Michigan Overdose Data to Action county scorecard
Michigan Overdose Data to Action
Following the success of the CBHJ SIMPLE Scorecard in providing a county-level assessment of services for behavioral health disorders across criminal-legal systems, we have started development of a MODA Scorecard. For this tool we are using the CDC's Evidence-Based Strategies for Preventing Opioid Overdose as a guiding document to identify and measure the appropriate strategies being implemented at the county-level.
The scorecard process thus far has entailed the identification and operationalization of data elements to measure the CDC strategies. As shown in Table 1, some of the strategies are driven by state legislation (e.g. Good Samaritan legislation and targeted naloxone distribution) while other strategies require county- and local-level implementation. For example, some points, such as the existence of the Good Samaritan laws, may only be applicable to a state level, and we may not expect county-level variance. We also aim to look at when these practices were implemented, and also include new and promising practices where appropriate. Additionally, some practices will have sub-scores, where counties will be assessed by the level of fidelity achieved at a particular time, which is associated with additional points on the MODA scorecard.
While some of the data and information necessary to measures these factors is public, and others come from novel data acquired by the CBHJ and state partners, there remain notable gaps in our potential to measure these strategies. CBHJ will continue to work with state-level partners to refine operationalization methods for the remaining points on the overdose prevention scorecard and identify data sources, or proxy data sources, to measure each of the factors. Many of these data points are now available through the MODA Dashboard; however, if key CDC points remain un-operationalizable or measured, the CBHJ will design a survey to local public health departments and related partners to fill gaps. Our ultimate goal is conduct analysis that combines these factors to determine if or how they are associated with county-level fatal and nonfatal overdose rates.
| CDC Category | Point name | Scope of data | Operationalized | County variation | Start date known |
|---|---|---|---|---|---|
Targeted Naloxone Distribution | Targeted Naloxone Distribution program exists | Statewide | Maybe | Yes | Unknown |
| Police agencies carry Naloxone | Unknown | Not yet | Yes | Unknown | |
| County hospital partnered with MI-OPEN to distribute Naloxone | Statewide | Maybe | Yes | Unknown | |
| EMS agencies leave behind Naloxone after overdoses | Statewide | Yes | Yes | Yes | |
Medication Assisted Treatment | Methadone provider exists within county | Statewide | Yes | Yes | No |
| Buprenorphine availability | Statewide | Yes | Yes | No | |
Academic Detailing | The CBHJ is involved with the site | Statewide | Yes | Yes | Yes |
| The site is involved with OTE | Statewide | Yes | Yes | Yes | |
Eliminating Prior-authorization Requirements for MOUD | Physicians can prescribe MOUD without prior authorization requirements; May not vary on a county level | Unknown | Maybe | No | Maybe |
Screening for Fentanyl in Routine Clinical Toxicology Testing | Fentanyl testing available | Unknown | Maybe | No | Maybe |
911 Good Samaritan Laws | Police agencies honor Good Samaritan laws, even for bystanders | Unknown | Not yet | Yes | Yes |
| Did the state have Good Samaritan legislation? | Statewide | Yes | No | Yes | |
Naloxone Distribution in Treatment Centers and Criminal Justice Settings | Treatment centers have targeted Naloxone program | Unknown | Not yet | Yes | Unknown |
| Jail offers Naloxone to program participants | Statewide | Yes | Yes | 2020 only | |
| Jail offers Naloxone to anyone who asks | Statewide | Yes | Yes | 2020 only | |
MAT in Criminal Justice Settings and Upon Release | Jail offers Buprenorphine continuation | Statewide | Yes | Yes | 2020 only |
| Jail offers Buprenorphine induction | Statewide | Yes | Yes | 2020 only | |
| Jail offers Methadone continuation | Statewide | Yes | Yes | 2020 only | |
| Jail offers Methadone induction | Statewide | Yes | Yes | 2020 only | |
| Jail offers Naltrexone induction | Statewide | Yes | Yes | 2020 only | |
Initiating Buprenorphine-based MAT in EDs | Emergency Department physicians prescribe Buprenorphine | Unknown | Maybe | Yes | Unknown |
Syringe Service Programs | Syringe exchange program exists within county | Statewide | Yes | Yes | No |
| Was it run by a harm reduction agency other than the public health department | Statewide | Yes | Yes | No | |
(Non-CDC) Post-overdose Response Program | Post-overdose response program uses EMS data to spur a follow-up visit | Statewide | Maybe | Yes | Yes |
(Non-CDC) Paraphernalia laws do not exist | Municipality does not issue paraphernalia charges | Unknown | Maybe | Yes | Unknown |
(Non-CDC) User's union | Users' unions exist in the county | Unknown | Maybe | Yes | Unknown |
(Non-CDC) Behavioral Health Homes | County had an Office Based Opioid Treatment Provider registered by the state | Statewide | Yes | Yes | Maybe |
| County had an Opioid Treatment Program registered by the state | Statewide | Yes | Yes | Maybe | |
| County had a Behavioral Health Home registered by the state | Statewide | Yes | Yes | Maybe | |
(Non-CDC) Jail release protocols | Does the jail reactivate Medicaid upon release | Statewide | Yes | Yes | 2020 only |
| Does the jail have care continuity practices in place? | Statewide | Yes | Yes | 2020 only |