At hearing on opioid use disorder, legislators will learn how a UB program is successfully implementing the “warm handoff”

BUFFALO, N.Y. ­­— At a hearing on Nov. 17, members of the Committee on Alcoholism and Substance Abuse of the New York State Assembly will learn about New York MATTERS, a successful program developed by University at Buffalo emergency medicine physicians to expedite access to care for people with substance use disorder.

The purpose of the hearing is to discuss NYS Assembly Bill A7354 which will require a “warm handoff” to treatment for any substance use disorder patient who comes to any emergency department in New York State.

Robert McCormack, MD, physician adviser to MATTERS, chair of the Department of Emergency Medicine in the Jacobs School of Medicine and Biomedical Sciences at UB and president of UBMD Emergency Medicine, was invited to testify about New York MATTERS (Medication for Addiction Treatment & Electronic Referrals). The program provides medication-assisted treatment to opioid use disorder patients in emergency departments and rapidly transitions them into long-term treatment at a community clinic of their own choosing, all within about 24-48 hours.

McCormack will note: “Prior to the development of the New York MATTERS program, the care of patients with opioid use disorder in emergency departments left much to be desired. Patients were often discharged with a list of phone numbers of overwhelmed treatment clinics. Some of these numbers were not active and appointments were weeks away.”

Linkage to care

In 2016, McCormack’s colleague, Joshua Lynch, DO, (@JLynchDO) clinical associate professor in the Department of Emergency Medicine in the Jacobs School and a physician with UBMD Emergency Medicine, established Buffalo MATTERS, which has now been rebranded to New York MATTERS.

The program expedites linkage to care for people with substance abuse disorder throughout the hospitals of the eight counties of Western New York. It also implemented an aggressive effort to train emergency physicians and advanced practice providers in responsible opioid prescribing; in the prescribing of buprenorphine, which controls withdrawal symptoms; and in making rapid referrals to community treatment.

McCormack will testify: “The program offers referrals to treatment through a completely electronic process, securely housed on the New York State Health Commerce System. With hundreds of weekly appointment slots available, most patients select an appointment close to their home and are seen within 1-2 days. All patients are offered the same appointment opportunities regardless of past drug use, insurance status, and current substance use behavior.”

New York MATTERS partners with more than 100 community-based clinics, 1,000 pharmacies and more than 40 hospitals throughout the state. The program offers patients a medication voucher program, which covers the cost of a buprenorphine prescription for up to 14 days and is redeemable at hundreds of public and privately owned pharmacies across the state, including all CVS, Walgreens and Wegmans locations. These referrals are completed entirely online between the patient and provider, taking only 3-5 minutes.

In addition, New York MATTERS offers patients a transportation voucher to cover the round-trip ride for their first clinic appointment and a referral to a local peer support organization.

Not only are more hospitals throughout the state offering MATTERS, but departments of health in other states are currently in discussions with Lynch about how to create similar programs.

Virtual treatment

McCormack will also discuss MATTERS’ virtual treatment options through the development of virtual emergency departments staffed by UBMD emergency medicine physicians in Kaleida Health hospitals in Buffalo and at the Erie County Medical Center. Patients can be prescribed buprenorphine and receive a New York MATTERS referral without ever presenting in person to the emergency department. Patients referred through this telemedicine partnership will be offered the exact same harm- and barrier-reduction resources as individuals presenting to an emergency department in person.

Many clinic partners continue to offer virtual appointments, as well as other harm-reduction services, such as syringe-exchange programs and treatment for HIV/AIDS and hepatitis C.

Lynch explained that the New York MATTERS program serves as an integral resource to connect patients to outpatient programs that will best meet their needs while not overwhelming already challenged emergency departments.

“MATTERS is already helping substance use disorder patients in 20% of the hospitals in New York State,” he said. “The warm handoff bill will mandate this expediting of treatment for hospitals across the state. New York MATTERS increases access to medication assisted treatment, and quickly connects them to high quality outpatient treatment.

“The bill requires warm connections to treatment providers, which is what the MATTERS program does. MATTERS is what the warm handoff looks like,” Lynch said.

Funding for MATTERS comes from private foundations and government agencies, including the New York State Department of Health, the New York State Office of Addiction Services and Supports, the federal Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration and others.