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

Yolo County’s Response to Opioid Use 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 O CTO BER 9 T H , 2 0 1 8

Key Components  Naloxone Grant  Y olo County Emergency M edical Services Agency  Drug M edi-Cal Organized Delivery System (DM C-ODS)  Y olo 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 olo 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 olo County Libraries  Y olo 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

Adult Substance Use Disorder (SUD) Continuum of Care st , 2018 st , 2018 Previously Previously As of July 1 As of July 1  All of what was previously  Prevention available plus…  Intensive Outpatient-non-perinatal  Education/ Early Intervention  Withdrawal Management (Detox)  Outpatient  Narcotic Treatment Program (NTP)  Intensive Outpatient-Perinatal  Physician Consultation  Case M anagement  Residential  Recovery Services

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

Medication Assisted Treatment- CommuniCare Data Location of Clients Served Location of Clients Served Total Visits/Clients Served Total Visits/Clients Served West Sac 2% 1% 1% 2% 0 % Visits Patients Woodland 1% Davis Sac 32% 18 % Guinda 13,18 2 Outpatient Winters 694 43% Knights 1,658 Landing M AT Arbuckle 175 M adison 0 5000 10000 15000

Narcotic Treatment Program (NTP) Providers  CORE M edical – Currently located in Sacramento, anticipate opening West Sacramento Location January 2019  105 Y olo 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 olo 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

17/18 Medication Assisted Treatment Data  CommuniCare  175 Yolo Clients Served  1,658 visits provided  8 providers added to the network, 4 more in process  CORE Medical  99 Y olo 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)

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

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