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News Roundup: Addressing Addiction Needs in Oregon

The state of Oregon has not been immune to the effects of addiction, including the nationwide opioid crisis. Here is the addiction news making headlines in Oregon.

Oregon Has the Fewest Opioid Overdoses

According to Dr. Jim Shames, medical director for Jackson County, Ore., the state now has the fewest opioid overdoses in the nation. At the same time, however, he points out that there is an increase in heroin and fentanyl overdoses.

Dr. Shames credits several factors with the reduction in opioid overdoses. Oregon has been advocating naloxone training to help limit the effects of overdose. He also notes collaboration among numerous agencies, including the Oregon Health Authority and the Centers for Disease Control, and between lawmakers and healthcare providers.

Oregon’s Medicaid Program Considers Cutting Off Opioids

In the first proposal of its kind, Oregon state officials are considering an end to opioid medication coverage for patients with chronic pain enrolled in Oregon’s Medicaid program. Under this policy, patients enrolled in the state’s Medicaid program who receive opioids for chronic pain would see their doses tapered off to zero over 12 months, starting in 2020. This includes patients who may not show any signs of addiction.

Officials have not disclosed how many individuals would fall under the proposal, but Oregon’s Medicaid covers about 1 million patients. Across the United States, about 10 percent of adults experience chronic pain, defined as having pain every day for the previous three months.

Supporters say this change could help reduce the risk of addiction and overdose. Many patients, however, are already protesting the proposal, arguing that opioids have helped them manage their pain when nothing else worked. Some experts question whether it is really less dangerous for patients to be forced off of opioid use than to depend on them for chronic pain.

Correctional Facility in McMinnville Tries Medication-Assisted Program

Yamhill County Correctional Facility (YCCF) is piloting a medication-assisted treatment (MAT) program designed to help inmates struggling with addiction. YCCF has partnered with the Willamette Valley Comprehensive Treatment Center, a substance abuse facility, to provide these services.

Under the program, MAT and other substance-abuse services are available for any inmate processed through YCCF. Sheriff Tim Svenson and Captain Richard Geist of the YCCF initialized the program earlier this year, and received approval from the Oregon Health Authority.

Under Pilot Program, Portland Library Offers Naloxone Training

Multnomah County Library in Portland this summer launched a pilot program to provide naloxone training to the managers of five libraries. Managers are learning to administer the drug to help reverse the effects of opioid overdose. Under the program, participating locations are able to provide naloxone in spray form.

According to Shawn Cunningham, director of communications and strategic initiative for Multnomah County Library, problems within a community are likely to manifest in public places like libraries. This could make libraries a key location for targeting opioid misuse and getting faster help to individuals who may overdose.

BestNotes is a HIPAA-compliant solution specifically designed for behavioral health and addiction treatment providers. Contact us today to learn more

date:  Aug 21, 2018
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Study Finds U.S. Opioid Use Remains Unchanged

As lawmakers, clinicians, law-enforcement officials, and community leaders seek solutions to the opioid crisis, new research offers discouraging results.

Researchers report in BMJ that opioid use has been largely unchanged in recent years, despite ongoing efforts to reduce the use of opioid pain medications.

Study Population

The study included all commercially insured or Medicare beneficiaries who had medical and pharmacy coverage at any point in 2007 through 2016. The data included 48 million unique beneficiaries, in a wide range of age groups.

For measurement purposes, the researchers translated the milligram of each drug into milligram morphine equivalents (MME). Among their goals, the researchers aimed to determine the average daily opioid dose in MME.

Study Found Disturbing Trends in Opioid Use

Scientists report that opioid prescriptions for commercially insured patients have stayed around 14 percent for the past 10 years. In the same period, the quarterly prescription rate for aged Medicare beneficiaries rose from 11 percent to 14 percent.

Highest use of opioids were among disabled Medicare beneficiaries aged 45-54 years. Of these, 45 percent used prescription opioids from the fourth quarter of 2011 to the fourth quarter of 2013.

Despite the risk of opioid dependency associated with long-term use, most opioids prescribed were for this purpose. Among disabled Medicare beneficiaries, 14 percent of opioid episodes were classified as being for long-term use. This 14 percent accounted for 89 percent of the total opioids dispensed.

During the 10 years included in the study, the average daily observed dose among those disabled Medicare beneficiaries who were prescribed opioids never dropped below 50 MME. While this group is more likely to have significant pain and have an increased tolerance for opioids, it also presents real dangers. At this dose, the chances of overdose are two to four times higher compared to daily doses under 20 MME, the study authors write.

This coincides with reports by the CDC that the United States saw a 30-percent increase in hospital emergency department visits for opioid overdoses from July 2016 through September 2017.

What Can Be Done to Reduce Opioid Overuse

The new study’s researchers point out a need for evidence-based approaches that can make opioid use safer and improve patients’ pain management and abilities to function.

Based on their findings, the study authors suggest that both doctors and patients seriously consider whether long-term opioid use really helps improve the patient’s ability to function and their quality of life. If not, they should consider other treatments that can either supplement or replace the use of opioids.

The CDC supports medication-assisted treatment for patients with opioid use disorder (OUD), and expanded availability of naloxone to counteract overdose. As drugmakers come under fire for their alleged role in the opioid crisis, many companies are working to bring new, non-opioid drugs to market.

Opioids should be prescribed only when benefits outweigh risks, and after considering a patient’s overall needs, drug history, and level of risk. Providers may recommend alternative approaches to help patients experiencing severe pain, such as physical therapy. Providers also should be aware of behavioral health, addiction treatment, and social services that are available to those patients with OUD.

date:  Aug 13, 2018
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What to Expect With CARF Accreditation

Accreditation can help behavioral health and addiction treatment providers demonstrate high industry standards and stand out in the market. Patients and loved ones seeking appropriate providers can use accreditation as a sign of quality to help them make the best decision.

Not all accreditation is the same, however. Most providers have their choice of several accreditation groups. Here is what providers can expect when seeking accreditation by CARF International.

History of CARF International Accreditation

Founded in 1966 and based in Tucson, Ariz., the non-profit CARF International aims to survey and accredit human-service organizations. Besides addiction treatment and behavioral health facilities, CARF also accredits providers related to aging services, child and youth services, and durable medical equipment.

Process of CARF Accreditation

Organizations that intend to seek CARF accreditation should expect the process to require at least 6-9 months of preparation. The first step is to obtain a copy of CARF’s most recent standards manual. These manuals are updated each year.

After obtaining and reviewing the manual, providers should then consult with a designated CARF resource specialist to receive guidance for the accreditation process.

Before CARF conducts a survey of the provider, the applicant should conduct their own self-evaluation of how they meet current CARF standards. They should then submit a survey application to CARF with details about their services and facilities. The provider is then charged a CARF survey fee.

CARF chooses members of its survey team based on their expertise and the applicant’s needs. This survey team examines the applicant, observes its services, interviews patients, and reviews documentation. In addition, the survey team offers consultation to facility staff.

Based on the findings, CARF will issue either 3-year accreditation, 1-year accreditation, provisional accreditation, or no accreditation. CARF usually sends its decision within 6-8 weeks of completing the survey, along with a report and Quality Improvement Plan (QIP).

Within 90 days of receiving the decision, the applicant must then submit a QIP with the actions it will take to improve any areas noted in CARF’s report. If the provider received accreditation, it must also submit a signed Annual Conformance to Quality Report each year.

Once accredited, CARF encourages providers to contact the organization if they need help in maintaining its standards.

Benefits of CARF Accreditation

The primary benefit of CARF accreditation that it helps a facility raise and implement CARF’s high standards. The survey is an ideal way for providers to learn how to improve their services and facilities.

Once accredited, providers are eligible for further benefits. This includes continued education opportunities, such as the CARF Surveyor Continuing Education Conference and Winter Transforming Outcomes Institute.

CARF also provides ongoing communications, including newsletters and other news announcements, and updates to their standards as needed. Earlier this year, CARF hosted an International Standards Advisory Committee (ISAC) to discuss possible updates to technology standards in CARF’s ASPIRE to Excellence framework. At another meeting, an ISAC began work on new standards for Medication Assisted Treatment Programs.

Accreditation can be a lengthy, involved process, but it provides numerous benefits to behavioral health providers, as well as patients and other consumers. To learn more about CARF International accreditation, visit the CARF website.

date:  Aug 06, 2018
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The Benefits of Accreditation for Behavioral Health and Addiction Treatment Providers

Accreditation is an important way that addiction treatment and behavioral health providers can stand out in the market. Several nonprofit groups, such as CARF International, provide accreditation that holds these providers to particular standards.

Providers must be prepared to put time and effort into the accreditation process. Fortunately, they can expect to receive numerous benefits in return. Here are five ways that you can expect accreditation to pay off.

1. Accreditation shows dedication.

Any provider that seeks accreditation must demonstrate commitment to the accrediting organization’s standards. Although there are usually fees involved in accreditation, it is much more than a financial decision. CARF International and other accreditation organizations require members to meet certain criteria and standards. Providers that fail to meet these standards, or allow them to lapse, are at risk of losing accreditation.

By receiving and maintaining accreditation, treatment providers demonstrate that they are serious about the services they provide and willing to meet the required standards.

2. Accreditation helps consumer choices.

Consumers have access to vast amounts of information about different addiction treatment or behavioral health providers. Unfortunately, so many choices can backfire by becoming overwhelming, and many consumers may not know what to look for.

In such cases, accreditation serves as a “stamp of approval” that can point patients and loved ones to the right provider. Instead of combing through different options and confusing data, consumers can look for accreditation from trusted organization to find a provider that meets valuable standards.

3. Providers receive help to improve.

One benefit to accreditation is that the accrediting organization provides the standards that members must follow. Providers do not have to guess blindly. When an addiction treatment or behavioral health provider applies for accreditation, they consent to be audited and surveyed by the accrediting organization.

Upon completing the examination, the organizations usually offer recommendations to the applicants. This third-party audit can help providers improve their practices to help them meet standards.

4. Accredited facilities attract better staff.

Quality job seekers, whether providers or administrative staff, want to work with quality facilities. Just like consumers, potential employees want a provider that aligns with their goals and standards. Behavioral health providers that receive accreditation will stand out not just among patients, but also in the job market.

By adhering to accreditation standards and demonstrating dedication to quality, facilities can attract physicians and other employees that are more likely to match their culture and values.

5. Accreditation earns member benefits.

There is a mutual connection between an accreditation organization and the member facility.

Most accreditation members receive benefits from the accreditation organization, such as access to subject matter experts and continued education and training opportunities. CARF International, for example, provides regular communications to accredited facilities, including newsletters and industry research. Accreditation also can improve a provider’s standing among governing agencies, which may also increase its budget.

Although accreditation may seem like an intimidating process, it can provide a variety of benefits to behavioral health and addiction treatment providers that seek it out. For more information about CARF International accreditation, visit the CARF website.

date:  Jul 24, 2018
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The Move From Paper to EHR: 5 Tips for Your Practice

By 2018, most providers have moved from paper charts to an electronic health record (EHR) system. In many addiction treatment and behavioral health practices, however, the transition is incomplete or remains only in the planning stages.

For those behavioral health and addiction treatment facilities that have not completed the switch, here are five tips for moving to an EHR.

1. Plan as much ahead of time as possible.

Once a practice has decided to move to an EHR and has chosen a vendor, it’s time to create a detailed plan. Details to consider include:
Setting a specific transition period
Deciding what to do with old files, such as hiring a document shredding company
Current workflow and all the ways an EHR may change it
What facility staff will need to learn, or relearn if the workflow significantly changes

2. Make sure all staff members are on board and appropriately trained.

A facility’s decision-makers are not the only ones who should be on board with the new EHR. Any staff member who will interact with the system should support the change.

Explain the decision to both staff and patients. Make sure they understand the purpose of the switch to EHR, what they can to change, and how they will benefit. Provide thorough training for clinicians and administrative staff to help them get used to the new system.

3. Consider moving patient charts to the EHR individually rather than scanning all of them at once.

If your practice intends to remove the charts of absentee or deceased patients, it may be more helpful to move individual charts and weed out data you don’t want to keep.

However, it is up to the individual practice to decide if this is the best approach or not. While it can be helpful for reducing duplicate information and saving time on patients who have been away for many years, many facilities may want to keep even the oldest patient information.

4. Hire temporary, additional staff to help with the transition.

EHRs bring numerous benefits to a practice. The transition itself, however, can be cumbersome and time-consuming. Consider hiring one or two extra staff members on a short-term basis to help with new data entry and organization. This will allow existing team members to continue focusing on patients, billing, and other regular tasks.

5. Be patient and flexible.

Moving to a new EHR can be a difficult process. Give staff members and patients plenty of time to get used to the change. Make workflow adjustments as needed. Stay in communication with the EHR vendor, even after the move is complete. If something was left undone, if there are errors, or you require modifications, an ongoing relationship with the vendor makes it easier to iron out any kinks.

Looking for an EHR system tailored specifically for behavioral health and addiction treatment? BestNotes solutions offer HIPAA compliance and the ability to manage inquiries, admissions, medications, billing, aftercare, and lab results. Contact us to learn more!

date:  Jul 09, 2018
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