Application Overview

In partnership with California Department of Health Care Services and Cedars-Sinai, the Center for Care Innovations (CCI) is launching Addiction Treatment Starts Here: Primary Care. Below you will find information about the program and application process. You can also download the Request for Applications. For answers to common questions, view the FAQ sheet.

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

Download RFA as PDF

 

Background

The Center for Care Innovations (CCI) is launching Addiction Treatment Starts Here: Primary Care, a new program to increase access to medication-assisted treatment (MAT) in primary care for patients with opioid use disorder (OUD).

Federal, state, and local attention remains focused 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 ­methadone, buprenorphine, or naltrexone. Evidence supporting the use of MAT shows mortality among opioid addiction patients being cut in half or more. 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 seeks 40 primary care health center sites in California to participate in this 18-month learning collaborative, launching in February 2019 and concluding in July 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 CCI’s previous MAT program, Treating Addiction in the Primary Care Safety Net, which ended in February 2018. That two-year 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 our evaluation report, 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 is funded through generous grants from the California Department of Health Care Services and Cedars-Sinai.

Program Components

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

  • Track 1: Planning Stage – Health center sites 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 and standardize existing programs.
  • Track 2: Expansion Stage – Health center sites that have MAT programs in place that 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.

Participants on both tracks will have access to all program offerings. Within the program offerings, content and methods will be tailored specifically to each track’s needs, given the different stages described above.

Addiction Treatment Starts Here: Primary Care will offer training, tools, expertise, and support to design new or expand existing MAT programs at participating organizations. Content will address clinical and operational issues associated with MAT, including:

  • Building a culture around treating addiction as a disease.
  • Developing or scaling a MAT model for your organization.
  • Regulations for confidentiality and MAT operations.
  • Buprenorphine, Naltrexone, and Naloxone 101.
  • Patient identification and selection.
  • Managing buprenorphine inductions, stabilization, and maintenance.
  • 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 treatment.
  • Managing diversion.
  • Addressing stigma.
  • Creating financial sustainability for MAT programs.

Over the course of our 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 up to $50,000 to help offset the costs of participating in in-person events and developing and/or expanding your program.

Grant Installment Details

  1. $30,000 at the time you are accepted into the program.
  2. $10,000 for meeting Deliverable No. 1, which consists of submitting two quarters of data, a program charter, and Plan-Do-Study-Act (PDSA) cycles to date.
  3. $10,000 for meeting Deliverable No. 2, which consists of submitting two quarters of data, a progress report, and a final report.

Timeline

Addiction Treatment Starts Here: Primary Care runs from February 2019 to July 2020. Key dates include:

Request for Applications Released November 15, 2018
Informational Webinar November 27, 2018 (12-1pm PT)
Application Deadline December 14, 2018
Cohort Announced & Program Start February 1, 2019
Kick-Off Webinar February 13, 2019 (12-1pm PT)
In-Person Learning Session 1 April 10, 2019 – April 11, 2019 (Los Angeles)
In-Person Learning Session 2 September 18, 2019 – September 19, 2019 (Bay Area)
In-Person Learning Session 3 April 15, 2020 – April 16, 2020 (Los Angeles)
Program End July 31, 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. $30,000 at the time you are accepted into the program.
  2. $10,000 for meeting Deliverable No. 1, which consists of submitting two quarters of data, a program charter, and Plan-Do-Study-Act (PDSA) cycles to date.
  3. $10,000 for meeting Deliverable No. 2, which consists of submitting two quarters of data, a progress report, and a final report.

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 site must submit a separate application and will be eligible for a grant of up to $50,000. Up to three clinic sites per organization can apply. Organizations submitting multiple applications may have some crossover in their core project team members (e.g., a project manager for all MAT activities across all sites, administrative lead, clinical champion, etc.) but the project team at each site level must include a local prescriber and front-line team member from that specific site.

Organizations with multiple sites may apply in one of two ways:

  • Option 1 – your organization could submit a single application for one $50,000 grant if you intend to have a single MAT team that works across multiple sites. Organizations submitting a single application should describe how the program will operate across multiple sites and should clearly define the roles of the project team.
  • Option 2 – your organization could submit multiple applications (up to three, for a total of $150,000) if you plan to have separate programs and distinct MAT teams at each site working with different patient populations across the multiple sites.

For additional eligibility information, check out the FAQ Sheet. If you have additional questions about your eligibility or the application process, please email Susannah Brouwer at [email protected].

Participation Expectations

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

  • Develop a team of 4-8 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.
  • 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.
  • 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 six quarters of the program. A data portal will be available for participants to enter numerator and denominator information for each required measure and for optional measures you track (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 current draft description of the measures. The finalized definitions of program measures, including detailed specifications, will be shared during the program’s Kick-Off Webinar.

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 at your clinic site.
  • A clinician champion who is committed to advocate for and provide clinical support to the health center’s Addiction Treatment Starts Here: Primary Care 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 a specific set of measures.

FAQs & Informational Webinar

Interested organizations are encouraged to view the recording of the informational webinar below, which reviews program components and answers questions that attendees have. You may also review the slides.

For answers to questions that arose during the webinar, please view the FAQ document.

Apply Now!

Your proposal must be submitted online by Friday, December 14, 2018, 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, February 1, 2019.

For more information on how to apply, visit the Application Page.

Upon reviewing applications, we may request follow-up information or schedule a phone call with your team. We intend to select 40 teams for the program. CCI will contact you by February 1, 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 program and application process, contact Susannah Brouwer.

 

Download RFA as PDF