BOOM!Health South Bronx MAT Program Abstract:
The BOOM!Health Medication-Assisted Treatment Program for Opioid Use Disorders (MAT OUD) will be located at an existing high volume syringe exchange program in the South Bronx and will conduct outreach and accept clients from across NYC. The low-threshold program will serve adults age 18 and older who are anticipated to be 100% diagnosed with OUD, 73% male, 75% Hispanic of any race, 15% non-Hispanic Black, and 10% non-Hispanic White. At least 50% are anticipated to have co-occurring additional substance abuse and/or mental health disorders. The program will serve 160 unduplicated persons in each full year of operation and at least 720 unduplicated persons over the five-year project period.
The program goal is to expand access to effective low-threshold MAT services for unserved or underserved persons with an OUD. The objectives are: 1) reach an on-going caseload of 120 persons receiving MAT services during the second project year; 2) provide 50% of clients with assessment and service linkage for other SUD, co-occurring mental health disorders, and/or other support services (medical, HIV/HCV, housing, employment, education); and 3) achieve a 60% decrease in illicit opioid drug use and prescription opioid misuse at six-month GPRA follow-up.
The program will use evidence-based strategies that include: proactive outreach, low-threshold access to MAT at the site of a syringe exchange program, telehealth, individualized assessment, shared decision-making, Stages of Change to assess client willingness for different program activities, assist clients with support service linkages, integrate mental health and polysubstance use treatment into MAT care, outreach education to reduce stigma against MAT that discourages people from seeking care, mitigate barriers to receiving MAT such as transportation and hours of operation, provide pre-visit planning for patient-centered visits with empathetic communication, measure outcomes and identify specific quality improvement initiatives, and continuously evaluate need for revised policies, workflow procedures, and patient education practices. Retention is the outstanding problem of MAT programs. To address this need, the program will conduct a client satisfaction survey with every client to identify barriers and facilitators to effective care. Survey findings will be reviewed on an on-going basis to support continuous quality improvement and develop a program model that maximizes retention.
The proposed program will be leveraged by and integrated into a wide range of support resources available from BOOM!Health and its parent organization, Argus Community. These include syringe exchange, health insurance enrollment, HIV/HCV services, health care coordination and navigation, services for homeless persons (clothing, showers, laundry, meals, and access to supportive housing), mobile van outreach, staff and client MAT OUD education at substance abuse treatment agencies, evidence-based treatment services for substance abuse and co-occurring mental health disorders, High School Equivalency programs, pre-vocational training, and supported work experience for unemployed adults.
