Monday, April 29, 2024
4/29/2024
The HealthRIGHT 360 (HR360) Homeless Outreach for MAT Expansion (HOME) project will increase access to medication assisted treatment (MAT) for adults with opioid use disorder (OUD) who are homeless in San Francisco (SF), California. Access will be expanded primarily by outreach workers (OWs), who will conduct Screening, Brief Intervention, and Referral to Treatment (SBIRT) in places where people who are homeless are known to spend time. During 2017 the rate of all-opioid overdose death in SF, 7.3 per 100k, was much higher than California’s overall rate of 4.5 per 100k. It is unknown how many of those deaths occurred among homeless single adults (HSA), but that is a population with tremendous overall health vulnerability. Among HSA in SF, 58% live unsheltered. Self-reported health conditions among SF HSA include drug/alcohol abuse (41%), psychiatric or emotional conditions (39%), chronic health problems (31%), PTSD (29%), physical disability (23%), and AIDS/HIV related conditions (11%). However, only 19% had current enrollment in Medicaid, despite their eligibility under California’s participation in Medicaid expansion. When HOME OWs identify adults with OUD or at risk for OUD through screening, they will use motivational interviewing (MI) strategies to support change oriented and treatment seeking attitudes. The OWs will provide information about MAT and treatment opportunities available through the HOME project, and make referrals to treatment. HR360 offers MAT using Suboxone at the primary care clinic in its Integrated Care Center (ICC) in the heart of SF, which is also the site for substance use disorder (SUD) and other behavioral health assessment, intake, and outpatient treatment. Participants with greater assessed needs can access residential SUD treatment after intake at the ICC. The HOME project’s Patient Safety Navigator (PSN) will assist participants in accessing the diverse health care services available through HR360 and will support project retention and engagement. HOME’s goal is to expand OUD treatment for homeless (or at-risk) adults in SF by improving their access to MAT and comprehensive psychosocial services. The five objectives that will demonstrate success are as follows: [1] OWs will conduct screening for OUD and other SUD with at least 960 unduplicated people (240 in year 1, 360 in year 2, 360 in year 3) who are homeless or at risk for homelessness, using SBIRT; [2] HR360’s DATA-waived medical providers will add 320 new patients (80 in year 1, 120 in year 2, 120 in year 3) to their Suboxone panels; [3] All 320 new patients treated by HR360 for OUD will be screened for co-existing mental disorders at or before their second visit, using the PHQ-9, the GAD-7, and the PCL-5. [4] The PSN will ensure that all participants who are not already engaged in comprehensive psychosocial services will be linked to a HR360 SUD treatment program and/or health-clinic-based individual therapy within one month of their first medical appointment; [5] The project will achieve at least an 80% six-month follow-up rate, through innovative use of technology and increasing incentives at data collection points.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
