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21 <br /> We anticipate that approximately 50 unique individuals will directly benefit from this resource in year one, <br /> and that 190 individuals will directly benefit from this service over three years. This estimate is based on a <br /> five-year upward trend in opioid overdose incidents paired with anticipated inbound referrals once services <br /> have been established. <br /> Projected Annual MAT Enrollees <br /> 140 <br /> 120 <br /> 100 <br /> 80 <br /> 60 <br /> 40 <br /> 20 <br /> 0 <br /> 2023 2024 2025 2026 2027 2028 <br /> Projected MAT Enrollees <br /> Assessment of Need and Proposal Summary <br /> Between 2018 and 2022, OC-EMS has responded to 466 opioid-related overdose incidents equating to a <br /> 226% annual increase. Of all opioid overdose incidents from 2018 through 2022, 68% of the affected <br /> persons were transported by OC-EMS to local emergency departments, 30% refused transportation, 1.5% <br /> were deceased on scene and 0.4%were transported to an inpatient alternative destination facility for OUD <br /> treatment. Of the 466 total incidents, 106 (23%)were the result of 42 individual patients that utilized OC- <br /> EMS for an overdose on more than one occasion. <br /> When OC-EMS responds to an opioid overdose, there are currently three possible disposition pathways: <br /> (1)transport to an Emergency Department; <br /> (2)transport to a local inpatient treatment facility; or <br /> (3)refusal of transport. <br /> Buprenorphine use, as part of MAT,has been associated with a significant reduction in illicit opioid use for <br /> persons with opioid use disorder(OUD) (Soeffing et al., 2009). MAT with buprenorphine has been shown <br /> to be more effective in the reduction of illicit opioid use, risk of drug-related overdose, and overall <br /> healthcare and utilization costs when compared to abstinence-based addiction treatments for those with <br /> OUD(Kinky et al.,2019).Although OC-EMS offers harm reduction efforts aimed at providing specialized <br /> alternative destinations of transport, a specialized overdose refusal protocol (attachment E), as well as <br /> distribution of naloxone, sterile syringes and educational materials; there is no pathway in place for an <br /> individual to be offered MAT from the scene of an EMS incident. Further, even in the event that an <br /> individual is transported to a local Emergency Department (ED), there is no guarantee that they will be <br /> offered services consisting of MAT or connection with ongoing treatment options upon exit from the ED. <br /> Although Orange County has a range of opioid treatment programs (OTPs) and office-based opioid <br /> treatment (OBOT) options available within the county, there is an identifiable void in connecting <br /> individuals with these services. Even in the event that an individual is aware of these services, the time- <br /> 2 <br />