The X-Force Fellowship is a summer program that provides student technologists and entrepreneurs a chance to serve their country by solving real-world national security problems in collaboration with the U.S. Department of Defense (DoD).
The fellowship is a 10-week, full-time (40 hours per week), paid opportunity where multidisciplianry student teams bring unconventional thinking and novel approaches to building solutions as embedded fellows within military commands.
Undergraduates, graduate students, and recent graduates are eligible to apply for the X-Force Fellowship. Top applicants will have demonstrated technical or entrepreneurial experience. Evidence of past self-directed work is strongly preferred.
The X-Force Fellowship diversifies the national security innovation base by creating a new model of national security service. Minimal experience working with the military is not only acceptable, but preferred. Applicants with prior military or government work experience will be evaluated and accepted by exception.
Successful applicants should anticipate an expectation of proficiency in both technical and entrepreneurial skills. Strong candidates will have a robust technical skillset, solid project-based work, an entrepreneurial mindset, and demonstrated leadership ability.
In the past, X-Force Fellows have worked on a wide range of projects including hardware design and prototyping, software development, data analysis and visualization, technology scouting, communications and marketing strategy, and policy research. X-Force Fellows are matched with a problem and a DoD project military sponsor based on skill set, educational background, and interview feedback. Each X-Force Fellowship team will consist of at least two Fellows with complementary skill sets to ensure the creation of innovative, effective solutions.
The 2024 Fellowship is expected to take place predominantly in person, with virtual problems accepted on an as-needed basis. All X-Force Fellowship projects are sponsored by DoD organizations located within the United States. Successful applicants will be notified of their specific placement in their acceptance letters. Fellows are expected to be located within commuting distance of their project sponsor for the duration of the summer.
All intellectual property developed during the X-Force program belongs to the program participants. However, students are required to turn over a copy of their product to their DoD sponsors at the close of the fellowship, with the understanding that the government retains government purpose rights to findings and solutions.
The NSIN X-Force program addresses national security problems that require technical and entrepreneurial expertise. If your component seeks X-Force summer talent, please visit the X-Force Information for DoD Mission Partners page to learn more about the program and to submit a national security problem.
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ACEP has advocated for years for Congress to repeal the X-waiver requirement, which was a significant barrier to the treatment of opioid use disorder and contributed to stigma around the disease. As mentioned in a recent regulatory blog post, ACEP reached out to SAMSHA and the DEA immediately upon the passage of the legislation to request that they issue guidance effectuating the policy change as soon as possible.
As stated in the guidance, an X-waiver is no longer required to treat patients with buprenorphine for opioid use disorder. Going forward, all prescriptions for buprenorphine will only require a standard DEA registration number. There are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine. Existing state laws or regulations still apply.
Separately, the Consolidated Appropriations Act, 2023 also introduced new training requirements for all prescribers. These requirements will not go into effect until June 21, 2023. The DEA and SAMHSA are actively working to provide further guidance and DEA will follow up with additional information on these requirements shortly.
In all, now all physicians and other health care professionals with a regular DEA license can prescribe buprenorphine. ACEP has clinical tools and training courses to help provide you with best practices and the most up-to-date evidence-based protocols regarding this treatment. We can also help answer any questions you have about this significant change in policy.
Section 1262 of the Consolidated Appropriations Act, 2023 (also known as Omnibus bill), removes the federal requirement for practitioners to submit a Notice of Intent (have a waiver) to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD). With this provision, and effective immediately, SAMHSA will no longer be accepting NOIs (waiver applications).
All practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for opioid use disorder in their practice if permitted by applicable state law. SAMHSA encourages practitioners to treat patients within their practices who require treatment for a substance use disorder.
This means that the special waiver (e.g., a DATA-Waiver) is no longer required to treat patients with opioid use disorder (OUD). Additionally, the DATA-Waiver registration number is no longer required on opioid use disorder prescriptions. Opioid use disorder prescriptions, like all prescriptions, now only require a standard DEA registration number.
The federal reporting requirements, previously required of those with a DATA-Waiver (i.e., those under 42 C.F.R. 8.635), no longer apply. However, as with any patient encounter, detailed records must be kept in compliance with the Health Insurance Portability and Accountability Act (HIPAA) (PDF 721 KB) and 42 CFR part 2, where applicable. SAMHSA again reminds providers that this pertains to federal requirements, and providers should ensure they are aware of and in compliance with any applicable state law.
Buprenorphine, which is a Schedule III medication, can be prescribed by means of telehealth, so long as the prescription adheres to all relevant federal, state, and local laws; regulations; and other related requirements. Under the COVID-19 public health emergency (PHE), telehealth prescribing was expanded. The Department of Health and Human Services will continue to provide practice updates, particularly as the COVID-19 PHE starts to wind down in anticipation of ending on May 11, 2023.
The answer to this question depends on state law. Along with staying up-to-date with current state laws regarding buprenorphine treatment, practitioners and pharmacies should contact their state health departments with questions about state laws governing OUD practice and prescriptions.
The Act does not override state laws, and medical providers should review the state and local laws in their jurisdictions for further information. State departments of health should be contacted if further information is required about specific state regulations.
Because many patients will have other behavioral health conditions, like anxiety and depression, capacity to treat or refer to counseling is strongly recommended as an evidenced-based practice, but is not required. Although people often focus on the role of medications in treating OUD, counseling and behavioral therapies that address psychological and social needs may also be extremely helpful to patients as part of a holistic treatment plan. However, an inability to provide these services, or patient refusal of such interventions, should not prevent practitioners from prescribing buprenorphine. The decision as to when counseling and other services, such as case management and peer support, should be made in conjunction with the individual patient.
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