it could be facilitating today's webinar today we're going to be introducing the work of a new center known as the University of Rochester's recovery center of excellence the center looks to translate research into real-world ideas that you can implement in your communities to prevent substance misuse today we're going to dig into the unique challenges and opportunities for substance misuse prevention in rural communities how can we make sure that what happens in academic settings what we know about best practices is translated and really makes this way into practice in the communities on the ground before we start today I'm gonna turn it briefly over to Carrie Lemoine who is also at the Education Development Center she's gonna walk us through the technology um for those of you who have not yet used Adobe Connect in the past Carrie thanks Christian welcome everybody the phone lines will be muted for the duration of this webinar if you have any questions or comments throughout the presentation please let us know in the key looks to the left at this green arrow we as Christian said we will be recording the webinar and that's about it thank you all and I'll pass it back to Christian you thanks so much Carrie we are actually going to get started today by jumping first into a poll I think it's helpful to you know a little bit about what you're hoping to accomplish today in order to to really you know kind of best direct our discussion so we're gonna pull up that poll in just one second and you'll see it pop up here on the slide the question is what are you hoping to accomplish on today's webinar and we're actually asking that you choose all that apply so are you hoping to learn more about specific drugs that might disproportionately impact pharrell communities this includes things like methamphetamine offense no heroin are you looking to discuss the unique challenges and opportunities in applying evidence-based practices for opioid misuse prevention in rural communities or did you want to hear more about the goals of the University of Rochester's medicine recovery center of excellence and how your personal community might from the program looks like folks are really particularly interested in really understanding the the intersection between opioid misuse prevention opportunities in rural communities I'm seeing a lot of folks you know with a lot of interest there which is great because we're going to be focusing a lot of our discussion today on that very topic you folks another minute or so with it with the with the poll here and then we will get started all right great thank you so much for for filling out our poll you'll see a couple of these as we go through today's webinar a couple of polls I just focus out the opportunity to really intersect with the with the platform I also want to remind you as Carrie mentioned there's the Q and a pod this is a thought for you to put your questions in so that way we can answer them during some predetermined parts that you know that we've put into insta presentation so please use the Q&A pod for any questions that come up for you and we'll get started with supplies now so again thanks for filling out that poll looks like folks are very interested in that in that second goal there on really you know just figuring out how they can make best practices in prevention solutions kind of work in in rural communities all right so first I want to talk about the objectives of the University of Rochester's Recovery Center of Excellence the Recovery Center is looking to do three interconnected efforts to reduce the harmful effects of substance use disorder particularly opioid use disorders on particularly as they relate to synthetics they want to partner with Appalachian communities in Kentucky New York Ohio in West Virginia so they can best identify adapt and implement evidence-based practices that make sense in the cultures and communities in those areas we want to test emerging best practices in New York southern tier as communities in that region create an ecosystem of recovery we also want to synthesize wisdom by building a storehouse of recored resources and providing technical assistance to rural communities across the United States want to be a space that really packages the best practices that we've formed in the communities that we've and in store those resources and and make sure that we we were able to disseminate them across the country to other places that you know that have rural rural communities that could benefit this is the the team for for the recovery center for excellence they have a you know the deep bench I think of efforts and rural health substance use prevention and evaluation and our speakers today are Gloria Basquiat's and Michelle Lawrence who are the co-principal investigators of the center since 1986 Gloria bass has a specialized in the treatment of addiction in her current role as the medical director of strong recovery in the University of Rochester's department of psychiatry she works in education administration and clinical care she is certified in addiction medicine by the American Board of preventive medicine and is board-certified in psychiatry with added qualifications in addiction psychiatry dr.
Paz Lewis is the co-principal investigator for the University of Rochester's recovery center of excellence Michele Lawrence is also a co-principal investigator for the recovery center of excellence and as an assistant professor of psychiatry and community and preventive medicine she's worked closely with rural Appalachian communities for over 17 years creating financially viable hospitals primary care and behavioral health programs that partner with each other to improve the health of these communities and of all their residents I want to turn it over first you Gloria who's going to update us on the state of the field of prevention Gloria good morning and thank you very much for coming to our webinar today so our hersa grant focuses on preventing deaths and other harmful effects from opioid overdose in rural Appalachian areas especially with a focus on the synthetic opioids such as fentanyl our second speaker michelle lawrence will talk more about the specific appalachian areas that where we are involved well substance use disorder especially opioid use disorder has been in the news a great deal lately there are 700,000 American deaths from drug overdose between 1999 and 2017 68 percent of these deaths involved opioids in 2012 there were 81 opioid prescriptions for every 100 people that dropped to 58.7
by 2017 so there has been a decrease in opioid prescriptions because doctors are being educated about the need to decrease opioid prescriptions and to decrease the quantities involved in opioid prescribing but many people who have developed opioid use disorder problems have actually transitioned from pills to heroin and the heroin that's available today nationwide is laced with fentanyl quite often so what's the challenge here we've heard a lot about these problems before but especially in rural areas there is a challenge of treatment treatment not being available for the need that exists the
PCP office can be quite overloaded there are many other patients that the PCP might want to focus on there may be only one PCP in the entire community or even in a several County area mental health and substance abuse treatment doors can also be closed or perceived to be closed because of long waits or perceived long ways or perceived stigma of accessing mental health or substance use disorder treatment there may be a long wait also for accessing medication assisted treatment with buprenorphine methadone or naltrexone because these medications for opioid use disorder are not available in all
areas or they may be have only limited availability so a person can start on a medication like buprenorphine in a substance abuse treatment facility and then when the substance use treatment is done the the person needs to continue the buprenorphine for an indefinite amount of time and there's no place for the person to continue this medication with the emergency department door however is always open and that can become a problem for people the emergency practitioners are stressed as it is and often don't have any options for people who have opioid use disorder or other substance use
disorder they often do not have the capacity to start buprenorphine in emergency departments and even if they do they need support they need a place to send people who they have started on buprenorphine Michelle Lawrence will be in fact talking a little bit more about these different problems in rural areas and what we've done with some of the rural areas in the southern tier of New York State regarding these problems of easy access and who is available to see people in the IDI the stigma that we've mentioned is a very real problem it's often hard for many people to have conversations about
anxiety depression substance use or more serious concerns it's also hard to access mental health and substance use services in rural communities and in many urban communities community members and treatment providers may hold very negative beliefs about those who struggle with mental health problems or with substance use disorder resulting in discrimination and devaluation of these individuals or what has been called public stigma people are afraid of losing their spouse their children their job the things that matter to them they internalize these negative stereotypes that they care about or
feel from others and this phenomenon has been called self stigma fear and shame may drive people to hide their mental health or substance abuse problems and it may be very difficult for them to engage in treatment in rural communities this can be even more difficult in many ways because the towns can be very small perhaps the mental health or substance use treatment facility is right on Main Street and people may be afraid of being seen going into that place so the opioid crisis we've all heard about the opioid crisis and nearly 80% of people who are using heroin now reported misusing
prescription opioids prior to heroin where do they get the prescription opioids well sometimes they get them directly from a prescriber or perhaps multiple prescribers but the picture shows someone accessing them from a medicine cabinet partly because they often get them from other people's medicine cabinets or maybe from a relative medicine cabinet from they often get these medications from a friend for free or take them from people that they know and later on get get started abusing prescription opioids at some point they may progress to heroin or fentanyl over a hundred and thirty people
die each day from opioid related drug overdoses heroin comes in many forms and part of the reason that we have this slide is a lot of people think it's white or maybe they've heard about black tar heroin so they think it's always black but basically there are many colors that heroin comes in depending on where it comes from and how it's been processed heroin is cheaper and more easily accessible than prescription opioids it's it's more potent to use heroin in terms in via injection for example than to swallow a pill it gives the person a bigger rush to inject it and that's some of its appeal
also when you inject the medication into a vein that is that becomes a hundred and bioavailable so heroin is cheaper and more easily accessible sometimes than prescription opioids but there are even cheaper substances and that leads us to sin - no I'm sure everyone's heard of sin to know and dealt with fentanyl in people who use heroin and other opioids fentanyl overdoses are on the rise and fentanyl is in fact responsible for the majority of overdoses today of opioid overdoses fentanyl is a synthetic opioid approved for treating severe pain such as enhanced advanced cancer pain it is usually
illicit ly manufactured a lot of people when they hear the term fentanyl think about the medication that is prescribed for serious pain but actually most of it that we are concerned with now comes into this country from illegal manufacturers in other countries and this this substance is produced extremely cheaply and it is the main driver of recent increases in synthetic opioid deaths so fentanyl is 50 to a hundred times more potent than morphine and it is responsible for increasing the amount of synthetic opioid deaths across the u.s. so in the graph there you see that there was a 73%
increase from 2014 from 2016 - I can't read those numbers here sorry but I know that you can and illicitly manufacture fentanyl is also often mixed with heroin or cocaine so one slogan that I've seen fentanyl may be hiding in the drugs that you're using this is a very important thing because we often get people coming into the substance use disorder clinic with who think that they are using mostly heroin that's what they think they're buying on the street but when we test their urine they're only positive for fentanyl or they say that they're only using cocaine and their urine is positive for
cocaine and fentanyl they may be using fentanyl unbeknownst to them and fentanyl has been reported in some communities even in marijuana added to marijuana so the other medication that is of concern is the stimulant class of medications this is a very profitable business for people and this is the medication that is believed to be something that will be a source of more problems after the opioid crisis decreases after the deaths from opioid crises decrease there are predicted to be more use of stimulant medications such as cocaine and methamphetamine and also more deaths related to cocaine
and methamphetamine so that that will be our ongoing concern as well we can certainly work on opioids and synthetic opioids a great deal but we need to also be aware of addressing the stimulant and methamphetamine bump that will likely occur so basically and this is the last slide in this set Everitt the bottom line is there have been many studies over the years which have demonstrated that every one dollar invested into a diction treatment yields a return of four to seven dollars in reduced drug-related crime criminal justice costs and best not to mention all the mothers fathers sisters and
brothers who who are saved so it's very important to focus on what we could do in drug treatment and drug use prevention and with that I will turn it over to Kristin who will talk about our next poll a thank you so much Laurie appreciate that we are gonna put up our next poll which is asking you to classify which is the following or an issue for your community or specific community it's gonna be things like alcohol use continues to be a problem prescription opioids continue to be over over prescribed heroin use continues to be a problem fentanyl use marijuana use is increasing or becoming
teens with fentanyl stimulant use is rising dramatically particularly medicine methamphetamine please feel free to check all that apply as well and while you're doing that one of the things that we're hoping you'll do is also fill in in the Q&A pod if you have any questions for Gloria based on her presentation I'll give you all a second you do that of giving a couple of tasks here so if you can fill out the poll and if you have any questions again please put them in the Q&A pod and we will we will get to them in just a second looking at the poll it seems like stimulant use is rising
dramatically particularly on methamphetamine seems to be a big concern for folks in their communities and Gloria is presentation you know we focused quite a bit on fentanyl and that seems to be a problem for for many communities as well appearing in both heroin as well as in cocaine mass Gloria outlines would might be a problem in some communities as well give you one more seconds to do that and also to fill in the QA and while we're waiting for folks to do their their Q&A Gloria I wanted to run a question by you on I wanted to you know we're thinking very specifically about rural communities
here and I was wondering if you could speak to the fact you or how I think how rural communities happen or if they have been disproportionately impacted by the opioid crisis so do you think based on what you've seen and what you've what you've read that rural communities haven't is proportionately impacted by the opioid crisis and if so why yes they have been disproportionately impacted by the opioid crisis and you can look up the figures on for example the CDC website there are many maps showing this that the deaths are more prevalent per number of population in the rural areas of Appalachia
and particularly West Virginia and why is it can be a difficult question because it is just so multifactorial and there have been many thoughts about why one could be economic depression but others are also lack of availability of treatment especially medication assisted treatment and also perhaps on the prescribing end that there may have been more difficulty with prescribers or with possibly with differences in state laws that enforce more more caution about opioid prescribing and so forth so that it's a very multifactorial thing thank you and this is Michelle let me just add to that you
know I think the other thing that we know is that there are many drug dealers that target rural communities particularly if they feel like there is an opportunity for them to be able to blend in or hide and it's easier to develop some of these drugs in rural communities where there's not as much day-to-day oversight potentially by the correctional organizations it's just hard to cover a big geography in rural areas great thanks to you both on will be introducing Michelle in just a second so she can do her her presentation as well but I really appreciate that that feedback in addition to
Gloria's um and I think one of the things too that was mentioned was um was the epidemiological tools that are available through the CDC the CDC has a really valuable tool called wonder wonder it's epidemiological tool that allows communities to really drill down on their individual Geographic spaces so they can take a look at you know how deaths are being recorded in their in their communities on and so they can get a sense of the impact as well so if you're looking for that website it is wondered CDC does on and that's see that's the website that that Gloria was referencing when she was
talking about CDC's epidemiological tools the other question I had for Gloria or Michelle you mentioned that there are some challenges in seeking treatment and I'm wondering what unique challenges do you see that impact help-seeking in rural communities well I think one of the one of the differences is just scarcity itself lack of treatment providers locating in rural communities and also the distances that some people have to travel to access treatment are often a barrier for people as well as economic depression sometimes even though people can save more money in the long run by getting
into treatment and getting into recovery not spending money on drugs anymore it is often perceived as a barrier because there are co-pays to pay and people are have a hard time looking at the the long-term benefit of treatment I always think as well that that is something that may change considerably for the worse with the economic stresses that are being brought about by the coded 19 pandemic so we'll have to see what will what will happen there no I think that was great great you know and actually it kind of brings up another thought for me a gloria or Michelle I'm not sure if you can weigh
in here with regard to access to telehealth I know that that's an issue in rural communities but it's something that is and being increasingly used particularly as we face our Kovach 19 do you think or how do you think the move to telehealth models in this kind of new environment will impact all communities or it may be impacting rural communities oh well this is Gloria and I think it will be strictly a move for the better though the trouble is in rural communities there is not often a very good broadband internet access so that's going to be a barrier and a lot a lot of people don't have
access to a platform for example although I think we do have a moment here I know the University of Rochester is moving to primarily telemedicine based visits across a lot of our clinical service lines and I'm sure that that includes our mental health and substance use and I'm sure other states will start to do the same and being forced to move in that direction certainly creates a lot of opportunities I think it's a little intimidating sometimes at first but the feedback that we get from patients is very positive in that area I'm going to talk about that a little more and I'd like to those
okay oh I'm sorry this is Gloria again I'd like to also mention that when we think about televizzle often think about something that includes video we're also allowed to do some visits while during the current covin 19 crisis were allowed to do something called a telehealth is it which is involves only a telephone which of course more people in rural areas might have access to so I think that that has a lot of hope in it as well and our patients have been very accepting of it especially during this current crisis hey thanks to you both so Kari if you could remove the pole thanks to you all
for participating it looks like the fentanyl and stimulant news now seems to be a particular community concern for rural communities so thanks to you folks for replying to that poll we can use that information to help guide our future conversations in the meantime I'm going to turn it over to Michelle Lawrence who is going to talk a little bit more about the recovery center of excellence Michelle thanks Kristin ok so in terms of the Recovery Center of Excellence Kristin touched on some of the objectives here before I do want to just focus for a minute on number three really synthesizing the
wisdom that exists I think that every community is doing something out there that is interesting related to substance use disorders as well as mental health and we are very interested in understanding what the best practices are that you see in your community there are certainly things that we are doing but we learn everyday from conversations that we have with all of you so at the end of the presentation you're going to see ways that you can contact us I strongly encourage you to either reach out directly through our website where there will be a technical assistance form you can put best
practices as well as needs that you have for your community call our 800 number if you would like to and just let us know what's happening in your community we would really like over the course of the next couple of years to highlight things from a variety of community because I think one of the best ways that we can resolve this crisis is for all of us to work together I want to talk for a moment about how we're approaching dissemination clearly there's a lot of evidence-based practices that are out there but often evidence-based practices are developed in urban communities and they assume
some things implicitly that that are not true in in rural communities all the time so a lot of times they will assume that there's access either within walking distance or by a public transportation or cars that is close enough by that people can access treatment without disrupting their their life we see often in rural communities that people may end up driving two hours a day in each direction so four hours total it's very hard to hold down a job when you're spending that much time accessing care many other challenges as well so what we will be doing in addition to evidence identifying the
evidence-based practices is really adapting those practices for rural communities taking what we've learned what other communities have learned and trying to help rural communities understand how best to implement these in their environment you're going to see on our website that we will have webinars related to a variety of evidence-based practices I'm going to go through some of the ones that we've identified already today but this is not an exhaustive list if there are other ideas that all of you have around best practices you would like to see or best practices you have that you would
like to share we would like to understand those and not only understand what they are but with each of these webinars we're really going to be focused on developing a toolkit that helps all of you take these and implement them right away so we will be including things like job descriptions workflows within a practice practice pro formas that help you understand how to make work any other tools within that you that you think would be helpful so let us know exactly what it is that you need this is map that just shows the areas that we are focused on I recognize a lot of you are dialing in from
all over the United States today we are happy to help anyone from any community we're obviously just focused on this rural Appalachian area right here that we've identified but we have a lot of experience with rural communities I've actually worked with rural communities on the west coast as well as on the East Coast so happy to help anybody anywhere this is a list of the best practices that have been identified by the CDC in regards to addressing opioid use in our communities I'm sure most of you are familiar with these if you have not had the opportunity to look at the write-up that the CDC
has done that will also be posted on our website it goes through each of these practices and talks about what they actually are and some of the opportunities and challenges you face in addressing these we started here before going through some of our community needs assessment as that was going on so we've actually been reaching out to our target areas and collecting the community needs assessments from those areas we encourage communities to share additional community needs assessments with us so we can see what are the challenges that you're facing as those continue to evolve but in looking
at the community needs assessments we then went back to our identification team and said okay in a rural community if you know it's very hard to do ten things all at once if you could just do three things what is it that you would do and they suggested a targeted naloxone distribution the medication assisted treatment and the butan or Fein in the emergency department in a lot of ways because as Gloria mentioned earlier patients are presenting in the emergency department so being able to access in the emergency department is really important it just so happens that the team that we have
working in the southern tier had is a different team and had identified these same areas so we actually are working and implementing all of these in the communities that we directly serve as well and then academic detailing was the fourth one that they identified you know if that was possible and I want to just comment on this because I think this is one that people often don't understand so academic detailing in its traditional definition tends to involve a non clinician who is working to educate clinicians about the use of a medication or treatment what we have found to be particularly
helpful is to engage the chief medical officers at rural community hospitals or the leaders of large community primary care practices and to have those leaders begin to talk with their peers about the importance of m80 and the importance of treating patients in their practice not necessarily all the patients in the universe that seems overwhelming which is starting with treating the patients who are in your practice today that has been a very successful strategy for us and then this slide shows more specifically what we have done in Allegheny and Steuben County two of the Appalachian counties
that we serve in the southern tier of New York so some of these practices are practices that are emerging best practices and you will see us highlighting those in particular the behavioral health assessment officer is really an old practice that we have reinvigorated for rural communities and that is the practice that we will be highlighting in one of our upcoming webinars this is we faced and in these communities a challenge with accessing both mental health and substance use and we faced a challenge in our emergency departments being overwhelmed and not really able to address mental health
and substance use issues that presented in the easy the behavioral health assessment officer is a person who could be dedicated to assessing patients when they come in and really in a care management kind of role doing the handoffs with other organizations and and not just a handoff of here's an appointment for tomorrow but let me walk you over and introduce you to the folks in the substance use treatment organization even if that organization is across the street it's really helpful to have that actual introduction and feel like someone's kind of gotten your back as you're making that
transition we will also be modifying based on some practices we've seen be very effective here the buprenorphine in the emergency department one of the things that has been effective is partnering with our substance use treatment organizations to have peers from those organizations come in to the IDI take patients up and begin to engage them in the treatment right then they will take them back even if it's not in the same County they will take them over an hour away if they need to to engage in substance use treatment so that addresses a lot of challenges as well so a lot more details will be
coming on all of those things but this is kind of our overarching approach and our one thing to say here about our philosophy is after working very closely with our primary care physicians all of whom are very overwhelmed in this community our approach has been to really start where the patients are at in the emergency department and not try to push everything through primary care so this ecosystem of recovery really starts in the emergency department and starts with our partners in mental health and substance use and tries to work to surround the primary care providers and their practices
with the support they need to be successful while I'm on this slide there is Gloria mentioned some thoughts about mass and and other stimulants one of our charges in in being a center of excellence is to help prevent the next and so we are already reaching out to understand some of the best practices around math and around some of the other stimulants we've connected with the University of Kentucky that's doing some great work in this area and we hope to work more closely with them but I encourage anyone who may be doing some of that work to please reach out to us we would love to hear your
stories we'd love to hear what you're doing that's working I also would like to just add a plug in the midst of the Kovach crisis here one of the things that we are seeing is that there is a lot more isolation and loneliness even in this this last week in New York that is happening as patients are leaving work and working from home as we've had the elderly who are pretty much staying at home alone so we're doing a lot to really encourage people to reach out particularly by phone by FaceTime things where people can connect with each other and see each other face to face we were concerned about
this being an epidemic and that this will potentially impact mental health and substance use not only for patients who are in recovery today but people who may have undiagnosed mental health and substance use issues or people who are now facing anxiety depression and other challenges for the first time so there's a lot of really good material if you have not seen it posted on the Samsa website about how to address this particularly in this crisis I would encourage you to check it out we're going to try to put a link to that on our website as well I'd also encourage you to think about how to
develop some solutions around that I know that we're facing some challenges in terms of how to continue to do group therapy in this environment so we can certainly encourage community groups to form that keep people connected we can encourage individuals who may be good at cooking or writing or genealogy or any other interest to host a group online we can also encourage organizations that may not be open like the local library or bookstore or even a coffee shop to gather people together online I think it will make a huge difference in in the challenges we're facing right now and help with
mental health and substance use across all of our communities this is a list of our upcoming webinars we hope that you will be able to join them I do need to caveat that the schedule may end up changing where we're trying to be respectful of our providers that are dealing with kovat 19 right now so we may need to move some of these around but if you continue to check our website we will have the most up-to-date schedule and we will cover all of these topics eventually we just need to have little flexibility at the moment and with that I'm going to turn it back over to Kristin for the next
poll all right thank you so much Michelle so we're gonna put up a poll that asks you about your technical assistance needs we're actually going to be asking you which of the following topic areas are of most interest for you with regards to receiving technical assistance I'll wait so that poll pops up before I read in some of the choices so the the choices are going to be the standardization of X labor training for providers provide staff training on the programs we discussed today identifying evidence-based practice as well students you rural communities establishing partnerships using data
for decision-making disseminating information about successful efforts or something else and if it's something else please put your list there's there's a option below where you can actually type in your answer again this information is really important to us because it can help us direct our efforts moving forward all right so I'll give you a few more seconds or so to answer the the poll and while you're working on that I had a question for Michelle or Gloria so Michelle one of the things that really intrigued me about what you were talking about is this idea of the behavioral health officer
and the warm handoff on where you know you actually physically walk someone to their next appointment you actually make those introductions for them very similar to you know they're very successful as their a suicide model that's used in suicide prevention where there's really like just no no space between one provider and the next in terms of handing off a patient making sure that those appointments are are made but that kind of system level change requires a lot of buy-in at the leadership level I'm just wondering if you could talk a little bit or maybe we're going to do this on a future
webinar but if you could talk a little bit about what that leadership by and looks like in rural communities and and you know what would that take sure I I really think you have to start by identifying a champion someone who really understands the impact of this and it may not be necessarily where you're expecting to look so I'll use myself as an example I am NOT someone who spent a lot of time in the mental health or substance use area in the beginning of my career but I have been very involved with rural communities and I saw that as many rural communities were starting to move towards
value-based contracting the importance of addressing mental health and substance use I also saw at a leadership level that there was a lot of stigma in the board room in the executive suite having to do with mental health and substance use concern about how are we going to pay for these services concern about what it would mean to treat people in this area and I think that if you can find a leader who's willing to learn about that as I did with Gloria and and learn from the community providers you can have a champion there that really moves things forward at that leadership level and engages
the community more broadly I think that is really critical to success yeah that makes a lot of sense to show and I think that it probably relates and maybe a little bit to my next question which is you know you mentioned that you know you're planning on having a listening tour and you're you've been in the process of having a listening tour with the communities that you're that you're serving and I love this idea I think it's a really great idea in order to really get on the ground needs on can understand this better can you describe a little bit of what you've learned so far in the listening
tour I have learned so much already first of all that every community is doing something but that every community is also doing something slightly different so and that every community may face slightly different challenges so it's really important to understand from each of you what it is that your community needs and what I've seen best practices in a lot of places that I'm interested in adopting here but I would really like to understand more about what's going on and what you think your community needs some communities are facing huge challenges around stimulants other communities are
struggling with axe waiver training that may not be very standardized and you know concerns about is the next epidemic going to come from providers who may not have been trained appropriately you know so lots of different concerns there's that we've had discussions about does it make sense to have more integration around mental health and substance use I think absolutely it does and how do you do that so that's you know I'm sure we have a lot more to learn and I look forward to sharing with everybody all of the best practices that we find in green I think it actually speaks to some of what
we're seeing on the poll right now and that the majority of our participants are saying that identifying evidence-based practices that are well suited to rural communities as of critical importance for them in an area of technical assistance need can you talk a little bit about the technical assistance model that the rural Center for Excellence will be employing you know tell us a little bit about you know your your ca structure and you know and how you're planning on sort of rolling out some of these things sure so first of all our website is live so it is Recovery Center of Excellence org
and I'll just say that again Recovery Center of Excellence or that should show up on the last slide here and welcome everybody to go check the website out today we've got some initial material that's on there and there is a technical assistance form on the website so you can put in to that technical assistance form questions things that you think you need best practices that you're looking to understand how they've been adapted for rural communities resources that you think we should be aware of anything that you think is relevant to this please put it on that form we also have an 800 number
because of the outbreak here particularly in New York we've actually had to go to to having you leave a message on that line we're checking it constantly throughout the day but we're not able to have people in the office staffing that live so we will go back to that but for the time being if you could just leave a message on there we will get back to you so there's a couple of ways you can access that and then as we gather these requests we're essentially looking at what the requests are and bringing those back to our identification team to help us identify where the evidence-based or
emerging best practices are and then we also have an adaptation team that looks at what our academic partners are recommending that a patient team is comprised of clinicians that work in rural communities and we bring in experts to that adaptation team based on the subject matter that we're discussing and really try to talk through how can we make this work in a rural community so you know some of the challenges that we face in rural communities are you know you may have a best practice that works really well in an urban setting where there's 700,000 people but when you're talking about a
hundred thousand people over a hundred or two hundred miles how do you structure that in a way it is financially viable and accessible to folks telemedicine can be a big part of that but we really kind of get into the nuts and bolts of how you're going to make that work and that's some of the information we'll be sharing on our website as well there's also clearly we've heard a lot about workforce challenges in terms of both the workforce clinical workforce on the ground how do we recruit and retain those folks as well as the administrative workforce there's a there's often a shortage of
administrative workforce in rural communities so to the extent that we can provide help and tools that allow folks to kind of pull something off the shelf and implement it right away without having to do a lot of additional research themselves which they may not have time to do if they're trying to while they were managing three jobs last week they're probably doing ten this week with the Kovach crisis so really trying to help with that as much as we can great thanks Michelle and just recognizing that we we have a few more minutes a quick question for you in rural communities non
non-traditional partners I'm talking about you know folks like coroner's or police departments emergency services business owners they become really critical in in substance misuse prevention is there a space or a way that our Center will integrate with you know with non-traditional partners or helps to inform non-traditional partners in their work or is it that will the model is such that we will mostly be translating the research for folks like those we see on the webinar today and having them translate it for their community members that's a great question actually one of the new ideas
that we've been talking with hersa about is some training that will be targeted at community health workers or folks that may not technically be in the healthcare field they they may be people who are in the office for aging or they may be you know providers or or staff that are in the Department of Health and how can we train folks in those areas to recognize this of opioid use in clients they may be serving how can we help them to recognize clients who may be at risk of overdose or suicide related to that use so we're really interested in developing some training around that and I think
there's there's great opportunity to engage as many partners as we possibly can fantastic ok great so we're gonna take the poll down and we're gonna close out by providing you with some of the links to the website and are in our 800 number that Michelle had mentioned I'm saying we put those up and now so as you see we really look forward to your input on here's are all of our contact information also as you exit today if you hold on just two seconds what's gonna pop up as an evaluation the evaluation is going to ask you some questions about the content of our of our presentation today and
it's really really important that you fill that out because that's going to help us inform our future efforts but we we suggest that you please hold on the line and you'll be kicked over to that evaluation link where you can fill that out just checking the Q&A one last time for any other questions and not seeing any come in so again you'll you know we're looking forward to receiving your feedback thank you so much for joining us today and we look forward to seeing you on our next call thanks so much everyone