The Arkansas Department of Health seeks to convene an action group, the Prescription Drug Overdose (PDO) Advisory Council, to encourage and support cross-system planning and collaboration to reduce the incidence of morbidity and mortality related to opioid overdose. The approach will include integrating prescription drug monitoring program (PDMP) data with all identified data sets, developing composite tables that combine indicators across data sources, providing training and education to opioid prescribers, assessing the impact of specific policy changes to the PDMP, and creating the Opioid Misuse Action Group to provide feedback on the data sets. The Arkansas Department of Health will also implement the Dose of Reality educational campaign to combat opioid abuse.
The University of California, Davis (UC Davis) will work with the California Department of Justice and other partners to perform a rigorous evaluation of California’s new law mandating use of its prescription drug monitoring program. The evaluation will focus on effects of mandated PDMP use on prescribing patterns and health outcomes, including potential unintended consequences. UC Davis will work with the Northern California High Intensity Drug Trafficking Area (HIDTA) to establish a foundational relationship between public health and law enforcement agencies. In particular, UC Davis will focus on exploring new data sources from law enforcement agencies to share with public health agencies about opioid supply and overdose. The goal is to develop protocols to predict opioid overdose and share information about supply disruptions with emergency departments, first responders, and other key agencies. UC Davis will also explore protocols for communicating directly with local emergency services directors.
The Ventura County Health Care Agency–Ventura County Behavioral Health Department, the Ventura County Sheriff’s Office, the Ventura County Public Health Department, the Ventura County Emergency Medical Services Agency, and the Ventura County Ambulatory Care Department will convene the County Opioid Abuse Suppression Taskforce (COAST) to improve the quality, consistency, sharing, and integration of local and state prescription drug monitoring program (PDMP) data to monitor community-level conditions/outcomes and target/coordinate resources to increase impact in response to the opioid abuse epidemic. Funds will also be used to complete, document, and disseminate an evaluation of state and local prescriber trends by scope of practice and to deploy the ESRI ArcGIS Opioid Epidemic Solution. EVALCORP Research and Consulting will serve as the research partner for the proposed project.
The Connecticut Prescription Monitoring Program (PMP), in partnership with other state agencies, will merge the Office of the Chief Medical Examiner (OCME) and the state forensic laboratory system with the Connecticut Prescription Monitoring and Reporting System (CPMRS) to allow prescribers and pharmacists to identify patients who have died and reduce inappropriate dispensing; create a new module to allow law enforcement users access to both death data and toxicology information within the CPMRS to assist in their investigations; and conduct educational campaigns to introduce these new features and the benefits that would expand the ability of prescribers, pharmacists, and law enforcement to avoid and deter controlled substance misuse or diversion.
The State of Connecticut Department of Consumer Protection, Drug Control Division is upgrading the Connecticut Prescription Monitoring and Reporting System (CPMRS) to the NarxCare Platform, enhancing the administrator portal features to allow prescription monitoring program (PMP) staff members to better assist all user groups, identify and correct problems, and address requests for research data. The division is adding a Mandatory Use Compliance module to produce PMP administrator reports of providers and review histories, and reports for providers of their missed reviews. It is conducting three educational campaigns to introduce the NarxCare platform, new features, and benefits to prescribers, pharmacists, and law enforcement.
The Florida Department of Health will enhance the Florida Prescription Drug Monitoring Program (PDMP) system, known as E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program), by employing an epidemiologist to provide data analysis to inform and guide health-care practitioners and policymakers and expanding existing outreach and education. E-FORCSE will also fund integration of PDMP information into clinical workflow by providing mini-grants to small physician practices and independent pharmacies.
The Idaho Department of Health and Welfare (IDHW) will build a sustainable data infrastructure to ensure timely collection, analysis, and dissemination of opioid data. In addition, an action researcher will establish a suspected drug-induced death mortality review team. The data will be shared with Idaho’s strategic planning workgroup and other stakeholders. To address vulnerable populations, IDHW will work with the Idaho Office of Drug Policy to distribute naloxone in communities across Idaho. To educate prescribers in rural Idaho on substance abuse treatment and safe prescribing, IDHW will work with the University of Idaho to extend its Project ECHO program, an evidence-based, technology-enabled collaborative learning model that builds a clinician’s knowledge and ability to treat complex conditions. To evaluate Idaho’s efforts in educating prescribers on safe prescribing and prescription drug monitoring program (PDMP) utilization, IDHW will contract with a third-party evaluator.
The North Chicago Police Department will establish the New Beginnings Community Resource Center that is accessible 24 hours a day to North Chicago residents (population of 32,574) and the Lake County citizenry (population of 703,520). This community resource center will be staffed by licensed social workers, substance abuse clinicians, and a crime data analyst. The licensed social workers will specialize in the following areas: drug counseling, victim’s assistance, opioid addiction services, nonprofit charities, career training, and immigration support. The resource center will provide information for the following: drug rehabilitation services, fact sheets on opioid addictions, drug use safety, support groups, counseling programs, career training and financial assistance, schedules of public transportation, childcare assistance, and job placement. This community gathering place will also assist victims of domestic violence, violent crimes, and human trafficking and financially needy families. As such, planting a community development center inside of the police department will immediately reduce drug-related crimes within the City of North Chicago.
The Illinois Department of Human Services will, in collaboration with the University of Illinois at Chicago, develop a comprehensive training program that will provide academic detailing, automated connection education, and prescription monitoring program (PMP) website usage education. Working with its vendor, Logicoy, Inc., the grantee will help the Illinois PMP connect to 78 hospital, clinic, or pharmacy electronic health record (EHR) systems, thus reducing the access time from minutes to seconds, which is critical during trauma situations. Finally, in collaboration with the Illinois Department of Public Health, the PMP will expand the unsolicited alert system by increasing the types of alerts sent to hospitals and medical providers.
The Kansas Board of Pharmacy, the administrator of the Kansas Prescription Drug Monitoring Program (K-TRACS) will implement a public awareness campaign for K-TRACS; conduct an audit of K-TRACS records and recommend corrective action, remedial measures, and policies; and hire a special investigator to define and develop the criteria to expand the analysis of K-TRACS data by identifying individuals with questionable behaviors, suspicious prescribing patterns, or harmful practices.
The University of Kentucky Research Foundation, on behalf of the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health (DPH), will (1) develop an algorithm-based mechanism to identify high-volume, high-risk opioid prescribing specialty groups within a health-care system to provide actionable information to health-care leadership to initiate targeted education; (2) develop an algorithm to identify inpatients whose specific principal diagnoses increase the likelihood that they will receive opioid prescriptions upon discharge and during follow-up care; and (3) develop diagnosis-specific patient education materials to facilitate a health-care system intervention for inpatients with these diagnoses. The results will be disseminated by developing reports, peer-reviewed manuscripts, and a repository of developed and tested patient- and prescriber-oriented educational materials to facilitate replication in other health-care systems and settings.
The Lowell Police Department is proposing to enhance and expand the Community Opioid-Outreach Program team (Lowell Police, Fire, Health, Trinity EMS, Lowell House) by: adding a youth services coordinator to focus on the needs of children affected by the opioid epidemic, two outreach specialists to expand service to the homeless community by serving as a liaison between agencies to improve communication and connect their various resources, and conduct pro-active outreach to any individuals with substance use disorder before an overdose. Grant funds will support a coordinator, crime analyst, full-time clinical recovery specialist and youth services coordinator, outreach recovery specialist and research team. University of Massachusetts Lowell will serve as the research team comprised of researchers from Center for Community Research & Engagement, School of Criminology and Justice Studies, and Community Health and Sustainability.
St. Mary’s County Health Department in Maryland will work with other community agencies to expand the data that are used to support the Opioid Intervention Team. The utilization of Overdose Detection Mapping Application Program (ODMAP), Prescription Drug Monitoring Program (PDMP), and first responder data will be increased. In addition, the agency will increase the multidisciplinary engagements with community organizations and neighboring jurisdictions and increase recovery support services and educational opportunities for prescribers and patients.
The Minneapolis Health Department will partner with the Hennepin Health, Hennepin County Medical Center, Minneapolis Police Department, Minneapolis Fire Department, Emergency Medical Services, and Serve Minnesota to implement both hospital-based and community-based services to connect individuals at risk for overdose and/or survivors of a nonfatal overdose and their families with substance abuse and behavioral health treatment providers and recovery support. The Minneapolis Health Department Research and Evaluation Team will serve as the research partner for the proposed project.
Itasca County in Minnesota proposes to embed substance abuse clinicians in local law enforcement agencies to improve their responses to individuals in need of support and treatment; establish an interagency taskforce; and provide specialized training to first responders. First Call for Help of Itasca county will hire a half-time coordinator and 2.5 full-time recovery support specialists (embedded in law enforcement) to expand recovery services. Also, overdose detection mapping application program (ODMAP) will be incorporated.
The County of Monmouth, under the auspices of the Monmouth County Sheriff's Office Corrections Division, known as the Monmouth County Correctional institution (MCCI), will expand an existing in-custody medication-assisted treatment (MAT) program and provide cognitive behavioral treatment.
The New Jersey Department of Law and Public Safety will develop clinical alerts and unsolicited reports to alert prescribers of potential doctor/pharmacy shoppers, excessive dosages, and dangerous drug combinations and establish a pharmacy inspection program to audit for prescription drug monitoring program (PDMP) compliance and prompt training and education upon identification of practice deficiencies.
The Reno Police Department, in partnership with the Washoe County Health Department and other community partners, will implement evidence-based practices in the field of tobacco prevention by launching a mass-reach health communication campaign with the goal of changing the social norms surrounding prescribed opioids. This program will also follow up with individuals/families who have experienced a suspected overdose and provide information regarding resources such as how to seek a substance abuse evaluation and/or counseling, medication-assisted treatment (MAT) and other treatment, and where to obtain naloxone. Finally, the program will launch a prescriber education campaign.
Sevier County will enhance the Sevier County Offender Recovery Program (SCORP), a comprehensive, collaborative effort to identify and refer individuals to treatment and recovery following incarceration. Interventions begin during incarceration; however, the majority of services are provided immediately at release during the probationary period. Funds will be used to hire a peer mentor coordinator, a women’s service liaison, and a probation/life skills coach for incarcerated women enrolled in the program and expand the substance abuse prevention education program to include the families of SCORP participants.
The Montgomery County, Texas, District Attorney’s Office will take the lead with a multiagency collaboration to comprehensively tackle issues surrounding prescription opioid abuse in the county. A preventive and proactive data-driven approach will be adopted to identify doctor shoppers, “pill mill” doctors, problematic pharmacies, and prescription opioid addicts. The goal is to hold doctors and pharmacies accountable and to prosecute doctor shoppers who divert prescription opioids to streets for profit. The two primary components of the project include a pre-crime unit and a Prescriber Outreach and Education Program.
Washington’s prescription opioid death rate for calendar year 2015, 5.5 per 100,000, was much higher than in 1999, 2.7 per 100,000. The proposed data-driven response project, led by the Washington Department of Health, is to reduce opioid misuse and overdose fatalities in Washington by providing quarterly prescription drug monitoring program (PDMP) data to health-care facility chief medical officers (CMOs). The data provided will be based on key PDMP indicators that will identify potential outlier prescribers compared with current guidelines from both the Washington State Agency Medical Directors Group (AMDG) Interagency Guideline for Prescribing Opioids for Pain and the Centers for Disease Control and Prevention (CDC) prescribing guidelines. CMOs have the authority to engage with their prescribers in the development of proactive prescribing quality improvement (QI) interventions and to encourage provider use of the PDMP for clinical decision making. Development of QI interventions at the facility level will ensure effectiveness for the specific facility that can be closely monitored and amended as needed.
The Washington Department of Health will hire a prescription drug monitoring program (PDMP) onboarding coordinator (management analyst) who will perform outreach and education, and provide onboarding assistance to facilities interested in integrating the PDMP query into their electronic health record (EHR) systems. Washington’s Emergency Department Information Exchange (EDIE) is a care management tool that has been largely successful in integrating PDMP data into its reports. By supporting more EHR-PDMP integration, it is expected that more health-care organizations will uptake the technology and fully adopt the Agency Medical Directors Group (AMDG) Interagency Guideline for Prescribing Opioids for Pain. The Prescription Monitoring Program at the Washington State Department of Health will work with stakeholders, other state agencies, and health-care providers to develop metrics and measures to be included in provider feedback reports sent to prescribers to inform them of their own prescribing practices and how their practices relate to other prescribers of similar licensure and specialty.
The Wisconsin Department of Safety and Professional Services will enhance the Wisconsin Prescription Drug Monitoring Program (WI ePDMP) by convening user groups to identify and prioritize future enhancements to the WI ePDMP system. The Wisconsin Department of Safety and Professional Services will work to develop and deploy enhancements to meet user needs for a clinical decision support tool, a prescribing practice assessment tool, an interdisciplinary communication tool, and a public health tool.