addressing opioid-related issues by health care professionals in local health care settings. Statements made by federal, state and local level government officials, policy makers, researchers and practitioners alike call for establishing efforts that implement collaborative, integrative approaches, and include health care systems, community resources (coalitions), educational systems, and SUD treatment programs.

The University of Missouri-Kansas City (UMKC) PCSS-Universities project will implement sustainable education and training on medication-assisted treatment (MAT) in Doctor of Medicine (MD), Physician Assistant (PA), and Nurse Practitioner (NP) programs to ensure students and residents are able to fulfill DATA waiver training requirements to prescribe and thereby expand and enhance access to MAT services for persons with an opioid use disorder. The UMKC PCSS-Universities project is a collaboration between the School of Nursing and Health Studies and the School of Medicine. Project goals are to increase the number of UMKC student and faculty physicians, physician assistants, and nurse practitioners who: 1) complete training requirements for the DATA waiver; 2) obtain a DATA waiver and are eligible to prescribe buprenorphine; and, 3) prescribe buprenorphine in clinical settings. Measurable objectives and activities include: a) confirmation of a DATA waiver training plan; b) at least 46 faculty will obtain waiver training and a DATA waiver to effectively train and supervise students; c) by May 2020, DATA waiver training will be integrated and implemented as a standard part of MD, PA, and NP curricula offered to all students in didactic and clinical practice settings; d) by September 2022, 240 MD students, 60 PA students, and 230 NP students will meet DATA waiver training requirements by graduation; e) plans will be implemented to sustain inclusion of waiver training in the MD, PA, and NP program curricula past the completion of the grant project; f) MD, PA, and NP students, faculty, and residents will be informed about waiver training and steps to obtain a DATA waiver; and g) by the end of each project year, the number of students, faculty, and residents with a DATA waiver and who are actively prescribing in clinical practice will increase. A new PCSS Medical Student Waiver Course with eight hours of training will be utilized. Additional 16 hours of training required for NPs and PAs will be accessed from available online courses. A resource repository using a cloud content management platform will be established for faculty and students to easily access current training and educational resources in a central location. The project will monitor and report on performance measures, program implementation, and implement continuous quality improvement strategies.

The goal of the Wright MAT project is to expand and enhance access to medication-assisted treatment (MAT) services for persons with opioid use disorder (OUD) in the southwest Ohio region, the geographic section of Ohio with the highest rates of alcohol/drug misuse and drug overdose death. Wright MAT will aim to ensure that students fulfill the training requirements needed to obtain a DATA waiver to prescribe MAT in office-based settings. This will be accomplished by providing education and training on the topics of OUD and MAT to students and residents in the medical, physician assistant, and nurse practitioner fields. Specifically, students to be trained are 4th Year medical students at the Wright State University (WSU) Boonshoft School of Medicine (BSOM), 3rd and 4th Year BSOM medical residents in Family Medicine, Internal Medicine, Psychiatry, Obstetrics/Gynecology, and Emergency Medicine, physician assistant (PA) students at Kettering College (KC) and the University of Dayton (UD), and certified nurse practitioner (CNP) students at WSU. The geographic catchment area for this project is southwest Ohio, where the population demographics are 51% female, 49% male, less than 1% transgender, 10% lesbian, 9% MSM, 5% bisexual, and 99% English-speaking. Montgomery County (OH), where WSU is located, has the highest opioid overdose death rate (56.5 per 100,000) in the state, according to the most recent (2017) Ohio Drug Overdose Report by the Ohio Department of Health. Montgomery County also has the highest rate of illicit drug use in the state, the fourth highest rate of non-medical pain reliever use in the state, the highest rate of non-alcohol drug abuse in the state, and the highest rate of unintended opioid overdose deaths in 2016 (the last year for which there are published data). According to the latest SAMHSA-published National Surveys on Drug Use and Health (NSDUH) data, Montgomery County has the highest percentage of individuals in the state of Ohio ""needing but not receiving treatment for illicit drug use in the past year."" Wright MAT project objectives are to develop a DATA waiver training plan for medical students and residents, and PA and CNP students, that will become a required component of their respective curricula and sustained beyond the funding period of the grant. For fiscal years 2021 and 2022, as well as in subsequent years, a minimum of 115 medical students, 70 medical residents, 100 PA students, and 10 CNP students will be trained annually. At least 815 students/residents will be trained over the life of the project. Information about this curricular component will be included in marketing materials for prospective students of the respective training programs included in the project. At least two BSOM faculty members will be trained and receive certification to lead DATA waiver trainings. The BSOM will also provide regularly scheduled DATA waiver training for licensed practitioners and faculty.

Physician Assistant Student Training-Medication Assisted Treatment (PAST-MAT) The Pacific University School of Physician Assistant Studies (PAS), in collaboration with Ideal Option, will incorporate into its existing curriculum new DATA-waiver training with integrated tobacco cessation, Veteran’s cultural competency content, and supervised clinical experience. All PAS students will complete the training and be prepared to provide Medication Assisted Treatment (MAT) to address the needs of patients with opioid use disorders. Up to 60 PA students will take part in the project each year (180 over three years) and, prior to graduation, will interact with a minimum of 1,440 MAT patients each year (4,320 over three years) during their clinical experiential rotations. Our three primary goals are to a) develop, b) implement, and c) evaluate a DATA-waiver training curriculum that includes didactic and experiential training. To achieve these goals, we will develop a sustainable DATA-waiver curriculum plan that includes all topics outlined in the Comprehensive Addiction and Recovery Act, is sensitive to the behavioral health and social support needs of returning Veterans and their families, integrates tobacco cessation principles, is culturally sensitive, and adapts to community needs. The training plan includes 24 hours of didactic training and a minimum of 16 hours of experiential training at substance use disorders clinics that provide MAT services. We will implement this training plan within our existing curriculum with the objective of increasing the percentage of PAS graduates completing the DATA-waiver training requirements from 0 to 50% by Year Two, and to 100% in Year Three and all subsequent years. Using RCQI principles, we will comprehensively evaluate the success of the program in preparing PAS students and will assess post-graduate practice behaviors, including MAT prescribing. Evaluation data will be carefully analyzed to determine progress achieved, barriers encountered and efforts to overcome the barriers, and impact of the project on behavioral health disparities. All data will be shared with internal and external stakeholders as appropriate and included in regular reports to SAMHSA.

Project Abstract Summary The number of admissions for heroin in Alabama increased 220% from 2014 to 2017. Yet, only 3% of physicians in Alabama have completed advanced DATA 2000 training. Thus, Alabama has a profound gap between the number of people needing Medication-assisted Treatment (MAT) service and the number of clinicians who are eligible to deliver MAT service. This project, Urgency to Implement DATA Waiver Training at The University of Alabama at Birmingham (UAB), would serve to close that gap through education of both doctor-in-training and the attending physicians that train them. The UAB Medical Center houses the largest ACGME accredited internal medicine and psychiatry residency programs in the state of Alabama. Yet, consistent with state statistics, only 8% of Internal Medicine and 20% of Psychiatry clinical faculty have completed DATA 2000 training. The focus of our proposed project is to provide training to clinical faculty in the department of psychiatry (29 faculty) and division of general internal medicine (35 faculty) at the UAB medical center. Once clinical faculty members have had initial training and exposure to MAT, we will begin to train residents in these programs. There are thirty-two residents in the psychiatry residency program with eight new trainees added each year. There are one hundred sixteen residents in the internal medicine residency program with thirty-eight new trainees added each year. Thus, in year one, we would be providing initial education to the fifty-four faculty members in both Dept of Psychiatry and division of general internal medicine who do not yet have DATA 2000 training as well as one hundred fifty residents. In years two and three, we would provide supplemental education and support to the clinical faculty. Forty-seven residents will graduate (eight from psychiatry and thirty-eight from internal medicine). One hundred three returning residents will receive re-education and support of what they learned the prior year; and forty-seven new residents will begin the training. Our overarching goal is to expand MAT access through the measureable objectives of increasing; 1) the number of trainers (clinical faculty) with DATA 2000 waivers and skilled in providing MAT, 2) the number of residents who graduate with DATA 2000 waivers, and 3) the number of educational hours addressing MAT that are integrated into the standard curriculum of these residency training programs. We aim to do this through commencing addiction focused didactic lectures and integrating clinical rotations in different settings, including UAB Beacon Addiction Treatment Center, our established MAT clinic, and inpatient addiction unit at UAB. In addition, starting in year two, we will also provide repeated on-site DATA-waiver training to decrease barriers to pursuing this training.