1. Jessica Bass, LCSW, CAC III, Program Manager Outpatient and Offender Services Arapahoe House

2. AIM (Plan) Baseline use of Vivitrol was 0 Limited referrals for any MAT; some use of antabuse for alcohol dependent clients. Goal was to increase use of Vivitrol in Intensive Residential Treatment (IRT) program for clients stepping down into outpatient Started screening clients in February 2009

3. Change (Do) Barrier → Clinician lack of knowledge/bias towards MAT Surveyed staff to find out knowledge and comfort level with MAT Provided training on the benefits of MAT and Vivitrol specifically Incorporated education on MAT into clinical supervision groups Barrier → Lack of agency procedures for screening clients and delivering Vivitrol Started screening all alcohol dependent clients for appropriateness for Vivitrol Enhanced education around Vivitrol and other MAT in client residential curriculum Got donation of Vivitrol from Alkermes; arranged for doctor/nurse to see clients Creating reports to track when clients are due for their next dosage Improved coordination between IRT and OP staff as clients transition

4. RESULTS (study) Screening all alcohol dependant clients in IRT 15 clients have started on Vivitrol since March 09 OP clients are beginning to get screened and 2 have started on Vivitrol Clients are reporting high levels of satisfaction!

5. NEXT STEPS (Act) Continue to educate staff and client Develop stable funding sources –Utilize patient assistance program through –More education/advocacy needed on cost-benefit of paying for MAT → Outreach to private insurers –Increase Medicaid utilization; formed change team with provider and Medicaid representatives to resolve barriers around licensure and billing issues –Working with child welfare and other referral sources to educate on the benefits of MAT and get these services added to contracts

6. IMPACT (Business Case, Lessons Learned) Arapahoe House Vision All types of MAT fully integrated into treatment for clients at all levels of care Finding sustainable payer sources Network of providers to collaborate with for prescribing medication Lessons Learned Need to keep up with new medications and constantly educate staff about the landscape of options Need to continue dispelling myths about MAT for clients