In May 2020, The DC Health staff planned and facilitated an online engagement session with about eight community providers who serve people with substance use disorder. Facilitators asked providers for their perceptions of what was happening in the lives of people who misuse drugs, including identifying their top concerns, service gaps, and what they see as the strengths of the community.
Gaps on the substance use disorder care continuum – DC has many substance use disorder resources, but they are unevenly distributed. Not everyone can get the type of care they need, when and where they want it. Assessment and referral challenges are prevalent. The District needs more harm reduction services (such as syringe access, safer consumption spaces, naloxone distribution, sobering centers) and primary and secondary prevention services. Service capacity is hindered by low payment rates and cumbersome licensure, certification, and documentation requirements.
Provider training and capacity building – Ongoing training and education are necessary for providers at all levels, including clinical, paraprofessional (such as case managers, peer leaders, peer recovery coaches, and recovery specialists), and nonclinical staff (such as front desk staff, managers, and referral coordinators) to promote high-quality patient engagement.
Care transitions – People are often discharged into the community or to other service providers with limited support, which hinders recovery. Some populations (such as individuals experiencing homelessness or with unstable housing, survivors of abuse, individuals who were formerly incarcerated or returning citizens, older adults, and people with children) require specialized attention and care.
System improvements and capacity-building needs – Substance use disorder providers need improvements to infrastructure and systems, including enhanced payment and compensation mechanisms, workforce training and technical assistance infrastructure, quality and performance improvement and accountability structures, and systems to promote the use of health information technology (IT) and health information exchange to coordinate care, integrate services, and improve quality, care transitions, and crisis stabilization.
Gaps in the substance use disorder care continuum:
Provider training and capacity building:
System improvements and capacity-building needs: