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SUD in LTC

Since 2019, DPH has been partnering with Abt Associates to develop resources for long-term care (LTC) facilities to better care for residents on medication for opioid use disorder (MOUD). The MOUD in LTC Initiative has been funded by the State Opioid Response (SOR) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) across three iterations of the program. This page describes each iteration and contains training documents and materials prepared as part of this initiative.

Iteration 3 (2023-2024): The team is developing and hosting quarterly webinars as well as a new bi-annual summit to facilitate professional growth and community partnerships while continuing to provide individualized coaching and technical support to facilities.

Iteration 2 (2021-2022): The team developed an online self-paced training for LTC staff, hosted peer-to-peer webinars, and provided individualized coaching and technical support to facilities.

Iteration 1 (2019-2020): The team hosted regional in-person trainings, developed an ECHO® series and the LTC Toolkit while providing individualized coaching and technical support to facilities.

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Iteration 3 (2023 – 2024)

The program team is building upon their previous work by continuing to provide training and technical assistance for LTC facilities caring for residents with opioid use disorder (OUD) and administering and expanding the self-paced online training developed in the second iteration of the program. They are also developing and convening new quarterly webinars to address questions and needs identified by working with facilities over the years, as well as a recent bi-annual in-person summit to provide educational and networking opportunities to LTC facilities, connecting them with their peers, governmental agencies, and community resources such as Opioid Treatment Programs (OTPs) and Office-Based Addiction Treatment (OBAT) programs. The presentations from this bi-annual summit and the webinars will be available on this page as video recordings. In this iteration, the team will also incorporate knowledge and best practices around managing polysubstance use, including alcohol use disorders.

Technical Support

If you are a long-term care facility seeking guidance on best practices for admissions, providing adequate care, and/or facilitating medication treatment for residents with OUD, Abt Associates is offering personalized coaching to assist your facility in providing the best care for all your residents. To request coaching support, please email SUDinLTC@abtassoc.com, including your name, facility’s name, and a short overview of your needs.

Materials

Virtual Summit (March 30, 2023): Moral and Legal Obligations to Care for Residents with Substance Use Disorders in Long-term Care

Virtual Summit (May 18, 2023): Building Community Connections with OTPs and OBATs to Support your Residents

In Person Conference (June 27, 2023): Collaborating on the Care of Residents with Substance Use Disorders (flyer) (PDF) | (DOCX)

Iteration 2 (2021 – 2022)

Working collaboratively with the Bureau of Health Care Safety and Quality (BHCSQ) and the Bureau of Substance Addiction Services (BSAS), the program team recruited 57 long-term care facilities to participate in this program iteration. We also engaged a statewide MOUD in LTC workgroup to oversee the development of program content. The workgroup had collaborated with the team on the previous iteration. The workgroup provided input periodically throughout the current program as the team developed a MOUD in the LTC toolkit, core competencies, training materials, and the implementation approach.

The program team built upon the MOUD in LTC Toolkit developed in the first iteration of this program by including content on co-occurring stimulant use disorder and translating it into Spanish. Additionally, this content was adapted into a self-paced online training program, which provides continuing education units (CEUs) upon completion. The updated Toolkit and online training link were provided to all 57 recruited LTCFs and shared with all LTCFs.  Facilities that had previous experience caring for residents with OUD were also offered training and technical support through telephone and email contact, infographics, virtual site visits, and a series of peer-to-peer sessions developed by the program team. The peer-to-peer sessions were educational presentations that encouraged information sharing between facilities. Three sessions were hosted virtually as webinars and a fourth was hosted in-person at three locations across the Commonwealth. Facilities that had little to no prior experience with caring for residents with OUD were invited to a virtual Mentoring Session led by three experienced facilities sharing their approaches. The team collected qualitative and quantitative data to assess the program’s impact. Additionally, in partnership with BHCSQ, the team shared information about the MOUD in LTC program with stakeholders, including non-participating LTCFs, by posting the toolkit and other training materials on the BHCSQ website.

Impact of COVID-19

COVID-19 continued to impact Massachusetts LTCF throughout the Year 2 MOUD program. Not only were facilities continuing to manage variants of the virus, but they were overwhelmed with severe staff shortages. As a result, some program activities experienced low participation rates. To help maintain facility engagement during downtime, the team forwarded relevant infographics to participating facilities.

Materials

MOUD in LTC Toolkit (English and Spanish)

Self-paced online training

Self-paced training

Peer to Peer Trainings

Infographics

Coming soon: Final report

Iteration 1 (2019 – 2020)

Working collaboratively with BHCSQ, the Abt Team recruited 42 LTCFs to participate in this program. They also engaged a statewide MOUD in LTC Workgroup to oversee the development of program content. The MOUD in LTC Workgroup provided input periodically throughout the current program as the Team developed example policies, the MOUD in LTC Toolkit, core competencies, training materials, and the implementation approach. 

In addition to the LTCFs and the MOUD in LTC Workgroup, the Abt Team engaged five opioid treatment programs (OTPs) and five office-based opioid treatment providers (OBOTs) for this project. The Abt Team provided all 42 participating LTCFs with a MOUD in LTC Toolkit developed specifically for this program as well as in-person and remote training and technical support. The Team provided training and technical support through telephone and email contact, virtual site visits, an in-person learning session, and a virtual Project ECHO® series. The Team also conducted pre-implementation site visits to a sample of the participating facilities to learn more about their on-site practices and interview staff. We collected qualitative and quantitative data to assess the program’s impact.

Impact of COVID-19

The Abt Team had proposed to conduct all components of the MOUD program as in-person events throughout the spring and summer of 2020. However, due to the novel coronavirus disease 2019 (COVID-19) outbreak, except for the first in-person learning session conducted in January 2020, we redesigned the mode of presentation to virtual events. During the interim we sent bi-weekly infographics to maintain facility engagement. The Team resumed telephone outreach in July; however, facilities were still overwhelmed as a result of COVID-19. Not only were they continuing vigilance to control the disease, but facilities were inundated with new reporting requirements, additional infection control oversight, and several required or incentivized Project ECHO® sessions. As a result, the later program activities experienced low participation rates.

Materials

In-Person Learning Session Slides

ECHO Sessions

ECHO Session 1: Telehealth

  • Session 1a
  • Session 1b

ECHO Session 2: Hospital Transitions

  • Session 2a
  • Session 2b

ECHO Session 3: Community Partnerships

  • Session 3a
  • Session 3b

ECHO Session 4: Transportation

ECHO Session 5: LTCF to Home

  • Session 5

ECHO Session 6: Regulations

  • Session 6

Infographics

Presentations

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