WHOLE: West Side Holistic Opioid recovery and Low-barrier Mobile Engagement - WHOLE: West Side Holistic Opioid recovery and Low-barrier Mobile Engagement is a proposal from the University of Illinois Chicago (UIC) Community Outreach Intervention Projects (COIP) to develop an integrated health home for individuals with opioid use disorder (OUD) on Chicago's West Side. The project will provide access to all three FDA-approved medications for OUD (MOUD) through both a brick-and-mortar clinical site and linked mobile unit, co-located with primary medical care, behavioral health care, and wraparound services, empowering patients throughout their recovery journey from initial engagement into sustained treatment and recovery, reaching communities with the highest overdose rates in Illinois. Population and Need. WHOLE will serve individuals with OUD, and those with any mental illness (AMI), including serious mental illness (SMI), or other substance use disorders (SUD). The geographic catchment area is Chicago's West Side, including the Austin, West Garfield Park, East Garfield Park, North Lawndale, and Humboldt Park neighborhoods, which are disproportionately burdened by OUD and co-occurring disorders. Despite this burden, residents face a persistent shortage of SUD treatment and mental health providers. This access gap results in some of the city's highest rates of opioid overdoses and opioid-related mortality. Goal and Approach. WHOLE's primary goal is to establish an integrated health home for people who use drugs and people with mental illness, delivering access to all three FDA-approved forms of MOUD through both brick-and-mortar and mobile medical unit outreach. Over five years of funding, WHOLE aims to serve at least 1,000 unduplicated patients for SUD, AMI/SMI, and recovery support. Patient-centered care will be delivered by a multidisciplinary team consisting of physicians, pharmacists, mental health professionals, peer recovery support specialists, and social workers. The COIP West Side Field Station will serve as the brick-and-mortar hub for these holistic services. WHOLE proposes implementation of a co-located Opioid Treatment Program (OTP) linked to a mobile OTP unit that extends MOUD access in the catchment area. This design builds on an established partnership between Family Guidance Centers, Inc. (FGC), Mile Square Health Center (MSHC), and COIP, which together contribute methadone treatment, behavioral health, and mobile outreach expertise, respectively. FGC and MSHC have successfully demonstrated the feasibility of integrating an OTP within primary care at Mile Square's main location; WHOLE translates that model into COIP's walk-in, same-day access framework to reach patients who face barriers to traditional care settings. Services. Patients will have access to all three FDA-approved MOUD formulations, medical and psychiatric care, counseling for SUD and co-occurring disorders, and infectious disease screening and treatment. COIP's outreach and peer recovery support will drive engagement and screening using validated tools for OUD, SUD, AMI/SMI, and infectious diseases. Measurable Objectives. WHOLE objectives include: 1) Improve MOUD access by enrolling approximately 200 unduplicated patients annually; 2) Reduce the time from initial patient contact to MOUD initiation, aiming to initiate MOUD within 24 hours for at least 75% of individuals engaged by WHOLE; 3) Improve retention in MOUD treatment, with an objective of achieving 50% retention at 6 months; 4) Improve screening for co-occurring AMI/SMI and other SUD among individuals with OUD through screening at least 90% of WHOLE patients annually using a validated tool; 5) Increase engagement with clinically appropriate counseling, pharmacotherapy or psychosocial support for individuals who screen positive for co-occurring AMI and SMI to 40% and 50% respectively; and 6) Reduce opioid-related overdose events among enrolled patients from baseline.
