Quarter 3 Quarterly Reporting Survey Report

Thank you to everyone for completing the Quarter 3 Quarterly Reporting Survey! We have created agency-level reports summarizing your agency's response(s) to the Recovery and Treatment surveys for Quarter 3. These reports are in a sub-folder in your agency’s Dropbox folder titled "Quarterly Reporting Survey Reports".

For any Quarterly Reporting Survey questions, please visit our Quarterly Reporting Survey resource page and/or reach out to our team at SORSupport@omni.org!

From SAMSHA: Updated TIP 63 -- Medications for Opioid Use Disorder

New Publication: August 3, 2021

This updated version of Treatment Improvement Protocol (TIP) 63: Medications for Opioid Use Disorder reviews the use of the three Food and Drug Administration-approved medications used to treat Opioid Use Disorder (OUD)—methadone, naltrexone, and buprenorphine—and other strategies and services needed to support recovery for people with OUD.

Updates include–

  • Additional information about the qualifications of practitioners who are eligible to apply for a waiver to prescribe buprenorphine (i.e., clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives) that explains exceptions under the latest buprenorphine practice guidelines on obtaining a waiver.

  • Citations that support induction onto extended-release naltrexone of people with positive urine tests for opioids so long as they pass the naloxone challenge.

  • Clarification that naltrexone can result in decreased opioid cravings.

  • Where needed, clarification of whether discussion about naltrexone refers to the oral formulation or the extended-release injectable formulation.

  • Updated statistics on opioid-related deaths, overdoses, accidents, and hospitalizations.

View publication at this link.

SOR II, Year 2 Guidance for Submitting Proposals

Dear Subgrantees, 

Earlier this week you received communication from our office (via OMNI) regarding proposals for the upcoming SOR II grant year (October 1, 2021 - September 30, 2022). We admit that the post would've benefitted from a few more details. So, hopefully this one, in FAQ form, will answer any lingering questions about this-coming year's proposal process. 

SOR II, Year 2 Proposal Process FAQs

1) Will we be submitting proposals for both treatment and recovery awards? 

Yes

2) Is the SOR team going to give each of us treatment and recovery annual award amounts to create budgets around like they did last year? 

No. Not this year. Given the effects of Covid on nearly all of our subgrantees' SUD programming, making this past year anything but normal, we determined that it wouldn't be fair to dictate amounts based on what was or was not accomplished during SOR II, Year 1. 

3) Okay, so how much funding should we ask for? 

Use last year's treatment and recovery award amounts as your guide. You may request up to 40% more than those totals, or, of course, less money if you choose. 

4) What kind of format should our proposals be in? 

Use last year's format. Separate out treatment and recovery programming into two different categories. (See the graphic at the end of this post listing what items fall into recovery and what are considered treatment.) Please include budget narratives and line-item spreadsheets. Do not include other funding sources in your ask. That just confuses everyone.

5) When are our SOR II, Year 2 proposals due? 

Close of business, Friday, September 3rd, 2021. (Yes, we know that the first communication said September 1st, but we're offering two extra days.)

6) How do we submit our proposals? And to whom? 

Via email. Send them to all three SOR team members. Mike Zohab, (mike.zohab@dbhds.virginia.gov) Patrick Wessells and Angela Weight (same email address format for all of us). 

7) How/when will the SOR team respond to our proposals? 

If we approve your proposals and have no follow-up questions or requests, you'll receive a formal notice from our office listing the treatment and recovery amounts your organization will receive. You'll also receive Exhibit Ds from the DBHDS Office of Management Services. Our goal is to have Exhibit Ds out by September 25, 2021. Of course, this is dependent on other DBHDS departments, so that date may vary slightly. 

8) Speaking of Exhibit Ds, will they be the same ones as last year? 

Nope. We're working on making the wording much more relevant and approproate to standard CSB programming. Stay tuned. 

9) Will the SOR team be sending out the SOR II, Year 2 Notice of Award like in previous years? 

Absolutely! As soon as SAMHSA sends it to us. 

10) What about our unspent funds from SOR II, Year 1? Do you want those back? 

Yes. You'll receive communication from the DBHDS finance department regarding any unspent monies. 

Okay, those are all the questions I can think of that you may have about the SOR II, Year 2 proposal process. If I've left anything out, don't hesitate to email for further clarification. Mike, Patrick and I very much like hearing from our subgrantees and hope that our responses are timely and informative. 

We enjoy working with each of your organizations and are so proud of the SUD work you all do. 

Have a great weekend, everyone! 

Angela Weight

State Opioid Response Recovery Services Coordinator

Virginia Department of Behavioral Health and Developmental Services

Cell: 804-297-5457

SOR Treatment Community Forum on Follow-Ups: Recap & Recording

Thanks to all who attended the Inaugural CSB/Agency Treatment Community Forum on Follow-Up GRPAs: Tools, Tips, & Best Practices on 7/29. We enjoyed offering the time for CSBs/agencies, DBHDS, and OMNI come together to share and learn from each other.

If you were not able to attend, or want to review it, the forum was recorded and is available in the Other Resources>>Trainings area of our website. Here is a direct link to the recording and to the PDF of the slides.

To convey the importance of the topic, here is a graphic we shared during the forum that illustrates Virginia's Follow-Up GPRA interview status compared to that of all grantees and to SAMSHA's goal. As of July 2021, Virginia had only a 36% GPRA follow-up interview rate. We hope by working together to share tips and best practices, we can raise Virginia's follow-up rate a great deal more.

We are also producing two TA sheets we mentioned at the meeting. We are taking extra time with one of them, so we can incorporate the great feedback and tips gleaned from CSB conversations during our forum! We all learned so much.

  • Engagement Information Sheet for Clients -- designed to be shared with your clients so they can have a better understanding of the GPRA and its purpose.

  • Tips and Best Practices for Follow-Up GPRA Administration (Coming Soon. We will post an announcement when this is ready.)

As with many others resources, these re available on the website under Resources>>Supporting Materials.

Lastly, we kindly ask you to complete a very brief evaluation of the forum, if you've not done so already. Even if you did not attend, feel free to answer the very first question only, as we are seeking suggestions for future forum topics there. https://www.surveymonkey.com/r/CTTCTBF

Reminder! Inaugural CSB/Agency Treatment Community Forum on Follow-Up GRPAs: Tools, Tips, & Best Practices - 7/29 11am ET

The OMNI and DBHDS Teams invite you to join in our inaugural CSB/Agency Treatment Community Forum of 2021. Per popular request, we will provide the opportunity for a facilitated discussion on GPRA Follow-ups.

The Forum, Follow-Up GRPAs: Tools, Tips, & Best Practices, is Thursday, July 29 from 11am-noon EDT.

Please click here to register for the Forum.

OMNI will provide a very quick refresher on GPRA follow-ups, and then share some tips and best practices that we've learned of through CSBs/agencies and our own work. This is a more informal forum in which all can hear from each other about successes and challenges. We'll learn from each other, ask questions, and share existing best practices.

We've invited a couple CSBs to share some of their successes, challenges, and recommendations regarding follow-up GPRA administration in a spotlight segment, and we'll break into smaller groups so CSBs/agencies can talk more about it and also share ideas, ask questions, and learn from each other, before coming back to share some points with the larger group.

Questions? Reach out to us at SORSupport@omni.org.

DEA Mobile Van Update - Webinar in mid-August

This is a follow up to the DEA Mobile Van announcement to let you all know that a webinar covering this new development will be held in mid-August. For more information, please see the message from AATOD below.

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For more information contact Mark W. Parrino, MPA - AATOD President: info@aatod.org

http://www.aatod.org/

As most of our readers know, the Drug Enforcement Administration released the final regulations with regard to mobile vans, operating under the auspices of licensed Opioid Treatment Programs on June 28, 2021. The regulations will take effect on July 28, 2021. We are grateful to the DEA for completing their work on this important policy initiative and have been working with the DEA over the course of five years toward this outcome.

The expanded use of mobile vans will extend the reach of OTPs in rural and other underserved areas of the United States. We have been communicating with representatives from the Department of Agriculture, which has funding to purchase such vans as long as OTP operators use these vans in rural settings (population – 50,000 or less).

We have also been in communication with SAMHSA, so that OTPs can gain access to purchase and operate such vans using SAMHSA funds in suburban and urban areas, serving individuals, who are not able to travel to OTPs.

In our judgment, the use of such vans will work well in correctional settings, where the vans would provide increased access to the three federally approved medications to treat opioid use disorder. In this case, inmates would be inducted through these vans and maintained on such medications until they are released to an OTP.

Additionally, we have been in discussion with federal agencies, which have jurisdiction in this policy area to encourage the use of satellite medication units, operating under the aegis of OTPs.

Unlike mobile vans, the satellite medication units are fixed brick and mortar sites. The use of such medication units is permissible under existing SAMHSA regulations. We are encouraging OTPs to work in conjunction with the State Opioid Treatment Authorities to expand the use of such mobile vans and medications units.

AATOD has a number of committees, which will be developing policies to make existing OTP regulations more flexible in a post COVID-19 environment. To be sure, we have learned that providing patients with additional flexibility regarding take-home medications and the use of telehealth services (visual and audio) also provided greater flexibility to our patients.

We also have our colleagues at John Hopkins/OTPs working in conjunction with pharmacies to have clinically stable patients get access to medications through pharmacies as the patient remains in treatment at the OTPs. We look forward to learning more about the success of this approach.

____________

We plan to produce a “How To” webinar with regard to the process of developing mobile van services around mid-August 2021. This webinar will aim to do the following:

  • feature speakers, who have been operating mobile van services for many years;

  • provide details on federal and state funding support in developing such van systems;

  • discuss the cost of purchasing such vans from leading manufacturers;

  • provide updates on reimbursement mechanisms to support the use of such vans for patients, who have Medicaid/Medicare eligibility; and

  • beginning the development of Best Practice Guidelines in using such vans to extend the reach of OTPs.

___________

In conclusion, the OTP system has new opportunities to expand access to care while preserving the comprehensive nature of how we treat our patients. It is understood that we should use our recently learned experiences from the COVID-19 pandemic as a means of providing more flexible care to our patients. We will also renew our interest in using telemedicine in inducting new patients to OTPs with methadone through telehealth.

AATOD will work with our provider and policy partners in order to make the best use of these new opportunities. We recognize that we may not always agree on how to achieve these goals through certain policy partners but our Association is extremely clear on the need to preserve the integrity of care while expanding access to care during a time when fentanyl use is on the rise and we are treating patients with greater opioid tolerance.

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#200.112 Per 2 C.F.R. § 200.112-1113 The Federal awarding agency must establish conflict of interest policies for Federal awards. The non-Federal entity must disclose in writing any potential conflict of interest to the Federal awarding agency or pass-through entity in accordance with applicable Federal awarding agency policy. Failure to adhere to these statues will result in immediate termination of funding.

Virginia’s State Opioid Response (SOR) grant is awarded at the discretion of DBHDS and SAMHSA. All recipients of SOR funding supports evidence-based prevention, treatment and recovery services to address opioid and stimulant misuse and use disorders, including for cocaine and methamphetamine. The SOR grant is not intended to be utilized as a long-term or permanent funding source. All SOR proposals must include a realistic plan for financial sustainability beyond the grant period.