The program has a family medicine physician, 2 nurse
practitioners, a case manager, a nurse, a full-time
counselor, and a peer support specialist (PSS). The RHC
in Bolivar is the hub but sends a medication-assisted
treatment (MAT) provider to Eldorado Springs, Hermitage,
and Osceola for treatment and counseling. The program
will soon serve Stockton in January 2024 and will also
expand to have a peer support specialist accompany the
MAT provider to outreach clinics.
Counseling for patients and families, including play
therapy for children
Hepatitis C treatment
Collaboration with OB/GYN for prenatal and substance
Nicotine replacement products
Case management for social needs
The program also offers contingency management, in which
patients receive sobriety coins or other tokens at
different milestones: at the beginning of treatment, 90
days, 6 months, and every year. Children of patients also
receive a gift or token. After a year of treatment,
patients have the option to ring a bell in the clinic and
receive a certificate, T-shirt, and picture. Families are
invited to celebrate with the patient.
The program had 15 patients in the first month (January
2018) and was open two days a week. Now, the program
operates 5 days a week and sees 400 patients each month.
Since the program began offering contingency management,
no-show rates for appointments have decreased.
The program is partnering with law enforcement and will
start offering MAT at the Polk County jail.
When program coordinators began looking for partners and
champions, some providers turned them down, saying that
their communities did not have a substance use problem or
that they did not want to serve patients with substance
use disorder. These sentiments indicated a need for
community education and stigma reduction. Now, these same
providers are reaching out to the program to collaborate
after seeing its successes. In addition, more individuals
are inclined to seek services as treatment becomes less
Before implementing this program, coordinators looked at
models that reduced barriers for patients, such as
self-referrals, walk-in availability, and starting MAT as
soon as possible (medication-first approach).
The PSS was hired using grant money to avoid any issues
with RHC-specific billing requirements.
The program partners with law enforcement, OB-GYN
programs, a pregnancy resource center, housing
assistance, and child welfare services. In addition, the
program is working with the Mobile
Integrated Healthcare Network, a community paramedic
and community health worker program, to start offering
MAT in patients' homes. The Osceola program also partners
with its community's AA program and transportation
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.