North Carolina Emergency Department Peer Support Pilot Project

The North Carolina Healthcare Association is pleased to announce The North Carolina Emergency Department Peer Support Program for Improving Response to Opioid Overdose. On May 9, NCHA joined the NC Department of Health and Human Services at Wake Forest Baptist Medical Center to announce the six hospitals receiving grant awards as part of a pilot program to combat the opioid crisis facing our state. The awards are part of a $1.37 million grant, funded through DHHS, that will enable participating NC hospitals to embed certified peer support specialists in their emergency departments to connect patients presenting with opioid overdose to treatment, recovery, and harm reduction supports.

Sites were selected based on applications and include: Carolinas Healthcare System Northeast (part of Atrium Health), Cone Health, Novant Health Presbyterian Medical Center, Southeastern Regional Medical Center, UNC Hospital, and Wake Forest Baptist Medical Center.

See the event news release here

See photos from the event here

Background

Over the past decade, North Carolina has seen a marked rise in opioid overdose emergency related visits. Since 2009, emergency departments across the state have received over 32,000 opioid overdose patients. In 2017 alone, North Carolina had more than 5000 emergency department (ED) visits for overdose and the vast majority of patients presenting in the emergency department were either Medicaid/Medicare (~25%) or Uninsured/Self-Pay (~50%). As such, the ability to coordinate peer support services, partner with the existing framework (Local Management Entities/Managed Care Organizations (LME/MCO) System) and develop a protocol and support structure in the ED is needed. These efforts are expected to reduce future avoidable opioid-related emergency department visits and overdose deaths and engage more patients in treatment. Critical to the treatment of substance use disorders (SUD) are both treatment needs assessment and a whole person approach along a continuum of care that includes prevention, treatment, maintenance, and recovery support. Evidence shows that peers can play a vital role in the continuum.

This program seeks to improve connections to ongoing treatment, recovery, and harm reduction supports for patients presenting to emergency departments with non-fatal opioid overdose. Programs will embed certified peer support specialists to the emergency department to connect patients presenting with opioid overdose to treatment, recovery, and harm reduction supports. Peer support specialists will have been in recovery for three years and be trained in specific recovery strategies and behaviors by local peer organizations or state level Local Management Entities/ Managed Care Organizations.

Eligible hospitals will be based in North Carolina, be a not-for-profit acute care hospital and have an accredited Emergency Department.

Proposals will identify physician, addiction professional, and peer advocate champion

Peer Support Program Requirement

  • Designate a program lead to oversee implementation, completion of deliverables, and to serve as the primary point of contact with NCHA Program Lead
  • Hire a minimum of 2 certified peer support specialists (to act as liaisons between community and ED)
  • Have a Certified in Addiction Medicine Professional available for consult
  • Secure commitment from Hospital Leadership (please include leadership commitment letter)
  • Conduct and record all training and coordination for peer in community w/ discharge 
planning
  • Track and report on relevant metrics determined by NCHA & NC DHHS on patients 
served such as referrals/connections, 30-day readmissions, mortality rates, number of 
ED visits annually, types of peer support services provided and relevant assessments
  • Provide an outline of organizational structure and levels of supervision for certified peer 
support specialists
  • Outline sustainability plan for continuation of the project after funding period
  • Attend 2-day Peer Support Integration Training Seminar
  • Participate in bi-monthly consortium calls
  • Attend program retreat in late 2018
  • Submit monthly budget invoices/reports to ensure fiscal responsibility
  • Confirm that patients are connecting with community assets and track 
connections/referrals

Participating hospitals will participate in routine technical assistance site visits, coaching calls, webinars, and other relevant events with TA Team at NCHA & in partnership with Wake Forest Baptist Medical Center.

Funding awarded through this grant program should be used to establish an ED based Peer Support program at your facility. It is not meant to support the entirety of your programming in peer support efforts, or to supplant current funds. Collaboration with other organizations in your community is expected (as well as within the collaborative program), as is leveraging of existing funds to
optimize programming. Facilities will receive no more than $180,000 from NCHA via a cost for reimbursement grant. All awards will be paid based on monthly invoice of actual expenses.

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