HHS official gets overview of Buffalo MATTERS program

An innovative opioid treatment program developed by emergency medicine physicians from the Jacobs School of Medicine and Biomedical Sciences at UB gained critical federal support last Thursday as U.S. Department of Health and Human Services Region 2 Director Dara Kass met with program leaders.

Kass, who oversees HHS operations in New York, New Jersey, Puerto Rico and the U.S. Virgin Islands, participated in a roundtable with MATTERS leadership and community health partners. Kass was in Buffalo for a few days to convene a series of stakeholder meetings with partners aligned with HHS’ health priorities, which include treatment for opioid use disorders.

The program, which started out in Buffalo as Medication Assisted Treatment and Emergency Referrals, or Buffalo MATTERS, is now available statewide. Plans are also in the works to expand the program to contiguous states, including New Jersey.

MATTERS 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.

MATTERS now offers more than 1,700 appointment slots each week, program founder and medical director Joshua Lynch said during the roundtable, held in the Harold J. Levy, MD ’46 and Arlyne Levy Dean’s Conference Room at the Jacobs School. Lynch is UB clinical associate professor of emergency medicine and a physician with UBMD Emergency Medicine.

Kass was impressed by the level of integrated care MATTERS provides patients, and said President Biden fully supports programs like it. “This administration is committed to supporting programs that get medication into the hands of patients who need it,” said Kass, an emergency medicine physician by training who Biden appointed as HHS Region 2 director in November 2021.

“I am grateful to be here with you. I am grateful to everyone working together and providing an incubator and a pilot for what I hope to help communicate to the rest of the country,” Kass added.

Allison Brashear, vice president for health sciences and dean of the Jacobs School, praised the work Lynch and his colleagues have done in expanding MATTERS across New York State. “We are so proud of what has been created here,” she said, adding that UB’s breadth of health sciences schools and their associated educational and research opportunities uniquely position UB among other schools nationally, especially when it comes to treating conditions such as opioid use disorder.

“We are committed to training the next generation of physicians to be patient-centered. This means understanding what care patients and families need, such as social work, pharmacy and other services, to make sure they get the services that they need,” Brashear said. “We really focus on team science, and this (MATTERS) is a great example of team work.”

Thursday’s roundtable discussion included several Jacobs School faculty members affiliated with MATTERS, as well as key community health partners, such as Evergreen Health Services, Horizon Health Services and BestSelf Behavioral Health. Additional partners present included Cheektowaga Police Chief Brian Gould and representatives from Albany Medical Center’s Department of Emergency Medicine and various New Jersey state agencies that have signed on to the MATTERS program.

There were also representatives from three New Jersey organizations with which MATTERS is forging a partnership as the program continues its expansion: Cooper Health, the New Jersey Department of Human Services and the New Jersey Department of Health.

Brian Clemency, professor in the Department of Emergency Medicine in the Jacobs School who serves as MATTERS’ director of program evaluation, explained the life cycle of a patient in the MATTERS program.

MATTERS refers patients with opioid use disorder to community-based clinics from a number of settings, including emergency departments, correctional facilities and in-patient units. MATTERS patients start on opioid treatments buprenorphine or suboxone, then receive a referral to a community health clinic within 72 hours, and also receive a medication voucher to cover the cost of a prescription of buprenorphine for up to 14 days.

“Once we identify someone who might be a candidate for buprenorphine, the first thing we’ve done is try to really remove as many barriers on the physician side as possible,” Clemency said.

MATTERS created a standardized dose of buprenorphine that emergency room doctors can administer to patients currently in withdrawal. If the patient isn’t experiencing withdrawal, then they are given instructions on how to administer buprenorphine at home once they begin having severe withdrawal symptoms.

Next, the patient is provided with an iPad that shows them the options they have for a community clinic to attend.

“One of the most unbelievably empowering things for a patient who’s used to being told what to do is handing them an iPad and saying ‘here are all the places that you can go tomorrow to be seen; you tell us where you want to go,’” Clemency said.

Lynch noted that the MATTERS app for Apple and Android devices will also launch soon, offering links to referrals and patient resources.

MATTERS was designed to work in any size hospital setting, Lynch explained. “We designed MATTERS to work just as well in a 500-bed hospital as a critical access community hospital staffed by a physician assistant with two nurses. It can be applied however that hospital wants it to be.”

After the roundtable, Lynch said he’s excited to see where MATTERS goes next.

“We were pleased to welcome Dr. Kass to the Jacobs School of Medicine and Biomedical Sciences today. We greatly appreciate the opportunity to share how the MATTERS program integrates with many different community organizations and look forward to working with Dr. Kass as we expand services and work to partner with other states,” he said.