Engaging the justice system to address the opioid crisis: The Justice Community Opioid Innovation Network (JCOIN).

Many individuals with opioid use disorder come into contact with the justice system each year, making the nexus between the criminal justice system and the health care system a critical juncture for responding to the opioid crisis and simultaneously promoting public health and public safety. Collaborations across these sectors are essential to providing effective screening, treatment, and discharge planning; connecting individuals to services following release; promoting long-term recovery while reducing recidivism; and ultimately bringing the opioid crisis under control. In 2019, with the support of the NIH Helping to End Addiction Long-term (HEAL) Initiative, the National Institute on Drug Abuse launched the Justice Community Opioid Innovation Network (JCOIN). JCOIN is a >$150M multisite cooperative designed to facilitate transdisciplinary collaborations that can create actionable, translatable insights for the justice system and community-based organizations to address the opioid epidemic in justice-involved populations. JCOIN brings together 11 Research Hubs, a coordination and translation center (CTC), and a methodology and advanced analytics resource center (MAARC), with the goal of generating evidence that is greater than the sum of the parts. Collectively, the network will field at least 12 large-scale multisite clinical trials, which are described in this special issue. This article provides a brief overview of the scientific underpinnings for these trials; describes the broad themes connecting them; and discusses the intersections of the JCOIN initiative with the COVID-19 pandemic.

Laying the Foundation: Factors Associated With Medical Home Recognition Among Health Centers.

INTRODUCTION: The characteristics associated with medical home recognition among federally qualified health centers were explored. The results will help guide the transformation of health centers and other providers to the medical home model of practice. METHODS: This study included the universe of 1,198 federally qualified health centers in calendar year 2012; the data were collected in 2013 and analyzed in 2014-2015. Using the 2012 Uniform Data System, descriptive statistics were calculated and differences in means of health center characteristics by third-party medical home recognition status were tested. Multivariable logistic regression models examined correlates of recognition. RESULTS: In 2012, 17.3% of health centers had third-party medical home recognition. Health centers in the Northeast had more than three times the odds of being recognized as medical homes, compared with health centers located in the South (OR=3.3, p<0.001). Health centers with medical home recognition were larger and had higher odds of having electronic health records in all sites (OR=3.08, p<0.001). Recognized health centers had a higher percentage of total staffing composed of behavioral health specialists, compared with health centers that had not attained medical home recognition in 2012 (OR=1.06, p<0.001). CONCLUSIONS: These findings highlight the importance of monitoring which types of health centers are falling behind, encouraging the adoption of health information technology, and enabling the recruitment of onsite behavioral health staffing.