East Tennessee Healthcare Holdings Inc

TO OPERATE AN OUTPATIENT OPIOID TREATMENT PROGRAM TO TREAT OPIOID USE DISORDER AND PROVIDE RECOVERY FOR EACH AND EVERY PATIENT. ALL OVERMOUNTAIN RECOVERY PERSONNEL, FROM ITS PROGRAM LEADERSHIP TO STAFF MEMBERS, AIM TO REDUCE THE BURDEN OF ADDICTION ON THE REGION IT SERVES. OVERMOUNTAIN RECOVERY IS FOCUSED NOT JUST ON PROVIDING A SERVICE, BUT ON MAKING THE COMMUNITY A HEALTHIER AND SAFER PLACE TO LIVE, WORK, LEARN AND DO BUSINESS.

EAST TENNESSEE HEALTHCARE HOLDINGS, INC. D/B/A OVERMOUNTAIN RECOVERY (OMR) IS A NOT-FOR-PROFIT OUTPATIENT OPIOID TREATMENT PROGRAM IN JOHNSON CITY, TENNESSEE. IN 2016, MOUNTAIN STATES HEALTH ALLIANCE (MSHA) AND EAST TENNESSEE STATE UNIVERSITY RESEARCH FOUNDATION (ETSU) FORMED OMR TO TREAT PEOPLE IN ITS SERVICE AREA WITH HEROIN, MORPHINE AND PRESCRIPTION OPIOID ADDICTIONS, INCLUDING HIGH-ACUITY INDIVIDUALS WITH CO-OCCURRING MENTAL AND PHYSICAL HEALTH CONDITIONS, AS WELL AS VULNERABLE POPULATIONS SUCH AS WOMEN WITH SUBSTANCE-EXPOSED PREGNANCIES. THE SERVICE AREA CONSISTS OF 39 CITIES AND 11 COUNTIES INCLUDING: CARTER, GREENE, HANCOCK, HAWKINS, JOHNSON, SULLIVAN, UNICOI AND WASHINGTON IN TENNESSEE AND LEE, SCOTT AND WASHINGTON IN VIRGINIA, INCLUDING THE CITY OF BRISTOL, VIRGINIA. ACCORDING TO THE TENNESSEE DEPARTMENT OF HEALTHS REPORT TENNESSEES ANNUAL OVERDOSE REPORT 2021, IN 2019, THERE WERE 1,543 OVERDOSE DEATHS INVOLVING OPIOIDS IN TENNESSEE-A RATE OF 23.4 DEATHS PER 100,000 PERSONS. ACCORDING TO THE CDC, IN 2019, TENNESSEE PROVIDERS WROTE 74.6 OPIOID PRESCRIPTIONS FOR EVERY 100 PERSONS. ALTHOUGH THIS IS ALMOST A 9% DECLINE IN TENNESSEES OPIOID PRESCRIBING RATE FROM 2018, TENNESSEE TIED FOR THE THIRD HIGHEST PRESCRIBING RATE IN THE COUNTRY AND WAS ALMOST 60% HIGHER THAN THE AVERAGE U.S. RATE OF 46.7 PRESCRIPTIONS. FROM 2018 TO 2019, THE RATE OF OPIOID PRESCRIPTIONS FOR PAIN DECREASED IN EVERY TENNESSEE COUNTY. THIS DECREASE INDICATES A CHANGE FROM AN EPIDEMIC CAUSED BY PRESCRIPTION PAIN RELIEVERS TO AN EPIDEMIC THAT ALSO INCLUDES ILLICIT OPIOIDS AND STIMULANTS.NEONATAL ABSTINENCE SYNDROME (NAS) OR NEONATAL OPIOID WITHDRAWAL SYNDROME (NOWS) MAY OCCUR WHEN A WOMAN USES OPIOIDS DURING PREGNANCY. THE INCIDENCE RATE OF NAS/NOWS IN TENNESSEE IN 2018 WAS 14.5 CASES PER 1,000 HOSPITAL BIRTHS WHILE THE NATIONAL INCIDENCE RATE OF NAS/NOWS WAS ONLY 6.8 CASES PER 1,000 HOSPITAL BIRTHS.OMRS OPIOID TREATMENT PROGRAM REPRESENTS A UNIQUE COMPREHENSIVE, INNOVATIVE, HOLISTIC MODEL OF CARE FOR THIS PATIENT POPULATION BY BRINGING TOGETHER THE LOCAL ACADEMIC AND RESEARCH RESOURCES OF ETSU; COUPLED WITH THE MEDICAL CARE EXPERTISE AND CAPITAL RESOURCES OF MSHA. THESE TWO ENTITIES HAVE ALSO CONTRACTED WITH FRONTIER HEALTH TO PROVIDE THERAPEUTIC AND RECOVERY-BASED SERVICES.OMR IS ONLY ONE COMPONENT OF A LARGER FOCUS TO INCORPORATE EDUCATION, OUTREACH, RESEARCH, AND EVALUATION, ALL AIMED AT MAKING A SIGNIFICANT DIFFERENCE IN THE MANAGEMENT OF THE CHRONIC DISEASE OF ADDICTION. OMR IS AN ENTITY THAT EMPHASIZES EVIDENCE-BASED, LONG-TERM TREATMENT THAT ADDRESSES SUBSTANCE ABUSE DISORDER (SUD) AS A CHRONIC, RELAPSING DISEASE. OVERMOUNTAIN IS FOCUSED NOT JUST ON PROVIDING A SERVICE, BUT ON MAKING THE COMMUNITY A HEALTHIER AND SAFER PLACE TO LIVE, WORK, LEARN AND DO BUSINESS BY REDUCING THE BURDEN OF ADDICTION PLAGUING ITS SERVICE AREA. BOTH ETSU AND MSHA HAVE LONG-TIME ROOTS IN THE COMMUNITY. ETSU, FOUNDED IN 1911, IS A STATE-SUPPORTED, COEDUCATIONAL INSTITUTION. ETSU CURRENTLY HAS A STUDENT POPULATION OF NEARLY 15,000 UNDERGRADUATE, GRADUATE, MEDICAL AND PHARMACY STUDENTS. ALTHOUGH MOST STUDENTS ARE FROM TENNESSEE AND THE SURROUNDING SOUTHEASTERN REGION, 45 STATES AND 76 COUNTRIES ARE ALSO REPRESENTED. THE MAIN CAMPUS IS IN JOHNSON CITY, TENNESSEE WITH SATELLITE CAMPUSES IN KINGSPORT, ELIZABETHTON, AND SEVIERVILLE IN TENNESSEE, ABINGDON IN VIRGINIA AND ASHEVILLE IN NORTH CAROLINA. ETSU HAS A STRONG HEALTH CARE FOCUS WITH COLLEGES OF PHARMACY, CLINICAL AND REHABILITATIVE HEALTH SCIENCES, NURSING, PUBLIC HEALTH, AND MEDICINE.MOUNTAIN STATES HEALTH ALLIANCE, FOUNDED IN 1998, IS PART OF A LARGE, INTEGRATED, NOT-FOR-PROFIT HEALTH CARE SYSTEM BASED IN JOHNSON CITY, TENNESSEE. IN FEBRUARY 2018, MOUNTAIN STATES HEALTH ALLIANCE (MSHA) AND WELLMONT HEALTH SYSTEM (WHS) MERGED TO FORM BALLAD HEALTH, A TAX-EXEMPT ENTITY AND PARENT COMPANY OF MSHA AND WHS. BALLAD OPERATES 21 HOSPITALS, LONG-TERM CARE FACILITIES, HOME CARE AND HOSPICE SERVICES, RETAIL PHARMACIES, OUTPATIENT SERVICES AND COMPREHENSIVE MEDICAL MANAGEMENT CORPORATIONS. OMR IS COMMITTED TO ITS PATIENTS RECOVERY. OMR PROVIDES CARE THAT IS CUSTOMIZED TO THEIR PATIENTS PERSONAL NEEDS AND TAKES INTO CONSIDERATION HOUSING, EDUCATION, EMPLOYMENT, LEGAL ISSUES, SECURITY, TRANSPORTATION AND OTHER AREAS IN ORDER TO GAIN A COMPLETE PICTURE OF THE INDIVIDUAL. ANOTHER KEY FACET OF PATIENT-CENTRIC APPROACH TO CARE IS TO HAVE A RELIABLE WAY OF GETTING INPUT FROM PATIENTS. OMR CONVENES FOCUS GROUPS OF PATIENTS WHO MEET BI-MONTHLY WITH THE DIRECTOR AND HAVE RECOVERY LIFE COACHES WHO CONDUCT PEER GROUPS, INCLUDING ESTABLISHING AN OVERMOUNTAIN GROUP ON THE TN RECOVERY APP. OMRS RECOVERY LIFE COACHES HAVE ALSO STARTED A NEW PROGRAM FOR SOR GRANT PATIENTS CALLED THE HIGHLAND PEER PROGRAM. THIS PROGRAM INVOLVES CONTINGENCY MANAGEMENT THAT IS GOAL ORIENTED AND STRENGTH-BASED PRACTICE. GOALS OF THE PROGRAM INCLUDE IMPROVE TREATMENT RETENTION AND OUTCOMES, PROVIDE TANGIBLE EVIDENCE OF ACCOMPLISHMENT, AND EMPHASIZE CLIENT-DIRECTED TREATMENT.IN FY20, OMR ADMITTED 203 PATIENTS INTO THEIR PROGRAM. DURING THE 12 MONTHS ENDING JUNE 30, 2021, OMR ADMITTED 261 PATIENTS, AN INCREASE IN THE MONTHLY AVERAGE OF 28.6%. THE AVERAGE MONTHLY CENSUS INCREASED FROM 309 PATIENTS IN FY20 TO 371 IN FY21, WHICH IS AN INCREASE OF 20%. THE AVERAGE MONTHLY SOR GRANT CENSUS INCREASED FROM 209 IN FY20 TO 246 IN FY21, WHICH IS AN 18% INCREASE.OMRS COMMUNITY ADVISORY COMMITTEE MEETS QUARTERLY TO KEEP THE COMMUNITY ABREAST OF WHAT IS HAPPENING AT OMR. DURING FY21, MEMBERS OF THE JUDICIAL SYSTEMS IN THE SURROUNDING COUNTIES WERE INVITED TO OMR FOR AN OPEN HOUSE. THE GOAL FOR OMR IS TO HELP ASSIST INDIVIDUALS WITH TREATMENT AFTER INCARCERATION OR TO PROVIDE A TREATMENT OPTION TO AVOID INCARCERATION. ETSU HAS AN ADDICTION MEDICINE FELLOWSHIP AND OMR IS A PARTICIPATING SITE. DURING FY21, ONE FELLOW SPENT TIME AT OMR. THIS PROGRAM WILL ASSIST IN PREPARING PHYSICIANS TO TREAT PERSONS WITH SUBSTANCE USE AND BEHAVIORAL DISORDERS IN OMRS SERVICE AREA. ALSO, AN ETSU NURSE PRACTITIONER STUDENT ROTATED THROUGH OMR, PROVIDING BENEFIT TO ITS PATIENTS AS WELL AS TRAINING FOR FUTURE PROVIDERS IN THE TREATMENT OF ADDICTION. OMR CONTINUES TO CONTRACT WITH THE DEPARTMENT OF HEALTH TO PROVIDE HEPATITIS C RAPID TESTING.OVERMOUNTAIN REGULARLY MEASURES AND REPORTS ON THE PERFORMANCE OF ITS PROGRAM. OMR TRACKS BOTH EFFICIENCY AND EFFECTIVENESS MEASURES. BECAUSE OF THIS DEDICATION TO QUALITY, OMR EARNED A THREE-YEAR ACCREDITATION FROM CARF (THE COMMISSION ON THE ACCREDITATION OF REHABILITATION FACILITIES) IN AUGUST 2018. CARF THREE-YEAR ACCREDITATION IS THE HIGHEST ACCREDITATION LEVEL AWARDED TO ORGANIZATIONS LIKE OVERMOUNTAIN.TO RECEIVE THREE-YEAR ACCREDITATION FROM CARF, ORGANIZATIONS ARE PUT THROUGH A RIGOROUS ONGOING PROCESS THAT INCLUDES, AMONG OTHER REQUIREMENTS, LIVE ON-SITE SURVEYS. THESE REQUIREMENTS ENSURE OMRS PROGRAM MEETS CARFS HIGH STANDARDS OF QUALITY AND ACCOUNTABILITY. OVERMOUNTAIN RECOVERY WAS ALSO AWARDED THE STATE OPIOID RESPONSE (SOR) GRANT IN DECEMBER 2018, WHICH WAS RENEWED IN SEPTEMBER 2019 AND EXTENDED THROUGH FISCAL YEAR 2021. THE SOR GRANT IS A HUB AND SPOKE MODEL WITH OVERMOUNTAIN BEING THE FIRST HUB OUT OF FOUR ACROSS THE STATE OF TN. SPOKES INCLUDE WOODRIDGE (MSHA INPATIENT BEHAVIORAL HEALTH HOSPITAL), FAMILIES FREE, FRONTIER HEALTH, APPALACHIAN COUNSELING, CCS, AND RED LEGACY. THIS HAS ALLOWED US TO HELP MANY PATIENTS WHO COULD NOT OTHERWISE AFFORD TREATMENT. THE GRANT INCLUDES FUNDING THAT ALLOWS PATIENTS ASSISTANCE WITH TRANSPORTATION, SOCIAL SERVICES, HELP PAY UTILITY BILLS, PROVIDE CLOTHES FOR AN INTERVIEW, AND COMMUNITY AWARENESS OF THE SERVICES OMR PROVIDES FOR TREATMENT OF OPIOID ADDICTION. A THIRD-PARTY RESEARCH AGENCY, EVALUATION, MANAGEMENT, AND TRAINING ASSOCIATES, IS CONDUCTING RESEARCH ON THE STATE OPIOID RESPONSE GRANT AT OVERMOUNTAIN RECOVERY. THIS RESEARCH IS SPONSORED BY THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMSHA). THE RESEARCH PROJECT IS TITLED EVALUATION OF THE TENNESSEE STRATEGIC OPIOID RESPONSE (TN SOR): CHANGING BEHAVIOR, COORDINATING CARE, AND RESTORING LIVES. THESE ASSESSMENTS ARE CONDUCTED AT INTAKE, AT 6-MONTH REVIEW AND AT DISCHARGE FROM THE GRANT. THROUGHOUT THE FISCAL YEAR, THESE DATA WERE USED TO TRACK TRENDS IN OPIOID USE AND EFFECTIVENESS OF TREATMENT UNDER THE SOR GRANT. ALL DATA AND REPORTS ARE PROVIDED DIRECTLY TO SAMSHA AND TO THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.WITH THE COVID-19 PANDEMIC, OMR CONTINUED TO ADJUST ITS PROGRAM TO FOLLOW ADVICE FROM THE STATE OPIOID TREATMENT AUTHORITY (SOTA) AND CDC GUIDELINES. CONFERENCE CALLS WERE CONDUCTED BI-WEEKLY WITH THE SOTA AND OTHER CLINICS ACROSS THE STATE. PER SOTAS REQUEST, OMR WOULD CLOSE ON SUNDAYS FOR DEEP CLEANING. OMR WAS ABLE TO SUPPORT THEIR PATIENTS STABILITY WHILE ALSO TRYING TO PREVENT THE SPREAD OF COVID-19 BY PROVIDING MORE TAKE-HOME MEDICATION THAN WOULD NORMALLY BE ALLOWED, COUNSELING SESSIONS WERE COND