Alaska’s Prescription Drug Monitoring Program (PDMP) is underutilized—only 82 percent of potential prescribers are registered. The Alaska Department of Health and Social Services will use grant funds to assist in assessing the levels of awareness of the PDMP among health-care practitioners; identifying statewide trends in controlled substance prescribing; increasing provider self-awareness of prescribing habits; expanding the data collected by increasing usage of the PDMP; and recommending policy changes to prevent opioid overuse, misuse, abuse, and overdose. The current PDMP program will be enhanced by adding a prescriber report card function to track prescribing habits.
The Alabama Department of Public Health will develop updated training for prescription drug monitoring program (PDMP) users, produce public service announcements to educate the public, integrate the PDMP into electronic health records and pharmacy dispensing software, and analyze the PDMP data.
The Orange County Health Care Agency applied for a Category 1a rural area grant in the amount of $1,200,000. The Orange County Health Care Agency’s Closing the Gaps by Expanding Access for Reentry Clients program will provide (1) a transfer for those leaving Orange County Central Jail to a peer support recovery specialist for transportation and immediate connection to a case coordinator at one of four MAT and substance use disorder (SUD) treatment county clinics, (2) MAT and SUD treatment services by psychiatrists at the four county clinics, and (3) training by addiction specialist(s) for mental health workers and physicians in the county clinics on SUD and best-practices for working with MAT clients. This project serves Orange County, California, with approximately 3.2 million residents. The project includes partnerships between Correctional Health Services (CHS) and is supported by the Orange County Sheriff’s Department. Priority considerations addressed in this application include high rates of overdose deaths and a need to increase accessibility to treatment providers in the City of Santa Ana with areas of 25 percent poverty.
The Connecticut Prescription Monitoring Program (PMP), in partnership with other state agencies, will merge the Office of the Chief Medical Examiner (OCME) and the state forensic laboratory system with the Connecticut Prescription Monitoring and Reporting System (CPMRS) to allow prescribers and pharmacists to identify patients who have died and reduce inappropriate dispensing; create a new module to allow law enforcement users access to both death data and toxicology information within the CPMRS to assist in their investigations; and conduct educational campaigns to introduce these new features and the benefits that would expand the ability of prescribers, pharmacists, and law enforcement to avoid and deter controlled substance misuse or diversion.
The State of Connecticut Department of Consumer Protection, Drug Control Division is upgrading the Connecticut Prescription Monitoring and Reporting System (CPMRS) to the NarxCare Platform, enhancing the administrator portal features to allow prescription monitoring program (PMP) staff members to better assist all user groups, identify and correct problems, and address requests for research data. The division is adding a Mandatory Use Compliance module to produce PMP administrator reports of providers and review histories, and reports for providers of their missed reviews. It is conducting three educational campaigns to introduce the NarxCare platform, new features, and benefits to prescribers, pharmacists, and law enforcement.
The New Castle County Division of Police is proposing to expand Hero Help, a law enforcement led diversion by creating a team (substance abuse clinician, nurse, police officer, case manager, victim advocate) embedded in the patrol division, to respond immediately to 9-1-1 calls for service. Grant funds support a full-time project coordinator, nurse, child victim advocate (respond to overdose where children are impacted) and a licensed clinician. Additionally, to improve analytic capacity, develop a data collection tool to capture near real-time fatal and nonfatal overdoses. University of Delaware, Center for Drug and Health Studies, and Daniel O’Connell will serve as the research partner.Project Profile
The Florida Department of Health will enhance the Florida Prescription Drug Monitoring Program (PDMP) system, known as E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program), by employing an epidemiologist to provide data analysis to inform and guide health-care practitioners and policymakers and expanding existing outreach and education. E-FORCSE will also fund integration of PDMP information into clinical workflow by providing mini-grants to small physician practices and independent pharmacies.
The Palm Beach County Comprehensive Opioid Abuse Program will reduce the number of overdose fatalities and mitigate the impacts on crime victims by supporting a comprehensive, collaborative, county-wide initiative to the opioid epidemic, with a special emphasis on assisting with the provision of transitional/recovery housing options for targeted individuals with a substance use disorder in order to support their recovery process and success in diversion referral programming. Palm Beach County will offer medication-assisted treatment (MAT) in jail along with additional treatment services, including peer support. A reentry specialist will assist with coordinating services when the individual leaves jail. This project will engage Florida Atlantic University as a research partner.Project Profile
Guam’s Department of Public Health and Social Services will enhance and improve data analysis by upgrading to the AWARxE Advanced Prescription Monitoring Program analytics. Guam will also partner with the Commonwealth of the Northern Mariana Islands to increase the capability of public and private pharmacies to report prescription information to the Guam Prescription Drug Monitoring Program (PDMP).
The Idaho Department of Health and Welfare (IDHW) will build a sustainable data infrastructure to ensure timely collection, analysis, and dissemination of opioid data. In addition, an action researcher will establish a suspected drug-induced death mortality review team. The data will be shared with Idaho’s strategic planning workgroup and other stakeholders. To address vulnerable populations, IDHW will work with the Idaho Office of Drug Policy to distribute naloxone in communities across Idaho. To educate prescribers in rural Idaho on substance abuse treatment and safe prescribing, IDHW will work with the University of Idaho to extend its Project ECHO program, an evidence-based, technology-enabled collaborative learning model that builds a clinician’s knowledge and ability to treat complex conditions. To evaluate Idaho’s efforts in educating prescribers on safe prescribing and prescription drug monitoring program (PDMP) utilization, IDHW will contract with a third-party evaluator.
The Idaho State Board of Pharmacy will support the proactive use of the Prescription Drug Monitoring Program (PDMP) by providing practitioners with one-click, in-workflow access to patient information by enhancing Idaho’s Prescription Monitoring Program AWARxE with the NarxCare Enterprise platform and funding implementation fees and Gateway licenses for up to 30 prescribers or dispensers. Idaho will expand the prescriber reports to state-to-state comparison and compare the prescribing habits of a health-care specialty among states. The Board will comply with BJA data sharing requirements by implementing RxCheck.
The Boone County Health Department will use grant funds to integrate behavioral health services into the jail’s detainee health services, including introducing medication-assisted treatment and initiate a Recovery Navigator program to provide comprehensive case management to detainees and opioid-abusing individuals coming into contact with law enforcement and first responders. The grant funds will support a full-time navigator and project coordinator. The Boone County Task Force will provide direct support to include developing a screening and referral process, identify and implement evidence-based services; develop sustainability and implementation plans, and an evaluation plan to track impacts and outcomes.Project Profile
The Illinois Department of Human Services will, in collaboration with the University of Illinois at Chicago, develop a comprehensive training program that will provide academic detailing, automated connection education, and prescription monitoring program (PMP) website usage education. Working with its vendor, Logicoy, Inc., the grantee will help the Illinois PMP connect to 78 hospital, clinic, or pharmacy electronic health record (EHR) systems, thus reducing the access time from minutes to seconds, which is critical during trauma situations. Finally, in collaboration with the Illinois Department of Public Health, the PMP will expand the unsolicited alert system by increasing the types of alerts sent to hospitals and medical providers.
The Circuit Court of LaPorte, Indiana, will develop a family recovery court (FRC) to provide a holistic approach to families of children in need of services (CHINS) with co-occurring substance abuse problems. CHINS cases are filed by the state against parents who are neglecting or abusing their children. Project partners include Choices! Counseling Services, Swanson Center, Department of Child Services, and the Public Defender’s offices. Dr. Roy Fowles from Purdue University Northwest will serve as the researcher.Project Profile
The Kansas Board of Pharmacy, the administrator of the Kansas Prescription Drug Monitoring Program (K-TRACS) will implement a public awareness campaign for K-TRACS; conduct an audit of K-TRACS records and recommend corrective action, remedial measures, and policies; and hire a special investigator to define and develop the criteria to expand the analysis of K-TRACS data by identifying individuals with questionable behaviors, suspicious prescribing patterns, or harmful practices.
Floyd County Fiscal Court applied for Category 1c rural/tribal area grant funding in the amount of $600,000. The Floyd County Family Services Program will (1) increase access to evidence-based treatment and recovery support services for 150 adults and/or families involved with the criminal justice system, (2) improve the health and recovery of 150 adults and/or families impacted by substance use disorders or co-occurring mental illness and substance abuse (including opioid use disorders), (3) reduce the number of overdose fatalities, and (4) improve the safety of children affected by parental drug overdose. This will be accomplished by addressing four allowable uses of funds, including (1) embedding social services (therapist) with law enforcement to rapidly respond to drug overdoses where children are affected; 2) provide naloxone for law enforcement to address opioid overdoses; 3) provide evidence-based treatment, recovery and peer recovery support services for the targeted population; and 4) coordinate with courts to prioritize and expedite treatment and recovery services to individuals at high risk for overdose and family issues stemming from SUD. This project serves Floyd County, Kentucky, with a population of 36,926. The project includes partnerships between the Mountain Comprehensive Care Center as the region’s Community Mental Health Center, Healthcare for the Homeless provider and Rape Crisis Center, Floyd County Family Court, Floyd County District Court, Floyd County Sherriff’s Office, Kentucky State Police, Appalachian Research and Defense Fund of Kentucky, Big Sandy Health Care, and Big Sandy Area Community Action Agency. Priority considerations addressed in this application include a rural community that faces a persistent-poverty and has a Qualified Opportunity Zone and areas with high rates of overdose.
St. Tammany Parish will develop an information system to analyze and track the opioid client population across justice system and health intercepts in order to reduce cases of overdose and increase treatment and recovery service access. Key partners for this project include the 22nd Judicial District Court, the Safe Haven Advisory Board, St. Tammany Parish Hospital, the St. Tammany Parish Sheriff’s Office and Jail, and the District Attorney’s Office.
The New Bedford Police Department (NBPD) will increase its capacity to offer outreach and referral services to individuals who have chosen diversion from prosecution and who have overdosed or been identified as at risk of overdosing. NBPD will (1) hire a full-time project manager to coordinate efforts within the department and with external partners; (2) add two recovery coaches to provide outreach and follow-up post-treatment coaching; (3) implement the Critical Incident Management System (CIMS) to house the necessary data to monitor and evaluate this effort and; (4) complete yearly evaluations to assess the overall effectiveness of the project in achieving its overall goals/objectives and evaluate the processes and implementation by tracking critical measures associated with the implementation of the program model. Kelley Research Associates will serve as the research partner for the proposed project.Project Profile
St. Mary’s County Health Department in Maryland will work with other community agencies to expand the data that are used to support the Opioid Intervention Team. The utilization of Overdose Detection Mapping Application Program (ODMAP), Prescription Drug Monitoring Program (PDMP), and first responder data will be increased. In addition, the agency will increase the multidisciplinary engagements with community organizations and neighboring jurisdictions and increase recovery support services and educational opportunities for prescribers and patients.
The Minneapolis Health Department will partner with the Hennepin Health, Hennepin County Medical Center, Minneapolis Police Department, Minneapolis Fire Department, Emergency Medical Services, and Serve Minnesota to implement both hospital-based and community-based services to connect individuals at risk for overdose and/or survivors of a nonfatal overdose and their families with substance abuse and behavioral health treatment providers and recovery support. The Minneapolis Health Department Research and Evaluation Team will serve as the research partner for the proposed project.Project Profile
Itasca County in Minnesota proposes to embed substance abuse clinicians in local law enforcement agencies to improve their responses to individuals in need of support and treatment; establish an interagency taskforce; and provide specialized training to first responders. First Call for Help of Itasca county will hire a half-time coordinator and 2.5 full-time recovery support specialists (embedded in law enforcement) to expand recovery services. Also, overdose detection mapping application program (ODMAP) will be incorporated.Project Profile
The Minnesota Board of Pharmacy will move to the new prescription monitoring program (PMP) AWARxE platform with the inclusion of the deployment of NarxCare analytics, visualizations, and clinical intervention tools. To educate users about the database and the updated functionalities to ensure continued, accurate use of the system, a Quick Tips Guide—which was an appreciated educational tool in the past—will be created and distributed. Finally, the PMP will expand the system’s report-generation capabilities as used by the PMP administrator and the PMP pharmacist consultant to analyze and identify trends and provide requested data to stakeholders.
The North Carolina Controlled Substances Reporting System improvement program improves the exchange of information and collection of data on controlled substances II-V among states by increasing the number of prescribers regularly using the prescription drug monitoring program; provide a training program for system users based on their identified needs; produce and disseminate educational materials using online resources and cross-sector expertise; and support collaborations among law enforcement, public health officials, and prosecutors by increasing the system’s ability to respond to sector needs.
The Nebraska Department of Health and Human Services Division of Public Health will add provider dashboard enhancements to the Nebraska Prescription Drug Monitoring Program (PDMP) that support clinical decision making. The Division of Public Health will also develop updated training for prescribers, dispensers, and designees on the provider dashboard enhancements and produce updated training videos.
The New Jersey Department of Law and Public Safety will develop clinical alerts and unsolicited reports to alert prescribers of potential doctor/pharmacy shoppers, excessive dosages, and dangerous drug combinations and establish a pharmacy inspection program to audit for prescription drug monitoring program (PDMP) compliance and prompt training and education upon identification of practice deficiencies.
The Nevada State Board of Pharmacy will support the proactive use and enhancement of the Prescription Drug Monitoring Program (PDMP) by (1) enhancing the Nevada PDMP with the addition of NarxCare, a software platform that will improve prescription monitoring program (PMP) reports by allowing for the incorporation of NarxCare analytics, visualizations, clinical intervention tools, and additional public health data sets into Nevada’s PMP AWARxE database; (2) improving the quality and accuracy of PMP data through an extension of the Board of Pharmacy and PMP’s current Audit Project, which looks at the accuracy and completeness of the data in the Nevada PMP; and (3) enhancing the PMP’s ability to provide quality reports of suspected fraudulent or otherwise unlawful or inappropriate prescribing patterns to authorized law enforcement agencies and/or occupational licensing boards for further investigation.
The Reno Police Department, in partnership with the Washoe County Health Department and other community partners, will implement evidence-based practices in the field of tobacco prevention by launching a mass-reach health communication campaign with the goal of changing the social norms surrounding prescribed opioids. This program will also follow up with individuals/families who have experienced a suspected overdose and provide information regarding resources such as how to seek a substance abuse evaluation and/or counseling, medication-assisted treatment (MAT) and other treatment, and where to obtain naloxone. Finally, the program will launch a prescriber education campaign.
The Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County will use grant funds to support a Data Subcommittee of the Heroin and Opioid Task Force (HOTF). The Data Subcommittee will develop an action plan and a blueprint for an integrated data sharing platform to be implemented by the HOTF. Begun Center of Case Western Reserve University will serve as the research partner for the proposed project.
The Ohio Board of Pharmacy will improve overall data quality by developing a prescription drug monitoring program (PDMP) enhancement that requires all users to automatically update their information within the system every six months and correct any missing information; create a treatment location tool for clinicians in the Ohio Automated Rx Reporting System (OARRS) that uses dispensing data from the system and other external sources to locate active prescribers of medication-assisted treatment to treat opioid abuse; continue to review data in the state PDMP; and work with state, federal, and local law enforcement to initiate criminal and/or administrative investigations of health-care providers.
The Oklahoma Bureau of Narcotics will improve the quality and accuracy of prescription monitoring program (PMP) data by hiring an additional compliance and data quality analyst. The PMP will also add standard reports, more data analytics, and prescriber report cards to reduce inaccurate or missing information and provide users with a complete picture.
The Pennsylvania Department of Health will develop a robust prescriber and dispenser-controlled substance report, strengthen the prescription drug monitoring program (PDMP) system by improving data quality and compliance, produce and disseminate Rx Awareness educational material, and connect to the RxCheck hub to support interstate data sharing.
The South Dakota Board of Pharmacy will support the proactive use of the prescription drug monitoring program (PDMP) by providing practitioners with an enhanced patient profile report that will be available via one-click, in-workflow access. Enhancing South Dakota’s prescription monitoring program (PMP) AWARxE with the NarxCare Enterprise platform and facilitating Statewide Gateway Integration will integrate the South Dakota PDMP into all prescriber electronic health record platforms and all pharmacy management systems.
Sevier County will enhance the Sevier County Offender Recovery Program (SCORP), a comprehensive, collaborative effort to identify and refer individuals to treatment and recovery following incarceration. Interventions begin during incarceration; however, the majority of services are provided immediately at release during the probationary period. Funds will be used to hire a peer mentor coordinator, a women’s service liaison, and a probation/life skills coach for incarcerated women enrolled in the program and expand the substance abuse prevention education program to include the families of SCORP participants.Project Profile
The Tennessee Department of Health will improve the state prescription drug monitoring program (PDMP) (known as the Controlled Substances Monitoring Database [CSMD]) by joining the RxCheck hub, exploring the potential for integrating into electronic health records in Tennessee, and incorporating additional risk models and clinical information that can provide enhanced data to sites engaged in electronic health record integration.
The Washington Department of Health will hire a prescription drug monitoring program (PDMP) onboarding coordinator (management analyst) who will perform outreach and education, and provide onboarding assistance to facilities interested in integrating the PDMP query into their electronic health record (EHR) systems. Washington’s Emergency Department Information Exchange (EDIE) is a care management tool that has been largely successful in integrating PDMP data into its reports. By supporting more EHR-PDMP integration, it is expected that more health-care organizations will uptake the technology and fully adopt the Agency Medical Directors Group (AMDG) Interagency Guideline for Prescribing Opioids for Pain. The Prescription Monitoring Program at the Washington State Department of Health will work with stakeholders, other state agencies, and health-care providers to develop metrics and measures to be included in provider feedback reports sent to prescribers to inform them of their own prescribing practices and how their practices relate to other prescribers of similar licensure and specialty.
The Washington State Department of Health (DOH) will engage a competitive solicitation through a Request for Proposal (RFP) process for a vendor-provided Prescription Drug Monitoring Program (PDMP) solution and contract with the winning vendor. Specific breakdown of costs for system enhancement, customization, and implementation will be provided by prospective vendors via the RFP process. To develop a Request for Proposal, Washington PMP will engage in an evaluation project with DOH IT resources to evaluate the needs of the program, enterprise needs of the agency, and options for PMP system replacement. Awarded funds will be used to support the staff and resources in developing the Request for Proposal announcement, including review of program needs and alignment with agency enterprise needs.
The Lac Courte Oreilles Band of Lake Superior Indians (a federally recognized Indian Tribe) applied under Category 1c for grant funding in the amount of $589,959. This project will serve the Ojibwe Indian membership of the Lac Courte Oreilles Tribe (LCO) of rural northern Wisconsin. The population of the Tribe is 7,796, with thousands more familial descendants. The purpose of the project is to provide evidence-based opioid treatment that supports services to tribal individuals in need of transitional or recovery housing with a Bimaadiziwin tribal culture-based peer recovery support services, including medication-assisted treatment and recovery. The project will improve collaboration and partnerships between tribal and community-serving agencies in support of an EBT “wraparound” system of comprehensive Anishinaabe culture-based mental health treatment and recovery that uses the ASAM Criteria to determine the most appropriate level of treatment and care. This project includes important partnerships between the LCO Residential Treatment Center and tribal and county human services agencies, such as: LCO Comprehensive Community Services, LCO Tribal Court, LCO Bizhiki Wellness Center, Social Services Department, Vocational Rehabilitation Program, and the Minimaajisewin Home Program. OJP policy priority areas for Category 1 that are addressed by this project application from the Lac Courte Oreilles Tribe applicant are: applications that address specific challenges that rural communities face, individuals who reside in high-poverty areas (the reservation), and individuals who offer enhancements to public safety in economically distressed communities.
Milwaukee County, with an estimated population of 945,726, through the Milwaukee County Medical Examiner’s Office and in collaboration with the Milwaukee Community Justice Council, the Medical College of Wisconsin, and a variety of public health and public safety partners, sought $1,200,000 in Subcategory 1a grant funding to create a Milwaukee Overdose Public Health and Safety Team (OD-PHAST). This project would expand and further coordinate current efforts to address overdoses, as well as overall substance misuse issues across the county. The OD-PHAST project aims to: (1) expand the delivery and analysis of near real-time data between multiple public health and public safety partners; (2) utilize both aggregate data and insights from case reviews to develop strategies and recommendations for changes to reduce the likelihood of future overdose incidents; (3) increase capacity to deliver timely toxicology findings to public health and safety partners; (4) enrich understanding of fatal overdose risk factors through expanded next-of-kin interviews; and (5) connect families impacted by overdose, particularly children, to services to mitigate the impact of the trauma experienced. Priority considerations addressed in this application include high-poverty areas and Qualified Opportunity Zones.