The State of Maine is unique in that it was one of very few states that did not implement the Medicaid Expansion provided under the Affordable Care Act, until January 2019, where its implementation was required through the issuance of an Executive Order. A subsequent Executive Order was issued that focused primarily on the Substance Use health crisis, and required a substantial increase in the number of Recovery Coaches trained and active statewide, and increased distribution of Naloxone to emergency responders and other public health organizations. The goal of Maine’s First Responders-Comprehensive Addiction and Recovery Act grant (CARA) will be to partner with law enforcement to embed Substance Use Disorder (SUD) clinicians that can provide Early Intervention and Navigation services through referrals and direct contacts with individuals known to have drug and alcohol addiction. With the CARA funding, Maine hopes to increase Medicaid enrollment of these persons with SUD, and reduce overdoses and substance use related deaths through the provision of these treatment and system navigation services, and alleviate compassion fatigue experienced by emergency responders.
The Office of Substance Abuse and Mental Health (SAMHS) intends to implement this project by contracting with up to six municipalities located in “treatment deserts”, identified previously in Maine’s State Opioid Response application. Municipalities experiencing high per capita rates of non-fatal and fatal overdoses, and limited access to treatment providers, would have the ability to hire a co-located SUD clinician that can:
• facilitate Medicaid enrollment and care system navigation for high-risk community members.
• provide treatment services short-term as they work to find permanent settings for continued community-based treatment and recovery supports.
• prioritize referrals to providers offering integrated care models, where available.
• maintain statistics and records of client contacts.
• educate members of the police department and community about related recovery resources that are locally available.
• establish strong working relationships with community providers.
This opportunity would help Maine to build upon current Federal funding efforts, including: a focus on improved data collection around overdoses and Naloxone administrations in real-time by emergency responders, and the development of a mobile app that provides information on overdose symptom recognition and how to properly administer Naloxone.
ME SAMHS plans to additionally utilize a small portion of the funding to:
-Offer best practice Peer-to-Peer technical assistance to the five chosen agencies by the Portland Police Department’s Substance Use Disorder Liaison.
- An Opioid Response team pilot in the City of Bangor, offering a team-based follow-up to non-fatal overdoses that occur within city limits through partnerships between emergency responders,