To be healthier, our community must overcome the opioid crisis. This is the reality for many communities, and King County, Washington is no exception. According to the 2018 Overdose Death Report, published by Public Health – Seattle & King County, “The number of confirmed drug and alcohol deaths investigated by the King County Medical Examiner’s Office has increased over the past decade: from 265 in 2009 to 415 in 2018. In 2018, 67% of drug and alcohol-caused deaths involved an opioid.”

‍What We’re Doing

‍HealthierHere is committed to collaborating and aligning with efforts to reduce opioid deaths by providing increased access to community-based Opioid treatment. We are excited to announce our partnership in two initiatives focused on improving access to care for individuals with Opioid Use Disorder (OUD). These initiatives have been selected to launch as part of HealthierHere’s Innovation Fund investment strategy, which aims to catalyze and test innovative solutions to health and social challenges in our community:

• Country Doctor Community Health Centers’ Innovative Approach to Transforming Medication Assisted Treatment in Central Seattle
• Public Health – Seattle & King County’s Buprenorphine at Navos Mental Health and Wellness Center Project (Bupe NoW) Expansion in South King County

Both models are designed to address a high priority need that was brought to our attention by local subject matter experts in HealthierHere’s Opioids Learning Collaborative.

‍The Need

‍State and county resources have been focused on efforts to increase inductions of Medication Assisted Treatment (MAT) in emergency departments (EDs) and jails in King County. This provides individuals with OUD an opportunity to begin the process of starting Opioid treatment while they are in the ED or jail.After leaving the ED or jail, however, individuals often find themselves without access to the support and resources they need to successfully continue treatment. There are many barriers to continuing treatment when transitioning back into the community. For example, a person may have trouble finding an appropriate MAT provider with immediate availability, might lack transportation, or could have other unmet needs like legal system challenges, housing insecurity and/or other physical or behavioral health conditions. Given the challenges of transitioning from the ED or jail back to the community, many people lose access to their medication and treatment regimen. This gap in care often leads to relapse and the continued cycle of addiction.

‍The Goal

‍According to local experts, as well as the Centers for Disease Control and Prevention’s “Evidence-Based Strategies for Preventing Opioid Overdose”:

• MAT is one of the most effective forms of treatment available for individuals with OUD
• It works best when treatment is consistent, without interruption
• When the individual leaves an ED or jail, it works best with a warm hand-off, in which a trained professional (e.g., case manager, peer support specialist) provides direct support to link the individual to further treatment immediately

The goal of these innovative projects with Country Doctor Community Health Centers (CDCHC) and Public Health – Seattle & King County (PHSKC) is to reduce the care gap for individuals with OUD who have received a MAT induction in an ED or jail, by increasing warm hand-offs and reducing barriers for individuals to continue their MAT with community-based, low-barrier MAT providers. These projects will expand and improve care for some of the most vulnerable people in our community, and they will test innovative models of care coordination. Additionally, CDCHC and PHSKC will partner with additional health and social service organizations for each project, and this will help strengthen cross-organization and cross-sector relationships and model the value of collaboration in improving our health care and social services systems.‍

What’s Next?

‍CDCHC, PHSKC and their partners are moving forward with the behind-the-scenes work needed to implement their strategies. Each organization will report on quarterly milestones for their project, and the first reporting period will include completion of HealthierHere’s Equity Tool as well as work to collaboratively develop evaluation strategies for each test of innovation. We look forward to sharing updates as this work progresses. In the meantime, please consider joining our Partner Learning Webinars to learn about other exciting models, tools and resources being used to improve care in our community. To receive updates when webinars are added to the schedule, join our mailing list. Our next webinar is November 8, 2019 from 12:30-1:30: Improving Chronic Disease Outcomes: The Community Health Worker Asthma Home Visit Model.