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Clinics Working Collaboratively to Treat OUD Patients
By Jan Schnellman, Med, TTS Alaska, Oregon, Washington
Photo: Fairbanks, Alaska. By FairbanksMike [CC BY 2.0 (https://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Alaska's Division of Behavioral Health contacted STR-TA asking for assistance creating a strategic plan to
increase client enrollment services at two nonprofit clinics who are treating patients for opioid use
disorder. The two non-profit clinics, Fairbanks Native Association (FNA) and Interior AIDS
Association/Interior Medically Assisted Treatment (IAA), found themselves competing with a new for
profit treatment facility. The concern for providers was that the private clinic only offered patients one
option for treatment: buprenorphine. While for many that is the best approach, they wanted to be able
to provide methadone as well as buprenorphine.
While FNA and IAA technically compete with one another, they agreed to work collaboratively on this
project. The clinics have a slightly different focus as FNA is an opioid treatment program providing
behavioral health and other non-pharmacologic treatment. IAA is an Office Based Opioid Treatment
center (OBOT) prescribing buprenorphine and methadone with ongoing counseling. Each of these
organizations proposed to work collaboratively to treat persons with opioid use disorder. Fairbanks
Memorial Hospital's emergency department is working with these two organizations as well.
The grantees indicated that they would find most helpful:
- A strategic plan to increase client enrollment in services and decrease enrollment in the commercial option.
- Integration of evidence-based practices so that MAT providers include behavioral health and psycho-social supports in treatment plan
- Collaboration/cooperation between grantees and community providers
- Social marketing plan to inform consumers of availability of services and reduce stigma
associated with enrolling in services
Ultimately, a system of care to integrate MAT into primary care practices will be implemented and
sustained in Fairbanks that promotes safe evidence-based prescribing and expands recovery-oriented
systems of care in Alaska. The overall goal is increased enrollment in services and collaboration among
service entities (FNA, IAA and Fairbanks Memorial ED).
- The STR-TA consultant worked with Kathryn Chapman, LCSW, MAC; Health Program Manager
IV/State Opioid Treatment Authority, Division of Behavioral Health to conduct a comprehensive
- Initial visits made by the TTS to Fairbanks Native Association, Interior Aids Association/Interior
Medical Assisted Treatment organizations in Fairbanks
- Engaged the services of STR-TA prescriber consultant, Dr. Sarah Spencer in Anchor Point, AK to
assist in the effort.
- Consultation with STR-TA Implementation consultant, Dr. Aimee Campbell via email and phone
to develop the Action Plan following the Exploration, Preparation, Implementation and
Sustainment (EPIS) Model.
- First meeting of coalition on 9/12/18. Participating were representatives from FNA, IMA,
Requester, Consultants and local ER physician, Dr. Mark Simon. The stated aim was to explore
possibilities for collaboration across programs, to include other Fairbanks stakeholders.
Presentation on various service delivery models was made to include Hub and Spoke, Nurse
Care Manager, OTP/OBOT Collaborative Care and hospital emergency department or inpatient
initiation of MAT with follow-up in the community.
- Provided an 8-hour MAT waiver training for 6 participants.
- An additional TA request was made to include Recovery consultants to focus on the needs of
patients and to integrate with prescribers
Our plans are to meet again in Fairbanks in the near future to gain external and internal support
from all and to develop a plan to integrate a collaborative model into the Fairbanks systems.