NYC ‘Hotspotting’ Pilot to Address Opioid Use Disorder in the ED
NYC Health + Hospitals is developing a pilot program at NYC Health + Hospitals/Lincoln to support people living with opioid use disorder and reduce overdose deaths, nonfatal overdoses, and use of the emergency department.
NYC Health + Hospitals is the largest provider of behavioral health in New York City. The system provides almost 60% of behavioral health services citywide serving 78,000 patients annually across emergency, inpatient and outpatient care. This includes 10 outpatient substance use disorder clinics, four ancillary withdraw programs, and four Opioid Treatment Programs.
Expected to launch later this year, the “Hotspotting” program was developed in partnership with the Staten Island Performing Provider System (SIPPS) and is modeled after its program.
Under the Hotspotting model, patients in the Lincoln Hospital emergency department for opioid use or nonfatal overdose will be connected to a dedicated team, including community health workers and peer counselors. For up to a year following the discharge from the hospital, the team will reach out to patients biweekly to offer support and connection to addiction services, medical care, as well as community-based resources, public benefits, and housing as needed. The program will offer patients a cell phone and a service contract to help them stay connected to care.
Overdose deaths in New York City in 2023 decreased slightly after four consecutive years of increases with a 1 percent decrease, and according to provisional data, the first quarter of 2024 had the lowest quarter of overdose deaths on record since 2020. However, there has more than a 100% increase in overdose deaths since the start of the COVID-19 pandemic, with 1,452 deaths in 2018 and 3,046 deaths in 2023. The Bronx has the highest rate of opioid overdose death in New York City, and patients who experience a nonfatal overdose are at increased risk of having a fatal overdose in the future.
NYC Health + Hospitals received $600,000 from Robin Hood to support this patient navigation program, which is expected to serve approximately 150 patients with substance use challenges when they are at the highest risk of relapse.
“Treating our patients with opioid use disorder and supporting their recovery are absolutely essential in light of our national opioid epidemic and public health emergency. Our Hotspotting program will provide continuity of care as patients transition from the hospital into the community setting and will help them stay connected to healthcare and addiction services,” said Daniel Schatz, M.D., medical director of substance use disorder services in the Office of Behavioral Health at NYC Health + Hospitals, in a statement. “Our goals are to support people living with opioid use disorder, reduce overdose deaths and nonfatal overdoses, and reduce use of the emergency department – all while making our patients feel seen and treating them with dignity. We are dedicated to addressing the substance use crisis, better understanding and treating patients living with this disease in the community, providing education, support, and a sense of continuity of care.”
Patients with opioid use disorder are most likely to initially engage with NYC Health + Hospitals in the emergency department as opposed to outpatient clinics. This presents a critical opportunity to engage patients, earn their trust, provide treatment, connect them to outpatient services and care, and help ensure they remain connected to services. The Hotspotting program builds on the success of NYC Health + Hospitals’ ED Leads program, which provides patients with substance use disorder with screenings, brief interventions, individual counseling, substance use treatment and referrals before leaving the hospital and is available at 11 hospitals in the health system.
