Use Opioid Settlement Funding to Expand Access to Integrative, Person-Centered Healthcare

• Host summits with key stakeholders across the health sector, including payers, providers, hospital administrators and legislators, to educate decision makers about the need to increase access to NPT to combat opioid misuse, address pain, and improve overall health of the population.
  • Example: Building Bridges Symposium: Implementing Healthcare Solutions to Prevent Opioid Addiction and Chronic Pain in Connecticut | University of Bridgeport
• Coordinate community health messaging with local healthcare industry leaders, including payers, providers, hospital systems and advocacy groups to promote guideline concordant use of NPT.
• Create public service announcements using trusted community voices to educate the community about the appropriate use of NPTs for managing pain.

Many states have limited or uneven coverage of NPT. Access to NPT is especially important in a Medicaid population, who have a greater prevalence of high-impact chronic pain.

• Petition state legislators and your state department of health to direct settlement funding to cover NPT within Medicaid plans, using state plan amendments or other federal waiver authorities.
  
  • Note: expanded NPT services would be multiplied by receipt of additional federal funds via the federal match, further enabling states to deliver these services. 
• Advocate for insurance regulation to similarly expand access to NPT in other health care plans among state legislators, and your state’s department of health and attorney general’s office.

Improving pain management programs, research, and care delivery for marginalized populations should be prioritized and should be considered for fund allocations at all jurisdictional levels. 

• Engage administrators of local Federally Qualified Health Centers (FQHCs), community-based health clinics, and health clinics on tribal lands to discuss the value of NPT to support pain management among the populations they serve.
• Expand availability of NPT within FQHCs and tribal clinics. 
• Engage leaders and elders from marginalized communities to conduct needs assessments and to facilitate successful implementation of new initiatives. 

Not all evidence-based therapeutic interventions within NPT need to be delivered by a healthcare provider.

• Work with your local community centers, health departments, fitness centers, and schools to provide group-based mindfulness, exercise, yoga, or tai chi classes. 
  • Philanthropic grants, such as the one found here can provide examples of utilizing grants to fund and expand access.
• Develop videos or apps to provide individuals with online access to mindfulness, yoga, tai chi, or other NPT interventions.

Funding should support actions that address barriers and create access to NPT. 

• Establish clinics (including pop-up and mobile clinics) to provide NPT in underserved communities.
• Create grants and loan forgiveness programs to incentivize practitioners to provide NPT in rural and underserved communities.
  • Example: Minnesota Rural Physician Loan Forgiveness Guidelines – MN Dept. of Health
• Provide vouchers for public transportation to facilitate adherence to NPT, especially when multiple treatment visits are required.
• Engage key stakeholders (e.g. provider/ payer summit, economic assessment report) to advocate for the elimination of co-payments associated with NPT.

The gap between known best practices for non-drug pain management and the care that is actually delivered to the public must be addressed.

• Conduct needs assessments of local care delivery systems to identify misalignment with The Joint Commission guidance on pain management.
  • The following needs assessment outlines one state’s analysis of opioid use with sections related to opioid prevention. Nevada Opioid Needs Assessment and Statewide Plan 2022
• Identify clinical care pathways where guideline-adherent NPT could be encouraged as first-line interventions before opioid initiation, especially in emergency departments, urgent care clinics, primary care clinics, and dental clinics where opioid initiation is most common.
  • Emergency Department Alternatives to Opioids Program | SAMHSA

Integrating NPT alongside Opioid Use Disorder (OUD) medical treatment and mental or behavioral health programs for substance abuse rehabilitation is an innovative option for opioid settlement funding. 

• Establish collaborative care models to integrate NPT across different phases of care in addiction recovery, including inpatient and outpatient programming.
  • Learn About the Collaborative Care Model
• Develop virtual or home-based care to support long-term recovery and reduce recidivism.

Investing in health technology and informatics could better coordinate pain management, improve outcomes and decrease costs.  

• Create standardized clinical care pathways that integrate NPT into acute and chronic care plans.
• Design automated clinician-targeted nudges for electronic health records that encourage consideration of NPT prior to opioid initiation.
  • Clinical decision support, as shown here, Electronic Clinical Decision Support Tools: Safer Patient Care for Opioid Prescribing, can serve as a model on the value of improving adherence to guidelines and avoiding medically unnecessary opioid prescriptions. 
• Use technology to build referral networks that allow patients and providers to identify local clinics and providers who deliver high-value NPT for common pain disorders.

Survey the local landscape to identify individuals, groups or organizations who may share your advocacy interests

• What allies bring perspective to your proposal that you do not represent?
• Do they share your mission and values?
• Are they a respected entity in your community?
• Do they have relationships with decision makers you do not?

Understanding what arguments could be used against your idea can help you prepare a more effective proposal

• What stakeholders have interests counter to yours (note, that doesn’t make them wrong, it just makes their priorities different)?
• What are the limitations or vulnerable aspects of what you are proposing?
• Are there opportunities to learn of issues that opposing stakeholders are interested in advancing?  

Strong collaborations are built on trust and rapport

• What are their needs, and how might what you are proposing support their interests?
• Is the ally interested in endorsing your effort, testifying or lobbying in support, making introductions to key decision makers, or engaging community support?  
• What will be your shared advocacy strategy, including messaging and outreach?
• What resources can you leverage between one another?
• How can you provide allies with support, resources, or recognition for their contribution?
• If the opposition is unable to support your idea, would they consider shifting to a neutral position from opposing?
• Is there common ground or a separate shared interest you could forge with opposing stakeholders?

• Patient advocacy groups (e.g. chronic pain, addiction groups)
• Community leaders 
• Other healthcare professionals/ professional associations
• Health plans 
• Local hospitals and hospital associations 
• Research universities, medical schools, or other healthcare education programs
• Local (public) health departments 
• policy maker or government officials