Opioid Crisis Response

Opioid Crisis Response: Addressing the Opioid Public Health Emergency

In 2021, more than 220 people died every day from an opioid-related drug overdose in the United States. In 2020, Congress estimated economic burden of fatal and non-fatal opioid overdose was nearly $1.5 trillion- up 37% from 2017, when the CDC last measured the cost.

The opioid public health emergency is nationwide and impacts health, justice and child welfare systems. In recent years, the federal government has awarded funds across the country to help states combat the growing epidemic. States, counties and local units of government are partnering with prevention and treatment providers and other stakeholders to address the overwhelming needs of their communities. HMA helps clients develop and implement solutions and can align this work with funding goals and expectations, tight timelines and the desire for a sustainable infrastructure.

The HMA opioid team has unique expertise and more than 30 years of experience tackling every part of the substance use disorder system. They have led the development of comprehensive prevention, evidence-based treatment, and recovery solutions at the state, county and community level. Our team is ready to help clients create actionable and sustainable programs to address the opioid epidemic and addiction treatment.

What we do

  • Ecosystem Development and Community Organization
    • Building the entire continuum of care in communities, counties and states
    • Planning for, prioritizing, and responding to needs in the community with existing resources and action plans
    • Creating coalitions for coordinated state approaches, facilitating multi-stakeholder collaboration that drives collective action
  • Training and Certification Programs
    • Technical assistance and training for state and local agencies, partners and community members on comprehensive prevention approaches across the continuum
    • Public education, naloxone dissemination and use, policy approaches
    • Leveraging community health workers (CHWs) to screen and link community members with needed services
  • Health System and Provider Response
    • Facilitating the design and implementation of comprehensive addiction evaluation and treatment strategies for hospitals and health systems of all sizes
    • Integrating SUD treatment into primary care
    • Performing treatment capacity needs assessments
    • Training providers on safe prescribing, alternative pain management, outpatient withdrawal management, medication-assisted treatment, all forms of evidence-based addiction treatment and behavioral health interventions
  • Health Plans and ACO Support
    • Understanding impact and developing solutions to support H.R. -6 and developing a multi-stakeholder cross-cutting community, telehealth solutions and procurement support
    • Improving network capacity to provide meaningful access
    • Developing formularies and implementing guidelines and protocols
    • Providing strategies for alternate payment models
  • Strategic planning, program design and implementation
  • Research and evaluation to address emerging trends

What we do: Examples

  • HMA has developed large scale educational platforms covering addiction pain and behavioral health. HMA currently has a team dedicated to expanding addiction treatment in the California prison system and in collaboration with Stanford University, improving the care for pregnant and parenting women across the state of California.
  • HMA created a video, with funding from the California Health Care Foundation, to capture the thoughts and feelings of various stakeholders in the criminal justice system about treating Opioid Use Disorder with Medication Assisted Treatment (MAT).  It includes comment from two clients who received MAT through the criminal justice system.  The parties interviewed are all involved in a project HMA is administering to coach teams from 29 counties to expand access to at least two forms of MAT in jails and drug courts.

Who we help

For over 30 years we have informed and supported the opioid crisis response of:

  • States and counties
  • Behavioral health, addiction and public health agencies
  • Hospital systems
  • Primary care providers
  • Federally Qualified Health Centers
  • Health plans
  • Accountable care organizations
  • Departments of Corrections
  • Jails and prisons
  • Community stakeholders

Who we help: Examples

No matter the scope or size of the project, HMA has experience working with states and community organizations to develop impactful, sustainable responses to opioid crisis issues.

Client: Cambridge Health Alliance (CHA), Massachusetts

Project Name: CHA: Analysis and Recommendation for Addiction Treatment Services

Projected Impact: To improve systemwide addiction treatment services, providing a framework to drive management improvement in addiction and overall population health at CHA.

Project Summary: HMA analyzed the current state of CHA’s addiction services through institutional documents and conducted surveys to better inform on-site engagement. Using the information gathered, HMA convened two, full-day meetings with internal stakeholders and conducted a gap analysis as well as current and future state value stream maps. HMA provided a final report with a detailed analysis of the future of the CHA addiction services ecosystem and how it can interface between departments, including current and future state value stream maps, based on American Society of Addiction Medicine (ASAM) criteria.

Client Type: Delivery Systems

Duration of Project: 7 months

Client: St. Francis House, Massachusetts

Project Name: St. Francis House: Recovery Center

Projected Impact: To help the St. Francis House leadership and board evaluate the opportunity to provide substance use disorder (SUD) services to guests.

Project Summary: Working with the leadership team at St. Francis House, HMA’s opioid crisis response is providing strategic support to facilitate the development of clear goals and priorities for the recovery center, including leveraging strong relationships with the Boston Health Care for the Homeless Program and providing an inventory of existing SUD program options. HMA will work to support submission of a SAMHSA grant application to provide recovery services within the shelter walls, develop a financial model to sustain the program and a roadmap, with a clear timeline for implementation, and key deliverables, timelines and measures of success.

Client Type: Delivery Systems, Community Based Organizations

Project Name: BHS Baltimore: Maryland Screening, Brief Intervention, and Referral to Treatment (SBIRT) Survey

Projected Impact: To design, implement and analyze a statewide general population survey to explore patients’ perceptions and experiences with drug and alcohol screening and referrals in clinical settings.

Project Summary: HMA is collaborating with Behavioral Health System Baltimore (BHSB) and the Maryland Department of Health, Behavioral Health Administration (BHA) to conduct a public survey of Marylanders’ exposure to SBIRT services and their perceived value of those services. The team will conduct research of SBIRT initiatives, campaigns and literature of similar studies. HMA will identify key research questions, develop and administer surveys and analyze results. A final report and presentation will be delivered to BHSB and BHA.

Client Type: Delivery Systems, State Government, Community Based Organizations

Client: Delaware (DE) Department of Health and Social Services (DHSS), Division of Public Health (DPH)

Project Name: DHSS: Opioid Crisis Response

Projected Impact: To identify areas in the state with a high burden of opioid-related overdoses and overdose fatalities and create local response teams that can activate in the event of an overdose spike.

Project Summary: HMA provides support for DPH in administering its Centers for Disease Control Cooperative Agreement – Public Health Response to the Opioid Crisis. This includes assistance establishing and managing a statewide Overdose System of Care and coordination to ensure alignment of opioid response activities across state agencies and their contractors. HMA is also conducting an analysis of gaps in community services to support individuals with opioid use disorder or who are in recovery and creating community response teams to respond to local overdose spikes.

Client Type: Delivery Systems, State and local Government, Community Based Organizations

Delaware Opioid Community Response Teams

Client: Delaware Department of Health and Social Services

Project Name: Delaware (DE) Division of Substance Abuse and Mental Health (DSAMH): Phase 2 START Initiative

Projected Impact: To improve the system of care with individuals suffering from substance or opioid use disorder through technical assistance and individualized coaching.

Project Summary: HMA has been supporting DSAMH’s efforts to enroll providers into the START initiative in order to optimize transitions of care, referrals, inductions and overall system functionality. Work involves thorough ongoing engagement with providers, meeting them where they are at their time of entry to the START program, as well as implementing a rigorous, data-based project plan to ensure progress toward START goals and improved capacity and performance among DE providers as a whole.

Client Type: Delivery Systems, State and local Government, Community Based Organizations

Client: California Department of Health Care Services (CA DHCS)

Project Name: CA DHCS: Medically Assisted Treatment in Drug Courts and Jails

Projected Impact: To help jails and drug courts across the state develop practices to continue MAT treatment for persons who begin treatment in the community and initiate addiction assessment and treatment in criminal justice settings. The county’s approach to addiction treatment will extend to persons involved in county criminal justice systems.

Project Summary: In collaboration with the CA DHCS Substance Use Disorder division, HMA has recruited teams from 32 counties to participate in a learning collaborative to expand the use of MAT in jails and drug courts. The teams are made up of representatives from jail custody and healthcare, the county manager, country drug treatment program, courts, probation and others. HMA is facilitating three, in-person learning collaboratives, providing monthly coaching calls to each team, managing a team of project advisors, developing a series of webinars and podcasts, and providing technical assistance to the teams and the state to address barriers. Thousand of jail detainees are receiving MAT already, and many more will be in the future.  Under new funding for two more years, teams will continue to remove barriers to MAT and will begin new focus on treating detainees with co-occurring serious mental illness and those with methamphetamine use.

Client Type: Correctional Health, State and Local Government, Community Based Organizations

Duration of Project: 4 years 

Client: California Department of Health Care Services (CA DHCS)

Project Name: CA DHCS: Opioid Systems of Care

Projected Impact: To form a comprehensive, county-focused effort aimed at making all American Society of Addiction Medicine (ASAM) levels of care available in target counties, and to reduce delays between treatment requests and medication starts formedication assisted treatment (MAT) and the emergence of high fidelity and predictable practice methods with sustainable delivery.

Project Summary: HMA is providing a sophisticated program of process improvement and technical assistance in 10 counties in California called Transitions of Care. Our effort focuses on strengthening addiction treatment systems through a multi-pronged approach. HMA, in collaboration with county leaders and stakeholders, will evaluate and enhance the transitions of patients entering and moving between levels of addiction treatment care. We will provide outreach and technical assistance to increase the number of buprenorphine quick start sites in those areas.  HMA will also provide coaching and technical assistance to stakeholders to build a consistent knowledge base in order to provide high-touch, evidence-based MAT and behavioral therapies for patients with substance use disorders

Client Type: Delivery Systems, State and local Government, Community Based Organizations

Client: California Department of Health Care Services (CA DHCS)

Project Name: CA DHCS: Perinatal Medically Assisted Treatment (MAT) Expansion Project

Projected Impact: A reduction in neonatal abstinence syndrome severity and length of stay in the hospital, a decrease in the amount of erroneous child protection service referrals, an increase of mothers in long- term recovery, and ability to identify and treat 50 percent of predicted individuals in the targeted counties.

Project Summary: HMA is addressing the opioid crisis in the perinatal population by increasing access to MAT for the treatment of opioid use disorder, reducing unmet treatment needs, and reducing opioid overdose-related deaths through the provision of prevention, treatment and recovery activities for OUD. HMA is also working hand-in-hand with the California Maternal Quality Care Collaborative and the California Perinatal Quality Care Collaborative to facilitate learning collaboratives and deliver state-of-the-art treatment from the prenatal phase to the post-delivery phase.

Client Type: Delivery Systems, State and local Government, Community Based Organizations

What Drives Us

DHHS Announcement: Practice Guidelines for the Administration of Buprenorphine

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