driving under the influence (dui) medication assisted ... · the dui mat pilot project will help to...

Driving Under the Influence (DUI)

Medication Assisted Treatment (MAT)

Integration/Outreach Pilot Project

Stakeholder Informing Webinar

February 2019

1

Webinar Guidelines

� Controls at the bottom of the screen

� Use Q&A to ask a question� Questions will be answered at the end

� Use Chat to send a message to everyone or just the presenter

� Raise the Hand if you want to talk or if asked a question

� Press it again to Lower the Hand

Q&A Box

Chat Box

2

The DUI MAT Project Team

� Barbara Aday-Garcia, Executive Director

� Janice Forbes, DUI MAT Project Manager

� Michealine Flower, DUI MAT Program Liaison

� CADTP Executive Board Oversite� Craig French� Laura Kantorowski� Karla Hendrix� Jaime Campos

� DHCS� Tracy Langlands� Michelle Meza� Kelly Cowger

3

What is the DUI MAT Integration & Outreach Pilot Project?

� One of 26 Projects included in the Medication Assisted Treatment (MAT) Expansion Project 2.0 – managed by The Department of Health Care Services (DHCS)

� Funded through State Opioid Response (SOR) grant made possible through a grant by The Substance Abuse and Mental Health Administration (SAMHSA)

� DHCS released an RFA last October to select a Contractor to develop and manage the project

� CADTP applied and was awarded the contract, effective January 1, 2019� The length of the contract is fixed and will end September 29, 2020

� CADTP will work with DHCS to select up to 27 DUI Program Subcontractors with a projected start date of May 1, 2019

4

DUI MATInforming Webinar

Table of Contents

BACKGROUND AND OVERVIEW

THE DUI MAT PILOT PROJECT

THE APPLICATION PROCESS

PROJECT TIMELINES

RESOURCES Q & A

5

Background and Overview

The Big Picture

6

A National Crisis

47,600 opioid related deaths in 2017, nationwide

Currently an average of 130 people per day die of an opioid related cause

*Source: Center for Disease Control

7

• 38% tested positive for some form of marijuana

• 16% tested positive for opioids

• 4% tested positive for both marijuana and opioids

The publication also highlights the frequency of poly-drug use

Funded by the Foundation for Advancing Alcohol Responsibility (Responsibility.org), the report found that among drug-tested fatally-injured drivers in 2016:

The Opioid Crisis and DUI

8

Opioid Epidemic in

California

In 2017 California had…

� 2,196 opioid overdose deaths

� 429 fentanyl overdose deaths

� 4,281 opioid overdoes ED visits (excluding heroin)

� 21,787,042 opioid prescriptions

Source: California Opioid Overdose Surveillance Dashboard

9

California DeathsTotal Population – 2017

Source: California Opioid overdose Dashboard

County Rates Counts

1 Modoc 23.58 3

2 Humboldt 21.03 28

3 Mendocino 19.34 17

4 Lake 17.02 13

5 Shasta 14.06 24

6 Lassen 13.91 5

7 Yuba 13.15 9

8 Del Norte 12.56 4

9 Siskiyou 9.97 4

10 Ventura 9.8 85

11 San Francisco 9.62 99

12 San Benito 9.47 6

13 Tuolumne 9.47 5

County Rates Counts

14 San Joaquin 9.18 69

15 Kern 8.45 75

16 San Diego 7.84 285

17 San Luis Obispo 7.77 21

18 Butte 7.57 17

19 Orange 7.5 255

20 Santa Barbara 7.48 32

21 Marin 6.59 15

22 Santa Cruz 6.59 18

23 Sonoma 5.99 30

24 Riverside 5.67 140

25 Mariposa 5.51 1

26 Nevada 5.5 6

10

California’s Mission to Reduce Opioid Death and Addiction

Reduce Opioid Prescribing

Increase Availability of Naloxone (Narcan)

Increase Access to Medication Assisted Treatment (MAT)

11

DHCS MAT 2.0 Objectives

Develop additional MAT locations with a focus on rural locationsDevelop

Provide MAT access to specialized and underserved communitiesProvide

Transform entry points for individuals with opioid use disorders and create effective referrals into treatmentTransform

Develop coordinated referral processes to manage high-risk transitionsCoordinate

Engage current and potential MAT prescribersEngage

Enact overdose prevention activities to prevent opioid misuse and overdose deathsEnact

12

MAT 2.0 Projects

Builds upon the foundation created by the California Mat Expansion Project 1.0

which created the Hub & Spoke System

An estimated 270,000 people will benefit from this program which will run for two

years through September 2020

13

MAT ACCESS POINT EXPANSION

• MAT Access Points

• Access Point Transitions

• Counselors in Rural Eds

• Tribal MAT

• Special Populations

• Media Campaign

PRIMARY CARE

• Treating Addiction in Primary Care

HOSPITALS

• ED Bridge Program

• Project SHOUT

SUD PROVIDERS

� Toolkits

� NTP Treatment Capacity

� DUI MAT Integration

JUSTICE INVOLVED

� County Touchpoints

� MAT in Criminal Justice Settings

MENTORING RESOURCES

� 24/7 MAT Coaching

� CSAM Mentoring

� Waivered Prescriber Support

� MAT Workforce

� Academic Detailing

OVERDOSE PREVENTION

� Naloxone Distribution

� Fentanyl

� Drug Take-Back

� CURES PDMP

TECHNICAL ASSISTANCE

� SOR Consulting

� Evaluation

� DHCS Staff

MAT 2.0 Projects (26)

14

Funding and Accountability

SAMHSA $1 billion - Nationwide

California SOR Receives $140 million for MAT 2.0

DHCS to Issue and Oversee SOR Contracts – 26 Projects

DUI MAT Integration Pilot Project - One of 26 Projects

CADTP awarded contract to develop and manage DUI MAT

Up to 27 DUIP Subcontractors for DUI MAT Pilot Project

15

Expanding Access to MAT

The successful completion of the DUI MAT Pilot Project will help to fulfill the MAT 2.0 objective of:

“Transform entry points for individuals with opioid use disorders and create effective referrals into treatment”

and the supporting goal of

“Adding 200+ new MAT access points throughout California.”

MAT Access Points

� Primary Care

� Hospitals / Eds

� Medication units

� Jails

� Residential treatment centers

� Tribal health centers

� DUI providers

� Community mental health providers

16

The Hub & Spoke System

� The 19 Hubs are located all over the state of California.

� In addition to providing MAT services to patients in their clinic, the Hubs can also provide an array of services varying from onsite urine testing, to transportation, to counseling.

� The Hubs have a responsibility to serve as referral centers for the Spokes in the region and provide consultation services as needed to their spokes.

17

The Hub & Spoke System (H&SS)

18

Medication Assisted

Treatment

Medication Assisted Treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat Substance Use Disorders (SUD)

� Buprenorphine

� Naltrexone

� Methadone

https://www.dhcs.ca.gov/individuals/Pages/State-Targeted-Response-to-Opioid-Crisis-Grant.aspx

To learn more about the California MAT Expansion Project:

19

DUI MAT Integration/Outreach

Pilot Project Project Details

20

DUI MAT Pilot Project

Purpose

� To expand access to Medication Assisted Treatment (MAT) options through the DUI Treatment Program network

Project Overview

� Up to 27 DUI Treatment Program Subcontractors will work with the DUI MAT Project Team to develop, implement and report on programs and processes to identify and refer those with OUD to MAT treatment options

Project Timeline

� DUI Program Subcontractors participation - May 1, 2019 to September 29, 2020

21

The DUI MATPilot Project

Identification of Polysubstance Abuse•Screening

•At enrollment•At a face-to-face•Attends under-the-influence

Case Management Framework•Screening Instrument•Assessment •Linkage to Treatments•Monitor

Data Collection and Best Practices

Technical Calls and Visits

Virtual Training Sessions

Touch Base Program Project Website

22

CADTP

Key Functions as Project Contractor

Recruit, select, and support DUI program

subcontractors

Lead project teams to develop programs and processes for the pilot

program

Facilitate webinars, online training, conference calls,

and program materials

Collect, parse, and report project data

Analyze and report project results

Liaison with DHCS, DUI programs, court and

County representatives

Manage project funds including payments to

subcontractors

23

DUI Program Subcontractor

Responsibilities

IMPLEMENT PROCESSES TO

IDENTIFY OUD IN DUIP

ADHERE TO A CASE MANAGEMENT FRAMEWORK

UTILIZE MAT TOOLKITS

COLLECT AND REPORT DATA

TECHNICAL CALLS AND ONSITE VISITS

ATTEND ALL TRAININGS

24

RFA/SOWDeliverablesQuarterly Report

� Attend DUI MAT Project meetings

� Identification of Undiagnosed/Unmet Polysubstance Addiction

� Implement Case Management Framework

� Submit monthly Subcontractor Data Reporting

� Attend Required Trainings

� Technical Assistance Calls with CADTP

� Host Technical Assistance Subcontractor Visits

� Create invoice and forward to CADTP

� A standardized report will be provided

25

CHP 2-Day Workshop

Required for Subcontractors

CHP 2-day Workshops are intended for professionals working in DHCS licensed programs with the goal of establishing a systematic approach to recognizing and evaluating drug use and impairment, in order to establish early recognition and intervention opportunities.

The CHP is providing a total of eight (8), two-day long training workshops (16-hours total) throughout the state, designed for a maximum of 60 attendees each workshop session.

CEUs will be provided for CADTP and CCAPP Counselors.

26

Benefits of Becoming a DUI MAT Subcontractor

Provide treatment options for clients with OUD:• Identification and Case Management Framework• Integration into County treatment systems and MAT• Potential sobriety and recovery

DUIP receives $$ for Participation, paid quarterly upon successful completion of deliverables report

Comprehensive support from the DUI MAT Project Team

Stronger visibility and relationships with County administrators, Courts, and Probation departments

27

SubcontractorApplication Process

How to Apply

28

Application Requirements

DUI Treatment Program licensed in

the State of California

A business in good standing and

qualified to do business in California

Complete a Request for Application (RFA)

Agree to the Scope of Work (SOW)

29

The Request for Applications(RFA)

The Scope of Work (SOW)

Request for Applications

� Purpose/Background

� Time Schedule

� Qualification Requirements

� Content Requirements

� Evaluation and Scoring

� Selection

� Staffing Budget Example

� Budget Example

� Deliverables

Scope of Work

� Services Overview

� Description of Services to be Performed

� Deliverables Schedule

� Contract Requirements

� Federal Requirements

30

Your Application Will

Include:

� Statement of Interest – 1 Page Max

� Organizational Chart – 1 Page Max

� Plan of Operations –3 Pages Max

� Budget and Budget Narrative – 3 Pages Max

31

Each Subcontractor Will Receive:

$115,000 over the course of the project • $19,166.66 per quarter

Guidance, support, training from CADTP’s DUI MAT Project Team

Pilot Program framework and materials • Project website

Virtual training sessions

Technical assistance calls

Onsite technical visits

32

Scoring and Selection

� CADTP shall score applications and submit a written summary of scores and award recommendations to DHCS

� DHCS will confer final award decisions

� CADTP shall notify each DUI program of award decision

� CADTP will create and issue subcontracts to the awardees

33

Project TimelinesImportant dates!

34

Important Dates

FEBRUARY 14, 2019 RFA AND SOW RELEASED

1MARCH 14, 2019

APPLICATIONS DUE BY 11:59 PM

2APRIL 7, 2019

SUBCONTRACTORS SELECTED

3MAY 1, 2019

PROPOSED START DATE OF AGREEMENT

4

35

Resources For Additional Information

36

Resources

CADTP (For RFA, SOW and Webinar Recording – Available 2/14� https://www.CADTP.org

� DHCS MAT 2.0 Web Page� https://www.dhcs.ca.gov/individuals/Pages/State-Targeted-

Response-to-Opioid-Crisis-Grant.aspx

� California’s Hub & Spoke System� https://www.dhcs.ca.gov/individuals/pages/ca-hub-and-spoke-

system.aspx

� SAMHSA Pocket Guide to MAT� https://store.samhsa.gov/system/files/sma16-4892pg.pdf

37

DUI MAT Project Team

Contact Information

� Janice Forbes, Project Manager� 760-316-3003

� janice@cadtp.org

� Michealine Flower, Program Liaison� 760-960-2397

� Michealine@cadtp.org

� Barbara Aday-Garcia, Executive Director� 800-464-3597

� BarbaraAday-Garcia@cadtp.org

38

? Questions and Answers

39