Inside California's Massive Addiction Treatment Overhaul

By Maggie Ethridge 08/31/18

Medi-Cal recipients will now have expanded access to addiction treatment.

Inside California's Massive Addiction Treatment Overhaul

The California Health Care Foundation released a report on August 3 this year outlining the state’s new approach for residents using Medi-Cal and seeking substance abuse treatment options.

California is the first state in the United States to use the new health care system structure, in a five-year pilot program authorized by the federal Centers for Medicare and Medicaid Services.

Medi-Cal is California’s low-income health insurance, and previously covered very few addiction treatment services. In addition, patients had no database to explore what treatment plan would be best for their needs.

A new system, called Drug Medi-Cal Organized Delivery, ensures that counties who participate can offer many more services to people struggling with addiction, as well as coordinate, manage and evaluate quality of care in those services.

A huge leap forward is the increase in payment to treatment providers, allowing more access to various types of treatment. In California there are over 10 million people using Medi-Cal health insurance.

“It’s been an enormous change,” William Harris, assistant regional manager of Riverside County’s substance abuse treatment program, told California Health Report. “We’re operating under an entirely new paradigm and are able to expand services and be more inclusive and better meet the needs of the population of our county.”

Nineteen California counties have adopted the program with 21 more scheduled to do so in upcoming months. These counties represent 97% of the state’s Medi-Cal population.

The California Health Care Foundation study looked at the four 2017 adopters of the new Medi-Cal system, including Riverside, Los Angeles, Marin and Santa Clara counties. Co-author Molly Brassil told California Health Report that the Medi-Cal program report was a way to access the strengths and weaknesses of the system.

“This report sort of tells the story to other counties that, yes, (the implementation) is not without challenges and it isn’t easy, but it’s doable,” she affirmed. “I was taken aback by how positive all the counties were given the tremendous lift it is for all of them.”

The newly offered services have induced a flood of user demand. In Riverside there was a large volume of calls after launching a hotline to screen members for substance use disorders and refer them for possible treatment. Since the inception of the program in 2017, Riverside has had to triple its staff to meet growing demand.

The new system takes current research and implements it into their model, by treating substance use disorder like any other medical illness.

Brassil noted to California Health Report that the goal is for substance abuse screening and treatment to become a mainstream part of all health care.

The Medi-Cal program is working, and Brassil would like to see it put in place for good. “We’ve heard from folks overall that this is the right thing to do. It’s hard, but that doesn’t mean it’s not worth doing.”

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.