The Opioid and Stimulant Implementation Support-Training and Technical Assistance program (OASIS-TTA) at UCLA Integrated Substance Abuse Programs (ISAP) is a state-funded program supported by the Substance Abuse and Mental Health Services Administration (SAMHSA) State Opioid Response SOR 2 Grant to the California Department of Health Care Services (DHCS). It consists of three major Training and Technical assistance projects:
Training content promotes best practices in specialty and primary care settings to enhance the delivery of medications for addiction treatment (MAT) and promote MAT sustainability. Under the expanded OASIS-TTA program, content will address stimulants (methamphetamine and cocaine) and fentanyl and include an emphasis to improve care for vulnerable priority populations (including but not limited to youth, American Indian/Alaska Native populations, and persons experiencing homelessness).
The OASIS-TTA program incorporates multiple targeted implementation support activities:
With support from SAMHSA, the Alcott Center's Bridge to Recovery program is providing comprehensive mental health, substance use, and support services for justice-involved clients in Los Angeles County. UCLA-ISAP is providing the Alcott Center with evaluation and technical assistance services to support the Bridge to Recovery program.
Project Contact: Howard Padwa, Ph.D., hpadwa@mednet.ucla.edu
As part of the MAT Expansion Project funded through SAMHSA State Targeted and State Opioid Response grants, the CA Dept of Health Care Services is implementing the California Hub & Spoke System (CA H&SS). The CA H&SS aims to combat the opioid crisis in California through a collaborative effort of relevant stakeholders and increase access to MAT services throughout the state, particularly in counties with the highest overdose rates. The project design is an adaptation of the successful model used in Vermont, called the Hub and Spoke Model. The CA H&SS consists of narcotic treatment programs which are referred to as "Hubs" and serve as experts in treating OUD as well as office-based treatment settings which are referred to as "Spokes" and provide ongoing care and maintenance treatment. The CA H&SS is composed of 18 Hub and Spoke networks and over 200 Spoke locations. CA H&SS is actively increasing the availability of MAT for patients with OUD by increasing the total number of physicians, physician assistants and nurse practitioners prescribing buprenorphine, while working to develop a sustainable system of care using evidence based practices for patients with opioid use disorders.
UCLA ISAP is contracted to provide statewide implementation support through regionalized Learning Collaboratives and ongoing training and mentorship opportunities. Visit UCLA's California Hub & Spoke System project page to learn more, participate in upcoming learning opportunities, including monthly MAT ECHO clinics, access resources, and request free technical assistance.
Project Website: http://www.uclaisap.org/ca-hubandspoke/
Project Contact: Christian Frable: Cfrable@mednet.ucla.edu
As part of the MAT Expansion efforts combating the opioid crisis across the state of California, UCLA ISAP launched a statewide training initiative to provide customized technical assistance specifically to support and expand the impact of waivered prescribers to treat patients struggling with opioid use disorder. The objective of the MAT Waivered Prescriber Support Initiative is to identify the barriers to prescribing buprenorphine and provide the targeted mentorship, training, and technical assistance to address those barriers. Prescribers will connect with experienced buprenorphine providers throughout California to access direct consultation. Services offered may include direct mentorship by phone or video, on-site or off-site TA (e.g., program/provider visits, prescriber shadowing), and in-person or virtual training activities related to treating patients with OUD. UCLA conducted a statewide survey to assess treatment needs of waivered prescribers which served as the basis of the training/technical assistance plans.
Monthly WPSI webinars occur on the 2nd Tuesdays of each month 12-1PM (PT). Visit the WPSI project page to request free direct technical assistance, find self-paced and upcoming learning opportunities offering CE/CME continuing education credits, and more.
Project Website: http://uclaisap.org/MATPrescriberSupport/
Project Contact: Christian Frable: Cfrable@mednet.ucla.edu
As part of the state's effort to improve MAT access for tribal communities, a Tribal MAT ECHO Clinic launched in January 2019. Using the Project Extension for Community Healthcare Outcomes (ECHO) model, distance-based learning method that links specialists at an academic medical center with primary care clinicians in local communities, UCLA is implementing the Tribal MAT ECHO Project to support health providers in Indian Country to deliver MAT. UCLA is offering a monthly 1-hour virtual Tribal MAT ECHO clinics, which begin with a didactic presentation on a topic relevant to MAT care delivery and predominantly feature a de-identified case presentation and facilitated discussion. To inform this work, UCLA performed a needs assessment to determine the specific MAT technical assistance needs of Urban Indian and tribal health providers. CEs and CMEs available for certified and licensed participants.
Tribal MAT ECHO Clinic clinics occur every 3rd Tuesday of each month from 12-1PM (PT). Visit the project website to attend clinics, request a case to be reviewed, and access materials from all MAT ECHO clinics.
Project Website: http://www.uclaisap.org/ca-hubandspoke/html/training-activities.html#tribalEcho
Project Contact: Christian Frable: Cfrable@mednet.ucla.edu
In response to the nation's opioid crisis, SAMHSA awarded a two-year grant to provide technical assistance (TA) to states and territories to the American Academy of Addiction Psychiatry (AAAP) with a coalition of 27 national professional organizations, forming the Opioid Response Network (ORN). These TA activities are designed to enhance efforts already underway throughout the United States and territories. ORN provides training and technical assistance via local experts across the country, focusing on applying evidence-based practices in prevention, treatment and recovery to meet locally identified needs.
Each TA team assigned to every state and territory has a prevention, treatment (physician with two years' experience treating opioid use disorders with medications), and recovery consultant. These consultants have been identified and vetted by ORN. All consultants provide evidence-based practices and resources as defined by the consortium. The goal of ORN is to streamline efforts to fill all gaps where needed and as defined by states. UCLA ISAP oversees ORN TA requests covering SAMHSA Region 9 (Arizona, California, Hawaii, Guam, Nevada, New Mexico, American Samoa, CNMI, FSM, Marshall Islands, Palau).
Project Website: https://opioidresponsenetwork.org/
Project Contacts:
California's Narcotic Treatment Programs (NTPs) are ideally positioned to continue their pivotal role in expanding access to the full array of medications available to treat opioid use disorder. Through expanded and enhanced collaboration with community clinics, outpatient treatment programs, corrections departments, hospitals, and primary care providers, NTPs can continue to move California closer to its goal of dramatically increasing the availability of all opioid use disorder treatment medications throughout the state.
The NTP REACH project is designed to support NTPs in this endeavor by providing $1.5 million in subgrant funds for up to a dozen subgrantees. This funding will be awarded for the purposes of:
Advocates for Human Potential, Inc. (AHP) in partnership with UCLA-ISAP is funded by DHCS to implement NTP REACH in FY 2019-20 to achieve these goals.
Project Website: http://uclaisap.org/ntpreach/
Project Contact: Elizabeth Teshome eteshome@mednet.ucla.edu
With support from SAMHSA's Center for Substance Abuse Treatment, Skid Row Housing Trust is implementing its Peer-Supported Pathways to Care (PSPC) program. PSPC is developing an integrated care model using peer specialists with lived experience with homelessness to enhance its permanent supportive housing program for individuals with substance use disorders or co-occurring substance use and mental health disorders. UCLA-ISAP is providing Skid Row Housing Trust with evaluation and technical assistance services to support PSPC project implementation and quality improvement activities.
Project Contact: Howard Padwa, Ph.D., hpadwa@mednet.ucla.edu
With support from SAMHSA's Center for Substance Abuse Prevention, Sunrise Community Counseling Center's Projecto Creer/Project Believe is offering substance use, HIV, and hepatitis prevention services to improve behavioral health and clinical outcomes for racial/ethnic minority young men who have sex with men (YMSM) in Los Angeles. Through a blend of clinical and peer supports, PC/PB is designed to improve community capacity to deliver effective prevention services for YMSM in Los Angeles' most underserved communities. UCLA-ISAP is providing Sunrise Community Counseling Center with evaluation and technical assistance services to support the implementation of PC/PB.
Project Contact: Howard Padwa, Ph.D., hpadwa@mednet.ucla.edu
With support from SAMHSA's Center for Substance Abuse Treatment, St. Joseph Center is integrating substance use disorder treatment with a Housing First model of care to improve clinical outcomes and housing stability for individuals who are experiencing homelessness or are at risk for homelessness in Los Angeles County. UCLA-ISAP is providing St. Joseph Center with evaluation and technical assistance services to support the implementation of PRIME and facilitate ongoing quality improvement activities.
Project Contact: Howard Padwa, Ph.D., hpadwa@mednet.ucla.edu
On November 8, 2016, California voters approved Proposition 64, which legalized non-medicinal adult use of cannabis. UCLA-ISAP has received a contract from the California Department of Cannabis Control (DCC) to monitor the impacts that Proposition 64 has on rates of cannabis use, problematic use, cannabis use disorder, cannabis use disorder treatment, and other health-related outcomes of legalization. The purpose of evaluation activities is to generate data-driven, evidence-based recommendations for steps that the DCC, policymakers, healthcare systems, and other stakeholders can take to safeguard and promote the health and wellness of Californians in the age of cannabis legalization.
Project Contact: Howard Padwa, Ph.D., hpadwa@mednet.ucla.edu
As part of the MAT Expansion Project funded through SAMHSA State Targeted and State Opioid Response grants, the CA Dept of Health Care Services is implementing the California Hub & Spoke System (CA H&SS). The CA H&SS aims to combat the opioid crisis in California through a collaborative effort of relevant stakeholders and increase access to MAT services throughout the state, particularly in counties with the highest overdose rates. The project design is an adaptation of the successful model used in Vermont, called the Hub and Spoke Model. The CA H&SS consists of narcotic treatment programs which are referred to as "Hubs" and serve as experts in treating OUD as well as office-based treatment settings which are referred to as "Spokes" and provide ongoing care and maintenance treatment. The CA H&SS is composed of 18 Hub and Spoke networks and over 200 Spoke locations. CA H&SS is actively increasing the availability of MAT for patients with OUD by increasing the total number of physicians, physician assistants and nurse practitioners prescribing buprenorphine, while working to develop a sustainable system of care using evidence based practices for patients with opioid use disorders.
UCLA ISAP is contracted to provide evaluation services for the MAT Expansion Project including the CA H&SS. Visit UCLA's California Hub & Spoke System project page to find Evaluation Reports and other resources.
Project Website/Reports: http://www.uclaisap.org/ca-hubandspoke/html/reports.html#evaluationRpts
Project Contact: Kendall Darfler, MS: kdarfler@mednet.ucla.edu
The California Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver is a 5-year demonstration project designed to establish how organized substance use disorder care can increase the success of Drug Medi-Cal beneficiaries.
The waiver amendment was submitted by the Department of Health Care Services (DHCS) to the Centers for Medicare & Medicaid Services (CMS) in November 2014 and approved in August 2015. With implementation scheduled through 2020, the DMC-ODS waiver is anticipated to expand services available to Drug Medi-Cal beneficiaries, enhance care coordination, and support the development of an organized system of care for substance use disorders in participating California counties.
UCLA is contracted to assess the DMC-ODS waiver's success through various evaluation activities. Results and recommendations are then summarized and documented in reports and presentations. In addition, find information about the Treatment Perceptions Survey and the Brief Questionnaire for Initial Placement (BQuIP).
Project Website/Reports: http://www.uclaisap.org/dmc-ods-eval/
Project Contact: Valerie Antonini, MPH vpearce@mednet.ucla.edu
Policymakers in California have long been aware of the pressing need to expand and modernize SUD services for young people, and have concluded that increased services and regulatory reforms are sorely needed. Recent policy developments such as the Drug Medi-Cal Organized Delivery System (DMC-ODS) Demonstration Waiver and the Adult Use of Marijuana Act of 2016 (Proposition 64, which will generate funding for youth services) have created the potential for new services and resources. To help California seize these opportunities, the California Community Foundation (CCF) established a youth-first initiative focused on substance use, with an emphasis on underserved and high-risk communities in Los Angeles County (LAC). As part of this initiative, researchers from UCLA-ISAP and Azusa Pacific University are partnering with CCF to help develop a vision for a youth-centered system of SUD care in LAC. Through structured group exercises, group discussions, and interviews with LAC youth SUD providers, key stakeholders, and youth themselves, UCLA-ISAP and APU is creating a youth-centered vision that will be used to inform public education, system planning, and advocacy efforts in LAC and across California.
Project Contact: Sherry Larkins, Ph.D. slarkins@mednet.ucla.edu
Homelessness is a growing social and public health crisis in the United States, and on average, people experiencing homelessness (PEH) die 12 years sooner than the general U.S. population. Homelessness presents many logistical obstacles that make researching health and healthcare for PEH particularly difficult. To properly account for these factors, researchers need to partner with the ultimate experts on homelessness---PEH themselves—when conceptualizing and implementing research studies. Project RESPECT is bringing together a group of researchers and individuals who have personally experienced homelessness to improve the way that the perspectives of PEH are incorporated into research studies, generate a patient-centered agenda for research on homelessness, and develop guidance for researchers on how to effectively engage PEH in their studies.
Project Contact: Howard Padwa, Ph.D., hpadwa@mednet.ucla.edu
TACUNA is a UG3/UH3 research project funded under the National Institutes of Health (NIH) Helping to End Addition Long-term (HEAL) Initiative through the National Institutes on Drug Abuse (NIDA). Dr. Daniel Dickerson is co-Principal Investigator with Dr. Elizabeth D'Amico (RAND) on this project that focuses on the development and analysis of TACUNA, an opioid prevention program for urban American Indian/Alaska Native (AI/AN) young adults. The first phase of this project consists focus groups in 3 large urban areas of California in order to finalize the development of TACUNA, a program that combines motivational interviewing and AI/AN traditional practices, while focusing on social network factors. Phase two consists of analyzing the benefits of TACUNA in a randomized controlled trial by comparing AI/AN young adults who receive TACUNA to AI/AN young adults who receive opioid education. This project will also develop and test strategies to facilitate sustainability of TACUNA and will conduct an economic evaluation to quantify programmatic costs and cost-effectiveness of the TACUNA program.
Project Contact: Daniel Dickerson, D.O., M.P.H. ddickerson@mednet.ucla.edu
Dr. Daniel Dickerson is co-Principal Investigator with Drs. Elizabeth D'Amico and Wendy Troxel from RAND on this research project funded by National Institute on Minority Health and Health Disparities (NIMHD). This study examines individual factors (cultural identity, American Indian/Alaska Native (AI/AN) historical loss, discrimination, and mental health), family-level factors (family cohesion and conflict, and racial socialization), and community-level factors (perceived safety, cohesion, sense of community, and socioeconomic disadvantage) that may be associated with heightened risk for sleep disturbances among urban AI/AN adolescents. This project examines proximal (night-to-day) and longitudinal (over two waves) associations among sleep disturbances and cardio metabolic [higher levels of central adiposity, blood pressure, glycosylated hemoglobin (HbA1c) and lower levels of high density lipoprotein cholesterol (HDL-c)] and behavior health risk factors [alcohol and other drug use, tobacco use, caffeine intake, sedentary behavior, and electronic media use]. This project also uses qualitative methods to gain an understanding of the social and cultural context of sleep among urban AI/AN youth.
Project Contact: Daniel Dickerson, D.O., M.P.H. ddickerson@mednet.ucla.edu
UCLA ISAP has had the opportunity to lead and participate in multiple International collaborations and projects conducting research and building capacity. Visit the International Projects webpage to learn more.
Project Website: http://www.uclaisap.org/InternationalProjects/index.html
Project Contact: Sherry Larkins, Ph.D SLarkins@mednet.ucla.edu
(Note: Reports and manuals are Adobe PDF files. Some files are over one megabyte in size. Please be patient during download.)
Staying in Touch: A Fieldwork Manual of Tracking Procedures (Third Edition)
2016-2017 - California's Drug Medi-Cal Organized Delivery System
2015-2016 - California's Drug Medi-Cal Organized Delivery System
2014-2015 - Annual State Evaluation Report to CA’s Dept. of Health Care Services (ETTA contract)
2013-2014 - Annual State Evaluation Report to CA’s Dept. of Health Care Services (ETTA contract)
ISAP was chosen by the State of California to evaluate the implementation and outcomes of Proposition 36, a 2000 law mandating that nonviolent drug possession offenders be given the choice of substance abuse treatment in the community in lieu of incarceration. ISAP reports on the proposition's implementation, costs and cost-savings, and influence on offender behavior are available here.
Methamphetamine Treatment: A Practitioner's Reference 2007
Produced by the California Department of Alcohol and Drug Programs and UCLA ISAP, this free guide is a compilation of information on meth, including its effects, guidelines for assessment, treatment, and recovery, and its impact on special populations.
Treating Addicted Offenders: A Continuum of Effective Practices
The second volume of Treating Addicted Offenders: A Continuum of Effective Practices, edited by Kevin Knight, Ph.D., and ISAP's David Farabee, Ph.D., and published by Civic Research Institute.
