1. ADVANCING RECOVERY IN WEST VIRGINIA MEDICATION ASSISTED TREATMENT WITH BUPRENORPHINE/SUBOXONE AR LEVERS OF CHANGE JULY 2009

2. ARWV PARTNERS Genise Lalos, AR Project Change Leader, Prestera Center genise.lalos@prestera.org genise.lalos@prestera.org Karen Schimmel, Change Leader, Westbrook Health Serv. kschimmel@westbrookhealth.com kschimmel@westbrookhealth.com Jon Kemper, Change Leader, Seneca Health Services, jkemper@shsinc.org jkemper@shsinc.org Nancy Deming, Change Leader, Valley Healthcare, ndeming@valleyhealthcare.org ndeming@valleyhealthcare.org Merritt Moore, State Change Leader, Merritt.E.Moore@wv.govMerritt.E.Moore@wv.gov

3. AIM - Improve Access to MAT (Suboxone) Baseline data: 2-1-08 –ARWV partnership had 128 individuals receiving MAT (suboxone) 2-1-09 –ARWV partnership had 259 individuals receiving MAT (Suboxone) This represents an increase of 131 individuals or 102%

4. Aim: To Increase Client Assess to MAT Barriers:  Staff Resistance  Abstinence-Based Community  No Suboxone-Prescribing Physician  Agency policies that made access to MAT difficult Solutions:  Staff Education and In-service on MAT Approach  Community Providers Surveyed on MAT Awareness  Hiring of Suboxone-Certified Physicians  New look at old policies Lever: Intra-Organizational Operations Analysis

5. Finding Physicians Reckitt Benckiser Rep was a great help Recruiting Internally Working with Universities Working with Primary Care Clinic Docs

6. Lever: Regulatory Analysis Aim: Facilitate client engagement by lessening stringent data requirements Solutions: OHFLAC agreed to allow up to 30 days for completion of required paperwork for ARWV participants; Potential benefits: Less time devoted to administrative tasks early in treatment process, thus increasing the time the clinician can spend on engaging the client in the treatment process; Outcomes: State Change Team still evaluating results

7. Lever: Financial Analysis Aim: To Increase Client Assess to MAT Barriers:  Largely Uninsured Population Unable to Afford Treatment or Medication  Medicaid Redesign in WV Limited Coverage for Consumers and Restricted Clinician Pool Solutions:  Partnered with state on $75,000 indigent care funding plan to offset cost of care  Clinicians Placed on Medicaid Credentialing Track and Given Agency Assistance in Obtaining Necessary Training

8. State Challenges: No funding to offset the cost of care for indigent seeking MAT Change: The state set aside $75,000 for the ARWV partnership to use to offset the cost of care for indigent clients Potential Benefits : Makes MAT available for more people who could not otherwise afford this best practice treatment Outcome: Prior to indigent care partnership 0 indigent clients were receiving MAT. 1 st quarter increase of 20 indigent clients being served in MAT programs after indigent care fund.

9. CLIENT STORY Karen Schimmel presents one client's story of success made possible by the ARWV/State partnership indigent care funds

10. SUSTAINING : ADVANCING RECOVERY IN WV ARWV is dedicated to sustaining and spreading the present momentum with MAT throughout the state with the following activities: Sponsored In-State Change Leader Academy Presented ARWV data at National Social Work Conference ARWV Provider sent staff to Bup TOT Access to Recovery brochures created