ECHO Resources

• Minnesota's Tackling Opioid Use with Networks (TOWN) MOUD Program Manual
• AHRQ Medication-Assisted Treatment for Opioid Use Disorder Playbook (Interactive, Web-Based) (Agency for Healthcare Research and Quality (AHRQ)) This is a practical guide for implementing MAT in primary care and other ambulatory care settings. While the Playbook aims to help providers in rural primary care, the information in the Playbook should apply to other ambulatory care settings. This interactive, web-based product has the latest guidance, tools, and resources that address key aspects of implementation.
• The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder – 2020 Focused Update (American Society of Addiction Medicine (ASAM)) Guideline for the Treatment of Opioid Use Disorder includes topics on screening, assessment, diagnosis, and management.
• TIP 63: Medications for Opioid Use Disorder – Executive Summary & Full Document (Substance Abuse and Mental Health Services Administration (SAMHSA)) Full Guideline for the Treatment of Opioid Use Disorder that includes topics on screening, assessment, diagnosis and management, follow-up, and referral.

• Minnesota's Tackling Opioid Use with Networks (TOWN) MOUD Program Manual
• Low threshold nurse-led clinic in rural MN

• Recovery Within Reach: Medication-Assisted Treatment of Opioid Addiction Comes to Primary Care (California Health Care Foundation (CHCF))
  Includes other settings and service models
• Primary Care Buprenorphine Programs: Ten Elements of Success (California Health Care Foundation (CHCF))
• Guidance Document on Best Practices: Key Components for Delivering Community-Based Medication Assisted Treatment for Opioid Use Disorders in New Hampshire. Second Edition, April 2018. (New Hampshire Department of Health and Human Services, Bureau of Drug and Alcohol Services.) In-depth guide of OUD MAT in primary care that summarizes the evidence for MAT and implementational approaches. This detailed guide is a good resource for program components as well as tools and examples.
• Addiction Technology Transfer Center (ATTC) Network - White Paper Exploring Models of Care

Primary Care/Collaborative Care Models

• Primary Care-Based Models for the Treatment of Opioid Use Disorder: A Scoping Review (Korthuis et al. Ann Intern Med. 2017 Feb 21; 166(4): 268–278.): The attached article describes different models of delivering MAT in primary care settings.
• Low threshold nurse-led clinic in rural MN
• Collaborative Models for Medication-Assisted Treatment: Key Elements of the Massachusetts Collaborative Care Model (Medicaid Innovation Accelerator Program (IAP))
• Behavioral Health Integration in Minnesota: Recommended Actions (2021)
• Getting Paid in the Collaborative Care Model (American Psychiatric Association (APA))

Health Care Home

• Experiences of three states implementing the Medicaid health home model to address opioid use disorder—Case studies in Maryland, Rhode Island, and Vermont (Clemans-Cope et al. VOLUME 83, P27-35, DECEMBER 01, 2017)
• Rhode Island Health Home Model (Medicaid Innovation Accelerator Program (IAP))

Hub and Spoke

• Vermont Hub-and-Spoke Model of Care For Opioid Use Disorder: Development, Implementation, and Impact (Brooklyn et al. J Addict Med. 2017 Jul-Aug; 11(4): 286–292.)
• Vermont Buprenorphine-Hub & Spoke Model (Medicaid Innovation Accelerator Program (IAP)): Includes MAT Rate Design Tool Spreadsheet
• Key Elements of Vermont’s Hub-and-Spoke System (Medicaid Innovation Accelerator Program (IAP))
• Pennsylvania’s Novel Public-Private Approach to Combatting the Opioid Crisis (University of Pittsburgh School of Pharmacy/Pennsylvania Department of Human Services)

Pharmacist-led MAT programs

• Physician-pharmacist collaborative care model for buprenorphine-maintained opioid-dependent patients. (DiPaula BA, Menachery E. Physician-pharmacist collaborative care model for buprenorphine-maintained opioid-dependent patients. J Am Pharm Assoc (2003). 2015 Mar-Apr;55(2):187-92.): In this pharmacist-physician collaborative care model, pharmacists conducted intake assessments and follow-up appointments with patients taking buprenorphine in order to further expand access to treatment. This program demonstrated 100% 6-month retention rates and 73% 12-month retention rates with an estimated cost savings of $22,000. Data from this pilot was then used to develop a permanent program utilizing this model.
• Rhode Island Study to Offer Medication-Assisted Treatment at Pharmacies (Codac Behavioral Healthcare): In Rhode Island, a grant from the National Institute on Drug Abuse is being used to allow patients to receive addiction care at a community pharmacy. Through this program, patients receive their initial prescription from a physician and, when stable, a pharmacist will take over their care, including conducting toxicology swabs to determine adherence and providing motivational counseling. Participants reported increased convenience and comfort with receiving addiction care at their local pharmacy.

Mobile MAT

• Rice County Opioid Response – MAT Clinic Set up (Rice County Chemical and Mental Health Coalition)
• Colorado RV Clinic (Kaiser Health News)

Telehealth

• Exploring Telehealth Delivery Methods for Substance Use Disorder Treatment (Webinar & Audio) (Medicaid Innovation Accelerator Program (IAP))
• Telehealth-based buprenorphine management: Evidence and policy implications
• Advisory: Using Technology-Based Therapeutic Tools in Behavioral Health Services (Substance Abuse and Mental Health Services Administration (SAMHSA)) - last updated March 2021
• State Telehealth Laws and Reimbursement Policies Report (The National Telehealth Resource Policy Center: Center for Connected Health Policy)

• Minnesota's covered SUD care services outside of medical visits - last updated 5/4/2023
• Business Plan for Medication Assisted Treatment (MAT) (Providers Clinical Support System (PCSS)): Describes overall need and value for OUD MAT treatment in primary care, implementation tips and milestones, billing codes, and financial sustainability, clinical (pharmacotherapy) aspects of care and quality metrics.
• Documentation & Charge Capture Process: Medication-Assisted Treatment (Providers Clinical Support System (PCSS))
• Billing and Coding: Medication Assisted Treatment (American Society of Addiction Medicine (ASAM)): Tips on the approaches and considerations to document and bill for MAT services

• MAT Readiness and Implementation Checklist (National Council for Behavioral Health (NCBH)) 
• Six Building Blocks: A Team-Based Approach to Improving Opioid Management in Primary Care (University of Washington): This includes information on the following: Leadership & consensus; Policies, patient agreements & workflows; Tracking & monitoring patient care; Planned, patient-centered visits; Caring for complex patients; Measuring success

Clinical presentations and tools/templates

• Hennepin ECHO resources
• Stratis Health

Initial Screening/Assessment

• Screening and Assessment Tools Chart (National Institute on Drug Abuse (NIDA))
• ACE Score (National Council of Juvenile and Family Court Judges (NCJFCJ))

Intake

• Sample Intake Questionnaire (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Intake-click on the document
• Sample Initial Patient Contact about Buprenorphine (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Intake-click on the document
• Sample Medical History and Physical Exam Form (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Intake-click on the document

Withdrawal Scales

• Clinical Opiate Withdrawal Scale (online interface - MDCalc.com)
• Clinical Opiate Withdrawal Scale (for printing - National Institute for Drug Abuse (NIDA))
• Subjective Opioid Withdrawal Scale

Drug Accountability Forms (if dosing in office)

• Buprenorphine Stock Drug Accountability Record (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Drug Accountability Forms (if dosing in office)-click on the document
• Buprenorphine Patient Log (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Drug Accountability Forms (if dosing in office)-click on the document

Ongoing Treatment

• Progress Note Example (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Ongoing Treatment-click on the document
• Protocol for Follow-up Appointments (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Ongoing Treatment-click on the document
• Follow-Up Appointments (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Ongoing Treatment-click on the document
• Billing Information (Providers Clinical Support System (PCSS)): Go to Clinical Forms-Ongoing Treatment-click on the document