Washington State Hospital Association Rural Transportation and OUD Peer Needs Assessment

The Addictions, Drug & Alcohol Institute (ADAI) was contracted by the Washington State Hospital (WSHA) to conduct a rural needs assessment. The needs assessment will focus on transportation concerns and barriers, and substance use peer support, both from the perspectives of workforce members and patients, for treatment and services related to opioid use disorder (OUD) In North-Central Washington. Eligible counties were: Grant, Lincoln, Adams, Okanogan, Chelan, Douglas

The aims were to understand:

• Facilitators and barriers to rural transportation to OUD treatment and services,

• Resources needed to address transportation concerns,

• Facilitators and barriers to strengthening the OUD peer workforce infrastructure, and • resources needed to further develop a more robust peer transportation network.

We conducted surveys in English and Spanish with community members age 18 or older living in an eligible county about transportation barriers. We also conducted surveys and interviews with substance use disorder workforce peers and other professionals about observed transportation challenges experienced by their patients and clients, and challenges and resources needed to support peer workforce members.

Results

• More than 45% of community respondents reported having any transportation insecurity

• Younger community respondents and those outside of Grant County tended to have more transportation insecurity

• When referring to health care organizations, respondents reported the least amount of time getting to pharmacies, hospitals, and doctors’ offices, but more time getting to SUD treatment and mental health facilities

• Peer workforce organizations have integrated some transportation services within their operations to address high demand among clients, but lack the resources to address all of patients’ needs or those of SUD peers

• Peer workforce members pointed to a number of barriers to implementing a more robust peer network including availability of funding and community referral sources, supports for peer workforce members for their own recovery efforts, and stigma within the community and from health care professionals about people who use drugs • Peer workforce members felt that the Peer Recovery Coach Checklist was a useful tool for describing the peer activities and encompassed the scope of their work

Conclusion

Rural counties in North Central Washington are greatly affected by transportation insecurity, which may have an impact on access to specialty care delivery, such as substance use disorder treatment and mental health care. SUD peer workforce members and organizations are able to provide some transportation support, but demand for services outpaces available resources. Given challenges in the current funding environment for health care, tools such as the peer recovery checklist may be helpful for fruitful discussions on how to best optimize care with peer support, and better support peer workforce members.

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