(CLOSED) HRSA-19-108 Rural Communities Opioid Response Program Rural Centers of Excellence on Substance Use Disorders

This notice announces the opportunity to apply for funding under the Rural Communities Opioid Response Program – Rural Centers of Excellence on Substance Use Disorders (RCORP-RCOE). RCORP-RCOE is part of the RCORP initiative, which is a multiyear effort to reduce the morbidity and mortality of substance use disorder (SUD), including opioid use disorder (OUD), in rural communities at the highest risk for these conditions. RCORP-RCOE will provide up to three years of funding to support three Rural Centers of Excellence (Centers) on SUD.

The purpose of RCORP-RCOE is to support the identification, translation, dissemination, and implementation of evidence-based programs and best practices “related to the treatment for and prevention of substance use disorders within rural communities, with a focus on the current opioid crisis and developing methods to address future substance use disorder epidemics.”

The Centers will engage in research to identify “science-based prevention, treatment, and other risk reduction interventions, including community-based approaches that may be replicable in other rural communities and associated professional training.” After identifying rural-relevant interventions, the Centers will serve as a resource for “scientific and technical assistance to county and state health departments and other entities as identified seeking guidance on how to address the substance use disorder challenges in their community.” Other such entities in rural communities may include, but are not limited to, state offices of rural health (SORHs), critical access hospitals (CAHs), rural health clinics (RHCs), and other rural health care providers. Training and technical assistance (TA) should help rural communities translate best practices to their unique community settings and implement those practices to reduce the morbidity and mortality related to SUD, particularly OUD, in their area.

Over the three-year period of performance, the Centers should demonstrate how scientific and technical assistance and professional training related to evidence-based SUD interventions can improve prevention, treatment, and recovery in rural communities, with a focus on OUD. The Centers should also demonstrate how their programming improves health and other outcomes as well as systems for addressing current and future SUD epidemics in rural communities.

Applicant organizations may be located in an urban or rural area but all proposed and funded RCORP-RCOE activities must exclusively serve populations residing in HRSA-designated rural areas, whether across multiple states, within one or more regions, or throughout the nation. HRSA also expects applicant organizations to possess expertise related to rural health care delivery and/or policy.

Applicant organizations should select and respond to only one of the following three Focus Areas:

Focus Area 1: Innovative and effective treatment interventions for SUD, particularly OUD, in rural communities

The purpose of this Focus Area is to identify, translate, and disseminate evidence based programs and best practices related to the implementation of innovative and effective treatment interventions for SUD, particularly OUD (such as the hub-and spoke model), in rural communities as designated by the Health Resources and Services Administration (HRSA). This Center should provide scientific and technical assistance and training to rural communities to support implementation of such programs and practices. This Center is also encouraged to develop innovative treatment interventions for SUD, particularly OUD, including “patient-centered and family-based approaches to address the generational impacts of substance abuse;” and mitigate workforce and service delivery challenges common in rural communities, including those unique to RHCs, CAHs, and other rural providers.

Specifications:

Organization must satisfy each of the following requirements:

• Established at an academic university “in a rural state where over 60 percent of the population is defined as rural by the U.S. Census Bureau;”
• Established at an academic university that has a demonstrated track record of
  • “Developing innovative and effective treatment interventions for opioids;
  • A strong familiarity with rural workforce and service delivery challenges, including the requirements and challenges of rural health clinics, critical access hospitals, and other rural providers; and
  • Effective engagement with rural populations and health care providers in general;”
• Established at a university and connected medical school that has “experience in clinical trials research and the dissemination and training in best practices in rural communities;”
• Established at a university that has “experience evaluating the efficacy of comprehensive treatment of substance use disorders, including patient-centered and family-based approaches to address the generational impacts of substance abuse;” and
• Established at an academic university which is “connected to an associated medical school that is already utilizing a collaborative approach to behavioral health care, with partnerships between the university and medical school, and the state with an effective, systems-wide approach to addiction treatment, such as the hub-and-spoke model.”

Focus Area 2: Best practices in recovery housing programs for SUD, particularly OUD, intervention among low-income, high-risk individuals in rural communities

The purpose of this Focus Area is to identify, translate, and disseminate evidence based programs and best practices related to recovery housing programs for SUD intervention and other interventions for low-income, high-risk individuals who reside in rural communities as designated by HRSA. This Center should provide scientific and technical assistance and training to support implementation of such programs and practices. This Center is also encouraged to address other treatment and prevention services for low-income, high-risk individuals who reside in rural areas, including persons involved with the criminal justice system.

Specifications:

Organization must satisfy each of the following requirements:

• Established as “a public-private partnership between a non-profit and an academic university;”
• Able to “provide technical assistance and best practices on the development of recovery housing programs for substance use disorder intervention;”
• “Based on an intervention model with a demonstrated track record, including multi-year outcomes data conducted by an academic research institution;” and
• Focused on “best practices for successful substance use disorder intervention for low-income, high-risk individuals, including those who have been involved with the criminal justice system.”

Focus Area 3: Addressing synthetic opioid-related overdose mortality in rural communities in the Delta and/or Appalachian regions The purpose of this Focus Area is to identify, translate, and disseminate evidence based programs and best practices to address the disproportionate burden of overdose mortality due to use of synthetic opioids in the Delta or Appalachian regions, focused on rural communities as designated by HRSA. This Center should provide scientific and technical assistance and training to support implementation of such programs and practices. This Center is also encouraged to respond to the unique factors in the Delta and/or Appalachian regions that may contribute to the misuse of synthetic opioids in rural communities, including underlying social, economic, and environmental conditions.

Specifications:

Organization must satisfy the following requirement:

• Established at “an academic university located in a state included in the Delta Regional Authority or Appalachian Regional Commission with an overdose death rate for synthetic opioids as determined by the Centers for Disease Control and Prevention (CDC) higher than a 150 percent change between 2015 and 2016