Table 1 Payer intervention model of the advancing recovery framework (applied in Arm 2 only)

Pre-work for Leadership

To be completed as part of Executive Briefing by the Executive Director (or designee)

Executive sponsor (County Director) personal responsibilities checklist

Coach call to Executive Sponsor to review primer for Executive Sponsor

1. Identify an Executive Sponsor for payer portion of the project

Change leader training on how to apply and interpret the 5 Levers Barriers Assessment

2. Develop the strategic aim for buprenorphine adoption.

3. Select change leader and team members who are committed and make sure they have adequate time to participate in the project.

Preparing the Change Leader & Team

4. Change Leader & Team Training on organizational and policy change techniques.

NIATx Workbook (Change Leader Training Guide – Administrative Version)

Provided in Learning Session 1 and reinforced by coaches throughout

Planning (in conjunction with the treatment organization community)

5. Conduct the 5 Levers Barriers Assessment. (Customer Impact, Financial & Purchasing, Regulatory & Policy, Operational, & Inter-organizational) to identify list of potential barriers to remove

5-Levers Policy-Barriers Assessment

Provided in Learning Session 1 and reinforced by coaches throughout

6. Develop tactics to apply

Implementation charter form

7. Pilot test tactics

Implementation

8. Develop list of tactics to implement (based on planning)

Implementation charter form

Change leader training in Learning Sessions on the implementation and sustainability process

9. Assign a process owner, and timeline with deliverables for each tactic

Apply payer-based sustainability assessment form

10. Implement changes

11. Sustain gains