1. Center of Excellence Kate Henry LCSW, CCDPD Stacey Burroughs, LPC, CAADC Behavioral Health Service Line May 15th 2017

3. LG COE Program
DHS implemented 45 OUD Centers of Excellence (COE)
LGH’s COE Care Management team will help individuals with OUD navigate the health care system by:
Integrated Counselors representing our 7 geographic regions of care
Facilitating initiation into OUD treatment from emergency departments & primary care physicians
Helping individuals transition from inpatient levels of care as well as correctional facilities to ongoing engagement in outpatient treatment
Motivating & encouraging individuals with OUD to stay engaged in both physical health and behavioral health treatments

4. Why Medication Assisted Recovery?
Medication Assisted Treatment (MAT) is clinically and cost effective
Saves lives, saves money (healthcare and societal)
Only 30% of treatment programs offer MAT
3% of US physicians have DEA waiver-1% active
Less than half of eligible patients have access to MAT
MISSED OPPORTUNITY to use most effective medications we have to treat OUD amidst a crisis

5. Buprenorphine and naltrexone treatment
Lancaster County COE
LGH/ Penn Medicine receive the Lancaster County Primary Health COE award.
Buprenorphine and naltrexone treatment
Through the HealthChoices physical health network
T.W. Ponessa & Associates receive the Lancaster County Community COE award.
Licensed drug and alcohol provider that provides counselling, methadone, buprenorphine, or naltrexone assisted treatment

6. COE Team

7. SUSQUEHANNA COE
RCM COE
THE BUCK COE

8. LGH COE Regional Approach
DOWNTOWN-Recovery Care Medicine operating out of Comprehensive Care Medicine COE start date 1/1/17
4 physicians rotating 1/week
1 LCC
1 LPN
SOUTHERN- The Buck Family Practice COE start date 2/8/17
1 physician 1/week
1 CMA
COLUMBIA/YORK- COE at Susquehanna Family Practice April ‘17
2 physicians rotating 1/week

9. COE PHYSICIAN COE LCC Patient 1 1300 Patient 1 1315 Patient 2 1315
COE LCC will need additional intake time with patients (1 hour time slot)
Need to be seen every 30 days
Intake template
Progress note template
Patient agreement
Patient 2
1315
Patient 2
1330
Patient 3
1330
Patient 3
1345

10. Inpatient Referral Process

11. Outpatient Referral “AMB REF 385”

12. Patient Story
36 year old female 23 weeks pregnant arrives to Women's and Babies Hospital in opiate withdrawal
Struggling with using opiates and cocaine throughout pregnancy
SW at WBH initiated D&A consult on 2/17/17
COE LCSW met with patient at WBH completed level of care assessment for office based MAT 2/17/17
Coordination between COE physician and COE LCSW able to provide script for Subutex to patient 2/17/17
COE LCSW referred to Blueprints for D&A counseling on 2/17/17
Intake completed at Blueprints on Monday 2/20/17
Patient arrived for follow up at COE clinic on Tuesday 2/21/17
Provided UDS-negative for illicit substances, positive for Subutex
Referral for prenatal care and social worker initiated to Healthy Beginnings Plus
TIMELINE
Referral initiated to COE 2/17
LOC assessment completed 2/17
MAT started 2/17
Treatment intake 2/20
MAT follow up appointment 2/21
HBP referral 2/21