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By Jenny Wagner, Intelligencer staff writer December 24, 2016
People rushed to an emergency room after surviving an opioid overdose won't be released from a hospital without an effort to get them into treatment if a new initiative works as planned in Bucks and Montgomery counties.
The warm handoff programs being developed by county agencies and health care organizations will match hospitals with nearby treatment centers, which will provide certified recovery specialists to respond when overdose patients arrive in emergency departments.
Also known as peer specialists, CRSs have dealt with substance use disorders through their own experiences or a loved one’s, and they are trained to help people overcome barriers and access resources and services, including treatment.
“It’s someone who knows what it’s like to walk that road,” said Kay McGowan, deputy administrator of the Office of Drug and Alcohol Programs in Montgomery County.
Recent efforts to distribute the overdose antidote naloxone, also known by the brand name Narcan, have helped to save people’s lives, and warm handoff programs now will offer them treatment afterward, Bucks County Drug and Alcohol Commission Executive Director Diane Rosati explained.
Over the last two years, 191 successful overdose reversals occurred in Bucks because of local police carrying naloxone as part of a statewide program led by the Pennsylvania District Attorneys Association. In Montgomery, 134 successful overdose reversals occurred, according to statistics released this month by the association.
But more saves also have meant more patients arriving in emergency departments after overdoses, said Dr. Lawrence Brilliant, medical director of emergency services at St. Mary Medical Center in Middletown. Several area hospitals have policies and protocols in place for caring for patients with substance use disorders, but Rosati said warm handoffs will help that care and assistance continue after discharge.
“It’s an important next step,” Rosati said. “If someone were to appear in the emergency department having had a heart attack, we would make sure that they had all the testing they needed and the follow-up appointment very soon after … and that’s the expectation.”
The Bucks County Health Improvement Partnership has been facilitating the warm handoff program in the county, bringing together the hospitals and the Bucks County Drug and Alcohol Commission, which contracts with treatment centers that will provide the CRSs. Details are still be finalized, but the program could launch as soon as February, BCHIP Executive Director Eric Stark said.
In Upper Bucks, the program has matched Penn Foundation and Grand View Hospital; in Central Bucks and Lower Bucks the Council of Southeast Pennsylvania and Doylestown Hospital, St. Mary and Aria-Jefferson Health in Falls; and just in Lower Bucks, Gaudenzia and Lower Bucks Hospital in Bristol Township.
Montgomery slowly began launching its warm handoff program matching Pottstown Memorial Medical Center and Creative Health Services this summer, and then Einstein Medical Center Montgomery and Eagleville Hospital this fall. McGowan said the program could be expanded to the rest of the county’s nine hospitals soon after the New Year.
Abington Hospital-Jefferson Health has a crisis team of social workers already in place who respond to the emergency department around-the-clock for patients who have overdosed, are suspected to have a substance use disorder or request a crisis consultation. With the new warm handoff program, the Abington hospital also will have a CRS from Gaudenzia treatment center on site between 9 a.m. and 5 p.m. Monday through Friday, Nancy DeAngelis, director of behavioral health services for Abington-Jefferson Health, said.
Officials in both counties still are working with hospitals to collect data and determine needs such as whether CRSs will respond to hospitals on an on-call basis or be stationed there on certain days or hours, but there won’t be a one-size-fits-all solution, said Jon Rubin, director of the Division of Human Services in Bucks.
In Montgomery County, case management assessors who can help determine the appropriate level of care and services needed also may respond either alone or as a team with CRSs, McGowan said. She did not have specific budget numbers for Montgomery, but noted that state drug and alcohol funds are allocated for the program.
Also using state funds, the 2016-17 budget allocates $160,000 for the Bucks County Drug and Alcohol Commission to contract with treatment providers for the CRSs in the program.
“We’re happy to make this investment in prevention and hopefully avoid the repeat utilization of resources,” Rubin said.
Early results from the program at Pottstown showed it was successful in three cases in which individuals left the emergency room and completed treatment stays, McGowan said, noting that still others declined to meet with peer specialists, or met with them but declined to go to treatment.
Stark said the Independence Blue Cross Foundation is planning to fund a $100,000 study of the outcomes of the warm handoff program in Bucks.
“We’re hoping to measure success in the amount of patients who do talk to the certified recovery specialists and then beyond that, how many of them do go into recovery services and then longer-term,” he said. “We are very excited about the project and we think that it can have a great impact. ... The ultimate goal is to reduce the number of overdose deaths in Bucks County.”
Naloxone is helping save lives and more people are getting into treatment, McGowan said, but that also has meant waiting lists at treatment centers. Officials in Bucks and Montgomery said they have been working with treatment centers on the issue and some have been expanding beds.
Jenny Wagner: 215-949-5718; email firstname.lastname@example.org; Twitter: @ATJWagner
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