Primary Health Care Opioid Response Faqs

Primary Health Care Opioid Response FAQs

Can proposals be rejected and a Zone PCN Committee not be awarded funding? ...... 1 Can an individual PCN submit a proposal independently? ...... 1 Who do I contact if I have questions during proposal planning?...... 2 Where can we get data for the development of our health service plan? ...... 2 What are the knowledge translation activities to be delivered by the ACFP PEER team? ...... 2 When will the ACFP PEER team knowledge translation tools be available? ...... 3 What opportunities are there for the zones to collaborate with PEER on knowledge translation? ...... 3 What is required for physicians/nurse practitioners to be able to prescribe buprenorphine/naloxone (Suboxone) or Methadone? ...... 3 Can zones spend money on partnerships with community pharma? ...... 3 Can zones encourage pharmacists to bill for their services within PCN framework? .....4 Is OAT covered by the Alberta Health Care Insurance Plan? ...... 4 Will naloxone kits be provided under the PHC ORI for clinic use (e.g., in emergency/first aid kits? ...... 4 How can the Zone PCN Committees find our more information on the Indigenous opioid grants and engage with First Nations groups? ...... 5 When a family physician is attending training and professional development in Opioid Use Disorder, Opioid Agonist Treatment, or other areas identified in the Zone PCN ORI plans, what hourly or daily rates can they be reimbursed at? ...... 6 Where are the rural Opioid Dependency Program (ODP) locations? ...... 6 Do the data reports capture First Nations people? ...... 6 Can palliative care patients be identified on the data reports? ...... 6

Can proposals be rejected and a Zone PCN Committee not be awarded funding? All zones will receive the funding allocation. The Primary Health Care Opioid Response Initiative team will continue to support zones through the process until the proposal is accepted.

Can an individual PCN submit a proposal independently? No, all proposals must be submitted via the Zone PCN Committee with support from the Zone PCN Committee Dyad.

Who do I contact if I have questions during proposal planning? If you have any questions during the proposal planning phase, you can contact the Secretariat Project Manager: Email: [email protected] Phone: 780-901-7454 A Contact List has also been made available and includes Primary Health Care Opioid Response Initiative project team members and Zone Support Teams.

Where can we get data for the development of our health service plan? Multiple data sets are being coordinated through the provincial zone service planning approach and will be available to support the development of your plan. To ensure consistency in data methodology and its application across all zones, Alberta Health (AH) will be coordinating and supporting zone specific data requests. AH is continuing to work through the development of a provincial intake process for zone data requests. As your zone identifies specific questions/queries, please contact Cora-Lee Polansky: Email: [email protected] Phone: 780-901-7454

What are the knowledge translation activities to be delivered by the ACFP PEER team? The ACFP PEER Deliverable Summary provides a high level overview of the knowledge translation activities to be delivered. Activities include: • Simplified Primary Care Guide for Opioid Use Disorder (OUD) • Simplified Primary Care Guide for Pain Management • Simple 1-2 page algorithm/summary of guide • Online learning module related to guideline content • Infographic tools, educational videos and pamphlets for practicing clinicians and patients • C-TOP website (Comparing Treatment Options for Pain) • Publication of 3-6 Tools for Practice related to guideline content • Creation of 2 podcasts for each guideline for online distribution (BS Medicine) • Small group learning module on OUD in collaboration with the Foundation for Medical Practice Education (McMaster University)

When will the ACFP PEER team knowledge translation tools be available? The ACFP PEER Deliverable Summary provides the dates for delivery of the knowledge translation tools: • Simplified Guidance documents for Primary Care • Opioid Use Disorder – March 2019 • Pain Management – March 2020 • Pain management tools are available on the C-TOP website (Comparing Treatment Options for Pain): http://www.pain-calculator.com/ • Neuropathic Pain tool released April 2018 • Osteoarthritis and Back Pain to be future releases (dates TBD)

What opportunities are there for the zones to collaborate with PEER on knowledge translation? The ACFP PEER Deliverable Summary provides a summary of the opportunities for the zones to collaborate with PEER on knowledge translation, including: • Generate and provide presentations on Simplified guidelines • Development and delivery of fully accredited provincial roadshow presentation (3 – 8 hrs) on Simplified guidelines and related medical content • Provide and assist with development of academic detailing programs throughout the province on guideline content • Provide slide deck and sample presentation series for other local subject matter experts with “train the trainer” seminars Note: Cost for the PEER team resources are free. All other costs are the responsibility of the zone.

What is required for physicians/nurse practitioners to be able to prescribe buprenorphine/naloxone (Suboxone) or Methadone? At this time, pharmacists are employed by PCNs. Any new pharmacy services related to opioids that have been identified as part of the Primary Health Care Opioid Response Initiative proposal, will need to be approved as part of the PCN business planning process and include PCN board governance. Pharmacists are unable to direct bill via a PCN.

Can zones spend money on partnerships with community pharma? Yes, the grant does not restrict funding allocation to partnership activities with community pharmacy programs. The grant is one-time funding so it is not advised to allocate grant dollars to create net new operational staff.

Can zones encourage pharmacists to bill for their services within PCN framework? At this time, pharmacists are employed by PCNs. Any new pharmacy services related to opioids that have been identified as part of the Primary Health Care Opioid Response Initiative proposal, will need to be approved as part of the PCN business planning process and include PCN board governance. Pharmacists are unable to direct bill via a PCN.

Is OAT covered by the Alberta Health Care Insurance Plan? In 2017/2018, approximately 7800 Albertans were receiving Opioid Agonist Therapy (OAT). Approximately 25% of these people either paid for treatment out-of-pocket or through private insurance. The cost of opioid agonist therapies are highly influenced by the time of medication used and the treatment length. Average costs for one year of methadone range between $4,000-$9,000 and Suboxone (generics) from $5,000-$12,000. Universal coverage for OAT is not available at this time through Alberta’s government-sponsored health benefit plans which provides coverage for therapies, including the necessary dispensing fees. Alberta Health is currently exploring options regarding OAT coverage and accessibility.

Will naloxone kits be provided under the PHC ORI for clinic use (e.g., in emergency/first aid kits? PHC ORI grant is not providing funding for Overdose Response Kits (naloxone kits) above what is funded through the AHS Community Based Naloxone (CBN) program. Naloxone kits are not publicly funded for workplace use. Employers are responsible for the purchase of naloxone for workplace use. CBN program encourages clinics to procure naloxone for clinic use in the same manner as all other medications they have on-site or through Adapt Pharma, the supplier for nasal naloxone in Canada. PCNs and physicians are encouraged to become distribution sites. For more information, visit https://www.albertahealthservices.ca/info/Page13663.aspx

How can the Zone PCN Committees find our more information on the Indigenous opioid grants and engage with First Nations groups? Communication process can be facilitated through the AHS liaisons. Following is an overview of the organizations funded through the Indigenous grant funding stream.

Grantee Area / Nations supported Provincial Scope funding - AHS Edmonton and Calgary Indigenous Program ARCHES Lethbridge

Provincial Scope funding - Alberta Grande Prairie, Edmonton, Calgary and Lethbridge Native Friendship Centres HIV North Grande Prairie Provincial Scope funding - Metis Nation Citizens of the Metis Nation of Alberta across the province of Alberta (MNA) Metis Settlements General Council Metis peoples living within the 8 Metis Settlements: Buffalo Lake, East Prairies, (MSGC) Elizabeth, Fishing Lake, Gift Lake, Kikano, Paddle Prairie, and Peavine Athabasca Tribal Council Athabasca Chipewan First Nation, Chipewyan Prairie Nation, Fort McKay Nation, Fort McMurray No. 468 Nation, Mikisew Cree-Nunee Nation. Blackfoot Confederacy Blood Tribe, Piikani Nation, Siksika Nation Bigstone Health Council Bigstone Cree Nation (independent Nation not represented by a Tribal Council area) Enoch Nation Enoch Cree Nation

Kas Tas Kee Now Tribal Council Loon River Cree Nation, Lubicon Lake, Peerless Trout Nation, Whitefish Lake, Woodland Cree Nation Lesser Slave Lake RC Swan River Nation, Driftpile Cree Nation, Kapawe’no Nation, Sucker Cree Nation North Peace Tribal Council Beaver Nation, Dene Tha Nation, Little Red River, and Tall Cree Nation. Samson Cree Nation In agreement with Maskwacis Health Services, the grant project covers all four Maskwacis Nations: Ermineskin Nation, Louis Bull Tribe, Montana Nation, and Samson Cree Nation. Saddle Lake Cree Nation Saddle Lake Cree Natio Stoney Nakota/Tsuu T'ina Tribal Council Morley, Tsuut’ina, Bighorn, Eden Valley Tribal Chiefs Ventures Beaver Lake Cree Nation, Cold Lake Nation, Frog Lake Nation, Heart Lake Nation, Kehwin Cree Nation, Whitefish lake Nation No. 128 Western Cree Tribal Council Sturgeon Lake First Nation, Horse Lake First Nation, and Duncan’s Band First Nation Yellowhead Tribal Council Alexander Nation, Alexis Nakota Sioux Nation, O’Chiese Nation and Sunchild Nation.

When a family physician is attending training and professional development in Opioid Use Disorder, Opioid Agonist Treatment, or other areas identified in the Zone PCN ORI plans, what hourly or daily rates can they be reimbursed at? For physician remuneration, the current PCN program policy should prevail. It is recommended the PCN named as the fund holder use their established internal policies and processes to administer their grants, including the rates to their physicians and teams who are training in order to support the PHC ORI in their zone, PCN and practice.

Where are the rural Opioid Dependency Program (ODP) locations? Brooks Consort Lacombe St. Paul Airdrie Coronation Leduc Stettler Alix Devon Lloydminster Stony Plain Barrhead Drayton Valley Maskwacis Sundre Beaumont Drumheller Mayerthorpe Swan Hills Bentley Eckville Millet Sylvan Lake Blackfalds Edmonton Olds Thorsby Bonnyville Elk Point Onoway Two Hills Boyle Fort McMurray Ponoka Vegreville Calmar Fox Creek Red Deer Veteran Camrose Galahad Redwater Viking Carvel Hanna Rocky Mountain House Wabamun Cereal Hardisty Sedgewick Wainwright Clandonald Hinton Smoky Lake Westrose Cochrane Innisfail Spruce Grove Wetaskiwin Cold Lake Lac La Biche St. Albert Whitecourt

Do the data reports capture First Nations people? The data reports do capture First Nations people but does not differentiate First Nations status or FNIH Benefits.

Can palliative care patients be identified on the data reports? At this time, palliative care patients are unable to be identified on the data reports.