ATTOD Conference October 2004

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ATTOD Conference - October 2004
New England Opioid Treatment Authorities Alliance
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Challenge Statement and Goals
The State Methadone Authorities in New England
met in November 2003 to process and formalize
relationships. The group identified the need to
support and enhance state efforts to strengthen
and reinforce their responsibilities in providing
oversight to the Opioid Treatment Programs across
state lines.
Challenge Statement
Short-Term Goals

• Identify essential and basic responsibilities to
  Opioid Treatment Programs and the SSA.
• Build on the identified responsibilities to
  identify critical areas to focus future
  activities
• Collaborate on initiatives across state borders

• Strengthen the role of the SMA in their
  environment
• Provide a more uniform approach to advancing
  initiatives and resolving common issues.
• Share the outcomes from this development process
  that can become a template for other SMA in other
  regions of the country.

Long-Term Goals
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Overview
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New England State Opioid Treatment Authorities
Alliance Agreement

• We, the undersigned, as State Opioid Treatment
  Authorities, do hereby agree to the intent and
  purpose of the New England State Opioid treatment
  Authorities Alliance.
• Purpose To establish a regional alliance to
  ensure safe and effective services for patients
  receiving medication assisted treatment for
  opioid dependence by improving coordination of
  these services throughout the New England region.
• In order to accomplish this we agree
• To exchange information that informs policy and
  practices in New England State Opioid Treatment
  Authorities.
• To promote workforce development and cultural
  competency in the understanding of medication
  assisted treatment for opioid dependency
  management.
• To develop a vehicle for practice improvement
  through common outcome measures outline/utilizing
  the CSAT domains.
• To promote public understanding and acceptance of
  opioid dependence and treatment access issues.
• To promote access to medication assisted
  treatment through appropriate systems
  integration.

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New England State Opioid Treatment Authorities
Alliance Agreement

• To promote better/improved communication between
  opioid treatment providers and other health
  professionals, as well as, promote parity for
  healthcare coverage.
• To collaborate regarding
• Evidence Based Practices and address healthcare
  disparities as identified.
• Development of request for Technical Assistance
  and/or other identified funding opportunities.
• Review of state and federal regulations and
  applicable laws for the purpose of providing
  direction regarding the needs of the New England
  States.
• Developments of performance measurements systems
  that improve quality of care and service
  delivery.

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Connecticut

• Expansion of Opioid Agonist Treatment Protocol
  Diversion from detox to MMT through U.M./Q.I.
• Monthly meetings with OTP Directors
• Development of a Central Registry function
  within existing SSA client information system
• Facilitation of agreement by CT Medicaid agency
  to pay weekly MMT regardless of of unsupervised
  doses
• Expansion of Methadone Friendly residential
  treatment
• Participation in N.E. Node, Clinical Trials
  Network
• Waived SSA regs. In order to allow OTP pts.
  Access to extended take-home doses now available
  42CFR,part 8

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Maine

• Maines Office of Substance Abuse (OSA) has
  participated in local dialogue meetings on opioid
  treatment to facilitate communication among
  community service providers, OTPs, law
  enforcement and other interested individuals.
• OSA facilitates monthly meetings with the OTPs,
  licensing, and MaineCare (Medicaid)
• Maine has recently introduced a prescription
  monitoring program to promote treatment
  intervention and monitor potential diversion.
• Reviewing and revising state regulations to
  include intergration of co-occurring mental
  health and substance abuse treatment.

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Massachusetts

• Expand access to Office-based Opioid Treatment
• Expand Boston Medical Center pilot program to
  provide statewide training and clinical
  consultation services for OBOT providers
• In conjunction with Mass Health, develop targeted
  capacity expansion plan for community health
  Centers and hospitals
• Develop best practice guidelines for OBOT
  providers
• Develop and distribute consumer information on
  OBOT
• Convene approved providers to discuss barriers to
  beginning OBOT and devise strategies to address
• Implement an evaluation program to ensure
  appropriate treatment
• Interagency work group - Board Pharmacy, DEA,
  Mass. Food and Drug, Board of Medicine,
  Department of Public Health ( Substance Abuse ,
  AIDS bureau)
• Reviewing and revising state regulations
• Waiver process to address Take Home Provisions
  and Drug Screening (urine testing) techniques
• Addressing Disaster Response and preparedness
  plans
• In process of integrating substance abuse and
  mental health

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New Hampshire

• Collaborations between
• primary care that includes AOD outpatient
  treatment
• local hospital (w/ level 3 neonatal intensive
  care nursery)
• an OB/GYN 2nd yr. Physician's Residency Program
  to manage opiate-addicted pregnant women with
  methadone services and provide newborn
  care.Treating approximately 12 women and their
  children per year since 1998.

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Rhode Island

• Development and use of Central Registry.
• Dual Enrollment Project with Residential
  Programs, Intensive Outpatient Programs, and
  Partial Hospital Programs.
• New Behavioral Health Licensing Regulations
  integrate all substance abuse and mental health
  programs.
• Partnership grants include mental health
  treatment at an OTP
• Prison Project Inmates in methadone treatment at
  an OTP at time of incarceration can be medically
  withdrawn - those who are pregnant or for whom
  withdrawal would be medically contraindicated,
  can be maintained on methadone.
• State purchase of emergency dispensing unit.
• SMA participation in monthly meetings with the
  OTPs.

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Vermont

• By the end of SFY 05 will have nearly tripled its
  Methadone
• treatment slots
• Pregnant injecting drug users are offered
  treatment on demand including comprehensive
  OB-GYN, methadone, and comprehensive wrap around
  services for up to a year post partum.
• The most MD's trained in Buprenorphine per capita
  in the United States.
• Vermont will begin Mobile Methadone services in
  its three most
• rural counties in SFY 05.