Bay Rivers Telehealth Alliance

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM - MEDICATION ASSISTED TREATMENT ACCESS - APPLICANT: BAY RIVERS TELEHEALTH ALLIANCE | 618 HOSPITAL ROAD, TAPPAHANNOCK, VA 22560 | HTTP://BAYRIVERSTELEHEALTH.ORG/ PROJECT DIRECTOR: DONNA DITTMAN HALE, EXECUTIVE DIRECTOR, TEL. 804-443-6286 | FAX: 804-443-6150 |E-MAIL: DDHALE@COX.NET | GRANT PROGRAM FUNDS REQUESTED: $3MILLION, $1 MILLION PER YEAR. PROJECT TITLE: MAT ACCESS EXPANSION IN RURAL EASTERN VIRGINIA NEEDS TO BE ADDRESSED: THE MIDDLE PENINSULA AND NORTHERN NECK OF VIRGINIA ARE HIGHLY AFFECTED BY SUBSTANCE USE DISORDERS, INCLUDING OPIOID USE DISORDER AND ALCOHOL USE DISORDER. THE NINE COUNTIES OF THE TARGET SERVICE AREA HAVE MEDICATION ASSISTED TREATMENT WAIVERED PROVIDERS SERVING LESS THAN 5% OF THEIR POPULATION AND EXTREMELY LIMITED AVAILABILITY OF TREATMENT PROGRAMS, ESPECIALLY OFFICE-BASED ADDICTION TREATMENT FACILITIES. THERE ARE WAITING LISTS FOR ACCESS TO MEDICATION ASSISTED TREATMENT AT THIS TIME. IN ADDITION, THERE ARE SEVERE WORKFORCE SHORTAGES, ESPECIALLY OF MENTAL HEALTHCARE PROVIDERS AND PRIMARY CARE PHYSICIANS. GRANT FUNDS WILL SUPPORT STAFF, INCLUDING HEALTH NAVIGATORS, A DATA COORDINATOR, PEER RECOVERY SPECIALISTS, MENTAL HEALTH SUBSTANCE ABUSE CLINICIANS, AND ADDITIONAL MEDICAL PERSONNEL CAPACITY, SUCH AS PSYCHIATRIC NURSES AND A TRAVELING NURSE TO PROVIDE IN-PERSON CARE TO SUPPLEMENT EXISTING TELEHEALTH-ENABLED SERVICES. PROPOSED SERVICES: THE PROPOSED SERVICES INCLUDE: 1) ESTABLISHMENT OF TWO NEW MEDICATION ASSISTED TREATMENT ACCESS LOCATIONS ON THE MIDDLE PENINSULA AND NORTHERN NECK WHERE FDA-APPROVED MEDICATIONS WILL BE ADMINISTERED TO TREATMENT OPIOID USE DISORDER AND ALCOHOL USE DISORDER VIA BOTH IN-PERSON AND TELEHEALTH ENABLED MODALITIES; 2) INTEGRATION OF SUPPORTIVE SERVICES TO INCLUDE COUNSELING AND BEHAVIORAL THERAPIES, SUCH AS GROUP AND INDIVIDUAL THERAPY AND AN INTENSIVE OUTPATIENT PROGRAM FOR INDIVIDUALS WITH HIGHER LEVEL NEEDS. EACH INDIVIDUAL SERVED WILL BE ASSIGNED A PEER RECOVERY COACH AND A HEALTHCARE NAVIGATOR TO ASSIST WITH CASE MANAGEMENT NEEDS, COORDINATION OF CARE TO ADDRESS OTHER MEDICAL AND SOCIAL NEEDS, HELP TO ACCESS THIRD PARTY PAYMENT SUCH AS MEDICAID AND OTHER HEALTH INSURANCE, AND SUPPORT TO DEVELOP COMMUNITY AND FAMILY SUPPORT NETWORKS TO SAFEGUARD LONG-TERM RECOVERY; 3) RECRUITMENT, HIRING, SUPPORT, AND RETENTION OF INTERDISCIPLINARY TEAMS OF CLINICAL AND SOCIAL SERVICES PROVIDERS WHO WILL SUPPORT MEDICATION ASSISTED TREATMENT SERVICES AT THE TWO NEW ACCESS POINTS. 4) BUILDING NEW COMMUNITY PARTNERSHIPS AND STRENGTHENING EXISTING COMMUNITY PARTNERSHIPS TO ENSURE THAT THE NEW MEDICATION ASSISTED TREATMENT ACCESS POINTS ARE INTEGRATED WITH THE SURROUNDING COMMUNITY AND PARTNERS, INCLUDING MEDICAL, SOCIAL SERVICES, AND LAW ENFORCEMENT; 5) SUSTAINING THE NEW MEDICATION ASSISTED TREATMENT ACCESS POINTS THROUGH ENSURING ALL ELIGIBLE INDIVIDUALS ARE ENROLLED IN MEDICAID, AS WELL AS EXPLORING CHARITY CARE OPTIONS THROUGH COMMUNITY PARTNERS SUCH THAT TREATMENT SERVICES WILL BE AVAILABLE TO ALL WHO NEED THEM, REGARDLESS OF THEIR ABILITY TO PAY. POPULATION GROUPS TO BE SERVED: THE PROJECT PROPOSES TO SERVE SOCIO-ECONOMICALLY DISADVANTAGED INDIVIDUALS WITH NEEDS FOR MEDICATION ASSISTED TREATMENT FOR OPIOID USE DISORDER, ALCOHOL USE DISORDER, AND OTHER SUBSTANCE USE DISORDERS IN THE FOLLOWING RURAL COUNTIES OF EASTERN VIRGINIA: MIDDLE PENINSULA REGION COUNTIES (5): ESSEX, KING AND QUEEN, KING WILLIAM, MATHEWS, AND MIDDLESEX; NORTHERN NECK REGION COUNTIES (4): LANCASTER, NORTHUMBERLAND, RICHMOND, AND WESTMORELAND. THE POPULATIONS OF THESE COUNTIES ARE DISPROPORTIONATELY DISADVANTAGED AS COMPARED WITH BOTH VIRGINIA AND THE UNITED STATES WITH REGARD TO RACE (LARGE SUB-POPULATIONS OF BLACK AND AFRICAN AMERICAN INDIVIDUALS), DISABILITY (HIGHER PROPORTIONS OF INDIVIDUALS LIVING WITH A DISABILITY), AND SOCIO-ECONOMIC STATUS (LOWER PROPORTIONS OF INDIVIDUALS WITH GREATER THAN A HIGH SCHOOL EDUCATION AND HIGHER PROPORTIONS OF INDIVIDUALS LIVING I

RURAL PUBLIC HEALTH WORKFORCE TRAINING NETWORK PROGRAM - PROJECT TITLE: BAY RIVERS TELEHEALTH ALLIANCE EMERGENCY MEDICAL SERVICES WORKFORCE TRAINING APPLICANT ORGANIZATION NAME, ADDRESS, AND WEBSITE: BAY RIVERS TELEHEALTH ALLIANCE, 618 HOSPITAL ROAD, TAPPAHANNOCK, VIRGINIA 22560 HTTPS://BAYRIVERSTELEHEALTH.ORG APPLICANT ORGANIZATION FACILITY TYPE: NON-PROFIT TELEHEALTH NETWORK PROJECT DIRECTOR NAME, TITLE, AND CONTACT INFORMATION: DONNA DITTMAN HALE, EXECUTIVE DIRECTOR, TEL. 804-443-6286 EMAIL: DDHALE@COX.NET PROPOSED WORKFORCE TRAINING TRACK: TRACK #3 COMMUNITY PARA-MEDICINE TARGET SERVICE AREAS: VIRGINIA COUNTIES OF ACCOMACK, NORTHAMPTON, ESSEX, KING AND QUEEN, KING WILLIAM, MATHEWS, MIDDLESEX, LANCASTER, NORTHUMBERLAND, RICHMOND, AND WESTMORELAND LIST OF PROPOSED NETWORK PARTNER ORGANIZATIONS: EASTERN SHORE COMMUNITY SERVICES BOARD, LEDWITH LEWIS FREE CLINIC, RAPPAHANNOCK COMMUNITY COLLEGE, VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM, WESTMORELAND COUNTY EMERGENCY MEDICAL SERVICES, NORTHAMPTON COUNTY DEPARTMENT OF EMERGENCY MEDICAL SERVICES, ESSEX COUNTY EMERGENCY MEDICAL SERVICES, BAY AGING. TOTAL FUNDING AMOUNT REQUESTED FOR THE ENTIRE THREE-YEAR PERIOD OF PERFORMANCE: $1,545,000.00 CAPACITY TO SERVE RURAL UNDERSERVED POPULATIONS: BRTA BRINGS SIGNIFICANT STRATEGIC PLANNING, NETWORK LEADERSHIP AND MANAGEMENT, AND GRANT RESOURCE DEVELOPMENT SKILLS TO THIS PROJECT, DEVELOPED THROUGHOUT ITS 17 YEARS AS A SUCCESSFUL RURAL TELEHEALTH NETWORK. BRTA HAS AN EXCEPTIONALLY STRONG TRACK RECORD OF CROSS-AGENCY LEADERSHIP, DEVELOPED THROUGH LEADING NUMEROUS MULTI-AGENCY CONSORTIA IN THE DELIVERY OF FEDERAL GRANTS SERVING THE TARGET SERVICE REGION FOR THIS PROPOSED PROJECT. THE NETWORK FOR THIS PROJECT HAS GROWN OUT OF A LONG-STANDING NETWORK OF PARTNERS WHO HAVE A TRACK RECORD OF SUCCESSFUL COLLABORATION IN DELIVERING TELEHEALTH-ENABLED RURAL HEALTHCARE PROJECTS UNDER BRTA’S LEADERSHIP. TOGETHER (IN VARIOUS COMBINATIONS, BUT ALWAYS UNDER THE LEADERSHIP OF BRTA) THESE ORGANIZATIONS HAVE DELIVERED SU CCESSFUL, FEDERALLY GRANT FUNDED RURAL TELEHEALTH AND HEALTHCARE PROJECTS TOTALING OVER $6.3 MILLION OVER THE PAST EIGHT YEARS. EACH PARTICIPANT IN THE NETWORK HAS BEEN SELECTED DUE TO THEIR ABILITY TO CONTRIBUTE TO THE SUCCESS OF THE CURRENT PROJECT’S GOALS AND FOR THEIR ROLE IN CREATING AND MAINTAINING LASTING COLLABORATIVE RELATIONSHIPS TO SERVE THE RURAL TARGET SERVICE AREA FROM THE PERSPECTIVE OF THEIR PARTICULAR SECTOR, INCLUDING HEALTHCARE, EMERGENCY MEDICAL SERVICES PROVISION, EDUCATION, AND OTHER HEALTH AND HUMAN SERVICES. FUNDING PREFERENCE: BRTA IS REQUESTING A FUNDING PREFERENCE BASED ON QUALIFICATION 1. ACCOMACK, NORTHAMPTON, ESSEX, KING AND QUEEN, KING WILLIAM, MATHEWS, MIDDLESEX, LANCASTER, NORTHUMBERLAND, RICHMOND, AND WESTMORELAND COUNTIES ARE IN A DESIGNATED HPSA. SPECIAL CONSIDERATION: BRTA IS REQUESTING SPECIAL CONSIDERATION BASED ON THE INCLUSION OF A SIGNED MOA/U FROM ALL NETWORK PARTNERS INCLUDED IN ATTACHMENT 11.

TELEHEALTH ENABLED ACCESS TO YOUTH SUBSTANCE ABUSE TREATMENT & RECOVERY - BAY RIVERS TELEHEALTH ALLIANCE TELEHEALTH ENABLED ACCESS TO YOUTH SUBSTANCE ABUSE TREATMENT & RECOVERY ABSTRACT BAY RIVERS TELEHEALTH ALLIANCE(BRTA), IN PARTNERSHIP WITH THE MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD(CSB) AND FIVE RURAL SCHOOLS SYSTEMS IN EASTERN VIRGINIA, WILL DELIVER EFFECTIVE AND COORDINATED FAMILY-CENTERED, TELEHEALTH-ENABLED SUBSTANCE ABUSE SERVICES INCLUDING PREVENTION, EARLY INTERVENTION, TREATMENT, AND RECOVERY SUPPORT SERVICES TO ADOLESCENTS AND YOUTH IN TRANSITION WITH OR AT RISK FOR SUBSTANCE USE DISORDER(SUD) AND CO-OCCURRING DISORDERS(COD). BY ENHANCING AND EXPANDING THE SYSTEM OF CARE WITH COMPREHENSIVE EVIDENCE-BASED PRACTICES, BUILDING TELEHEALTH INFRASTRUCTURE LINKING MIDDLE AND HIGH SCHOOLS IN THE REGION WITH INTEGRATED TRAUMA-INFORMED, OUTPATIENT SERVICES, AS WELL AS SUPPORT FOR FAMILIES AND CAREGIVERS, AND CASE MANAGEMENT TO LINK WITH WRAP-AROUND SERVICES TO MEET SOCIAL DETERMINANTS OF HEALTH, THE PROPOSED SYSTEM OF CARE WILL MEET THE COMPLEX NEEDS OF ADOLESCENTS WITH OR AT RISK OF DEVELOPING SUBSTANCE USE DISORDER AND MENTAL ILLNESS, AND THEIR FAMILIES/PRIMARY CAREGIVERS. THE GEOGRAPHIC CATCHMENT AREA FOR SERVICE DELIVERY COMPRISES SIX COUNTIES OF TWO CONTIGUOUS, RURAL REGIONS IN EASTERN VIRGINIA KNOWN AS THE NORTHERN NECK (LANCASTER, NORTHUMBERLAND, RICHMOND, AND WESTMORELAND COUNTIES) AND THE MIDDLE PENINSULA (ESSEX AND MIDDLESEX COUNTIES). EVIDENCE-BASED PRACTICES TO BE USED TO DELIVER SERVICES INCLUDE THE ADOLESCENT COMMUNITY REINFORCEMENT APPROACH (A-CRA), COMMUNITY REINFORCEMENT AND FAMILY TRAINING (CRAFT), SEEKING SAFETY: AN EVIDENCE-BASED MODEL FOR SUBSTANCE ABUSE AND TRAUMA/PTSD, CHANGE COMPANIES CURRICULUM, AND ECOSYSTEMIC STRUCTURAL FAMILY THERAPY (ESFT). BY INITIATING, EXPANDING AND FACILITATING BEHAVIORAL HEALTH SERVICES FOR PREVENTION AND EARLY INTERVENTION IN THE SCHOOLS (GOALS 1 AND 2), IT IS ANTICIPATED THAT MORE YOUTH AND FAMILIES WILL BE IDENTIFIED AND EFFECTIVELY REFERRED FOR THE NEW CAPACITY DEVELOPED FOR SUD TREATMENT AND RECOVERY SUPPORT SERVICES BY THE MPNNCSB (GOAL 3). UTILIZING TELEHEALTH ENABLED SYSTEMS OF CARE TO CONNECT STUDENTS, FAMILIES AND CLINICIANS IN SCHOOL, AT HOME AND IN CLINICAL SETTINGS, WILL INCREASE ACCESS TO CARE BY REDUCING THE BARRIERS MANY FAMILIES FACE IN THIS REGION DUE TO TRAVEL DISTANCES, TIME CONSTRAINTS, LIMITED INCOME AND FAMILY RESPONSIBILITIES. IN ADDITION TO TRAINING STAFF AT THE SCHOOLS AND THE MPNNCSB, THE PROJECT ANTICIPATES SERVING THE FOLLOWING NUMBER OF UNDUPLICATED YOUTH. TOTAL NUMBER OF UNDUPLICATED INDIVIDUALS SERVED BY PROJECT: YEAR 1 – ENDING 8/31/22: 60; YEAR 2 – ENDING 8/31/23: 100; YEAR 3 – ENDING 8/31/24:120; YEAR 4 – ENDING 8/31/25:140; YEAR 5 – ENDING 8/31/26: 160; TOTAL - 580

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

TELEHEALTH NETWORK GRANT PROGRAM

RURAL HEALTH NETWORK DEVELOPMENT PROGRAM

TELEHEALTH NETWORK GRANT PROGRAM

INTEGRATING BEHAVIORAL HEALTH INTO PRIMARY CARE THROUGH TELEHEALTH EVIDENCE-BASED TELEHEALTH NETWORK

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-PSYCHOSTIMULANT SUPPORT

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

TELEHEALTH NETWORK GRANT PROGRAM

DLT OPIOID GRANTS

TELEMEDICINE GRANT

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM