Aegis Hub & Spoke System

Aegis Hub & Spoke System

Aegis Hub & Spoke System March 13, 2019 Sarah Khawaja, Psy.D. CA H&SS Grant Manager Agenda H&SS Introduction Patient Growth Progress H&SS Spoke and Coalition Partners Highlights of H&SS in Aegis (Rural North) Humboldt Region H&SS Grant Aegis CA Grant Map Original Spoke Projections June 2017 Current Hub & Spoke System H&SS Patient Growth Overall Growth 2,235 total pts ALL H&SS OUD PATIENT GROWTH 2400 2235 2125 2021 2000 1915 1821 1621 1600 1686 1723 1529 1446 Totals 1201 1200 1053

800 486 560 400 0 JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC JAN FEB H&SS Patient Growth Overall Spoke Growth 1,935 total Spoke pts Overall Hub Growth 300 total Hub pts H&SS SPOKE PATIENT GROWTH H&SS SPOKE PATIENT GROWTH

400 2000 1935 1835 350 1656 290 300 255 250 226 227 233 259 200 300 270 1600 1394 1238 241 1453 1482 1303 1200 Totals 177 151

1566 1400 208 149 150 1751 1800 161 1024 1000 Totals 892 800 600 100 400337 50 0 JAN 409 200 FEB MAR APR MAY JUN

JUL AUG SEPT OCT NOV DEC JAN FEB 0 JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC JAN FEB

Humboldt H&SS HUMBOLDT H&SS SPOKE PT. GROWTH 100 90 82 80 77 80 83 70 70 66 60 51 50 46 47 Jun Jul 40 30 27 20 10 0 May Aug Sept Oct Nov

Dec Jan Jan Humboldt H&SS Region Highlights 11 Spokes 3 Coalitions Contracted with local pharmacies to provide MAT medication to Spokes ED Bridge collaboration 516 Naloxone kits to the community Sponsored Opioid education events Residential Pilot Program MAT Aftercare Program Redding H&SS 400 380 360 340 320 300 280 260 240 220 200 180 160 140 120 102 100 80 60 40 20 0 Mar REDDING H&SS SPOKE PT. GROWTH 391 349

298 235 247 260 266 Jul Aug 306 277 217 Apr May Jun Sept Oct Nov Dec Jan Redding H&SS Region Highlights 13 Spokes 3 Coalitions Contracted with local pharmacies to provide MAT medication to Spokes 1716 Naloxone kits to the community Sponsored Opioid education events Supported for community OUD

awareness film project through SARA Coalition ED Bridge collaboration Chico H&SS CHICO H&SS SPOKE PT. GROWTH 300 292 299 280 260 258 264 246 240 220 216 200 225 222 197 180 160 140 141 120 100 80 60 40

20 0 May Jun Jul Aug Sept Oct Nov Dec Jan Feb Chico H&SS Region Highlights 7 Spokes 3 Coalitions Contracted with local pharmacies to provide MAT medication to Spokes 264 Naloxone kits to the community Naloxone for Camp Fire evacuees (ODs in shelter) 2018 California Opioid Summit w/ Butte County Public Health Vivitrol MAT spoke with Tehama County Marysville H&SS MRSVL H&SS SPOKE PT. GROWTH 700 616 600 540

538 551 564 575 Sept Oct 635 646 Dec Jan 660 499 500 434 439 Mar Apr 400 300 200 152 184 100 0 Jan

Feb May Jun Jul Aug Nov Feb Marysville H&SS Region Highlights 14 Spokes 2 Tribal Spokes Chapa-De Indian Health Center and Lake County Tribal Health Consortium 6 Coalitions Contracted with local pharmacies to provide MAT medication to Spokes 744 Naloxone kits to the community White Bison Training to provide culturally sensitive SUD training for native populations Community Education Summits facilitated quarterly by Spokes and Coalitions ED Bridge collaboration Roseville H&SS RSVL H&SS SPOKE PT. GROWTH 450 446 417 425 397 400 368

375 346 350 325 311 353 340 321 295 300 275 250 225 224 227 Feb Mar 233 200 183 175 150 125 100 Jan Apr May Jun Jul

Aug Sept Oct Nov Dec Jan Feb Roseville H&SS Region Highlights 10 Spokes 5 Coalitions Contracted with local pharmacies to provide MAT medication to Spokes 768 Naloxone kits to the community Selected as SAMHSA Hub site (one of only two in original 19 grants) Joined Placer-Nevada Coalition for televised Press Release to celebrate over 100th lives saved by Naloxone in 2018 w/ Assemblymen Dahle & Kiley, Placer & Grass Valley PD Radio PSA that aired in 4 Counties & 7 radio stations to discuss MAT/Opioid Epidemic. Opioid Summit in El Dorado County ED Bridge collaboration Manteca H&SS MANTECA H&SS SPOKE PT. GROWTH 50 45 40 37 35 29 30 26

24 25 24 20 14 15 12 10 5 13 7 4 2 0 Jan 1 Feb 3 0 Mar Apr May Jun Jul Aug Sept Oct

Nov Dec Jan Feb Manteca H&SS Region Highlights 6 Spokes, 2 are tribal spokes MeWuk Indian Health Center and Mathieson Memorial Health Clinic 3 Coalitions 2,418 community Naloxone Law Enforcement (Sheriffs dept, probation, SWAT team medics, field officers, detective units) University of the Pacific Opioid Coalitions Community Educational Events 10 of 11 Spokes are new to MAT! Partnering with Stanislaus County Behavioral Health for Opioid Summit 1,000 projected attendees Hub and Spoke Services MAT Team Salary Patient Provider visits Treatment for Underinsured and Uninsured Patients MAT Medications & Naloxone HIV/HCV & Urinalysis Testing Education/Training Funding Training Materials for MAT Program Outreach & Advertisement Opioid Coalition Funding Naloxone for Law Enforcement, First Providers, Community Medication Neutralizers (Deterra & Dispose Rx) Lock Boxes Patient Transportation Telehealth Equipment Implementation Infrastructure

H&SS Spoke Partners Adventist Health Barton Health Banner Health Clinic Butte County Behavioral Health Chapa- De Indian Health Center Community Recovery Resources County of Tehama Human Services Agency Dignity Health Dr. Staszel El Dorado Community Health Centers Fairchild Medical Center Full Circle for Integrative Medicine Groups Recover Together Hill Country Community Clinic Kima:w Medial Center Lake County Tribal Health Consortium Lucerne Community Clinic Mangrove Medical Group Marshall Medical Center Mendocino Coast Clinics Mendocino Community Health Clinic Mountain Valleys Health Centers Open Door Community Health Centers Plumas District Hospital Redwoods Rural Health Center Shasta Community Health Center Stallant Health

Tahoe Forest Hospital Waterfront Recovery Services Western Sierra Medical Clinic H&SS Coalition Partners Butte Glenn Medical Society Drug Abuse Prevention Task Force CoRR Youth Based Prevention Drug Free Coalition- South Lake Tahoe Drug Free Coalition- Tahoe and Truckee El Dorado County Opioid Coalition Hoopa Community Coalition Lake County Safe Rx Mendocino/Fort Bragg Safe Rx Mendonoma Health Alliance Northern Sierra Opioid Safety Coalition Rx Safe Del Norte Rx Safe Humboldt San Joaquin County Opioid Coalition Sierra Medical Foundation- Placer Nevada Safe Rx Siskiyou County Rx Addiction Stanislaus County Opioid Coalition Tehama County Opioid Coalition Trinity Opioid Safety Coalition Tuolumne County Opioid Coalition Yuba Sutter Health Council H&SS Naloxone Distribution Total of 6,426 Kits provided to H&SS community partners 3000 2418 2500 2000 1716 1500 1000 500 0 744 768

Marysville Roseville 516 264 Humboldt Redding Chico Naloxone Manteca Humboldt H&SS Grant Region 11 Spoke Locations Redwoods rural Health Center Redway Waterfront Recovery Services Eureka Full Circle Center for Integrative Medicine Arcata Kima:w Medical Center Hoopa Open Door Community Health Centers Crescent City, Eureka x2, Fortuna, Arcata x2, Willow Creek 2 Pharmacies Cloneys Limas 3 Coalitions Rx Safe Humboldt Rx Safe Del Norte Hoopa Community Coalition

Humboldt H&SS Highlights Residential MAT Pilot H&SS funding for residential bed nights for Waterfront Recovery Services MAT pts Funds 30 detox & 90 longer term residential bed nights per month MAT Aftercare Program Waterfront Recovery Services new program to allow patients to receive treatment in transition from MAT residential care to MAT primacy care ED Bridge Collaboration Collaborated with St. Joes & CA ED Bridge team to help get pts on Buprenorphine in the ED & transferred to spoke partners for MAT Naloxone Distribution 516 kits to law enforcement, public health, coalitions, community events 202 reported naloxone reversals! Humboldt Opioid Coalitions Humboldt H&SS Challenges MAT Access: Open Door Community Health Centers was one of the only MAT providers in Humboldt County and were treating apr. 500 OUD pts with Medication Assisted Treatment Beyond Open Door there were Limited Prescribers & MAT Patient Capacity In Humboldt County 7% of prescribers have a Data 2000 Waiver Many of these are not utilizing their Waiver to RX Buprenorphine Most are not treating the maximum number of patients they could Even though 500 pts were in MAT with Open Door, the Urban Institute estimated that an additional 800 people with OUD in the county were without local access to MAT treatment in 2016 Waitlists to receive MAT treatment MAT staff recruiting Limited number of Data Waived Providers, Nurses, Clinicians in rural areas Transportation especially in winter Lack of physical space in busy PCP practices Q&A Sarah Khawaja, Psy.D. CA H&SS Grant Manager Contact Information: Cell: 916-220-2753 Email: [email protected]

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