As the hub of local health care systems, CAHs can play an important role in addressing the problems of opioid use in their communities. For this project, we will employ qualitative interviews to examine the ways in which CAHs are engaged in reducing the impact of opioid use in their communities through collaborative prevention, treatment, and recovery initiatives. We will focus in particular on 10-15 rural counties that have been hardest hit by overdose deaths. We will also investigate the treatment capacity of CAHs in the most impacted communities, to help inform the Flex Program’s work in this area and help state Flex Coordinators target resources.

Opioid use initiatives may fall under a CAH’s community and population health obligations, its service mix, or its quality improvement portfolio. We will seek to answer the following questions:

1. What types of initiatives have CAHs undertaken to improve opioid prescribing practices and reduce local opioid supply (e.g., implementing prescribing guidelines, creating “oxy-free emergency departments”, offering alternative pain management programs, or creating opioid disposal programs) and/or implementing opioid treatment programs?
2. Are these internal hospital or collaborative community-focused initiatives?
3. What challenges did they face in designing and implementing strategies to address opioid issues? 4) What resources and technical assistance were needed?

Using national data, we will also address questions such as:

1. How many CAHs are offering opioid treatment programs such as medication assisted therapy, traditional substance use treatment programs, mental health services to address co-occurring disorders, or detox services?
2. Is there an alignment between CAH service capacity and community need?