DHSS to Expand Community Well-Being Initiative to Kent County

Goal is to Connect At-Risk Community Members to Substance Use Disorder Services

WILMINGTON (Sept. 19, 2022) – As a way to directly connect community members struggling with opioid use disorder and other behavioral health issues to treatment, recovery and prevention services, the Community Well-Being Initiative (CWBI), which began in 2021 in high-risk areas of New Castle County, will be expanded to serve targeted neighborhoods in Kent County in collaboration with Delaware State University, Department of Health and Social Services (DHSS) Secretary Molly Magarik announced today at a press conference at the Chase Center.

“This is about meeting communities where they are and offering on-the-ground support to neighborhood residents who have been significantly impacted by the opioid epidemic in our state,” Secretary Magarik said. “It is important that we are expanding the Community Well-Being Initiative to Kent County to help address the trauma and toxic stress that community members there experience as well. From the success of the New Castle County pilot, we have seen how important it is for Community Well-being Ambassadors to have lived experience and to reside in the areas they serve.”

The initiative, a partnership between the Department of Health and Social Services’ Division of Substance Abuse and Mental Health (DSAMH) and the University of Delaware’s Partnership for Health Communities, began in 2021 by identifying four ZIP codes in New Castle County – 19801, 19802 and 19805 in Wilmington and 19720 in New Castle – with high rates of fatal and non-fatal overdoses, and high rates of drug arrests. The initiative is funded through the Delaware State Opioid Response (SOR) grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

In the pilot, 24 Community Well-being Ambassadors, who were hired by the nonprofit Network Connect and embedded in the neighborhoods, worked to identify and engage with individuals and families who typically do not seek formal treatment and recovery services for opioid and other substance use disorders. By meeting people where they are, the ambassadors, who work through host sites in the community, were able to build trust with community members. From May 2021 to March 2022, 450 community members engaged with ambassadors, for a total of 2,522 total interactions, including:

  • Engaging people with behavioral health needs when they were ready to engage.
  • Improving coordination across referrals and access to additional social services, including employment, housing and transportation.
  • Providing prevention education and care management for opioid and other substance use disorders, along with support for mental, physical, social and spiritual well-being.
  • Preparing person-centered, peer-supported, long-term treatment support for individuals, families and communities.
  • Building prepared and resilient communities.

The expansion to Kent County will involve Delaware State University as the managing partner of the initiative, along with DSAMH and UD’s Partnership for Healthy Communities. Additional Kent County partners, include Network Connect, Minds in Motion Integrated Behavioral Health, the Center for Structural Equity/Community Intervention Team, GBA Consulting, and the host sites:

  • Delaware Multi-Cultural Civic Organization
  • DSU Biomedical, Behavioral and Allied Health Center
  • DSU-Downtown
  • Two additional sites (pending)

“Delaware State University is elated to be a managing partner for such a phenomenal initiative. The Community Well-being Initiative aligns with our university’s core values and mission,” said Dr. Gwendolyn Scott-Jones, Dean of DSU’s Wesley College of Health and Behavioral Sciences. “This behavioral health integration and 21st-century case management model of service delivery executed by Network Connect is a monumental approach to addressing health disparities, psychological crises, substance-related disorders, mental health disorders and identifying social determinants that can help us better understand and improve health inequities. More specifically, the partnership with DSAMH, UD, Network Connect and other community partners is a way forward to provide a service integration model that will help people in their environments.”

“We are grateful to Delaware State University for being the managing partner of the Community Well-being Initiative in Kent County,” said Rita Landgraf, Director of the University of Delaware’s Partnership for Healthy Communities. “The strength of the Community Well-being Initiative is about the diversity of partners coming together, including the communities themselves, to support residents and families who aren’t used to seeking treatment for substance use disorder. The value of promoting health equity is critical to both UD and DSU, as is the experience of being an innovation incubator, piloting new ideas, evaluating how projects work, and learning what will provide that collective impact in our communities.”

The expansion in Kent County will involve ZIP codes – 19901, 19902, 19904 and 19934 – that have high rates of fatal and non-fatal overdoses and high rates of drug arrests. The initiative, which began with Network Connect hiring staff in August 2022, will launch this fall in the communities and be staffed by 16 Community Well-being Ambassadors (CWA) and two CWA Program Coordinators.

“At DSAMH, we are excited to collaborate with so many community partners, including DSU, to embed ambassadors in these at-risk neighborhoods in Kent County,” said Division of Substance Abuse and Mental Health (DSAMH) Director Joanna Champney. “The Community Well-being Ambassadors have lived experience and provide support directly to community members in their communities. They help individuals and families identify their most pressing needs, provide relevant information, and develop strategies for addressing those needs, including a connection to behavioral health and other community services and ongoing support. Ambassadors also are trained in administering naloxone, a medication that can reverse an opioid overdose, and they distribute naloxone and other critical overdose prevention knowledge in the communities where they work.”

In the continuing New Castle County pilot, the 24 Community Well-being Ambassadors and two CWA Program Coordinators are embedded in neighborhoods and integrated with these host sites:

  • Center for Structural Equity
  • Game Changers
  • Hilltop Lutheran Neighborhood Center
  • Network Connect
  • West End Neighborhood House
  • Youth Empowerment Center

Lt. Governor Bethany Hall-Long, Chair of the Behavioral Health Consortium, said the Community Well-being Initiative and the Ambassador program are helping to facilitate two of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) goals under the State Opioid Response grants: to expand opioid use disorder/stimulant use disorder treatment engagement strategies and reduce barriers to accessing treatment, as well as to create a greater strategic focus on racial and ethnic populations in SAMHSA’s investments.

“As we saw in the targeted outreach in New Castle County and now in the expansion into Kent County, the Community Well-being Initiative is about promoting equity,” Lt. Governor Hall-Long said. “In order to encourage more community residents to seek treatment for substance use disorder, we need to have Community Well-being Ambassadors who live in the communities, collaborating with trusted community partners and building trust with the people they serve. This is another important way that we are building a stronger and healthier Delaware for more of our residents.”

“Our ambassadors really focus on everyday life skills,” said Cierra Hall-Hipkins, Co-Founder and Co-Executive Director of Network Connect. “They have people come to them with real-life situations that they, too, experienced themselves and they are able to be peer connectors – life coaches, so to speak – for everyday folks in our community. It’s a game-changer.”

In 2021, Delaware reported 515 overdose deaths, an increase of more than 15% over 2020, according to the Delaware Division of Forensic Science (DFS). In Kent County, overdose deaths increased 74% from 50 in 2020 to 87 in 2021. DFS also reported that 425 of the 515 deaths involved fentanyl, a synthetic pain reliever that is 50-100 times more potent than morphine.

 


DHSS Marks Milestone of 100,000 Referrals for Substance Use, Mental Health Services

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.


Health Officials Issue New Warning after 8 Deaths from Suspected Overdoses Occur Statewide in 4-Day Span

NEW CASTLE (Aug. 14, 2018) – Eight people have died from suspected overdoses in a four-day span across the state causing Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker to alert the community to the wave of deaths and urging people in active use to seek treatment immediately and to carry the overdose-reversing medication naloxone.

“The eight deaths beginning last Friday have doubled the total number of deaths from suspected overdoses this month,” said Secretary Walker, a board-certified family physician. “These deaths have happened in all three counties, to men and women, and to people in their 20s to those in their 50s. This horrific toll shows that no one in active use is immune from the risk of death in our state.”

As of Aug. 13, the Division of Forensic Science (DFS) has reported 16 deaths from suspected overdoses in Delaware this month. Since the start of the year, the total number of deaths from suspected overdoses reported by DFS is 167.

Elizabeth Romero, director of DHSS’ Division of Substance Abuse and Mental Health, encouraged individuals in active substance use in Delaware to see a medical provider immediately, ask police or other first responders for help, or to call DHSS’ 24/7 Crisis Services Hotline to be connected to trained crisis professionals who can discuss treatment options.

“If you are in active use, we urge you to seek treatment immediately,” Romero said. “If you continue to use substances, have the overdose-reversing medication naloxone with you because the risk for death is increased. Our first priority is to reduce harm and save lives. From there, we can connect people to the treatment options that will work best for them.”

In New Castle County, the 24/7 Crisis Services Hotline number is 1-800-652-2929. In Kent and Sussex counties, the number is 1-800-345-6785. Individuals and families also can visit DHSS’ website, www.HelpIsHereDE.com, to find addiction treatment and recovery services in Delaware or nearby states.

Naloxone is available at many Delaware pharmacies without a prescription, or by attending community trainings through Brandywine Counseling and Community Services. The next community training is at 6 p.m. Aug. 27 at Abundant Life Christian Church, 28714 Seaford Road, Laurel. As part of International Overdose Awareness Day on Aug. 29, atTAcK addiction will provide community naloxone training at 6:30 p.m. at Recovery Centers of America at Delaware, 2383 Limestone Road, Wilmington.

If individuals see someone overdosing, they should call 911. Under Delaware’s 911/Good Samaritan Law, people who call 911 to report an overdose and the person in medical distress cannot be arrested for low-level drug crimes.

If a user has ingested fentanyl or a drug laced with fentanyl, time is critical because the powerful opioid quickly affects the central nervous system and the brain. Users often have trouble breathing or can stop breathing as the drug sedates them. If someone is too drowsy to answer questions, is having difficulty breathing, or appears to be so asleep they cannot be awakened, call 911 immediately.

In 2017, about 61 percent of the overdose deaths in Delaware involved fentanyl and 40 percent involved heroin. In many overdose deaths, multiple substances are found in a person’s system during toxicology screens.

Naloxone, the overdose-reversing medication carried in Delaware by community members, paramedics, some police officers and other first responders, can be administered in overdoses involving opioids – fentanyl, heroin or opioid painkillers. Because fentanyl is more potent than heroin or opioid painkillers, multiple doses of naloxone may be needed to reverse an overdose. In 2017, Delaware paramedics and police officers administered naloxone 2,714 times in suspected overdose situations to a total of 1,906 patients.

Overdose deaths continue to increase in Delaware. In 2017, 345 people died from overdoses, up 12 percent from the 308 people who died in 2016, according to the Division of Forensic Science.

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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.


Department of Justice Begins New Program to Help Delawareans Denied Coverage for Substance Abuse Treatment

Program will provide assistance to persons appealing denials of insurance and Medicaid coverage for substance abuse treatment

Attorney General Matt Denn announced Wednesday that the Delaware Department of Justice’s new legal assistance program for Delawareans denied insurance coverage for substance abuse treatment is in operation and ready to assist Delawareans dealing with coverage denials.

Delawareans who have been denied insurance coverage for substance abuse treatment can contact the Department of Justice by phone or email to see if they are eligible for assistance in having insurance or Medicaid cover treatment they have obtained.

Under the new program, believed to be the only one of its type in the country, the Department of Justice will retain attorneys and other professionals to help persons appeal substance abuse treatment benefit denials by private insurance carriers or the state’s Medicaid program. Initial screening of cases will be done by DOJ personnel, and the legal work itself will be performed by attorneys under contract with DOJ.

Delawareans who have been denied coverage for substance abuse treatment can contact DOJ’s program by:

Persons seeking assistance will need to complete an application for assistance and may need to execute medical privacy releases in order to determine whether assistance can be provided. The forms are available on the program’s webpage.

The new DOJ program was made possible by House Bill 100, passed by the General Assembly last spring and signed by the Governor on May 30. The bill, which took effect on September 27, allowed DOJ to use funds from its Consumer Protection Fund for this new purpose of assisting Delawareans who were denied insurance coverage for medically-necessary substance abuse treatment.

“When I talk to Delawareans struggling with drug addiction and their families, this issue of insurance coverage being denied or cut off comes up more than any other concern. We are looking forward to using this new authority to come to the assistance of Delawareans who have wrongfully been denied coverage for substance abuse treatment,” Attorney General Denn said. “I am very grateful to the bi-partisan group of legislators who worked with us to champion HB 100 and ensured its passage last spring. I also want to thank Deputy Attorney General Christian Wright, director of DOJ’s Consumer Protection Unit, for all the work he has put in over the past several months setting up this program.”


Governor Carney Signs Package of Legislation to Combat Addiction Crisis

New laws expand access to substance abuse treatment, remove insurance barriers, and strengthen oversight of prescriptions

WILMINGTON, Del. – Governor John Carney on Tuesday signed into law Senate Bill 41, House Bill 91, and House Bill 100, a bipartisan package of legislation that will expand access to substance abuse treatment, strengthen oversight of opioid prescriptions, and combat Delaware’s addiction crisis.

Governor Carney signed the legislation during a ceremony that included remarks from Attorney General Matt Denn, members of the General Assembly, and Delaware advocates for improved access to substance abuse treatment – including families who have lost loved ones to Delaware’s opioid epidemic.

May 30 Bill Signings

“Far too many Delawareans, and Delaware families, have been affected by this crisis,” said Governor Carney. “These new laws represent a significant step forward in our efforts to combat Delaware’s addiction epidemic. To the Delaware families who have lost loved ones to addiction, and who are now fighting to prevent others from experiencing the same fate, your work is nothing short of inspiring. To the Delawareans who are using your own experience with substance abuse to help others, know that you are making a difference. We will continue to follow your lead. Thank you to Attorney General Denn and members of the General Assembly for your continued urgency on this issue.”

“The credit for these bills should go to the Delawareans who have overcome substance abuse, and the families who lost loved ones to drug overdoses, who stepped forward and shared their thoughts about where the system was failing and how it could be improved,” said Attorney General Matt Denn. “We listened and tried to turn their suggestions into laws, but the ideas came from those families, and after giving us the ideas they stood shoulder to shoulder with us to make sure the bills were passed.”

“I truly feel that every life matters,” said MaryBeth Cichocki, who lost her son to opioid addiction, and advocated for the new laws. “We are all one injury or surgery away from the disease that continues to take the lives of those we love. As long as I breathe, Matt will continue to live.”

“We are grGov. Carney signs legislation.ateful for all those responsible for the passing of these bills,” said Don Keister, a founder of atTAcK Addiction, whose son lost his battle with addiction. “When families need help, it’s important that services are available without additional delays. If these laws had been around when our son was battling this disease, he may still be alive today.”

Legislation signed into law on Tuesday will take a number of steps to expand access to substance abuse treatment, target barriers to insurance coverage, and improve Delaware’s response to the addiction epidemic.

The package will:

• Prevent private insurers from using pre-authorization and referral requirements to delay access to substance abuse treatment;
• Require insurance companies to cover 14 days of substance abuse treatment before conducting a “utilization review” that can delay treatment;
• Limit insurance companies from denying substance abuse treatment based on “medical necessity” grounds;
• Allow the Department of Justice to use consumer protection funds to advocate for those being denied coverage based on “medical necessity” grounds;
• Establish a new committee to help oversee opioid prescriptions, and strengthen the oversight of over-prescription.

“Even with limitless support, battling addiction is incredibly difficult. But it shouldn’t be made harder by insurance companies and health care providers standing in the way of critical treatment,” said Senate Majority Leader Margaret Rose Henry, the lead Senate sponsor of House Bill 100. “I am grateful to Governor Carney for signing this important legislation into law, so Delawareans never again have to worry about whether they’re covered by insurance before seeking substance abuse treatment that could save their lives.”

“Delawareans who take the initiative to seek treatment for substance abuse shouldn’t have to wade through red tape to get the help they need,” said Senator Stephanie Hansen, the prime sponsor of Senate Bill 41. “I appreciate the Attorney General’s leadership in helping us pass this important legislation, which ensures that insurance companies are forbidden from imposing pre-certifications, screenings, prior authorizations or referrals for those ready to make the potentially life-saving decision to get help.”

“In light of the scourge of addiction, we need to get these people appropriate treatment, when it’s needed,” said Senator Dave Lawson. “Current coverages are insufficient.”

“These measures are necessary first steps towards addressing the needs of a significant portion of the more than 90,000 Delawareans currently suffering from addiction. We mustn’t fail to provide safety-nets for those in need of immediate treatment, and we must work to ensure current policies align with the increasing needs of Delawareans affected by addiction,” said Senator Anthony Delcollo. “Lastly, we cannot continue to operate in a vacuum when addressing addiction, and I am committed to working with my colleagues to aggressively pursue solutions to improve the lives of almost 100,000 Delawareans affected by this horrific disease.”

“If people struggle and stumble as they seek treatment, they should have the ability to come back and get treated again. Addiction is a disease, just like cancer and diabetes, and should be considered as one when it comes to medical treatment. Delawareans struggling with addiction should be extended a helping hand when they seek treatment, not have the door shut in their faces,” said Representative Helene Keeley, the prime Bill Signingssponsor of House Bill 100. “These combined efforts provide us with the necessary resources to battle the opioid epidemic in the First State and remove the stigma associated with substance abuse.”

“These bills will help save lives in Delaware and I am proud to be part of this effort to combat the disease of addiction. Substance abuse treatment helps people reintegrate into society and lead productive lives,” said Representative Michael Mulrooney, the prime sponsor of House Bill 91. “If we deny people suffering from substance abuse the treatment they need, it can lead them to relapse and either end up in the criminal justice system or worse.”

“This package of legislation represents best practices that we are implementing in Delaware in order to strategically address our concerns in battling the heroin and opioid epidemic,” said Representative Ruth Briggs King. “And, we are not done yet. Other bills, such as the substance-exposed infant legislation is working its way through Legislative Hall and should be our next primary focus in this ongoing effort to combat this epidemic.”

“These bills are key to fighting the opioid epidemic in Delaware because they address a very important component of this process – making sure adequate treatment is available to those who need it,” said Representative Tim Dukes. “Without access to treatment, all our efforts may as well be considered for nothing.”

“Collectively, these bills also add to the public awareness that addiction is a disease, that it can be treated, and people do recover,” said Dr. Kara Odom Walker, Secretary of the Department of Health and Social Services. “With addiction, we know that when people are ready for treatment, the window can be small in terms of connecting them to that critical care. At the Department of Health and Social Services, we will do everything in our power to connect that person to the treatment they seek.”

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