NYS Responses to Opioid Use Charles W. Morgan, MD, DFASAM, FAAFP Medical Director Belinda M. Greenfield, Ph.D. Bureau Director, Adult Treatment Services NY State Opioid Treatment Authority (SOTA)
Oversees approximately 1,600 treatment, prevention, recovery, and housing programs. Treats more than 230,000 New Yorkers on an annual basis, with an average daily enrollment of nearly 100,000. Delivered direct prevention services to 336,000 youth during the 2015-2016 School Year. Operates 12 Inpatient Addiction Treatment Centers. Manages 2,810 Permanent Supportive Housing (PSH) apartment units.
Government spends more than $1.2B on SUD treatment, prevention and recovery. OASAS system has more than 12,000 treatment beds. OASAS system has more than 40,000 individuals in Opioid Treatment Programs.
New York is not immune. 2,185 1,710 2014 2015 NYS Heroin & Opioid Deaths Source: NYS Department of Health
Expanding our Services New Programs = Peer Engagement (Operating) 9 Locations = Peer Engagement (Pre-operational) 1 Location = Family Support Navigators 8 Locations = Youth Clubhouses (Operating) 7 Locations = Youth Clubhouses (Pre-operational) 4 Locations = Recovery Community Centers (Operating) 13 Locations = Recover Community Centers (Pre-operational) 1 Location = New OTP 9 Locations, 2,100+ Slots = Expanded OTP Capacity 9 Locations, 1,000+ Additional Slots = Rapid Capital Expansion Bed Awards 5 Locations, 96 Beds = Rapid Capital Expansion OTP Awards 4 Locations, 600 Slots
Medical Education Required Opioid Prescription Education for NYS Prescribers (4 hour course, 3 hour course) Presentations to Ob/Gyn specialists, NYAFP, Pain Specialists, GNYHA, MSSNY, Addiction Medicine Track (NYS ASAP) OTP Symposia Future: ED physicians, Local Medical Societies Public Defenders with Legal Action Center NYS Recovery Conference
Education BHO/MCO regular meetings with OMH VBP Summit for PPS s From Science to Practice to VBP : SUD as Healthcare LSBs/video education for OASAS providers re: admission priorities, etc. Support for MAT: communication from Counsel s Office CASA videos CPI video content NYSSBA Regional Presentations/MCOs/Providers/Community Groups
Public Awareness Reverse the Stigma Campaigns PSAs Parents/Family Groups Interaction with the public Pharmacy materials
PART D, Section 1. Section 19.09 of the mental hygiene law Effective October 22, 2016 Pharmacies registered in New York State must educate individuals at the time of dispensing a prescribed controlled substance medication. The dangers of misuse and the potential risk for addiction to prescription controlled substances. The physical and behavioral warning signs of addiction. Available alcohol and drug addiction treatment resources. Proper disposal guidelines for unused prescription controlled substances.
OASAS Main Website Page WWW.OASAS.NY.GOV
Combat Heroin and Prescription Drug Abuse Kitchen Table Toolkit https://combatheroin.ny.gov/kitche n-table-toolkit 2 videos 2 guidance documents
New York State Navigating the Substance Use Disorder System of Care SERIES GETTING HELP 1. Introduction to Treatment 2. Making an Informed Decision 3. Understanding Your Health Insurance 4. Treatment is Available in NYS TYPES OF TREATMENT 5. Inpatient Detox 6. Inpatient Rehab 7. Outpatient Treatment UNDERSTANDING YOUR RIGHTS WHILE IN TREATMENT 8. Appeals Process 9. 14 Day Rule and the Appeals Process 10. Patient Safety RECOVERY AND RELAPSE PREVENTION 11. Communicating with Your Health Care Provider 12. When Family and/or Loved one wants to help 13. Relapse Prevention: What a Family and/or Loved One Needs to Know
Download/Order materials from the website www.combatheroin.ny.gov/resources
Find Addiction Treatment
1 of 10
What are we doing? New funding to support: Treatment beds and Opioid Treatment Programs in unserved areas Family Navigators, Peer Engagement Recovery Centers and Adolescent Clubhouses
New Supports and Connections to Treatment Family Support Navigator Peer Engagement Recovery Centers Adolescent Clubhouses Medication in local jails Tele-health In Community Services Regional 24/7 Crisis Access Centers
Recovery Oriented Health Management Strategies Substance Use disorder must be treated on par with other health conditions. It is a chronic illness with acute state, remissions and exacerbations. It requires a long term management strategy. Identifying risky use (Screening), intervening early when a disorder exists and managing more severe forms of the illness through partnership with a robust treatment delivery system with the full continuum of care will make all of health care stronger and will help to achieve the triple aim.
Better Continuity of Care We need to make better connections between acute levels of care Emergency Department, Detox, Inpatient and Community Based Services. Follow-up after an acute admission within 14 days is below 40% - we can do better. Warm Hand-offs and peer engagement have been shown to be effective in connecting between levels of care. From hospital to community based treatment is especially important.
Residential Re-design OASAS is in the process of designating residential programs to provide services under new regulations. New regulations allow for Medicaid billing by Medicaid Managed Care plans for clinical services. Service elements provided within residential setting include: stabilization, rehabilitation, re-integration. Stabilization in particular will provide stable residential setting to encourage appropriate step-down and linkage from detox and inpatient.
Access, Integration, Quality OASAS is focused on Access new treatment availability tool, provider groups forming to create urgent and emergency 7 day (24 hour) assessment and linkage to care. DSRIP projects and Value Based Payment preparation create opportunities for integration. Partnerships between SUD and PH providers, hospitals and community based organizations, health providers and social service and housing providers to integrate the system of care. Quality of care needs to rise to standards expected by payers where services are provided because they add value.
Contact Information Charles W. Morgan, MD, DFASAM, FAAFP, DABAM Medical Director Charles.Morgan@oasas.ny.gov Belinda M. Greenfield, Ph.D. Bureau Director, Adult Treatment Services Belinda.Greenfield@oasas.ny.gov