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45 <br /> 2. Project Narrative <br /> A. Assessment of Community Need (16 points, page limit: not to exceed 1% pages) <br /> This project will serve patients who receive Medication for Opioid Use Disorder (MOUD) <br /> services at Piedmont Health Services, Inc. at one of two clinical sites: Carrboro Community <br /> Health Center and/or Chapel Hill Community Health Center, both located in Orange County. <br /> In 2023, Orange County had an overdose death rate of 32 deaths; additionally, the rate of <br /> Orange County residents prescribed buprenorphine (a medication used for Opioid Use Disorder) <br /> has steadily risen in the last few years, with 605 residents being prescribed buprenorphine in <br /> 2023, up from 488 residents in 2020. In fact, Orange County has one of the highest rates in the <br /> state of deaths involving illicit opioid overdose, at 21 deaths in 2023, or 65.6% of overdose <br /> deaths. (https://www.dph.ncdhhs.gov/programs/chronic-disease-and-injury/iniury-and- <br /> violence-prevention-branch/north-carolina-overdose-epidemic-data) <br /> The behavioral health workforce shortage in North Carolina greatly impacts the ability of people <br /> with Opioid Use Disorder (OUD) to receive the services they need. The 2023 Treatment Services <br /> rate for Orange County was 336.6 out of 100,000 residents, which is low, even though it <br /> represents a 10% increase from the prior year. Additionally, 72.8% of children in foster care in <br /> Orange County were there due to parental substance use, one of the highest percentages seen <br /> in North Carolina. (https://www.dph.ncdhhs.gov/programs/chronic-disease-and-iniury/iniury- <br /> and-v_io_lence-prevention-branch/north-carolina-overdose-epidemic-data) <br /> One of the main barriers to care for MOUD patients is cost; patients relay this information to <br /> clinicians and staff at PHS frequently. According to the 2022 NC Behavioral Risk Factor <br /> Surveillance Survey (NC BRFSS), 11.9% of all adults in our service area had at least one instance <br /> in which they could not get the medical care they needed in the past 12 months due to cost; for <br /> Hispanic patients,the rate was 22%. Of adults who did not access needed mental health care in <br /> North Carolina, 44.8% did not because of cost. <br /> (https://schs.dph.ncdhhs.gov/data/brfss/2022/nc/all/medcostl.htmi) <br /> In the past 365 days, 52.6% of the Orange County assistance requests received by 211 were <br /> related to housing and shelter, while 19.8%were related to utilities. (https://nc.211counts.org/) <br /> When the cost of living is unattainable, needed services for OUD can fall to the wayside in lieu <br /> of keeping the lights on or making rent.This funding would allow PHS to offer MOUD at no cost <br /> to the patient,thereby eliminating the financial barrier to care. PHS offers 2-in-1 appointments <br /> to patients receiving MOUD, ensuring that the provider visit and Behavioral Health Consultant <br /> visit occur back-to-back, thereby cutting the burden of finding transportation in half. PHS also <br /> operates in-house pharmacies, essentially providing everything needed —provider visit, <br /> Behavioral Health visit, labs, and meds - in one appointment. <br /> 1 <br />