Yolo Countys Response to Opioid Use I AN EVAN S YOLO COU N TY AOD - - PowerPoint PPT Presentation

I AN EVAN S YOLO COU N TY AOD ADM I N I STRATOR SARA GAV I N COM M U N I CARE HEALTH CEN TERS M ARSH ALL & GARRETT STEN SO N CORE M EDI CAL CLI N I C

Yolo County’s Response to Opioid Use

O CTO BER 9 T H , 2 0 1 8

Key Components

 Naloxone Grant

 Y

• lo County Emergency M edical Services Agency

 Drug M edi-Cal Organized Delivery System (DM C-ODS)

 Y

• lo County Health and Human Services Agency

 Health Resources and Services Administration (HRSA) Grant for M edication Assisted Treatment (M AT)

 CommuniCare Health Centers

 Narcotic Treatment Program (NTP) Services

 CORE and Baymark- 4 Locations

 Department of Healthcare Services (DHCS) Hub and Spoke Grant

 CommuniCare and CORE

Naloxone Grant

 Y

• lo County Emergency M edical Services (EM S) grant from California

Department of Public Health

 140 single dose nasal Narcan units

 Partners

 CommuniCare Health Centers  Y

• lo County Libraries

 Y

• lo County Housing Authority

 HHSA social workers and case managers

 Law Enforcement – Public Safety Narcan

 Winters Police Department– Completed training and implementation  West Sacramento, Woodland, and Davis – In Process

Previously Previously As of July 1

st, 2018

As of July 1

st, 2018

 Prevention  Education/ Early Intervention  Outpatient  Intensive Outpatient-Perinatal  Residential  All of what was previously

available plus…  Intensive Outpatient-non-perinatal  Withdrawal Management (Detox)  Narcotic Treatment Program (NTP)  Physician Consultation  Case M anagement  Recovery Services

Adult Substance Use Disorder (SUD) Continuum of Care

Medication Assisted Treatment (MAT) at CommuniCare

 Started July 2016- Federal funding for Health Centers

Treatment for Opioid Use and Alcohol Use with medications

and concurrent therapy

M ulti-disciplinary team (Physician/ Nurse Case

M anager/ Behavioral Health)

Woodland, West Sacramento and Davis sites Suboxone, Vivitrol Engage in substance use disorder and behavioral health

services concurrently

Location of Clients Served Location of Clients Served Total Visits/Clients Served Total Visits/Clients Served

Medication Assisted Treatment- CommuniCare Data

32% 43% 18 % 2% 0 % 2% 1% 1% 1%

West Sac Woodland Davis Sac Guinda Winters Knights Landing Arbuckle M adison

175 694 1,658 13,18 2

5000 10000 15000 M AT Outpatient Visits Patients

Narcotic Treatment Program (NTP) Providers

 CORE M edical – Currently located in Sacramento, anticipate opening West

Sacramento Location January 2019

 105 Y

• lo Clients as of July 2018

 M ethadone: 93 clients – 72% West Sacramento, 16.2% Woodland, 8.5%

Davis, 1.1% Knights Landing, 1.1% Esparto, 1.1% Clarksburg

 Buprenorphine: 12 clients – 25% West Sacramento, 16.7% Woodland,

41.7% Davis, 8.3% Esparto, 8.3% Winters

 BayM ark – 2 Sacramento Locations, 1 Fairfield Location  80 Y

• lo Clients as of July 2018

Hub and Spoke Grant

 September 2017 grant from Department of Healthcare Services – Partnership of

CommuniCare and CORE M edical

 Adaptation of the successful model used in Vermont.

 The primary goals are to prevent overdose and treat Opioid Use Disorder

(OUD) as a chronic disease.

 To improve, expand, and increase access to M edication Assisted Treatment

(M AT) services throughout the state.

 Increase the total number of physicians, physician assistants and nurse

practitioners prescribing buprenorphine, thereby increasing the availability of M AT for patients with OUDs.

 All Hub and Spokes must obtain or be currently enrolled in Drug M edi-Cal or

Fee-for-Service M edi-Cal.

Hub and Spoke Benefits

 Expanded services  Broader safety net  Expanded number of prescribers  Increased funding for uninsured  Increased access for community

 CommuniCare

 175 Yolo Clients Served

 1,658 visits provided  8 providers added to the network, 4 more in process

 CORE

Medical

 99 Y

• lo Clients served

 66% discharged satisfactorily  99% of clients had 0 arrests in last 30 days  80% reduction in opioid prescription abuse (those involved in tx for 3

years or longer)

 87% reduction in clients on parole/ probation upon completion (those

involved in tx for 3 years or longer)

 40% increase in clients connected with primary care (those involved in tx

for 3 years or longer)

17/18Medication Assisted Treatment Data

Next Steps

 Efforts already underway

 Communicare/ California Forensic M edical Group partnering on in-

custody Vivtrol treatment

 CORE opening West Sacramento clinic  CommuniCare/ CORE outreach to more waivered prescribers  CommuniCare to develop additional outcome measures for M edication

Assisted Treatment  Further coordination needed

 Hospitals implementing Vivitrol prior to discharge

 Future funding opportunities

 Department of Healthcare Services (DHCS) Opioid Treatment Grants

Questions