NEW CASTLE (Jan. 4, 2022) – The Department of Health and Social Services’ (DHSS) Division of Substance Use and Mental Health (DSAMH) has surpassed a milestone of 100,000 referrals through its Delaware Treatment and Referral Network (DTRN), a system for Delawareans seeking substance use and mental health services.

Delaware is the first state to make more than 100,000 referrals using this system, built on the OpenBeds® platform, a bed registry platform owned by Bamboo Health (formerly Appriss Health + PatientPing). The DTRN system identifies and tracks behavioral health and social determinants of health resources throughout the state, giving providers immediate visibility into resource availability across a shared network. This makes it easier to get people the help they need when they need it.

“One death from an opioid overdose or from a mental health crisis is one too many,” said Lt. Governor Bethany Hall-Long, Ph.D., RN. “For families coping with a loved one, who suffers from substance use disorder or mental illness, finding help is an immediate need that must be met. The 100,000 referrals through DTRN demonstrates that we are mending the fractured behavioral health system in Delaware, so people can get access to treatment and on the path to recovery. As Chair of Delaware’s Behavioral Health Consortium, we remain committed to saving lives through platforms like DTRN and the network of behavioral health providers. Newsweek recently recognized Delaware in November 2021 as one of only four states that the CDC reported as having a decrease in the annual percentage rate of opioid deaths. DTRN was a significant tool contributing to this reduction.”

“This milestone represents a systematic improvement in identifying and treating individuals with substance use disorders,” said Joanna Champney, Director of the Division of Substance Abuse and Mental Health. “That is 100,000 times where a pathway to treatment was made available for someone so they didn’t have to end up in the emergency room or worse.”

The Division of Substance Abuse and Mental Health launched DTRN in October 2018 as a way to improve outcomes for Delawareans suffering from a substance use disorder, while coordinating support for accompanying needs for housing, employment, education and other wraparound services. A recent white paper summarizing first-year results showed that the cloud-based network for expedited client referrals to inpatient and residential behavioral health programs generated a 45% increase in treatment referral requests in its first year, while improving rapid acknowledgment of referrals by 25%.

“Open Beds has been a fantastic platform that has provided transparency like never before,” said Steve Beltran, MSN, an RN Nurse Manager for ChristianaCare. “It has allowed us to place our patients in the right level of care faster. And has proven to be an effective method to communicate with care providers and agencies across the state.”

Overdose deaths continue to rise in Delaware, reaching 447 in 2020 (up from 431 in 2019 and 401 in 2018). Of those 447 deaths, 372 (83%) involved the use of fentanyl, a powerful synthetic opioid that is 50-100 times more potent than morphine.

The state’s opioid prescribing rate in 2020 of 45.2 per 100 people is higher than the U.S. average of 43.3, according to data from the Centers for Disease Control and Prevention (CDC).

Lack of visibility for providers in determining current inpatient and residential treatment center capacity can make it challenging to connect clients with appropriate substance use and behavioral health services in a timely manner. Referring physicians and treatment providers often struggle to share client data, admission criteria, and availability. For clients in need, these delays can be dangerous and even life-threatening.

By assisting providers with the onboarding process to encourage adoption of the Delaware Treatment and Referral Network, Delaware expanded the number of active users on its network by 264% in its first year. The referral platform also improved response rates to referral requests, with 65% of receiving organizations acknowledging a client referral within 30 minutes, an increase of 25% since the program’s inception a year prior.

“DTRN has been pivotal in connecting individuals with behavioral health and substance use issues with appropriate providers in an efficient and collaborative manner,” said John McKenna, CEO of Rockford Center. “This technology has substantially improved not only access to treatment for individuals and families, but also has facilitated an enhanced level of communication between the referring agency and our Assessment Center. Whether it’s accepting individual referrals at our front door, or helping our discharging patients get connected to community services prior to leaving our facility, DTRN has assisted in removing barriers and promoted access to a wider range of resources in our state. The system also provides us with critical data that allows us to better understand patient and family needs, engagement in treatment, and potential service gaps.”

“The Delaware Treatment and Referral Network has allowed the Department of Correction to connect individuals in our custody to vital health care services upon their release to the community,” said Department of Correction Commissioner Monroe B. Hudson Jr. “DTRN makes possible a seamless transition to resources like Medication-Assisted Treatment for offenders who struggle with addiction. Simply put, keeping these behavioral and medical health care services in place without interruption saves lives and is helping the DOC and our partners improve reentry outcomes across Delaware.”

If you or a loved one is struggling with addiction in Delaware, call DHSS’ 24/7 Crisis Hotline to be connected to treatment and recovery options at 1-833-9-HOPEDE or visit www.HelpIsHereDE.com or treatmentconnection.com.

NEW CASTLE (Nov. 12, 2021) – Atlantic Family Physicians plans to expand access to lifesaving Medication for Opiate Use Disorder (MOUD) for more than 100 patients with opioid use disorder this year. The Georgetown-based family practice, headed by Dr. Fabricio Alarcon, currently has 12 patients on MOUD. Two full-time nurse practitioners have been hired to help provide treatment for additional patients. The expansion is funded by a federal grant provided through the Division of Substance Abuse and Mental Health in response to the state’s opioid epidemic.

Dr. Alarcon said he was inspired about the use of medication-assisted treatment for opioid use disorder eight years ago when he filled in as the medical director for a nearby outpatient treatment center. “I loved that helping patients stay sober could change their lives,” he said. “I’ve seen marriages be saved, and families get stronger when people get treatment.” Dr. Alarcon went on to obtain his board certification in addiction medicine. He began treating patients with opioid use disorder years ago, but says he’s now focused on integrating medication-assisted treatment into the primary care office setting.

Sussex County ranks high for overdoses, and its rural setting creates challenges for getting to office visits for patients who may lack transportation. “It’s critical for the state to expand the number of treatment providers in Sussex County,” said Joanna Champney, Director of the Division of Substance Abuse and Mental Health.

Champney said that expansion of treatment and overdose prevention in the state’s rural areas is a major focus of the Overdose System of Care Committee, which she co-chairs with Dr. Rick Hong, Medical Director for the Division of Public Health. “Rural areas are particularly vulnerable because people are isolated,” she said, “and they can’t get to treatment as easily, and there are fewer providers to choose from.”

The Department of Health and Social Services’ Division of Substance Abuse and Mental Health (DSAMH) is funding additional staffing and supports for Atlantic Family Physicians to expand its MOUD practice through a federal grant. The State Opioid Response (SOR) grant brought in $37 million in discretionary funds for the state to expand opioid and stimulant use treatment and overdose prevention initiatives. The Atlantic Family Physicians initiative is one of 56 sub-grant applications currently received by the division for SOR funding. In addition, 37 of the applications are focused on helping a variety of health care programs screen existing patients for opioid use disorder.

Offering medication for opiate use disorder (MOUD) in a primary care setting not only expands the provider network, but it also helps reduce the stigma around patients seeking treatment from a formal drug and alcohol treatment center. In response to the transportation barrier common in rural settings, Atlantic Family Physicians will coordinate transportation to patients in need.

Medical office manager Jessica Riddle said she enjoys the long-term relationships formed with patients who regularly come in for treatment. “It is important to us that patients don’t feel judged coming in for treatment,” she said. “We treat all patients with respect.” Special bonds form with patients as they engage in treatment. “We see them regularly, and we get to know them and then if they miss an appointment, we worry about them and call and check to make sure they are OK,” Riddle said.

Depending on the specific medication a patient is taking for opioid use disorder treatment, the frequency of office visits varies. Initially, patients come in weekly. As they continue to engage in treatment and begin to improve, office visits can begin to be spaced out. Most patients end up coming in monthly. Patients who are coming out of active addiction typically are prescribed buprenorphine, Dr. Alarcon said. Those who may be coming out of an inpatient or outpatient treatment program can be prescribed Vivitrol, especially if they are also using alcohol.

Alarcon says patients may stay on medication-assisted treatment for 6 months or up to 10 years or longer. “It really depends on the patient,” he said. “You have to let your brain retrain itself. People who are still emotionally unstable, experiencing mood swings, may not be ready. Their brains are still reacting to the addiction. You’ll know you can consider tapering off treatment when you start to feel more leveled.” In his experience, patients who stop treatment too early often struggle to manage their cravings and are at higher risk to relapse. Last year, there were 447 fatal drug overdoses in the state, with 122 in Sussex County.

Two nurse practitioners in the office completed 24 hours of training to obtain the necessary credentialing to prescribe medication for opioid use disorders. The credential is commonly referred to as the “x-waiver.” Dr. Alarcon also recently hosted a meeting to train and educate all the office staff about how to talk with patients about treatment for opioid use disorder. “It’s new to a lot of medical staff, and we want our patients to feel welcome at the practice,” he said.

In addition to obtaining the required x-waiver, Alarcon’s staff participated in the Office-Based Opioid Treatment (OBOT) Fellowship, which teaches treatment providers how to help patients manage opioid use disorder through treatment approaches. “The course was amazing and taught us how to design office workflows for this type of treatment. It also showed us how to bill insurance. It was probably the best training we’ve ever received,” Dr. Alarcon added. DHSS’ Division of Medicaid and Medical Assistance sponsored the OBOT fellowship this year, supported by the SUPPORT Act Planning Grant from the Centers for Medicare and Medicaid Services. DSAMH plans to offer the trainings to additional providers this year using federal funds.

The next challenge Dr. Alarcon hopes to address is the high number of patients who leave emergency departments after a non-fatal overdose, but never show up to start treatment. His dream is to offer 24-hour induction, meaning patients could be brought to his practice anytime, day or night, after leaving an emergency department, to begin treatment for their opioid use disorder. An expansion of this type would require additional staff. However, Alarcon admits that since he is always on call, he already sees patients on a totally flexible schedule, with no set time windows. “We are here. We are willing to help people not only get sober, but to get their lives back together.”

Asked what advice he would give to other doctor’s offices considering expansion to include treatment for opioid use disorders, Alarcon said he would tell them to “absolutely do it.” He said he is willing to mentor doctors in the process and welcomes the opportunity to show medical professionals first-hand how expanding their practices to include these patients can be incredibly rewarding. “Honestly, the patients are great. I had one patient who would literally go out during a hurricane or a tornado to get his next heroin fix. That’s how much he was in the grip of addiction. And now he’s sober. He tells me that I saved his life. Even though he actually saved his own life by getting sober, we helped him in the process.”

The state’s Bridge Clinics, which are operated by the Division of Substance Abuse and Mental Health, are also partially funded with the federal SOR grant funds. Three Bridge Clinics statewide – one in each county – see walk-in clients, at no cost, for any type of mental health or substance use disorder. Clients are evaluated promptly and a connection to a longer-term treatment plan is arranged.

Grant funds are also being utilized to add substance use clinicians within the Delaware State Police. The program, which is operational in three troops and seeks to double its reach this year, connects people with substance use disorder to a clinician in lieu of arrest when they have contact with police. Naloxone, the lifesaving overdose reversal medication, is also being distributed with the grant funds. During the past year, more than 13,000 naloxone kits have been distributed, along with training on how to appropriately respond to an opioid overdose and use the medication.

If you or a loved one are struggling with substance use, you are encouraged to call the Delaware Hope Line at 1-833-9-HOPEDE or text CONNECT to 55753.

Funding for these initiatives is supplied by grant number 5H79TI083305-02 from the Substance Abuse and Mental Health Services Administration (SAMHSA). The content of this publication does not necessarily reflect the views or polices of SAMHSA or the U.S. Department of Health and Human Services (HHS).

NEW CASTLE (July 12, 2021) – Department of Health and Social Services (DHSS) Secretary Molly Magarik today announced leadership changes for the organization involving three divisions.

Magarik said the changes will help DHSS begin to embrace the goals outlined in the agency’s draft Strategic Plan, “Achieving the Vision: Person-Centered Health and Human Services in Delaware,” of modernizing the infrastructure and delivery of health and social services in order to help Delawareans live their best lives possible.

The changes:

Tom Hall, who has served as Acting Director of the Division of Social Services since April 2021, has been named Division Director, effective July 12. Hall joined DSS in 2006 as a Social Services Administrator, with policy oversight of the TANF, refugee assistance, emergency assistance and general assistance programs. He was promoted to Social Services Chief Administrator in March 2014 and became Deputy Director in 2015. Before coming to DHSS, Hall spent 18 years in a variety of roles in the health care field in Delaware, serving as a counselor, social worker, clinical manager, director of outpatient operations and assistant executive director. As Acting Director and formerly as Deputy Director, Hall led the efforts – in concert with child care providers, other stakeholders and DHSS’ budget team – to complete a Child Care Market Rate Survey for the Division’s Purchase of Care subsidized child care program, which supports about 14,000 children and their families statewide. Based on that survey, which was completed in February 2021 – and with the support of the General Assembly and Governor Carney – those rates were raised as of July 1, 2021.

Marcella Spady, who has served as Acting Deputy Director since May 2021, has been named Deputy Division Director. She began her career with the Division of Social Services in 1994 as a Seasonal Social Worker Case Manager before promotions to a Merit Senior Social Worker Case Manager and then to a Social Services Social Worker Case Manager Supervisor.

In 2007, Spady was promoted to Social Service Administrator over the Customer Relations Unit and three months later became Senior Social Administrator for the Division of Social Services, Area 2. In 2014, she joined the Modernization Project as a subject matter expert and tester for the ASSIST Worker Web system and was part of the team that implemented the system in 2015. In January 2016, Spady was assigned to the DSS Program and Policy Unit as the SNAP Policy Administrator. Through that experience, Spady helped DHSS file a series of successful applications and waivers with the federal government for expanded food benefits during the COVID-19 pandemic that supported tens of thousands of Delaware families, including maximum emergency food benefits, the Pandemic-EBT program and, most recently, the summer Pandemic-EBT program.

Magarik said the experiences of Hall and Spady make them both well-positioned to advance the community-based work of Governor John Carney’s Family Services Cabinet Council.

Steven Costantino, who serves as DHSS’ Director of Health Care Reform in the Secretary’s Office, will serve as Acting Director for the Division of Substance Abuse and Mental Health beginning July 13 through the end of the month. Steven came to DHSS in May 2017 after serving as Commissioner of the Department of Vermont Health Access and Medicaid Director. He previously served as Cabinet Secretary for Rhode Island’s Department of Human Services. In addition, he served as Executive Director of the Drug and Alcohol Treatment Association of Rhode Island for eight years.

Joanna Champney, who serves as Chief of Planning, Research & Reentry at the Delaware Department of Correction (DOC), will join the Department of Health and Social Services on Aug. 2 as Director of the Division of Substance Abuse and Mental Health. During her tenure at DOC, Champney established and led the Department’s new Office of Reentry following Governor Carney’s issuance of Executive Order 27 to improve prisoner reentry. As part of the Governor’s Executive Order, she served as a Commission member of the Delaware Correctional Reentry Commission (DCRC) and is currently Chairing the Commission’s Transition Team. Champney’s team expanded DOC’s use of evidence-based practices, including implementation of cognitive behavioral therapy programming for incarcerated people, improving probationer and inmate assessment strategies, and creating an evidence-based release planning system for staff to utilize with individuals preparing to leave prison custody. The Planning Unit also managed all research and data projects for the DOC as well as accreditation and compliance activities for DOC’s facilities.

Most recently, Champney oversaw implementation of several large federal grants that supported system improvement, program evaluation, and cognitive behavioral therapy and vocational training for incarcerated people. In partnership with the Bureau of Prisons, Champney also implemented compliance tracking processes for provision of clinical care to incarcerated people who have mental illness. She also was instrumental in the recent redesign of the DOC’s prison-based substance use disorder treatment program, Road to Recovery (R2R), which has now implemented modern, evidence-based set of curricula and has adopted a treatment track system to differentiate between levels of care.

Prior to joining state government, Joanna served as the Executive Director of the Delaware Center for Justice (DCJ), which serves a variety of justice-involved populations through direct services, advocacy and policy reform work. While at DCJ, she oversaw a combination of direct service programs and policy reform initiatives. Previously, she worked with a criminal defense law firm in Maryland and with a finance company in Delaware. She earned a Master’s Degree in Criminology from the University of Pennsylvania and a Bachelor’s Degree in Political Science from the University of Delaware.

Finally, in the Division of Management Services (DMS)/Office of the Secretary (OSEC), Secretary Magarik announced these changes:

Michele Stant, formerly Deputy Director of the Division of Management Services (DMS), was named Chief of Staff for the Secretary’s Office. Her first day was July 5. She will oversee communications, constituent relations, Freedom of Information Act (FOIA) requests and special projects. Stant replaces Gabriela Kejner, who left to work for the Health Unit in the Department of Justice’s Civil Law Division. She will continue to work closely with some of DHSS’ divisions.

Alexis Bryan-Dorsey, who previously served as Chief of Administration for the Division of Medicaid and Medical Assistance (DMMA) since 2017, has been named Deputy Director for the Division of Management Service in the Office of the Secretary. She began her new role on July 5. Bryan-Dorsey will oversee the Financial Management, Contracts Management and Procurement and Quality Control units in DMS/OSEC. She reports to Dava Newnam, Associate Deputy Secretary and Chief Operating Officer for DHSS.

Rebecca Reichardt, who has been Chief of Administration in the Office of Management and Budget since 2018, will join DHSS on July 18 as Deputy Director for the Division of Management Services. She has previously supported DHSS in a variety of roles with the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD), the Division of Public Health (DPH) and the Division of Developmental Disabilities Services (DDDS). Reichardt will oversee the Budget & Revenue Management, Grants Management and Audit & Recovery Management units in DMS/OSEC. She will report to Dava Newnam, Associate Deputy Secretary and Chief Operating Officer for DHSS.

“I am grateful to have all of these individuals in these critical positions,” Magarik said. “They each bring important experiences to these roles, they have helped DHSS and other state agencies respond to the COVID-19 pandemic, they know how to reach out to employees, clients, providers, and other community partners, and they are committed to innovating and doing the hard work of strategic planning.”

The Department of Health and Social Services, with about 3,500 employees, is responsible for meeting the health and social service needs of Delawareans by promoting health and well-being, fostering self-sufficiency and protecting vulnerable populations.

NEW CASTLE (May 24, 2021) – The Division of Substance Abuse and Mental Health (DSAMH) and the Opioid Response Team are announcing community grant funding opportunities through DSAMH’s federal State Opioid Response (SOR) grant.

Through the grant program, DSAMH will fund eligible providers to:

• Implement new initiatives to strengthen active engagement and re-engagement and boost client retention in substance use disorder (SUD) services to improve safety and recovery outcomes (Tier 2). Tier 2 grants will be funded up to $100,000.
• Implement innovative, evidence-based and high-impact SUD treatment and overdose prevention programming that targets underserved and high-risk populations (Tier 3). Tier 3 grants will be funded up to $500,000.

“We know that some of the best and most innovative responses to Delaware’s opioid crisis come from the providers who are closest to individuals and families impacted by this crisis,” said Department of Health and Social Services (DHSS) Secretary Molly Magarik. “We encourage providers of all sizes to review the requirements and apply for this important community funding.”

The grants are provided through DSAMH’s State Opioid Response (SOR) grant, funded by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). For the first round of funding, grant applications are due on June 14, 2021, and funded projects may begin as early as July 1, 2021. Projects can vary in length, but the final deadline for completion will be September 2022.

Prospective applications also are encouraged to register to attend a virtual technical assistance webinar: 5-6 p.m. Tuesday, May 25; register here:
https://healthmanagement.zoom.us/meeting/register/tJAvd-yppj4sHdAlqZhKhXgQyQ_nwgRh1Hu_

The grant application is available on the DSAMH website:
https://www.dhss.delaware.gov/dhss/dsamh/startexp.html. Final applications can be emailed to DSAMH.ORT@delaware.gov

Providers who previously applied for Tier 1 funding to implement universal screening are eligible and encouraged to apply for these community grants.

In 2019, the Delaware Division of Forensic Science reported 431 overdose deaths in Delaware, an increase of almost 8% over 2018. The 2020 report has not been issued. Of the 431 total deaths in 2019, the Division reported that 341 (79%) involved fentanyl, a synthetic pain reliever that is 50-100 times more potent than morphine. The percentage of total cases in 2019 involving fentanyl was 5 percentage points higher than in 2018.

Delawareans who are suffering from substance use disorder can call DSAMH’s 24/7 Delaware Hope Line to be connected to treatment services at 1-833-9-HOPEDE or 1-833-946-7333. Or they can visit DHSS’ one-stop website, HelpIsHereDE.com.

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The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

NEW CASTLE (Feb. 5, 2021) –Two Maryland prescribers associated with a clinic in Denton, Maryland, on the Eastern Shore of Maryland surrendered their Drug Enforcement Administration (DEA) Registration for cause in early January. The associated prescribers to this practice are no longer able to prescribe controlled substances. Patients of this Eastern Shore practice, including Delaware residents, should seek alternatives for care.

Of the prescribers’ 300 now former patients, about 50% live in Delaware, mostly in Sussex County. To increase the opportunity for continuity of care for these patients, the Delaware Division of Public Health, the Delaware Division of Substance Abuse and Mental Health, the Delaware Division of Professional Regulation and the Office of Controlled Substances are coordinating efforts to notify hospital and community pharmacies, hospital emergency departments and treatment programs.

Delaware officials said the most effective way to provide the clinic’s former patients with guidance and referrals to other providers is through the patients’ primary care physicians. If that doesn’t occur, patients being treated over long periods of time for pain with opioids such as oxycodone, fentanyl, morphine and oxymorphone will need to access providers with expertise in treating and managing pain.

Delaware patients who are seeking referrals to physicians may contact the Delaware Hope Line at 1-833-9-HOPEDE (1-833-946-7333).

In addition, the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration provides a 24/7 National Helpline to provide referrals for treatment services at 1-800-662-4359.

While opioids serve a purpose in managing a patient’s pain, they belong to a family of prescription drugs, which can lead to addiction. Delaware is one of the top 20 states in opioid prescriptions per capita and currently has the nation’s highest prescription rate for high-dose opioids. Delaware also ranks in the top five states for most overdose deaths per capita.

In its annual report for 2019, the Delaware Division of Forensic Science reported 431 overdose deaths in Delaware, an increase of almost 8% over 2018. Of the 431 total deaths, the Division reported that 341 (79%) involved fentanyl, a synthetic pain reliever that is 50-100 times more potent than morphine. Many of those deaths involved fentanyl powder, fentanyl mixed with heroin, or counterfeit controlled substance pills containing fentanyl. The percentage of total overdose deaths in 2019 involving fentanyl was 5 percentage points higher than in 2018. A final report on overdose deaths for 2020 is not expected until April, but Delaware expects to see an increase in overdose deaths over the 2019 total.

Recognizing the importance of harm reduction, prevention, treatment and recovery, the Department of Health and Social Services (DHSS) launched www.HelpIsHereDE.com to offer resources to Delawareans and their loved ones suffering from substance use disorder (SUD). In 2020, DHSS also launched the 24/7 Delaware Hope Line at 1-833-9-HOPEDE (1-833-946-7333) to provide a connection to treatment for anyone suffering from substance use disorder, anxiety, depression, or any other behavioral health issue.

Division of Public Health Director Dr. Karyl Rattay urged Delawareans who are worried about the risk of overdose among family members or friends to obtain naloxone – a medication that can reverse an opioid overdose – through a new DPH mail-order service that can deliver Narcan to an eligible person’s home for free; at one of DSAMH’s Bridge Clinics in each of the three counties; through a participating pharmacy – where no prescription is required; or as part of a naloxone training session.

“Naloxone saves lives,” said Division of Public Health Director Dr. Karyl Rattay. “We also encourage Delawareans to download OpiRescue Delaware, a smartphone app that provides life-saving step-by-step instructions on how to respond to an overdose, including administration of naloxone.” To find the Bridge Clinic in your county, naloxone training or distribution events, or a participating pharmacy, go to HelpIsHereDE.com, and click on the overdose prevention tab.