In California, a Grantmaker is Embracing Community-Led Efforts to Take on the Opioid Crisis

While the number of opioid prescriptions has fallen in recent years, the carnage from opioid-related deaths in the U.S. remains enormous, claiming 47,000 lives in 2018. This public health crisis has led grantmakers to look at new approaches to solving the issue. As we’ve reported previously at Inside Philanthropy, recent funding from grantmakers like Bloomberg Philanthropies and the Community Foundation of Southeast Michigan has focused increasingly on private-public partnerships that work to advance medication-assisted treatment (MAT) programs.

The Center at Sierra Health Foundation is also backing this approach, recently making more than $16.4 million in grants through its Medication Assisted Treatment (MAT) Access Points Project. It’s funding 120 organizations at more than 270 “access points” throughout the state of California.

“MAT is the gold standard of care for individuals suffering from opioid use disorder,” said Samantha Garcia, Communications Officer at the Sierra Health Foundation, of the motivation for the grantmaking initiative. “For example, the National Institute on Drug Abuse has found that MAT not only decreases opioid use, opioid-related deaths, criminal activity, and infectious disease transmission, but patients were more likely to remain in therapy compared to patients receiving treatment that did not include medication.”

The MAT Access Points Project is funded via the California Department of Health Care Services’ MAT Expansion Project. It is administered by The Center at Sierra Health Foundation.

Why Targeting Specific Barriers is Vital to Success

While MAT has been proven effective, many barriers have posed a problem that can only be addressed by increased funding for large-scale coordination, implementation and education efforts. Currently, many rural communities in particular don’t have providers with the waivers required to prescribe MAT. Additionally, lack of understanding of addiction leads to widespread stigma, both culturally and individually, which hinders individuals’ willingness to seek care and providers’ ability to deliver it effectively. Long treatment wait lists, language barriers and high costs also present problems for many patients.

The recent round of grants is geared at addressing each of these needs within the specific context of each community or facility. In particular, as Sierra Health Foundation leaders explain, grant funds are used to coordinate efforts between key stakeholders, such as medical providers, law enforcement officials, educators and community organizers.

“A critical component of this statewide, coordinated investment effort is building the capacity of partners who have the commitment and relationships required to reach people and families in communities that are disproportionately experiencing poor access to MAT substance use disorder treatment and high opioid-related mortality rates,” said Chet P. Hewitt, president and CEO of Sierra Health Foundation and The Center, in a press release.

One particularly important funding pain point for those living in rural California is the difficulty of transportation, Garcia explained. The MAT Access Points Project will fund the development of telemedicine programs, which will play an especially important role for people living in remote areas.

“Organizations are using the funding to train their providers on addiction medicine and to get them waivered, shortening wait lists and providing needed transportation assistance. Organizations are also expanding telemedicine capabilities in order to provide services in hard-to-reach communities,” said Garcia.

Community Buy-In Helps to Provide Sustainable Solutions

Long-term solutions to complex problems that lead to real change require sustained investment and ongoing support. Fostering community buy-in and local support is vital to the MAT Access Points Program’s long-term sustainability. “One thing we know for sure after decades of community-led philanthropy is that those at the center of an experience are the best experts on designing solutions specific to their neighborhoods and communities,” Garcia said in this vein.

Moreover, she explained, the racial, ethnic, cultural and geographic communities most impacted by criminalization of substance use and addiction often require additional kinds of support that vary from community to community. The foundation is working to tap into organizations’ authentic community connections with the goal of reducing opioid use rates by educating people about available healthcare services and some of these novel approaches.

Because California is such a geographically large and culturally diverse state, building an effective and accessible statewide system of care can be an obstacle for funders. “Therefore, it is vital that service providers work in collaboration and unison with community leaders to build trust and provide culturally appropriate services that utilize the perspective of the community in which they work,” said Garcia.

That’s why the recently announced grants target a wide range of access points at every infrastructural level, from narcotic treatment programs and DUI program providers to tribal health centers, emergency departments, primary care practices, residential treatment centers, correctional facilities, hospitals and mental health centers. The variety of selected recipients drives funds toward virtually every possible “off-ramp” from substance abuse.

In the first round of funding, sub-contracts between $16,000 and $861,426 will fund MAT enhancement efforts in existing programs and startup activities, such as medical equipment purchases and funding for staff recruitment and training. A second round of funding will be announced in the fall of 2019. A full list of organizations that received sub-contracts is available at the MAT Access Points Project website.

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