Low-Income Californians To Have Greater Access To Substance Abuse Treatment

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Low-Income Californians To Have Greater Access To Substance Abuse Treatment

By Victoria Kim 12/15/15

Substance abuse treatment will be available in 2016, though one caveat remains.

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Starting in 2016, California is rolling out a new policy to expand substance abuse treatment services to low-income residents.

California is the first state to receive permission from the federal government to overhaul alcohol and drug treatment for Medi-Cal beneficiaries. Under this drug waiver, state officials are given new flexibility on spending so they may expand services which include inpatient care, case management, and medication.

According to the National Survey on Drug Use and Health, nearly 14% of Medicaid recipients are believed to have a substance abuse disorder.

The idea behind the new policy is that by supporting people with substance abuse issues, the repeated rotation through treatment centers, jails, and hospitals will hopefully be discontinued. Until now, low-income residents on Medi-Cal were very limited in terms of addiction treatment. Very few were able to get help. But starting next year, drug treatment centers will be able to get reimbursed for treating Medi-Cal beneficiaries.

Under the new policy, Medi-Cal beneficiaries will be able to access up to two 90-day residential stays per year, with the possibility of one 30-day extension if providers deem it is medically necessary. Counties will approve treatment for Medi-Cal patients based on medical necessity and criteria set by the American Society of Addiction Medicine.

There is one major caveat to this policy overhaul. Much of how the new policy will pan out depends on reimbursement rates for treatment providers, which have historically been low. In anticipation of the new wave of patients coming in on Medi-Cal, treatment providers will need to make the necessary updates—such as improving technology and training new staff members—to maintain the quality of services. This will prove difficult if rates remain low.

“There is a cost to raising the bar on treatment,” said Albert Senella, president of the California Association of Alcohol and Drug Program Executives. “If the rates aren’t adequate ... we are not going to be able to effectively meet the [new requirements] and the needs of the population.”

For now, the reimbursement rates are still being negotiated.

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