In Delaware, one of many states hit hard by the opiate epidemic, the state Department of Health and Social Services (DHSS) plans to use $2 million in federal funding to set up a new system to treat addicts, with the goal of serving 900 clients in its first year of operation.
The proposal calls for each of three treatment providers serving all three of the state’s counties to engage and treat 300 new individuals with opioid use disorder in the first year of operation, for a total of 900 patients. New patients are defined as individuals addicted to opioids who have not had services in the past 60 days.
In addition to helping patients to access medical and mental health care, the Centers of Excellence model will help clients in need of housing, vocational opportunities, education and other wraparound services, officials said.
Along with the $2 million provided under the 21st Century Cures Act, the DHSS’ Division of Substance Abuse and Mental Health (DSAMH) will also use Medicaid reimbursements and state general funds to finance the system.
In 2016, 308 people died from overdoses in Delaware, according to the state’s Division of Forensic Science. For that same year, the Division of Public Health’s Office of Vital Statistics reported 264 substance-related overdose deaths in Delaware to the Centers for Disease Control and Prevention, based on slightly different reporting criteria.
“We must reduce the harm caused by this horrific epidemic,” said DHSS Secretary Kara Odom Walker, M.D., a board-certified family physician. “Through the Centers of Excellence model approach, our goal is to offer care to individuals suffering from opioid addiction that is high-quality, comprehensive, coordinated, evidence-based and person-centered.
“The treatment hubs will not only care for the individual’s treatment needs, but also address the social determinants of health that impact a patient’s overall health and treatment outcomes.”
“We heard loud and clear from individuals, families and providers that we need to treat each person with an opioid use disorder as a whole person,” DSAMH Director Elizabeth Romero said. “A critical component of that is using certified recovery peers to help individuals navigate their way through both the treatment and the social services worlds.
“Relying on the advice of someone with a similar, lived experience will help individuals suffering from addiction to better coordinate their services and maintain their engagement with treatment.”
Romero said she expects the first Center of Excellence to open by the third quarter of 2018.
Once clients are in treatment, peers will help them navigate and stay engaged in the health care system, and involve family members as appropriate to discuss treatment questions, issues, needs, options and preferences. Peers also will connect pregnant women to existing programs that provide home visiting and prenatal care.
Each center’s team will have multiple components to its model including will also have a director and a community engagement and management team director (preferably a social worker).
Services provided at each center will include:
- Comprehensive substance use disorder evaluation.
- Development of an individually tailored treatment plan.
- Case management.
- Medication-assisted treatment induction and maintenance, including the use of all three Food and Drug Administration-approved medications required – buprenorphine and vivitrol by the start of the program, and methadone within six months.
- Group and individual counseling.
- Links to recovery/transitional housing.
- Psychiatric evaluation/treatment to include trauma-informed principles.
- Co-management of behavioral and medical disorders.
- Motivational strategies to encourage individuals with opioid use disorder to stay engaged in their treatment plans.
- Prescription Monitoring Program (PMP) checks and fluid drug screens as required by DSAMH.
Romero said the proposal also requires the centers to track and report outcomes, including intake assessments, clinical progress and receipt of supplementary services, and to participate in a learning collaborative with the other centers and treatment partners. DHSS also has a 24/7 Crisis Hotline. connected to treatment and recovery options.