Community Renewal Team's Response to SAMHSA 2018 MAT-PDOA RFP
Community Renewal Team, Inc. (CRT), Connecticut's largest and oldest community action agency, seeks to expand access to and the capacity of its Behavioral Health Services (BHS) to provide Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD). CRT-MAT will serve individuals in the Hartford region and will prioritize recently released ex-offenders and individuals involved with the criminal justice system. While only the third largest city in Connecticut, Hartford has the highest rate of opioid-related deaths (24.1 per 100,000) and the greatest number of ex-offenders in the state. Currently, the city does not have a program that focuses on individuals recently released from prison, who are at particularly high risk of overdose. In Year 1 of the grant, 75 eligible clients will be engaged and 50 enrolled in MAT. After that 150 will be engaged and 100 enrolled per year for a three-year total of 375 engaged, 150 enrolled in MAT. Of these individuals, most will be male, 95% will be at or below 200% of the federal poverty level, 60% will be people of color, 60% between the ages of 24 and 54, and 70% will have co-occurring disorder. Goals for CRT-MAT include increasing staff capacity, increasing the number of clients receiving integrated care (MAT plus support and recovery support services, and a decrease in the percent of opioid use at a six-month follow-up. Currently, CRT can provide all MAT services other that the administration of buprenorphine or methadone at its licensed and Joint Commission accredited behavioral health clinics. Present services include use of vivitrol, psychosocial assessments, counseling for mental health, substance use, and co-occurring disorders, medication management, development and updating of treatment plans, case management, instruction on Narcan usage, linkage with internal services such as HIV/Hep C testing, veterans' programs, tobacco cessation, supportive housing, basic needs and financial literacy. Our agency also has developed close collaborations with regional clinics and hospitals, legal service providers, and employment and vocational training programs, among others. Through this grant, we will retain a physician who can already provide buprenorphine, obtain waivers for two other medical providers (a physician and an APRN), and obtain certification for our agency. Our clinical services will be enhanced by the use of numerous evidence-based practices including, but not necessarily limited to Motivational Interviewing, Cognitive Behavioral Therapy ("Thinking for a Change"), Helping Men Recover, Dialectical Behavioral Therapy Treatment, Motivation Enhancement Therapy, Anger Management, and Post-Acute Withdrawal Symptoms Treatment. Further, our clinicians reflect the clients that we serve. Of BHS Division's 26 employees, nearly 70% are Black, Hispanic or Asian and staff includes providers who are fluent in English, Spanish, Korean, Cambodian, Vietnamese, and Akan (a language of Ghana). Many of CRT's BHS staff also has more than a decade working with individuals with histories of incarceration.