Improving care for patients with substance use disorders
Sponsored by California Academy of Family Physicians and CAFP Foundation
The overall goal of this project is to improve education, outreach and treatment for patients with substance use disorder disease, including stimulants and opioids, with a focus on medication assisted treatment options. Our goal is to enhance training for primary care and emergency medicine physicians while encouraging creative and innovative approaches to meet program and community needs. Projects will identify methods to improve or advance the standard of care for patients, demonstrate how best to implement those methods, and evaluate the outcomes of these efforts.
Our programs’ projects will:
Our expectation is that program have an identified need(s), a methodology to both implement the action plan and measure the project’s impact, and a timeline for spread and plan for sustainability. Collaboration and communication with other stakeholders, including community members, are also encouraged and should be outlined in the proposal.
Our 16 residency programs will work for one a little over a year on their projects and during that year also work as a collaborative – meeting to share resources, wins, challenges and results. They will participate in face-to-face meetings, webinars and check-in calls, and will present a final report in June 2022.
CAFP and the CAFP Foundation are very pleased to announce this year’s residency programs that will participate in our Collaborative. Congratulations to our 2021-2022 Grantees!
DHCS Alert (5.27.21): Closure of 29 Lags Pain Clinics
On May 25, 2021, DHCS learned that Lags Medical Centers voluntarily closed 29 California locations this month, even though DHCS only suspended seven National Provider Identifier numbers associated with up to 17 locations, potentially impacting about 20,000 beneficiaries access to pain management care. Read More
New Requirements for Buprenorphine X-Waiver (as of April 28, 2021) US Department of Health and Human Services (HHS) has released new practice guidelines for treatment of opioid use disorder. HHS has officially removed the X-waiver training requirement to treat patients with buprenorphine." Download PDF: xWaiver Training HHS ruling
How do I apply for an X waiver?
Go to the SAMHSA website to apply for the X waiver through the notification of intent (NOI). You will need your state license and DEA registration. When the system asks for Certification Qualification Criteria check “Other” and write in “Practice Guidelines.” (Please note, there have been reports of an error message regarding a form showing completed CME, which will hopefully be fixed. (SAMHSA buprenorphine info center can confirm submission via firstname.lastname@example.org).
How long will it take to get my X waiver once I apply?
SAMHSA will review applications within 45 days of receipt. Once the application is complete and the application is approved, SAMHSA will email an approval letter. The DEA will follow up with an updated DEA license showing X waiver. The whole process can take two months – a good reason to start the process now.
How do I write a prescription using my X waiver?
Once you have received your X waiver, you write a prescription for buprenorphine for opioid use disorder by indicating your X waiver license number on the prescription. The pharmacist will have no indication if the X waiver license was obtained after 8 hours of training or not. You can e-prescribe buprenorphine for opioid use disorder by indicating your X waiver license number in the “notes to pharmacy” section or NADEAN: x-license number section in the EHR.
How does the 30 patient limit work?
The removal of the training requirement allows you to apply for an X waiver for up to 30 patients. The limit of 30 patients applies only to active patients and is not an annual limit. A patient counts for this limit for the duration of the prescription. For example, an ED physician can write 30 one-week prescriptions weekly and up to 120 one-week prescriptions in a month and still be within the 30 patient limit.
Education: Access the Content Here
Treating SUD - Linking with Community Services – This activity is a recording of virtual session offered in March, 2021 through the Primary Care Residency Program Collaborative (PCRPC) around improving Substance Use Disorder (SUD) services and includes a list of additional resources and a robust Q&A section. Treating SUD - Linking with Community Services offers information, tools and resources to clinicians considering the addition of Medication Assisted Treatment (MAT) services for their patients. Hosted at Homeroom: Access the Content Here
Incorporating MAT into Practice – A Community Conversation – This activity is a recording of virtual session offered in March, 2021 through the Primary Care Residency Program Collaborative (PCRPC) around improving Substance Use Disorder (SUD) services and includes a list of additional resources and a robust Q&A section. Incorporating MAT into Practice – A Community Conversation offers learners an opportunity to listen in while more experienced MAT providers provide tips and tricks and discuss lessons learned throughout their career providing MAT services. Hosted at Homeroom: Access the Content Here
MAT waivered Prescriber Support (https://stanford.cloud-cme.com/course/courseoverview?P=0&EID=35466) - This online activity is sponsored by Stanford University School of Medicine and will update members of the healthcare team about different strategies for treating patients with chronic pain and provide strategies to reduce reliance on opioids for pain relief.
AAFP EveryOne Project - The EveryONE Project is an initiative, which is part of the American Academy of Family Physicians’ Center for Diversity and Health Equity, offers education and resources to help you advocate for health equity, promote workforce diversity, and collaborate with other disciplines and organizations to reduce harmful health disparities.
For those providers who wish to treat more than 30 patients after their first year of certification, SAMHSA funds the Providers’ Clinical Support System (PCSS) to provide practitioner training in the evidence-based prevention and treatment of OUD and offers the required trainings needed to apply for buprenorphine waiver notifications. Learn more about practitioner buprenorphine training requirements.
SAMHSA offers tools, training, and technical assistance to practitioners in the fields of mental and substance use disorders. Find information on SAMHSA training and resources. SAMHSA has developed a Buprenorphine Quick Start Guide (PDF | 1.5 MB) and pocket guide (PDF | 231 KB) for all practitioners seeking to prescribe buprenorphine.
Learn more about buprenorphine.
If you have questions, please direct them in writing to Jerri Davis, email@example.com.
|Carol Havens, MD, FAAFP, FASAM, EAP Chair||Family Medicine and Addiction Medicine Chair, CAFP’s Committee on Continuing Professional Development|
|Thomas C. Bent, MD, FAAFP||Family Medicine, CAFP Foundation Board of Trustees|
|Toni Brayer, MD||Internal Medicine, Large systems|
|Condessa Curley, MD, MPH, FAAFP||Family Medicine, Public Health|
|Tipu V. Khan, MD, FAAFP, FASAM||Family Medicine and Addiction Medicine with emphasis in Obstetrics|
|Keith Loring, MD||Emergency Medicine and Addiction Medicine|
|Aimee Moulin, MD||Emergency Medicine and Addiction Medicine|
|Heyman Oo, MD||Pediatrics|
|Michael Potter, MD, FAAFP||Family Medicine, Practice based research|
|Lee Ralph, MD||Family Medicine and Sports Medicine|
|Melanie Thompson, DO||Family Medicine|
|David Tran, MD, MPH||Family Medicine and Palliative-Hospice Medicine|
|Staff and Consultants|
|Jerri L. Davis, CHCP||CAFP VP of Education|
|Pamela Mann, MPH||CAFP Foundation Executive Director|
|Mary Ales, MBA, FACEHP||Mosaica Solutions|
|Shelly Rodrigues, CAE||Mosaica Solutions|
|Pam Kittleson, RPh||IPMA, Director of Quality|
|Debra Levinthal, DPM||IPMA Executive Director|
|Heidi Ness||IPMA Director of Education and Accreditation|
|Cheri Olson, MD||IPMA Medical Director|
This website will be continually updated with information to assist these and other residency programs that strive to make improvements in order to better serve their patients with SUD. Please check back as we post education, tools and resources on this website throughout the collaboration.