by Beth Blevins
Funding from HRSA’s Rural Communities Opioid Response Program (RCORP) program has helped several State Offices of Rural Health (SORHs) recently start—or strengthen—their work related to substance use disorder and opioid use disorder (S/OUD). Those who receive the RCORP Planning grant have a year to create or strengthen a consortium focused on SUD/OUD. (HRSA currently offers an RCORP Implementation grant that some SORH have received as well.)
For example, the South Carolina Office of Rural Health (SCORH) had never focused on S/OUD activities prior to receiving the RCORP Planning grant, according to Lindsey Kilgo, SCORH Director of Network Development. For them the grant was “about how we can understand what’s going on in the state,” Kilgo said. “There’s been a lot of information gathering, a lot of consortium and office conversations, a lot of convening and bringing folks together.”
Forging Stronger Partnerships
While creating their consortium, the Virginia SORH (VA SORH) discovered new partners. “There are additional people at the table who might not have been there because of the consortium,” said Heather Anderson, VA SORH Director. “We added to the conversation and got community health centers and other folks that maybe weren’t involved before. We have stronger partnerships in the region.”
Anderson continued, “Because of our experience with the planning grant, another agency was willing to run with the implementation grant. So we said, ‘Go for it. You’re local, you know all the people. We will support you any way we can, give you technical assistance, and help you convene people.’”
For the Michigan Center for Rural Health (MCRH), the planning grant “has allowed us to really bring everybody to the table and wrap our arms around the importance of the challenges in those counties we are working in,” said Crystal Barter, MCRH Director of Performance Improvement. “I think everyone has really bought into it, whereas before everyone was working in their own silo. And now we are working as a consortium and starting to leverage the resources each organization has.”
Hanneke Van Dyke, former SORH Coordinator at the Texas SORH, also talked about the importance of community outreach. “It was important to use relationships we already had and having an openness to expanding relationships to new project areas,” Van Dyke said. “In both of our (RCORP) project areas, community advisory councils—made up of community members and community leaders who are there for every step of the process—have been central. Making sure we built in a few back routes tied back to the community was very important for us.”
No Prior Expertise Needed
When asked what skills are needed for SORHs to engage with S/OUD work, Kilgo replied, “Having the determination to make things better and to make change—and then not being afraid to ask questions, in an effort to build knowledge, partnerships, and relationships.” Kilgo added, “For folks who work in this particular realm, it requires a level of passion and commitment. And when you have that shared passion and commitment, the relationship and trust come fairly easily. We all have a common vision and common theme. We’re moving forward together in a positive manner.”
The ability to seek out experts was also key for Van Dyke. “None of us on staff had worked on an S/OUD issues or had any particular training or experience with it,” she said. “As project coordinator, I’ve taken it on to educate myself through reading and talking with experts. I’m not an expert but I’m pretty comfortable now, knowing who to go to to get the right information.”
Although the North Dakota Center for Rural Health (NDCRH) has been involved with S/OUD activities for the state for a few years, they had no broad expertise in their office when they started their RCORP work, said Lynette Dickson, NDCRH Director. “Our knowledge has grown and continues to grow,” Dickson said.
“Even if you are not an expert in the field you can still have an impact in this arena,” Dickson explained. “Because what we (SORHs) do is convene people, and reach out and find the resources. You can have more confidence that you can have an active role in this—you can convene and connect like we do with anything else.”
For more information, see the new NOSORH Issue Brief, SORH Response to the National Substance Use Crisis. A full spectrum of NOSORH resources to address rural SUD/OUD are available in the Rural Opioids Educational Resources library on the NOSORH website.
Rural Opioid Educational Resources
The number of Americans being impacted by the misuse and abuse of opioids has reached epidemic levels. As opioid overdoses become more common, the greatest threat continues to be in rural communities that lack the capacity to deal with the issue on their own.
NOSORH has developed a compendium of all Rural Opioid Educational Resources available across our website to aid individuals looking for education, tools, and other resources. This includes reports, webinar presentations, meeting presentations, and a compendium of resources and lessons learned from grantees of the Federal Office of Rural Health Policy’s Rural Opioid Overdose Reversal (ROOR) grant program. As new resources become available, more information will be added. For more information on NOSORH’s rural opioid resources and education, contact Chris Salyers at firstname.lastname@example.org.
Click here for a list of all opioid resources on the NOSORH website.
Webinar Presentation: Rural Opioid Resources Slides
Resources:Rural Opioid Resources Reference List
by Beth Blevins
Illinois is tackling the opioid crisis in its rural communities through a series of opioid summits sponsored by the Illinois Center for Rural Health (ICRH).
“We realized there were no coalitions or groups working on opioid misuse in rural Illinois,” said Julie Casper, ICRH Director. “Community Health Needs Assessments have consistently listed drug use and addiction as problems in their communities, so making opioid misuse a priority was a natural conclusion.”
The first “Opioid Crisis Next Door” summit was held June 2016 with the stated purpose of building local coalitions to increase awareness of opioid and heroin use in rural communities and to identify ways for communities to respond to the crisis. At the end of the summit, attendees took a pledge to work together to combat opioid misuse in rural Illinois, Casper said.
Local coalitions, healthcare providers, and other rural community stakeholders attended the “Opioid Crisis Next Door: Identifying, Organizing and Activating Local Resources” summit in October 2017.
Each subsequent summit has added a specific focus. The opioid summit held in March of last year focused on “,” with the goal of encouraging dialog among providers. The October 2017 summit looked at “.” The next summit, scheduled for June 27 of this year, will be focused on “Keeping the Momentum: Are We Hitting the Mark?” and will include naloxone training for overdose treatment.
“All the summits have a rural focus, but it’s been different aspects of rural,” Casper explained. The summits have had an average of 100 attendees and all have been held in the state capital of Springfield, centrally located and within a few hours’ drive for everyone in the state, Casper said. Summits are held twice a year now, she said, because they realized they cannot wait a full year for the next one, there is so much to go over.
Rural stakeholders from across Illinois participate in a 2017 “Opioid Crisis Next Door” summit.
The target audience for the summits includes rural hospitals, rural providers, pharmacists, law enforcement, policymakers, community leaders, and behavioral healthcare providers. In addition to ICRH, the summits receive support from the Illinois Health and Hospital Association, the Illinois Pharmacists Association, the Healthy Communities Partnership, and the Illinois Critical Access Hospital Network (ICAHN).
“We are very fortunate that at the state level the reduction of opioid misuse is a priority for the governor and for the director of the Illinois Department of Public Health (IDPH),” Casper added. (ICRH is part of IDPH). “Nirav D. Shah, M.D., J.D., IDPH Director, has opened every conference and will open the next meeting.”
The summits have offered a variety of speakers, including physicians on treatment options, community leaders and hospital administrators on creating community coalitions, and past opioid users sharing their stories of addiction and recovery.
The opioid summits are funded using a small amount of Rural Hospital Flexibility Grant money, Casper said, with the rest of the cost, mostly for food and the rental of the space, paid by the attendees.
Although opioid misuse may not be as prevalent in Illinois as it is in other states, the number of opioid-related overdoses is growing every year, according to Heidi Clark, IDPH Division Chief of Health Data and Policy. While there were , there were an estimated 2,093 overdoses in 2017, Clark said, a number she attributes to the increasing use of dangerous synthetic opioids like fentanyl and its analogues.
“Opioid abuse is a statewide problem but there are specific issues in different parts of the state and among different demographics,” Clark continued. “In some of the more rural areas, there’s more prescription drug misuse, whereas in urban areas you’ll see more emerging drugs such as new fentanyl analogues. But rates of neonatal abstinence syndrome (NAS) are growing in rural areas in Illinois much faster than urban areas.” NAS is when a baby is born physically dependent on drugs and experiences withdrawal symptoms after it’s born.
IDPH has received a Comprehensive Addiction and Recovery Act first responders grant, Clark said, which is being used to fund naloxone training in 18 rural Illinois counties and to distribute naloxone to law enforcement who have taken the training. It also funds two care coordinators in those counties. “Once someone ODs and goes to the emergency room, they can be connected to a care coordinator who can help them navigate barriers,” Clark said. “If they don’t have insurance, the care coordinator might help them get insurance. If they have insurance, the coordinator will help them find a treatment provider who accepts that insurance and is accepting new patients. The care coordinators are there to make entering treatment an easy choice rather than a scary unknown.”
From her work with the summits, Casper said she has discovered that there are many people in the state who care about those with opioid addictions. “They care about them as people,” she said. “They see that they have value. You know there are a lot of law enforcement who believe that, but they’re not the ones who make the news. It makes you feel really good that there are people out there helping people who are struggling with these issues.”
Does your SORH have a “Promising Practice”? We’re interested in the innovative, effective and valuable work that SORHs are doing. Contact to set up a short email or phone interview in which you can tell your story!
Are you or your partners planning to write for any of the future rural opioid projects? Join the webinar Rural Opioid Resources: Preparing Your Organization for Future Funding Opportunities on May 7th at 3:00pm ET. The webinar will provide SORH and their rural health partners with a collection of resources which may be helpful in seeking funding for federal rural opioid funding opportunities.
The goal of the webinar is to provide a framework to begin planning for a grant application. Participants of the webinar will be introduced to some of the existing resources for selecting an appropriate intervention or strategy for their grant program. Data sources will be discussed which can assist applicants in refining their intervention or supporting the need for their grant application. The webinar will close with a discussion on how to work with partners to develop a consortium of members that are primed to react when grant opportunities are released.
This webinar will NOT focus on any specific funding opportunity that has been announced, but rather provide a potential framework for future applicants to gather the appropriate materials in preparation for writing for one of the funding opportunities. As guidances are released, NOSORH will conduct future webinars focusing on the specifics of individual funding opportunities.
NOSORH encourages all partners to share this information with potential applicants and other stakeholders. To register for this webinar, click here.
A recording will be made available on the NOSORH website within 24 hours following the webinar.
NOSORH is proud to announce the release of a report on the lessons learned from the Rural Opioid Overdose Reversal grants. The Federal Office of Rural Health Policy awarded grants to 18 organizations to combat the impact of opioid overdose at the community level. Awardees in the pilot project were funded to increase the availability and utilization of naloxone and to focus on the importance of referring individuals dependent on opioids to an appropriate substance abuse treatment center. Awardees freely shared lessons learned and educational resources developed. “This is a great compilation of the excellent work that can be conducted to build collaboration in rural communities,” said Teryl Eisinger, NOSORH Executive Director.
The report is available here on the NOSORH website. Stay tuned for more information on a webinar that will be held later this month to learn more about the resources and the report.
WEBINAR: Reducing Rural Opioid Overdoses: Lessons Learned from the Rural Opioid Overdose Reversal Grant Program (6-28-17)