Through two pilot projects, the California Department of Public Health (CDPH) partners with public health departments, emergency medical services (EMS) agencies, and 911-transport providers that engage in opioid overdose prevention and treatment during EMS calls.
Local Emergency Medical Services Agency (LEMSA) Pilot Projects
This project includes the following components:
- The EMS agency provides “leave behind” naloxone kits to patients, friends, and family members to use in the case of future overdoses.
- The 911 responders identify patients who are in acute withdrawal, give a first dose of buprenorphine to these patients in the field, and transport the patient to a designated opioid receiving center.
- The EMS agency provides a referral (“warm handoff”) of 911 patients to a public health outreach coordinator/intervention team. Once this warm handoff occurs, the public health team contacts the patient to assist in MAT program enrollment and accessing additional county services.
- The EMS agency establishes an overdose receiving center (ORC), [local Emergency Department (ED)] to receive the 911 patients. ORCs are EDs designated by EMS where evidence-based care for patients who have experienced an overdose is standardized, and includes specialized personnel, training, and expertise to provide overdose patients the best possible chance to engage in evidence-based interventions and treatment for overdose use disorder.
First Dose Buprenorphine Pilot Projects
This project includes the following components:
- Establish County EMS Agency Protocols in line with State of California EMS regulations for paramedic-initiated buprenorphine.
- Utilize previously established training resources, or develop new training resources, for 911 transport paramedics on buprenorphine administration/indications and MAT program information – including data tracking in electronic health records, quality assurance process for tracking buprenorphine use, and data sharing with a hospital substance use navigator.
- Train 20% of the frontline clinicians/county paramedics for each selected 911 Transport Agency per quarter using the materials and protocols created.
- Designate an ORC for leave behind naloxone, naloxone kits, and linkages to care.
These projects receive funding from the State Opioid Response (SOR) grant through the Substance Abuse and Mental Health Services Administration (SAMHSA).