Mobile Integrated Health MAT Access Advocate Program (MAAP)

Milwaukee County reported a 41% increase in opioid use disorder (OUD ) deaths in the last 18 months. The County‘s fragmented 18 suburban municipalities are experiencing high rate of overdose and OUD related deaths. These communities do not have the resources required to address their needs. The underserved area includes a population of 351,178 residents. According to the County’s Office of Emergency Management 23% of the County’s overdose incidents and 25% of the opioid deaths in 2020 occurred in Suburban communities with no opioid response teams in operation.  

Mobile Integrated Health (MIH) teams (1 community paramedic and 1 peer support counselor) are uniquely positioned to facilitate new enrollments or reengagements of OUD patients into medication-assisted treatment (MAT) services. West Allis Fire Department’s (WAFD) 24/7 MIH program has provided evidence-based services for 7 years and has demonstrated success in contacting OUD patients (85%) and enrolling them into MAT (55%).  

Responding to rising opioid related incidents, WAFD will partner with community MAT providers and the Medical College of Wisconsin (MCW; Research Partner) to implement the MAT Access Advocate Program (MAAP) in response to COSSAP and first responder service and training gaps in suburban Milwaukee County.   

MAAP will: 1) increase the number of OUD patients receiving MAT; 2) decrease illicit opioid drug use and prescription opioid misuse; 3) increase first responder agencies engaged in connecting people with OUD to MAT; and 4) complete a feasibility and potential pilot study related to first responders initiating MAT (buprenorphine) in the field. These goals are designed to provide immediate response to municipalities underserved by MIH, while working with the same municipalities to deliver long-term, sustainable opioid response services.   

We will meet these goals by expanding WAFD’s MIH opioid response to other suburban municipalities, while developing and delivering a comprehensive MIH/OUD training package that will instruct other first responders how to connect OUD patients to MAT. MAAP will prioritize transport of overdose survivors to EDs that offer MAT at point of care. MAAP and County and State EMS leadership will also evaluate demand and ability for first responders to begin buprenorphine treatment in the field, develop implementation practices and if supported MAAP will pilot MIH-initiated buprenorphine induction with telehealth and a warm handoff for long term treatment.  

MCW will collect process and outcome measures and facilitate dissemination of deliverables (training modules, policy briefs, scope of practice recommendations).