HomeMy WebLinkAbout2024-556-E-Health Dept-Freedom House-Services and support programs that serve persons with Opioid Use DisorderRevised 01/24
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[Departmental Use Only]
TITLE FFH Opioid Settlement
FY 2024-2025
NORTH CAROLINA
SERVICES AGREEMENT NO RFP/RFQ
ORANGE COUNTY
This Services Agreement (hereinafter “Agreement”), made and entered into this first day of
July, 2024, (“Effective Date”) by and between Orange County, North Carolina a political
subdivision of the State of North Carolina (hereinafter, the "County") and Freedom House
Recovery Center, Inc, a non-profit corporation, located at 104 New Stateside Drive, Chapel Hill,
North Carolina 27516, (hereinafter, the "Provider").
WITNESSETH:
That the County and Provider, for the consideration herein named, do hereby agree as
follows:
1. Services
a. Scope of Work.
i) This Agreement is for services to be rendered by Provider to County with respect
to (insert type of project): Services and support programs that serve persons with
Opioid Use Disorder (OUD).
ii) By executing this Agreement, the Provider represents and agrees that Provider is
qualified to perform and fully capable of performing and providing the services
required or necessary under this Agreement in a fully competent, professional and
timely manner.
iii) Time is of the essence with respect to this Agreement.
iv) The services to be performed under this Agreement consist of Basic Services, as
described and designated in Section 3 hereof. Compensation to the Provider for
Basic Services under this Agreement shall be as set forth herein.
2. Responsibilities of the Provider
a. Services to be provided. The Provider shall provide the County with all services
required in Section 3 to satisfactorily complete the Project within the time limitations set
forth herein and in accordance with the highest professional standards.
b. Standard of Care.
i) The Provider shall exercise reasonable care and diligence in performing services
under this Agreement in accordance with the highest generally accepted standards
of this type of Provider practice throughout the United States and in accordance
with applicable federal, state and local laws and regulations applicable to the
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performance of these services. Provider is solely responsible for the professional
quality, accuracy and timely completion and submission of all work related to the
Basic Services.
ii) Provider shall be responsible for all errors or omissions of its agents, contractors,
employees, or assigns in the performance of the Agreement. Provider shall
correct any and all errors, omissions, discrepancies, ambiguities, mistakes or
conflicts at no additional cost to the County.
iii) The Provider shall not, except as otherwise provided for in this Agreement,
subcontract the performance of any work under this Agreement without prior
written permission of the County. No permission for subcontracting shall create,
between the County and the subcontractor, any contract or any other relationship.
iv) Provider is an independent contractor of County. Any and all employees of the
Provider engaged by the Provider in the performance of any work or services
required of the Provider under this Agreement, shall be considered employees or
agents of the Provider only and not of the County, and any and all claims that may
or might arise under any workers compensation or other law or contract on behalf
of said employees while so engaged shall be the sole obligation and responsibility
of the Provider.
v) If activities related to the performance of this Agreement require specific licenses,
certifications, or related credentials Provider represents that it or its employees,
agents and subcontractors engaged in such activities possess such licenses,
certifications, or credentials and that such licenses certifications, or credentials are
current, active, and not in a state of suspension or revocation.
vi) Should any documents, exhibits, or addenda be attached to this Agreement, the
terms of this Agreement shall have priorit y in any conflict with or among the
terms of such referenced documents, exhibits, or addenda.
vii) Should this Agreement involve project designs, the construction or creation of
which is to be bid out or fulfilled by other contractors, and bidding or negotiation
with contractors produce prices which, when added to the other elements of the
approved total project cost, produce a cost that is in excess of the approved total
project cost, the Provider shall participate with the County in negotiation and
design adjustments to the extent such are necessary to obtain prices within the
approved total project cost. All activity of the Provider with respect to these
matters shall constitute Basic Services and shall be performed by the Provider
without additional compensation. If negotiation and design adjustments fail to
bring costs within the total project cost the County may reject all bids and
Provider will redesign or reduce portions of the project in an effort to reduce the
bid prices to within the total project cost and rebid the project. One such redesign
is included within Basic Services. If this second letting for bids does not produce
bids that are within the approved total project cost initially or after negotiations
with the contractor the cost is not reduced to an amount within the total project
cost, the Provider is not obligated to engage in further redesign.
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3. Basic Services
a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows
(fully describe services to be provided): Services and support programs, as listed in
Exhibit A, that serve persons with Opioid Use Disorder (OUD) or any co-occurring
Substance Use Disorder (SUD) or mental health condition as stated in the National
Settlement Agreement. Invoices and supporting documentation are to be submitted the
15th day after the end of the quarter (example: October 15, 2024 invoice for exepnses
dated July 1, 2024 through September 30, 2024). Per Exhibit B, one metrics report will
be required January 15, 2025 (for services dated July 1, 2024 through December 31,
2024) and a final metrics report will be due J uly 15, 2025 (for services dated January 1,
2025 through June 30, 2025) along with a narrative (success story) of 250 words or less.
4. Duration of Services
a. Term. The term of this Agreement shall be from July 1, 2024 to June 30, 2025.
b. Scheduling of Services.
i) The Provider shall schedule and perform its activities in a timely manner.
ii) Should the County determine that the Provider is behind schedule, it may require
the Provider to expedite and accelerate its efforts, including providing additional
resources and working overtime, as necessary, to perform its services in
accordance with the approved project schedule at no additional cost to the
County.
iii) The Commencement Date for the Provider's Basic Services shall be July 1, 2024.
5. Compensation
a. Compensation for Basic Services. Compensation for Basic Services shall include all
compensation due the Provider from the County for all services satisfactorily (as
determined by the County) performed pursuant to this Agreement. The maximum
amount payable for Basic Services shall not exceed One Hundred Forty Four Thousand
Nine Hundred Twenty Six and 53/100 Dollars ($144,926.53). Payment for satisfactorily
performed Basic Services shall become due and payable within thirty (30) days of
Provider properly invoicing County. Payment shall be subject to provisions of Section
5(b).
b. Disputes. In the event the amount stated on an invoice is disputed by the County, the
County may withhold payment of all or a portion of the amount stated on an invoice
until the parties resolve the dispute. Should Provider fail to perform its duties under the
terms of this Agreement, County may, without fault or penalty, withhold any payment
associated with the work to be performed until such time as said work is completed.
c. Additional Services. County shall not be responsible for costs related to any services in
addition to the Basic Services performed by Provider unless County requests such
additional services in writing and such additional services are evidenced by a written
amendment to this Agreement.
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6. Responsibilities of the County
a. Cooperation and Coordination. The County has designated (Orange County Health
Director, Quintana Stewart) to act as the County's representative with respect to the
Project who shall have the authority to render decisions within guidelines established by
the County Manager or the County Board of Commissioners and who shall be available
during working hours as often as may be reasonably required to render decisions and to
furnish information.
7. Insurance
a. General Requirements. Provider shall obtain, at its sole expense, Commercial General
Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any
additional insurance as may be required by County’s Risk Manager as such insurance
requirements are described in the Orange County Risk Transfer Policy and Orange
County Minimum Insurance Coverage Requirements (each document is incorporated
herein by reference and may be viewed at
http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If
County’s Risk Manager determines additional insurance coverage is required such
additional insurance shall consist of Professional Liability and a Molestation/Sexual
Assualt rider (if no additional insurance required mark N/A as being not applicable).
Provider shall not commence work until such insurance is in effect and certification
thereof has been received by the County's Risk Manager.
8. Indemnity
a. Indemnity. To the extent authorized by North Carolina law the Provider agrees, without
limitation, to defend, indemnify and hold harmless the County from all loss, liability,
claims or expense, including attorney's fees, arising out of or related to the Project and
arising from property damage or bodily injury including death to an y person or persons
caused in whole or in part by the negligence or misconduct of the Provider except to the
extent same are caused by the negligence or willful misconduct of the County. It is the
intent of this provision to require the Provider to indemnify the County to the fullest
extent permitted under North Carolina law.
9. Amendments to the Agreement
a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional
compensation or a change in duration of this Agreement shall be made by a written
Amendment to this Agreement executed by the County and the Provider. The Provider
shall proceed to perform the Services required by the Amendment only after receiving a
fully executed Amendment from the County.
10. Termination
a. Termination for Convenience of the County. This Agreement may be terminated without
cause by the County and for its convenience upon seven (7) days’ prior written notice to
the Provider.
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b. Other Termination. The Provider may terminate this Agreement based upon the County's
material breach of this Agreement; provided, the County has not taken all reasonable
actions to remedy the breach. The Provider shall give the County seven (7) days' prior
written notice of its intent to terminate this Agreement for cause. Either party may
terminate this Agreement upon notice to the other party that obligations pursuant to this
Agreement are made impractical due to declarations of emergency by Orange County or
by North Carolina due to events directly impacting Orange County. Both parties shall
remain responsible for all payment and performance due up to the receipt of such notice,
but shall have no further obligation or responsibility beyond that date provided the
terminating party has taken all reasonable steps to complete the performance of its
obligations.
c. Compensation After Termination.
i) In the event of termination, the Provider shall be paid that portion of the fees and
expenses that it has earned to the date of termination, less any costs or expenses
incurred or anticipated to be incurred by the County due to errors or omissions of
the Provider. Upon request of the County, the Provider shall submit to County all
relevant documentation, including but not limited to, job cost records, to support
its claims for final compensation.
ii) Should this Agreement be terminated, the Provider shall deliver to the County
within seven (7) days, at no additional cost, all deliverables including any
electronic data or files relating to the Project.
d. Waiver. The payment of any sums by the County under this Agreement or the failure of
the County to require compliance by the Provider with any provisions of this Agreement
or the waiver by the County of any breach of this Agreement shall not constitute a
waiver of any claim for damages by the County for any breach of this Agreement or a
waiver of any other required compliance with this Agreement.
e. Suspension. County may suspend the Basic Services and this Agreement at any time for
County’s convenience and without penalty to County upon three (3) days’ notice to
Provider. Upon any suspension by County, Provider shall discontinue work on the Basic
Services and shall not resume the Basic Services until notified to proceed by County.
11. Additional Provisions
a. Limitation and Assignment. The County and the Provider each bind themselves, their
successors, assigns and legal representatives to the terms of this Agreement. Neither the
County nor the Provider shall assign or transfer its interest in this Agreement without the
written consent of the other. There are no third-party beneficiaries of this Agreement and
nothing in this Agreement, express or implied, is intended to confer on any person other
than the parties hereto (and their respective successors, heirs and permitted assigns), any
rights, remedies, or obligations.
b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights
of respective parties hereunder shall be governed by the laws of the State of North
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Carolina. By executing this Agreement Provider affirms that Provider and any
subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter
64 of the North Carolina General Statutes. By executing this Agreement Provider
certifies that Provider has not been identified, and has not utilized the services of any
agent or subcontractor identified, on the list created by the State Treasurer pursuant to
G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not
been identified, and has not utilized the services of any agent or subcontractor identified,
on the list created by the State Treasurer pursuant to G.S. 147-86.81.
c. Non-Discrimination. Provider shall at all times remain in compliance with all applicable
local, state, and federal laws, rules, and regulations including but not limited to all state
and federal non-discrimination laws, policies, rules, and regulations and the Orange
County Non-Discrimination Policy and Orange County Living Wage Policy (each
Orange County policy is incorporated herein by reference and may be viewed at
http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Any
violation of the Orange County Non-Discrimination Policy is a breach of this Agreement
and County may immediately terminate this Agreement without further obligation on the
part of the County. This paragraph is not intended to limit and does not limit the
definition of breach to discrimination.
d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages
with respect to any provision of, or the performance or non-performance of, this
Agreement shall be brought in the General Court of Justice of North Carolina sitting in
Orange County, North Carolina. It is agreed by the parties that no other court shall have
jurisdiction or venue with respect to such suits or actions. Binding arbitration may not
be initiated by either Party, however, the Parties may agree to nonbinding mediation of
any dispute prior to the bringing of such suit or action.
e. Entire Agreement. This Agreement represents the entire and integrated agreement
between the County and the Provider and supersedes all prior negotiations,
representations or agreements, either written or oral. This Agreement may be amended
only by written instrument signed by both parties. Modifications may be evidenced by
facsimile signatures.
f. Severability. If any provision of this Agreement is held as a matter of law to be
unenforceable, the remainder of this Agreement shall be valid and binding upon the
Parties.
g. Ownership of Work Product. Should Provider’s performance of this Agreement generate
documents, items or things that are specific to this Project such documents, items or
things shall become the property of the County and may be used on any other project
without additional compensation to the Provider. The use of the documents, items or
things by the County or by any person or entity for any purpose other than the Project as
set forth in this Agreement shall be at the full risk of the County.
h. Non-Appropriation. Provider acknowledges that County is a governmental entity, and
the validity of this Agreement is based upon the availability of public funding under the
authority of its statutory mandate.
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In the event that public funds are unavailable or not appropriated for the performance of
County’s obligations under this Agreement, then this Agreement shall automatically
expire without penalty to County immediately upon written notice to Provider of the
unavailability or non-appropriation of public funds. It is expressly agreed that County
shall not activate this non-appropriation provision for its convenience or to circumvent
the requirements of this Agreement.
In the event of a change in the County’s statutory authority, mandate or mandated
functions, by state or federal legislative or regulatory action, which adversely affects
County’s authority to continue its obligations under this Agreement, then this Agreement
shall automatically terminate without penalty to County upon written notice to Provider
of such limitation or change in County’s legal authority.
i. Signatures. This Agreement together with any amendments or modifications may be
executed electronically. All electronic signatures affixed hereto evidence the consent of
the Parties to utilize electronic signatures and the intent of the Parties to comply with
Article 11A and Article 40 of North Carolina General Statute Chapter 66.
j. Notices. Any notice required by this Agreement shall be in writing and delivered by
certified or registered mail, return receipt requested to the following:
Orange County Provider’s Name
Attention:Kimberlee Quatrone Freedom House Recovery Ctr
P.O. Box 8181 104 New Stateside Drive
Hillsborough, NC 27278 Chapel Hill, NC 27516
[SIGNATURE PAGE TO FOLLOW]
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IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have
hereunder set their hands and seal, all as of the day and year first above written.
ORANGE COUNTY: PROVIDER:
By: _________________________________
Jamezetta Bedford, Chair, Orange County
Board of County Commissioners
By: __________________________________
Joyce Harper, CEO
Printed Name and Title
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ORANGE COUNTY—INTERNAL USE ONLY
______________________________________________________________________________
Finance Information
Vendor Name: Freedom House Vendor Contact Person: Joyce Harper Phone: 919-942-2803 Address: 104 New
Stateside Drive City Chapel Hill State: NC Zip: 27516 Department: Health Amount: $144,926.53 Purpose:
Services and support programs that serve persons with Opioid Use Disorder Budget Code(s): 27411020-630000-
92001 Vendor # 34104
Vendor Status with NCSOS: Current-Active Non-Profit Vendor is a BOCC consultant: Yes No
Contract Details
Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment )
Effective Date 7/1/24 End Date 6/30/25 Notice Date (Notice Purpose )
Award
Approved by Board (Agenda Date: April 18, 2023); Made or Administered by
Signature Authority
- BOCC Express Delegation (Agenda Date: )
- Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000
- Budget Policy Section XV (Capital Improvement Project: )
Bidding
Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# )
Department Affirmation
This agreement is approved as to technical form and content and I as Department Director affirmat ively state
work on this project has not been initiated prio r to execution of the agreement.
This agreement is approved as to technical form and content. Services related to this agreement have alread y
begun or been completed. Description of the nature of the emergency condition that was addressed: Waiting on
paperwork. Didn't want to stop necessary services to clients while finalizing contract.
Department Director’s Signature ________________________________________ Date: ________
Information Technologies
This agreement has been reviewed and is approved as to information technology content and specifications:
Office of the Chief Information Officer___________________________________ Date: ________
Inapplicable because no hardware/software purchases or related services
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
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9/30/2024
10/1/2024
10/1/2024
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Received for record retention:
Office of the Clerk to the Board __________________________________________Date:________
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Exhibits, page 1
EXHIBIT A TO NC MOA:
HIGH-IMPACT OPIOID ABATEMENT STRATEGIES (“OPTION A” List)
In keeping with the National Settlement Agreement, opioid settlement funds may support
programs or services listed below that serve persons with Opioid Use Disorder (OUD) or any
co-occurring Substance Use Disorder (SUD) or mental health condition.
As used in this list, the words “fund” and “support” are used interchangeably and mean to
create, expand, or sustain a program, service, or activity.
1.Collaborative strategic planning. Support collaborative strategic planning to address
opioid misuse, addiction, overdose, or related issues, including staff support, facilitation
services, or any activity or combination of activities listed in Exhibit C to the MOA
(collaborative strategic planning).
2.Evidence-based addiction treatment. Support evidence-based addiction treatment
consistent with the American Society of Addiction Medicine’s national practice
guidelines for the treatment of opioid use disorder – including Medication-Assisted
Treatment (MAT) with any medication approved for this purpose by the U.S. Food and
Drug Administration – through Opioid Treatment Programs, qualified providers of
Office-Based Opioid Treatment, Federally Qualified Health Centers, treatment offered in
conjunction with justice system programs, or other community-based programs offering
evidence-based addiction treatment. This may include capital expenditures for facilities
that offer evidence-based treatment for OUD. (If only a portion of a facility offers such
treatment, then only that portion qualifies for funding, on a pro rata basis.)
3.Recovery support services. Fund evidence-based recovery support services, including
peer support specialists or care navigators based in local health departments, social
service offices, detention facilities, community-based organizations, or other settings that
support people in treatment or recovery, or people who use drugs, in accessing addiction
treatment, recovery support, harm reduction services, primary healthcare, or other
services or supports they need to improve their health or well-being.
4.Recovery housing support. Fund programs offering recovery housing support to people
in treatment or recovery, or people who use drugs, such as assistance with rent, move-in
deposits, or utilities; or fund recovery housing programs that provide housing to
individuals receiving Medication-Assisted Treatment for opioid use disorder.
5.Employment-related services. Fund programs offering employment support services to
people in treatment or recovery, or people who use drugs, such as job training, job skills,
job placement, interview coaching, resume review, professional attire, relevant courses at
community colleges or vocational schools, transportation services or transportation
vouchers to facilitate any of these activities, or similar services or supports.
6.Early intervention. Fund programs, services, or training to encourage early
identification and intervention for children or adolescents who may be struggling with
problematic use of drugs or mental health conditions, including Youth Mental Health
Exhibit ADocusign Envelope ID: C2CD9F79-7C8E-4B6B-8B12-D37C626968D7
Exhibits, page 2
First Aid, peer-based programs, or similar approaches. Training programs may target
parents, family members, caregivers, teachers, school staff, peers, neighbors, health or
human services professionals, or others in contact with children or adolescents.
7. Naloxone distribution. Support programs or organizations that distribute naloxone to
persons at risk of overdose or their social networks, such as Syringe Service Programs,
post-overdose response teams, programs that provide naloxone to persons upon release
from jail or prison, emergency medical service providers or hospital emergency
departments that provide naloxone to persons at risk of overdose, or community-based
organizations that provide services to people who use drugs. Programs or organizations
involved in community distribution of naloxone may, in addition, provide naloxone to
first responders.
8. Post-overdose response team. Support post-overdose response teams that connect
persons who have experienced non-fatal drug overdoses to addiction treatment, recovery
support, harm reduction services, primary healthcare, or other services or supports they
need to improve their health or well-being.
9. Syringe Service Program. Support Syringe Service Programs operated by any
governmental or nongovernmental organization authorized by section 90-113.27 of the
North Carolina General Statutes that provide syringes, naloxone, or other harm reduction
supplies; that dispose of used syringes; that connect clients to prevention, treatment,
recovery support, behavioral healthcare, primary healthcare, or other services or supports
they need; or that provide any of these services or supports.
10. Criminal justice diversion programs. Support pre-arrest or post-arrest diversion
programs, or pre-trial service programs, that connect individuals involved or at risk of
becoming involved in the criminal justice system to addiction treatment, recovery
support, harm reduction services, primary healthcare, prevention, or other services or
supports they need, or that provide any of these services or supports.
11. Addiction treatment for incarcerated persons. Support evidence-based addiction
treatment, including Medication-Assisted Treatment with at least one FDA-approved
opioid agonist, to persons who are incarcerated in jail or prison.
12. Reentry Programs. Support programs that connect incarcerated persons to addiction
treatment, recovery support, harm reduction services, primary healthcare, or other
services or supports they need upon release from jail or prison, or that provide any of
these services or supports.
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Exhibit B
Start Date: 7/1/2024
End Date: 6/30/2025
Description Count How were efforts supported?Notes Additional Information & Helpful Hints about this Measure
# of naloxone kits distributed A naloxone kit contains two doses.
# of OTPs that dispense methadone, buprenorphine, and naltrexone
# of OTPs that dispense only methadone
# of OTP-based medical providers who prescribe methadone for OUD
patients
A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of referrals to opioid treatment programs Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique patients with OUD served at OTP
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of office-based clinics offering MOUD within county
# of individual OBOT providers who prescribe buprenorphine for
patients
A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of buprenorphine prescriptions provided at OBOT
# of naltrexone doses provided at OBOT
# of referrals to OBOT Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique patients with OUD served at OBOT
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of FQHCs offering MOUD within county
# of individual FQHC providers who prescribe buprenorphine for
patients
A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of buprenorphine prescriptions provided at FQHC
# of naltrexone doses provided at FQHC
# of referrals to FQHC MAT services Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique patients with OUD served at FQHC
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of hospitals offering in-patient MOUD within county
# of hospitalists who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of buprenorphine prescriptions provided through in-patient services
in hospitals
# of naltrexone doses provided through in-patient services in hospitals
2. Evidence-Based Treatment
Insert Start and End Date for this Strategy (MM/DD/YYYY)
Process measures answer the question, “How much did you do?”. Please quantify the process measures relevant to your implementation of this strategy. Indicate whether the
count represents efforts supported only by opioid settlement funds or efforts supported by multiple funding sources including opioid settlement funds. Process measures
should reflect numbers from the 2024 fiscal year (i.e., July 1, 2024-June 30, 2025).
STRATEGY-SPECIFIC PROCESS MEASURES
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# of referrals to in-patient MAT services Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique hospital in-patients with OUD served with MAT
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of emergency departments offering MOUD within county
# of emergency department providers who prescribe buprenorphine
for patients
A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of short-term buprenorphine prescriptions (14 days or less) provided
in the ED
# of longer-term buprenorphine prescriptions (15 days or more)
provided in the ED
# of naltrexone doses provided in the emergency department
# of referrals from emergency department to community providers Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique emergency department patients with OUD served with
MAT
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of Local Health Departments (LHD) offering MOUD within county
# of individual LHD-based providers who prescribe buprenorphine for
patients
A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of buprenorphine prescriptions provided at LHD
# of naltrexone doses provided at LHD
# of referrals to LHD MAT services Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique patients with OUD served at LHD with MAT
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of EMS programs offering MOUD within county
# of individual EMS providers who prescribe buprenorphine for
patients
A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of buprenorphine prescriptions provided through EMS-based MAT
programs
# of naltrexone doses through EMS-based MAT programs
# of referrals to EMS-based MAT programs Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
# of unique patients who received pre-hospital buprenorphine
treatment from EMS during a non-fatal overdose encounter
# of unique patients with OUD served through EMS-based MAT
programs
# of unique patients with OUD who declined services through EMS-
based MAT programs
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of Syringe Service Programs (SSPs) offering MOUD within county A provider may participate in multiple support programs so there may be
some duplication of # of providers.
# of providers who prescribe buprenorphine for patients at/through
an SSP
# of buprenorphine prescriptions provided through SSPs
# of naltrexone doses provided through SSPs
# of referrals to SSP-based MAT services Number of referrals do not equate to number of unique patients because
one individual may receive multiple referrals.
Docusign Envelope ID: C2CD9F79-7C8E-4B6B-8B12-D37C626968D7
# of unique patients with OUD served through SSPs with MAT
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
# of patients who are justice-involved that are referred to any MAT
program
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
Custom, strategy-specific measures may be entered in this row.
Custom, strategy-specific measures may be entered in this row.
Custom, strategy-specific measures may be entered in this row.
Process Measure Count Additional Information & Helpful Hints about this Measure
# of unique patients who have OUD, served
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
impact report. A patient may receive services across local government
boundaries (e.g., a person with OUD may reside in one county and receive
services in another county).
American Indian/Alaska Native Non-Hispanic
Asian Non-Hispanic
Black Non-Hispanic
Native Hawaiian or Other Pacific Islander Non-Hispanic
White Non-Hispanic
Hispanic
Some Other Race or Multiple Races
Unknown
Sum total of unique patients served (Autocalculated)
Does sum total (C87) match the reported # of unique patients (C77)?
(Autocalculated)Yes
Description Count Quality Measure Percent (Autocalculated)Notes Additional Information & Helpful Hints about this Measure
# of referrals to opioid treatment programs that resulted in 1st
appointment attended
# of referrals to opioid treatment programs
# of referrals to OBOT services that resulted in 1st appointment
attended at office-based clinic
# of referrals to OBOT services at office-based clinic
# of referrals to OBOT services that resulted in 1st appointment
attended at FQHC
# of referrals to OBOT services at FQHC
# of referrals to OBOT services that resulted in 1st appointment
attended at LHD
# of referrals to OBOT services at LHD
# of referrals to EMS-based MAT programs that resulted in 1st
appointment for treatment attended
# of referrals to EMS-based MAT programs
# of referrals to SSP-based MAT services that resulted in 1st
appointment for treatment attended
# of referrals to SSP-based MAT services
# of patients who are justice-involved that are referred to any MAT
program that resulted in 1st appointment for treatment attended
# of patients who are justice-involved that are referred to any MAT
program
% of referrals from justice system
programs that resulted in 1st
appointment for treatment
attended
Incomplete
% of referrals to EMS-based MAT
services that resulted in 1st
appointment for treatment
Incomplete
% of referrals to SSP-based MAT
services that resulted in 1st
appointment for treatment
Incomplete
% of referrals to OBOT services that
resulted in 1st appointment
attended at FQHC
Incomplete
% of referrals to OBOT services that
resulted in 1st appointment for
treatment attended at LHD
Incomplete
% of referrals to OTP services that
resulted in 1st appointment
attended
Incomplete
% of referrals to OBOT services that
resulted in 1st appointment
attended at office-based clinic
Incomplete
STRATEGY-SPECIFIC QUALITY MEASURES
Of the # of unique patients who have OUD, served in the count above, how many people identified as:
Quality measures answer the question, “How well did you do it?”. Please quantify the quality measures relevant to your implementation of this strategy. Quality measures should reflect numbers from the 2024 fiscal year (i.e., July 1, 2024-June 30, 2025).
Notes
DEMOGRAPHICS: Provide the following information on race and ethnicity for the # of unique patients who have OUD, served during the 2024 fiscal year (i.e., July 1, 2024-June
30, 2025).
Docusign Envelope ID: C2CD9F79-7C8E-4B6B-8B12-D37C626968D7
# of unique patients who have OUD, served, who report they are
satisfied with services
# of unique patients who have OUD, served
Description Count Outcome Measure Percent (Autocalculated)Notes Additional Information & Helpful Hints about this Measure
# of unique patients with OUD served who were connected and
adhere to treatment
# of unique patients who have OUD, served
# of patients who have OUD, served who report getting the social and
emotional support they need
# of unique patients who have OUD, served
# of community overdose reversals using naloxone # of community overdose reversals
using naloxone N/A
Description Notes Additional Information & Helpful Hints about this Measure
# of patients with OUD who received evidence-based addiction
treatment services across programs and settings
The Opioid and Substance Use Action Plan (OSUAP) Data Dashboard can be
found here. Use the "Metrics" tab to find the "Metric" (i.e., Outcome
Measure, Population-Level) and "Place" to find your county.
% of residents receiving dispensed buprenorphine prescriptions
The Opioid and Substance Use Action Plan (OSUAP) Data Dashboard can be
found here. Use the "Metrics" tab to find the "Metric" (i.e., Outcome
Measure, Population-Level) and "Place" to find your county.
% of individuals with OUD served by treatment programs who are
uninsured or Medicaid beneficiaries
The Opioid and Substance Use Action Plan (OSUAP) Data Dashboard can be
found here. Use the "Metrics" tab to find the "Metric" (i.e., Outcome
Measure, Population-Level) and "Place" to find your county.
Are you expecting to change this measure as a result of implementing this stragegy?
Incomplete Custom, strategy-specific measures may be entered in this row.
In addition to any program-level outcome measures captured above, population-level data on outcome measures are available from the OSUAP Data Dashboard. Please visit the Data Dashboard and become familiar with what is available. Then indicate if
STRATEGY-SPECIFIC OUTCOME MEASURES (POPULATION-LEVEL)
Incomplete Custom, strategy-specific measures may be entered in this row.
Incomplete Custom, strategy-specific measures may be entered in this row.
% of patients with OUD who adhere
to treatment __ months after first
appointment
Incomplete
Recommended measure at six months. If measure for adherence is taken at
another increment, please describe this in the "Notes" column.
% of patients who report getting the
social and emotional support they
need
Incomplete
Consider asking patients the Behavioral Risk Factor Surveillance System
question,
"How often do you get the social and emotional support you need?"
STRATEGY-SPECIFIC OUTCOME MEASURES (PROGRAM-LEVEL)
Incomplete Custom, strategy-specific measures may be entered in this row.
Incomplete Custom, strategy-specific measures may be entered in this row.
Incomplete Custom, strategy-specific measures may be entered in this row.
Outcome measures answer the question, “Is anyone better off?”. Outcome measures can be at the program- or population-level. Please quantify the outcome measures relevant to your implementation of this strategy. Outcome measures should reflect
numbers from the 2024 fiscal year (i.e., July 1, 2024-June 30, 2025).
% of patients, who have OUD, who
are satisfied w/ services Incomplete
A unique patient may participate in multiple treatment programs so there
may be some duplication of unique patients when numbers across
programs, project, sites, etc., are aggregated for the strategy-specific
Docusign Envelope ID: C2CD9F79-7C8E-4B6B-8B12-D37C626968D7
Docusign Envelope ID: C2CD9F79-7C8E-4B6B-8B12-D37C626968D7