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Clinics Working Collaboratively to Treat OUD Patients
By Jan Schnellman, MEd, TTS Alaska, Oregon, Washington
Photo: Fairbanks, Alaska. By FairbanksMike [CC BY 2.0 (https://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Alaska's Division of Behavioral Health contacted STR-TA asking for assistance creating a strategic plan to increase client enrollment services at two nonprofit clinics who are treating patients for opioid use disorder.
The two non-profit clinics, Fairbanks Native Association (FNA) and Interior AIDS Association/Interior Medically Assisted Treatment (IAA), found themselves competing with a new for profit treatment facility.
The concern for providers was that the private clinic only offered patients one option for treatment: buprenorphine.
While for many that is the best approach, they wanted to be able to provide behavioral counseling and offer methadone, naltrexone, and buprenorphine.
While FNA and IAA technically compete with one another, they agreed to work collaboratively on this project.
The clinics have a slightly different focus as FNA is an opioid treatment program providing behavioral health and other non-pharmacologic treatment.
IAA is an Office Based Opioid Treatment center (OBOT) prescribing buprenorphine and methadone with ongoing counseling.
Each of these organizations proposed to work collaboratively to treat persons with opioid use disorder.
Fairbanks Memorial Hospital's emergency department is working with these two organizations as well.
The grantees indicated that they would find most helpful:
- A strategic plan to increase client enrollment in services and decrease enrollment in the commercial option.
- Integration of evidence-based practices so that MAT providers include behavioral health and psycho-social supports in treatment plan
- Collaboration/cooperation between grantees and community providers
- Social marketing plan to inform consumers of availability of services and reduce stigma associated with enrolling in services
Ultimately, a system of care to integrate MAT into primary care practices will be implemented and sustained in Fairbanks that promotes safe evidence-based prescribing and expands recovery-oriented systems of care in Alaska.
The overall goal is increased enrollment in services and collaboration among service entities (FNA, IAA and Fairbanks Memorial ED).
- The STR-TA TTS worked with Kathryn Chapman, LCSW, MAC; Health Program Manager IV/State Opioid Treatment Authority, Division of Behavioral Health to conduct a comprehensive needs assessment.
- Initial visits made by the TTS to Fairbanks Native Association, Interior Aids Association/Interior Medical Assisted Treatment organizations in Fairbanks.
- Engaged the services of STR-TA prescriber consultant, Dr. Sarah Spencer in Anchor Point, AK to assist in the effort.
- Consultation with STR-TA Implementation consultant, Dr. Aimee Campbell via email and phone to develop the Action Plan following the Exploration, Preparation, Implementation and Sustainment (EPIS) Model.
- First meeting of coalition on 9/12/18. Participating were representatives from FNA, IMA, Requester, Consultants and local ER physician, Dr. Mark Simon. The stated aim was to explore possibilities for collaboration across programs, to include other Fairbanks stakeholders. Presentation on various service delivery models was made to include Hub and Spoke, Nurse Care Manager, OTP/OBOT Collaborative Care and hospital emergency department or inpatient initiation of MAT with follow-up in the community.
- Provided an 8-hour MAT waiver training for 6 participants.
- An additional TA request was made to include Recovery consultants to focus on the needs of patients and to integrate with prescribers.
Our plans are to meet again in Fairbanks in the near future to gain external and internal support from all and to develop a plan to integrate a collaborative model into the Fairbanks systems.