In an LA Times Commentary and Blog Post, RAND authors Beau Kilmer and Bryce Pardo suggest the fentanyl crisis should be viewed as a poisoning outbreak, rather than a drug epidemic. In 2018, two-thirds of opioid overdoses included synthetic opioids such as fentanyl. The authors state, “for most victims, fentanyl was not their drug of choice. Rather, they were poisoned by dealers who mixed it into baggies of heroin or pressed into fake-opioid tablets.” Viewing the fentanyl crisis from this perspective may inspire a new emphasis on harm reduction approaches such as naloxone distribution and low barrier access to medication assisted treatment (MAT).
Health Management Associates has released a new video highlighting the work of their Expanding Access To MAT In County Criminal Justice Settings project.
A collaborative research team comprised of American Indian and Alaska Native researchers, urban Indian agency partners, Tribal entities, and students and staff from the University of Southern California (USC) conducted research from March – November 2018 with Tribal and urban populations throughout the state of Californian culminating in Addressing the Opioid Crisis in American Indian & Alaska Native Communities in California: A Statewide Needs Assessment. This report recognizes the need to address the opioid overdose crisis in AIAN communities in California and aims to identify gaps in prevention, treatment, and recovery services (including medication-assisted treatment, or MAT) targeted to these communities.
Funding was provided by the California Department of Health Care Services (DHCS) through the California Opioid State Targeted Response (STR) to the Opioid Crisis Grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). The report contents are solely the responsibility of the authors and do not necessarily reflect the views of DHCS.
DHCS awarded the California Youth Opioid Response (YOR California) team — the California Institute for Behavioral Health Solutions (CIBHS) in partnership with Advocates for Human Potential, Inc., (AHP) — an allocated portion of the MAT Expansion Project funding to implement and expand medication assisted treatment (MAT) and opioid use disorder (OUD) prevention, treatment, and recovery services to youth and their family members. To advance this effort, the YOR California team issued a Request for Applications (RFA) in May to seek subgrant applications for the purpose of developing new and enhanced services and recently announced that a total of $11 million was awarded to organizations across the state of California.
These subgrantees will provide a wide array of services for youth (12-24) with, or at risk of, an OUD and prevent opioid overdose death. Twenty-two (22) implementation subgrants (total of $10.5 million) were issued to execute projects that remove barriers and fill gaps in services delivery, and ultimately increase access to youth-relevant OUD services. Subgrantees’ projects span the continuum of prevention, intervention, MAT and other treatment, and recovery services, and focus on positive youth development, age-appropriate and targeted engagement, implementation of evidence-based practices for youth, and the adoption of appropriate adult interventions to meet the needs of youth.
In addition to the implementation subgrants, the YOR California team also awarded 10 organizations with community planning subgrants (total of $550,000). Funding for these subgrants support planning activities, such as convening a community planning group, conducting an assessment, establishing partnerships, and creating a community action plan to reduce youth OUD and opioid related deaths.
Implementation Subgrantees
California School-Based Health Alliance
California University of Science and Medicine (Arrowhead Regional Medical Center)
Center Point Drug Abuse Alternative Center
Children’s Hospital Los Angeles
Communicare
Contra Costa Health Services
Door to Hope
Granite Wellness Centers
Imperial County Behavioral Health Services
La Maestra Family Clinic, Inc.
Los Angeles Centers for Alcohol and Drug Abuse
Mind OC
Partnership Healthplan
Phoenix House of Los Angeles, Inc.
Santa Barbara Neighborhood Clinics
Santa Clara County
Shasta County Health and Human Services Agency
Tarzana Treatment Centers, Inc.
The Teen Project, Inc.
UCSF Division of Adolescent and Young Adult Medicine
Volunteers of America of Los Angeles
Yurok Tribe
Planning Subgrantees
Atascadero Greyhound Foundation
BluePath Health
California After School Network
California Friday Night Live Partnership – Tulare County Office of Education
Fresno New Connection, Inc.
NAMI San Diego
National Asian Pacific American Families Against Substance Abuse (NAPAFASA)
Redwood Community Health Network
Tri-City Health Center
Valley Health Associates
The team’s work also includes the development of outreach and implementation plans, the creation of strategies to distribute OUD materials throughout the state, and the establishment of learning collaboratives.
This is an unprecedented opportunity to expand services for California’s young people, and the YOR California team looks forward to playing a part in meeting this goal. The combined national and state expertise in the development and management of youth-specific, MAT, and behavioral health services, as well as experience in developing and enhancing integrated and comprehensive systems of care, places the YOR California team in a well-matched position to assist DHCS in implementing and expanding MAT prevention, treatment, and recovery services for youth and young adults with OUDs in California.
Supporting All Californians to Address the Opioid Crisis Through a Multi-Pronged, Community-Based Approach
The Center at Sierra Health Foundation works to promote health and racial equity throughout California with a community-first funding model that centers the voices and priorities of marginalized communities. With more than 30 years of grantmaking experience, Sierra Health Foundation launched The Center in 2012 to best leverage its leadership, operational, and funding support to establish investment partnerships to make a deeper collective impact. With its infrastructure, experience, and health equity focus, The Center is partnering with DHCS to expand the reach of medication assisted treatment (MAT) services and wrap-around care to all who need it. The project is centered on increasing access to comprehensive prevention and education for substance use disorder (SUD), opioid use disorder (OUD), and MAT for people suffering from OUD, and to improve health outcomes for communities of color disproportionately impacted by and penalized for SUD. The goal is to increase awareness of and access to MAT for California’s most underserved communities by providing racially and culturally responsive outreach and education, prevention services, and referrals to MAT providers.
The MAT Access Points Project funding strategy includes the following components:
Support to organizations that want to increase access to treatment services by building their capacity to provide MAT.
Infrastructure support for California tribal health organizations to improve facilities to offer MAT.
Funding for community-based organizations to conduct racially and culturally responsive prevention and educational activities focused on: 1) increased understanding of SUD and OUD, 2) stigma reduction and recognition of the chronic nature of the disease of addiction, and 3) increased access to MAT services.
An ethnic media strategy to develop and promote a communications campaign tailored to racial and ethnic groups to increase community understanding of SUD, OUD, and the availability of MAT services and treatments.
A training and technical assistance program for partners around SUD, OUD, and MAT to build sustained capacity among community organizations to provide outreach and education and support MAT access.
To implement the first component, The Center at Sierra Health Foundation has, to date, awarded more than $16.2 million to 119 organizations representing 265 MAT access points throughout California. Continued funding will now focus on the remaining four components of the strategy.
The MAT Access Points Project will create a network of organizations throughout the state that work in partnership to address the opioid crisis for all Californians. With health and racial equity at the forefront of the model, the foundation is being laid for a sustainable, statewide system of education, response, and care that will help communities remain resilient and ready to tackle any challenge. Learn more at mataccesspoints.org and shfcenter.org.
