Application Overview

In partnership with California Department of Health Care Services, the Center for Care Innovations (CCI) is launching Addiction Treatment Starts Here: Primary Care, Wave 2. Below you will find information about the program and application process. You can join us for an informational webinar on July 12, 12-1pm PT (register here).

Table of Contents
Background
Eligibility Requirements
Program Components
Participation Expectations
Timeline
What Makes a Strong Applicant?
Grant Funding
Informational Webinar
Contact Us
Apply Now!

 

Background

The Center for Care Innovations (CCI) is launching the second wave of our Addiction Treatment Starts Here: Primary Care learning collaborative. The second wave of this program aims to increase access to medication-assisted treatment (MAT) in primary care for patients with opioid use disorder (OUD).

This program, Addiction Treatment Starts Here: Primary Care, Wave 2 is designed to build on federal, state, and local attention that has focused efforts on combatting opioids, the deadliest drug epidemic in US history. In addition to the devastating effects on the health of communities, OUD is also a major driver of high-cost service utilization, such as inpatient and emergency department care; the result is an enormous economic burden on health systems.

MAT is one approach to address and manage OUD. It combines psychological and behavioral therapy with FDA-approved medications including ­methadone, buprenorphine, or naltrexone. Evidence demonstrates that patients with OUD who use MAT reduce their risk of all-cause mortality by half. Yet despite overwhelming evidence that administration of methadone, naltrexone and buprenorphine are considered the gold standard of treatment, only 10 percent of people across the country receive this specialty treatment for OUD.

Health centers are natural collaborators for identifying substance use disorders and for coordinating effective treatment and recovery services. Primary care is usually the first point of contact for identifying and treating behavioral health conditions, including substance use disorders; therefore, health centers are well positioned to screen, triage, and treat addiction. However, while patients may receive behavioral therapy and counseling on medications to treat OUD, they typically do not have access to MAT.

Addiction Treatment Starts Here: Primary Care, Wave 2 seeks 20 primary care health center sites in California to participate in this 15-month learning collaborative, launching in August 2019 and concluding in September 2020. The program will provide methods and tools to guide grantees through designing new or expanding existing MAT programs in the primary care setting with a primary focus on opioid use disorders.

The curriculum has been designed by state and national experts and is based on lessons learned from the first wave of Addiction Treatment Starts Here: Primary Care that began in February 2019 and from CCI’s previous MAT program, Treating Addiction in the Primary Care Safety Net (TAPC), which ended in February 2018. The TAPC program, coupled with other efforts, enabled 25 participating health centers to add 70 new x-waivered prescribers and to triple the number of patients receiving MAT services. Results and key lessons learned in this program can be found in Treating Addiction In The Primary Care Safety Net: Implementing Medication-Assisted Treatment and the Lessons Learned. You can also learn about Marin City Health and Wellness Center’s participation in CCI’s programming and the transformation patients have experienced because of MAT by watching the video below.

Building upon this previous work, Addiction Treatment Starts Here: Primary Care, Wave 2 is funded through a generous grant from the California Department of Health Care Services.

Program Components

Addiction Treatment Starts Here: Primary Care, Wave 2 is designed to meet the needs of MAT program design, implementation, or expansion through two separate participant tracks.

  • Track 1: Planning Stage Health centers that do not have a MAT program in place or are in the early stages of development with a small number of patients receiving treatment and a small number of X-waivered clinicians. These sites are looking to design new programs, or refine, formalize and/or standardize existing programs.
  • Track 2: Expansion Stage Health centers with MAT programs in place and are managing the care of a consistent number of MAT patients. These sites are focused on the optimization, scale, and sustainability of their current program.

Addiction Treatment Starts Here: Primary Care, Wave 2 (ATSH:PC, Wave 2) will offer training, tools, expertise and access to all program offerings across both tracks. Within the program offerings, content and methods will be tailored specifically to each track’s needs, given the different stages described above. Content will address clinical and operational issues associated with MAT, including:

  • Building an organizational culture around treating addiction as a disease.
  • Clinician and staff engagement strategies to address stigma around addiction and other attitudes and beliefs that can impact the success of your program.
  • Developing or scaling a MAT model.
  • Regulations for confidentiality and MAT operations.
  • Buprenorphine, Naltrexone, and Naloxone 101.
  • Patient identification and selection.
  • Managing buprenorphine inductions, stabilization, and maintenance, including in-home and office-based care.
  • Assessing levels of care and building strong referrals to specialty care and community services.
  • Building partnerships to promote collaboration across health care transition points, such as the emergency department and hospital.
  • Effective strategies for tapering patients on long-term opioid therapy.
  • Managing complex chronic pain and harm reduction.
  • Contingency management.
  • Managing diversion.
  • Understanding the key drivers of financial sustainability for MAT programs.

Over the course of the ATSH:PC, Wave 2 program, we will offer to both tracks:

  • Three, two-day in-person learning sessions to share and learn from peers and experts.
  • Case consultations with clinical experts.
  • Webinars, including a mix of expert- and peer-led sharing on topics participants identify as challenges.
  • An online forum and resource center.
  • Grants of $50,000 to help offset the costs of participating in the in-person events and developing and/or expanding your MAT program.

Grant Installment Details

  1. $5,000 at the time you are accepted into the program.
  2. $25,000 for meeting Deliverable No. 1, which consists of submitting two quarters of data, a program charter, and attending convening #1
  3. $10,000 for meeting Deliverable No. 2, which consists of submitting one quarter of data, submitting a progress report, and attending convening #2.
  4. $10,000 for meeting Deliverable No. 3, which consists of submitting two quarters of data, a final report and attending convening #3.

Timeline

Addiction Treatment Starts Here: Primary Care, Wave 2 runs from August 2019 to September 2020. Key dates include:

Request for Applications Released July 1, 2019
Informational Webinar July 12, 2019 (12-1pm PT) Register here.
Application Deadline July 24, 2019
Cohort Announced & Program Start August 23, 2019
Kick-Off Webinar September 4, 2019 (12-1pm PT)
In-Person Learning Session 1 November 6-7, 2019 (Location TBD)
In-Person Learning Session 2 April 15-16, 2020 (Los Angeles)
In-Person Learning Session 3 August 6, 2020 (Location TBD)
Program End September 2020

Grant Funding

Grants of $50,000 will be awarded to each accepted clinic site to help offset the costs of participating in in-person events and developing and/or expanding your program.

Grant installment details:

  1. $5,000 at the time you are accepted into the program.
  2. $25,000 for meeting Deliverable No. 1, which consists of submitting two quarters of data, a program charter, and attending convening #1
  3. $10,000 for meeting Deliverable No. 2, which consists of submitting one quarter of data, submitting a progress report, and attending convening #2.
  4. $10,000 for meeting Deliverable No. 3, which consists of submitting two quarters of data, a final report and attending convening #3.

Eligibility Requirements

Safety net health care organizations in California that provide comprehensive primary care services to underserved populations are eligible to apply. Organizations must be non-profit and tax-exempt under 501(c)(3) of the Internal Revenue Service Code (IRC) or a governmental, tribal, or public entity. This includes:

  • Federally Qualified Health Centers (FQHCs) and FQHC look-alikes.
  • County-run community clinics, rural health clinics, and free clinics.
  • Ambulatory care clinics owned and operated by public hospitals.
  • Indian Health Services clinics.

CCI will accept applications from multiple clinic sites within the same organization. Each prospective site must have its own project team and submit a separate application. If a site is already participating in wave 1 of the Addiction Treatment Starts Here: Primary Care program, they are not eligible to apply for wave 2. Sites from a participating organization in Addiction Treatment Starts Here: Primary Care are eligible to apply if the applicant site is not a current participant in wave 1. Each site selected will be eligible for a grant of up to $50,000. Up to three clinic sites per organization can apply. For organizations that provide services other than primary care (e.g., specialty mental health, outpatient substance use disorder), your application should clearly define how you are planning to integrate MAT into primary care. Organizations interested in integrated MAT into non-primary care based services are not eligible for this program.

If you have questions about whether you qualify, please email Tammy Fisher at [email protected].

Participation Expectations

By applying to join Addiction Treatment Starts Here: Primary Care, Wave 2 applicants agree they will:

  • Develop a team of 4-6 individuals who will participate in program activities and work on implementation and/or expanding activities within their health center. Teams should include at a minimum:
    • A program lead who is responsible for day-to-day activities of the program.
    • At least one x-waivered clinician.
    • A clinical leader, such as a Behavioral Health Director, Medical Director or Chief Medical Officer.
    • At least one or more additional team members. This can include administrative leaders, such as the Chief Executive Officer, Executive Director, or Chief Operating Officer. It can also include care team members providing SUD services, such as addiction treatment counselors, nurses, licensed social workers, and quality improvement analysts.
  • Attend all three in-person learning sessions, with at least three of the same members of your core team joining each. Please note that the learning sessions will likely be held in both Northern and Southern California. We will finalize the locations once we finalize the cohort.
  • Share challenges, opportunities, bright spots and questions with your fellow program participants. This includes your team participating in all three in-person learning sessions and additional sharing opportunities with other teams.
  • Submit a project charter and quarterly program updates, including your progress and challenges in meeting your goals.
  • Participate in various landscape assessment and pre-work activities, including work to evaluate your current state, as well as network and learn more from teams about their current state and challenges.
  • Submit quarterly data in a timely manner on a standardized program measure set. Participants will submit data on three required measures and up to two optional measures for all five quarters of the program. A data portal will be available for participants to enter numerator and denominator information (no patient-level information will be entered into the data portal). Your organization will be able to download run charts to review your progress in real time. See Appendix A for a description of the measures.

What Makes A Strong Applicant?

CCI is looking for applicants with the following characteristics:

  • Commitment to work to build and/or scale a MAT program within primary care at your clinic site.
  • A clinician champion who is committed to advocate for and provide clinical support to the health center’s ATSH:PC, Wave 2 program team.
  • A strong leadership commitment to supporting team participation in program activities, as well as ensuring protected time for team members to design and implement MAT program changes. This is evidenced by having a senior-level clinical or administrative leader on your team who is present at learning sessions and is meeting with your team at least monthly.
  • Willingness to openly share approaches and lessons learned with other participating teams.
  • Ability to submit quarterly data on the specific set of required measures.

Informational Webinar

Interested organizations are encouraged to attend the informational webinar on July 12. Register here. The recording of the webinar will be posted after July 12th. For answers to questions that arise during the webinar, we will post an FAQ document after the webinar.

Apply Now!

Your proposal must be submitted online by Wednesday, July 24, 2019, at 5 pm PT. If multiple clinic sites from one organization are applying, each site must complete a separate application. The program cohort will be announced by Friday, August 23, 2019.

Upon reviewing applications, we may request follow-up information or schedule a phone call with your team. We intend to select 20 teams for the program. CCI will contact you by August 23, 2019 to let you whether you have been accepted into the program.

Contact Us

If you have any questions regarding the Addiction Treatment Starts Here: Primary Care, Wave 2 program and application process, contact Briana Harris-Mills.