RMOUD-MS (Revolutionizing Medications for Opioid Use Disorder in Mississippi) - The goal of the RMOUD-MS project is to strengthen the continuum of care for opioid use services by expanding and enhancing access to medications for opioid use disorder (MOUD) services for persons with an opioid use disorder (OUD) seeking or receiving MOUD. MS retains the unenviable ranking of having the fourth highest opioid prescription rate in the US. MS has seen significant increases in extremely potent high morphine milligram equivalent prescriptions. Prescription duration (days supply) is also unusually high. Between 2014 and 2017, hospital admissions for opioid poisoning increased by 23.3% and admissions for adverse effects increased by 119.3%. In Mississippi, the total number of drug overdose deaths increased sharply, rising 49%, from 2019 (393) to 2020 (586). During the same period, the number of deaths involving synthetic opioids (e.g., fentanyl) spiked by 125%. The RMOUD-MS project intends to (1) increase the number of individuals with OUD receiving MOUD; and (2) decrease illicit opioid drug use and prescription opioid misuse at six-month follow-up. The objectives for RMOUD-MS have been determined as follows: Objective 1.1. By the end of year 1, foster MOUD-focused infrastructure enhancement at state, local and community levels through the establishment of RMOUD-MS key positions (Project Director and Project Evaluator), Advisory Council, a coordinated care approach, and a MOUD-specific training curriculum; Objective 1.2: Enhance providers MOUD skills and utilization statewide and in-service region, with emphasis on culturally responsive implementation designed to address treatment needs of focal population, by offering a minimum of four (4) MOUD training sessions among providers annually, ultimately reaching a minimum of 50 clients during year 1; Objective 1.3: By the end of year 1, conduct a rigorous evaluation to ensure compliance with all data collection and reporting requirements while fostering catchment region and statewide MOUD-related quality improvements, as indicated by the completion of required data collection tools and dissemination of related reports; Objective 1.4: By the end of quarter 1 of year 1, complete all required grant management activities effectively, as indicated by documented and executed implementation, quality improvement, and sustainability plans; meeting attendance; and partnership agreements. Three interlinked service delivery healthcare channels, self, primary, and specialist, will be implemented as a means of achieving these outcomes. This three-pronged, team-based approach to care will incorporate DOJ COSSAP-funded Peer Support Specialists and Specialty Pharmacist; a RMOUD-MS funded MSDH MOUD Physician and Pharmacy Technician; FR-CARA-funded LCSWs; county health department providers; a board-certified Addiction Specialist; and the Mississippi Public Health Institute to employ a collaborative, coordinated continuum of care based on a framework of evidence-based interventions, stressing the establishment of partnerships between client and service providers, as well as equitable access for the whole population. RMOUD-MS providers will establish and implement a plan to mitigate the risk of diversion of buprenorphine and ensure the appropriate use/dose of medication by clients. SBIRT will be implemented to enhance and expand the continuum of care to populations with significant health disparities due to low socioeconomic status, limited access to care in rural counties, lack of insurance, and limited or no financial resources. The evaluation team will collect and report RMOUD-MS data on all required performance measures using the GPRA Tool.
