ALLEGHENY COUNTY DEPARTMENT OF HUMAN SERVICES C OLLABORATING WITH O PIOID U SE D ISORDER C ENTERS OF E XCELLENCE Presented by Latika D. Davis-Jones, PhD, MPH, MSW
Collaborating with Centers of Excellence C OLLABORATING WITH THE C ENTERS OF E XCELLENCE • Overview/Background of the Opioid Epidemic in Allegheny County • Addressing the Opioid Epidemic in Allegheny County • Overview of Centers of Excellence (COE) • Collaborating with Opioid Use Disorder (OUD) COEs
T HE O PIOID E PIDEMIC IN A LLEGHENY C OUNTY • 581 opioid related death in 2016 and 667 in 2017 • Opioid Use Disorder (OUD) is the #1 diagnoses • Fifty-seven percent (57%) have a co- occurring disorder • Revolving Door • Opportunities to intervene: – SUD Treatment (including MAT) – MH Treatment – Jail – EDs
Collaborating with Centers of Excellence Animated Overdose Heat Map (ArcGIS Online) www.alleghenycountyanalytics.us
Allegheny County Data Warehouse
In Allegheny County individuals are dying from drug overdoses more often than traffic accidents and homicides combined. From 2008-2014: • 119 caregivers involved with Children Youth and Families died as a result of overdose • 53 people who had received aging services died as a result of overdose • 100 people who had received DHS homeless services died as a result of overdose • 54 adults who had recently left the county jail died as a result of overdose • 510 adults who received behavioral health services (D&A and/or MH within the past year died as a result of overdose (231 deaths were within a month of their last behavioral health service)
Prior health and human service involvement In the year prior to their death: • 27 (3%) were listed as a parent on an open child welfare case o 87 children were potentially affected by the person’s death o 68 were <18 at the time of the death • 45 (5%) had some contact with homeless and housing services • 164 (18%) had been released from jail • 388 (43%) had received a publicly funded behavioral health service o 257 (28%) had received a substance use disorder service o 313 (34%) had received a mental health service o 182 (20%) had received both
Opioid-related Overdose Fatalities in Allegheny County 2015-16 Time (in days) between last public system encounter and fatal overdose: 2015-16 Top five MH services (n=140) Top five SUD services (n=97) …………………………………….
A DDRESSING THE O PIOID C RISIS Here’s what we are doing to address the crisis: 1. Identifying when substance use and risk of overdose is an issue for our consumers 2. Developing prevention programs within schools and community groups 3. Creating an easy point of entry into substance use treatment 4. Getting people into treatment and offering recovery supports as quickly as possible (COEs-Treatment on Demand/Warm Hand-Offs) 5. Making sure there is access to effective treatment, which includes medications (i.e., Methadone, Suboxone, and Vivitrol)
A DDRESSING THE O PIOID C RISIS 6. Expanding the use of Narcan including overdose education and prevention in all human services departments within ACDHS 7. Preventing overdoses through community outreach programs (Prevention Point Pittsburgh/ Central Outreach)
Collaborating with Centers of Excellence WHAT IS A CENTERS OF EXCELLENCE? Centers of Excellence (COEs) are responsible for developing care management teams (licensed and unlicensed professionals) that provide warm transitions and coordinate care for individuals with Opioid Use Disorder. Two main responsibilities of the care management teams are to: – Facilitate initiation into OUD treatment from emergency departments and primary care physicians (warm hand-off) – Facilitate transition of individuals with OUD leaving correctional facilities to ongoing treatment within the community (warm hand-off)
Collaborating with Centers of Excellence WHAT IS A CENTERS OF EXCELLENCE? Collaborating with local primary care providers to educate about screening, referral, and treatment for OUD Motivating and encouraging individuals with OUD to stay engaged in both physical health and behavioral health treatments a Facilitating recovery by helping individuals find stable housing and employment, and reestablishing family/community relationships
A LLEGHENY C OUNTY C ENTERS OF E XCELLENCE Six COEs are in Allegheny County: • Western Psychiatric Institute and Clinic (WPIC) • Gateway Rehabilitation Center • Tadiso, Inc. • Magee- Women’s Hospital of UPMC • University of Pittsburgh Physicians • West Penn Allegheny Health System * Three SUD Treatment Providers and 3 Physical Health Providers
Collaborating with Centers of Excellence A LLEGHENY C OUNTY o We have contracts with 3 of the 6 COEs o Convened our first meeting with the 6 COEs in January 2017 o Monthly meetings with COEs and other key stakeholders o Advocating on the behalf of COEs with PA DHS regarding data tracking requirements and implementation concerns Supporting COE’s to do their work in a more coordinated fashion o (coordinating meetings and work groups with EMS and the county jail) o Shared data with COEs so that we could assist them in making informed business decisions as it related to implementing COE responsibilities (i.e., sharing data from our data warehouse--Top 10 communities, intercept points, existing resources- overdose reports, MAT position statement)
Collaborating with Centers of Excellence A LLEGHENY C OUNTY o Mapped out ED coverage…12 of 16 EDs covered by COEs using various warm hand-off protocols (reducing duplication of effort with the goal of having coverage at all EDs) o COEs are learning from each and referring individuals within the system of the 6 COEs o Developing a protocol for MAT induction when individuals leave the emergency departments
Collaborating with Centers of Excellence A LLEGHENY C OUNTY Allegheny County COE Availability for Same Day Buprenorphine Induction and Peer Coverage in ED Same Day Induction UPMC GIM Mon, Tues, Thurs afternoons Tadiso do not offer - limited Suboxone hours Magee for pregnant women 24/7 in ED; non-pregnant women next business day Gateway open to exploring, would need to develop a process/identify which location(s) AHN recently started next day dose after first dose in an AHN ED; unable to broaden their scope at this time WPIC survey response indicates it could be 1-5 days before induction Peer Coverage in ED UPMC GIM M-F weekday coverage only, as needed in ED Tadiso Mobile counselors available 24/7 - coverage at EDs as needed Magee Peers visit at Magee ED M-F daylight Gateway Sun-Saturday during day/evening, however currently do not have coverage at Eds AHN M-F weekday coverage only, as needed at AGH/West Penn ED WPIC M-F weekday coverage only - coordinates with peer navigators already in various hospitals, but also not 24/7
Opioid Use Disorder Centers of Excellence F OR M ORE I NFORMATION C ONTACT : Latika Davis-Jones (Assistant Deputy Director/SCA Administrator) Latika.Davis-Jones@AlleghenyCounty.US
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