Implementing & Sustaining a Coordinated MAT Program for the Chippewa Valley

1. A collaboration between Prevea Health and HSHS Western Wisconsin Division Implementing & Sustaining a Coordinated MAT Program for the Chippewa Valley Toni Simonson, Clinical Director at HSHS Western Wisconsin Division & Prevea Behavioral CareJune Pikulski, Inpatient Manager-Nursing at HSHS L.E. Phillips-Libertas Treatment CenterJill Hasenberg, Medical Director at HSHS L.E. Phillips-Libertas Treatment Center; Physician at Prevea Health and OakLeaf ClinicsNicole Califf, Outpatient Manager at Prevea Behavioral CareSarah Bodeau, Behavioral Health Therapist at Prevea Behavioral Care

2. Aim • Implement MAT program for the Chippewa Valley • Provide education to staff to increase understanding and willingness • Finalize infrastructure that needs to be in place before taking on first clients • Consult with Hazelden, Prevea Health in Eastern Wisconsin, & Libertas of Marinette to align with best practices • Begin treatment with first cohort of clients at HSHS L.E. Phillips-Libertas Treatment Center • Converse with community members and referral sources to increase MAT understanding and acceptance • Review efficacy and improve processes as necessary • Replicate at Prevea Behavioral Care

3. Change • Past • In the process of recruiting prescribers interested in MAT • Minimal communication between prescribers and therapists • No required programming element when receiving medications from prescribers • Involvement with NiaTx • Treatment team attended the COR-12 Leadership Training at Hazelden in November 2017 • Current • Hired four new MAT prescribers who have been seeing patients at HSHS L.E. Phillips-Libertas Treatment Center and Prevea Behavioral Care • Implemented multidisciplinary approach to providing services to patients receiving suboxone • Induced first cohort of patients at HSHS L.E. Phillips-Libertas Treatment Center in September 2018 and have continued taking on new patients since then • Transferred the HSHS L.E. Phillips-Libertas Treatment Center Outpatient Program to Prevea Behavioral Care in Chippewa Falls, WI • Acquired the DBT and the 12-Steps curriculum from Hazelden and integrated this into treatment • Switched from UPC to ASAM to better advocate for insurance authorization of MAT services • Accommodated high MAT patient volumes by hiring additional therapists, nurses, and front office staff • Began offering MAT at Prevea Behavioral Care’s Eau Claire location • Reached out to area County Human Services Departments and worked with Hazelden to put on a community education event featuring William Cope Moyers

4. Results County residence distribution of current patients for one MAT prescriber Of the 109 patients this MAT prescriber has seen since the program started, only 18 have discontinued services. Of those 18 patients, only 6 were not transferred to services elsewhere.

5. Next Steps • Review processes for ensuring patients are involved in the therapy component of treatment • Connect with Joel Cycenas, Hazelden Accounts Director, to discuss future community events that increase awareness and build acceptance of MAT • Examine potential of Suboxone induction in the outpatient setting • Expand MAT program at Prevea Behavioral Care in Eau Claire, WI

6. Impact • Initially decreased the readmission rate for detoxification at HSHS L.E. Phillips-Libertas Treatment Center • Some dissonance between the formerly abstinence-based treatment program at HSHS L.E. Phillips-Libertas Treatment Center and the current harm-reduction model being used in the MAT program • High patient volumes indicate this is meeting a need in the Chippewa Valley and further support the decision to keep expanding this program

7. Sustainability • We will continue . . . • Providing education to staff about MAT to maintain staff buy-in • Reaching out to counties and other referral sources • Coordinating with partner facilities, such as HSHS L.E. Phillips-Libertas Treatment Center, Hazelden, Libertas of Marinette, and Prevea Health in Eastern Wisconsin • Receiving information on additional medications that could be incorporated into the MAT program, such as Sublocade • Building relationships with medication representatives who can advocate to insurance companies and provide education to staff members