2019-06-10 National Governors Association

Regional Workshops on Expanding Access to Medication Assisted Treatment for Justice-Involved Populations

June 10-11 and 13-14, 2019 | Cleveland, Ohio and New Orleans, Louisiana

NGA Solutions: The Center for Best Practices hosted two regional workshops on expanding access to medication assisted treatment for justice-involved populations for nine state teams and provided ongoing technical assistance. By the end of each  workshop, state participants were able to:

  1. Identify stigmas and stereotypes associated with substance use disorders and mental illness
  2. Understand the disease model of addiction, diagnostic criteria for opioid use disorders (OUD) and medication-assisted treatment (MAT)
  3. Understand the benefits of all available forms of MAT in a correctional setting and psychosocial supports in the treatment of opioid use disorders
  4. Identify a treatment model, potential funding and concrete next steps for implementing and/or expanding access to MAT in the state’s correctional system within 12 months
  5. Identify evidence-based practices in coordinating reentry processes for continuity of care regarding MAT services, linkage to healthcare, behavioral healthcare and social support services in communities

 

Midwest Agenda and Southeast Agenda

DAY 1

Welcome and Objectives

The National Governors Association (NGA), the American Correctional Association (ACA) and the Centers for Disease Control and Prevention (CDC) will welcome participants, provide an overview of the workshop and identify objectives for the convening.

  • Speakers:
    • Jeff Locke, Program Director, NGA Homeland Security and Public Safety
    • Elizabeth Gondles, Director, Office of Correctional Health, American Correctional Association
    • Sarah Bacon, Lead Behavioral Scientist, Opioid Overdose Prevention Programs Team, Centers for Disease Control and Prevention

 

State Introductions

State teams will introduce themselves and provide a brief overview of their state’s goals and desired outcomes for expanding access to opioid use disorder treatment in their corrections systems and communities.

  • Speakers:
    • Kirk Williamson, Policy Analyst, NGA Homeland Security and Public Safety

 

The Disease Model of Addiction, Treatment, and Approved Medications

This session will provide a brief overview of the disease model of addiction, diagnostic criteria for substance use disorders, co-occurring mental illness and co-occurring infectious diseases (such as viral hepatitis). This session will also provide an overview on opioid use disorder, the scope of the problem facing the country, treatment approaches, recovery and FDA-approved medications for opioid use disorders.

  • Speakers:
    • Jennifer Clarke, Medical Program Director, Rhode Island Department of Corrections
    • Rosemarie Martin, Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
    • Moderator: Elizabeth Gondles, Director, Office of Correctional Health, American Correctional Association

 

Eliminating Stigmas and Breaking Down Myths

During this session, participants will engage in a discussion on stigma, common myths and misperceptions associated with substance use, mental illness, incarceration and language as a barrier.

  • Speakers:
    • Jeannie Waldridge, Assistant Director of Substance Abuse Programming, Kentucky Department of Corrections
    • Rachel Kowalski, Lieutenant, Rhode Island Department of Corrections
    • Susan Tucker, Psychologist/Warden Care & Treatment, Louisiana Department of Corrections
    • Moderator: Sandra Wilkniss, Program Director, NGA Health

 

Health Services Delivery in a Correctional Setting and Continuity of Care

This session will highlight the delivery of healthcare services that includes medical, dental, substance use disorder, mental health, nursing, pharmaceutical services, personal hygiene, dietary and community services that addresses the physical and mental well-being of incarcerated individuals. The session will also discuss the importance of providing evidence-based treatment and maintaining continuity of care in the delivery of healthcare services in a correctional setting from the time an individual enters the correctional setting through their release back into the community.

  • Speakers:
    • Kenneth Williams, Chief Medical Officer, Tennessee Department of Correction
    • Lara Strick, Infectious Disease Physician and Corrections Program Director, Washington State Department of Corrections
    • Moderator: Michael Miskell, Senior Correctional Health Specialist, American Correctional Association

 

Working Lunch: Key Components of MAT Within Corrections

During this session the presenters will discuss core components of increasing access to MAT in correctional settings. By initiating the reentry process at post-sentencing, correctional staff can gather the full spectrum of factors contributing to an individual’s opioid use or substance use disorder during the screening and intake process. Once an individual has met the treatment criteria, protocols must be in place to initiate or continue MAT within the walls throughout post-release supervision. NGA and ACA will provide an overview of the findings from the correctional survey and state team questionnaire, highlighting approaches to treating substance use disorder for justice-involved populations across the states.

  • Speakers:
    • Jennifer Clarke, Medical Program Director, Rhode Island Department of Corrections
    • Annie Ramniceanu, Addictions and Mental Health Systems Director, Vermont Department of Corrections
    • Discussant: Elise Simonsen, Policy Analyst, NGA Homeland Security and Public Safety
    • Moderator: Elizabeth Gondles, Director, Office of Correctional Healthcare, American Correctional Association

 

Care Coordination from Reentry to Community: Delivery and Payment Strategies

The session will provide an overview of delivery and payment strategies underpinning effective coordination with community services upon reentry. This includes cross-sector collaboration among Medicaid, state substance abuse and mental health authorities and community providers to build capacity. State officials from Kentucky and Virginia will share lessons learned and best practice models for people reentering into the community. Examples will focus on working with Medicaid (including managed care organizations) to conduct “in-reach” into prisons, enrollment during the reentry planning process, and the use of application assistance.

  • Speakers:
  • Kristin Harrod, Director of Reentry Services, Kentucky Department of Corrections
  • Chethan Bachireddy, Chief Clinical Innovation Officer and Acting Chief Medical Officer, Virginia Department of Medical Assistance Services
  • Moderator: Sandra Wilkniss, Program Director, NGA Health

 

State Team Time

State teams will reflect on the morning’s discussions, review pre-work assignments, and begin drafting their action plans for implementing or expanding MAT.

 

DAY 2

Breakfast with the Experts

Participants will have an opportunity to meet and talk with experts on a variety of key issues associated with implementing successful MAT programs. Tables will be divided into various topics, and participants are encouraged to mix and continue discussions over breakfast.

 

From Incarceration to Community: Planning and Implementing Reentry

The days and weeks following reentry into the community are a time of increased vulnerability for those with substance use disorders. This session will discuss the key elements of successful reentry planning and the importance of preparing for reentry from the start of incarceration. The discussion will highlight approaches for coordinating care with community supports across corrections, community systems, and the larger justice systems.

  • Speakers:
    • Chris Holland, Deputy Secretary, North Carolina Department of Public Safety
    • Jae K. Davenport, Deputy Secretary of Public Safety & Homeland Security, Virginia
    • Melissa Gallardo, Manager, Colorado Department of Corrections/Adult Parole
    • Moderator: Kalyn Hill, Senior Policy Analyst, NGA Homeland Security and Public Safety

 

State Team Time

State teams will continue to work on their action plans.

 

State Team Report Out and Next Steps

A representative from each state team will briefly report out on their goals and next steps for work in their state. Participants will discuss strategies and challenges to implementation. NGA will review next steps for continued learning and collaboration.

  • Speakers: Jeff Locke, Program Director, NGA Homeland Security and Public Safety
  • Sandra Wilkniss, Program Director, NGA Health