1. SUD Policy: Accomplishments & Priorities All Member Meeting October 12, County Behavioral Health Directors Association of California

2. Drug Medi-Cal Reform AB 395 (CBHDA Co-Sponsored)
Requires DMC claims from providers and counties to be submitted within a 6-month timeframe (rather than the current 30 days), consistent with Medi-Cal FFS requirements.
Replaces outdated language regarding medications in SUD treatment, adds medications to the types of services that narcotic treatment programs may offer, and strikes the 20-person patient limit applied to office-based programs.
County of Responsibility Transition
Flowchart provides a tool counties can use to help them identify their options and financial responsibilities with regard to clients who seek or receive DMC services outside of their county of residence.

3. DMC Organized Delivery System Implementation
State General Fund Augmentation
State Budget allocates $141.6 million SGF in FY to support the expanded treatment services in the DMC-ODS Pilot program.
This funding for the state’s share of cost will draw down over $530 million in FFP.
Same-Day Billing:
ODS counties are able to submit DMC claims for the same beneficiary receiving more than one service on the same date without several of the restrictions currently imposed by state regulation.
ODS Forum
ASAM Training
Building successful partnerships with managed care plans
EQRO treatment/recovery metrics

4. Addressing the Opioid Crisis
Treatment Grants: Hub & Spoke Model
$90 million in federal Cures Act funding for Opioid Targeted Response Grants was awarded to California ($45 M/yr. for 2 years).
Funds will be used to provide medication-assisted treatment via narcotic treatment “hubs” in association with related “spokes” approved to prescribe medications.

5. The Opioid Epidemic Heroin addiction rates have risen roughly 90% in the past decade, to about 1 in every 500 people.

6. About 80% of US heroin now comes from six Mexican cartels, and is winding up in rural regions that never had it before.

7. US heroin is cheaper than ever, as low as $5 per hit.

8. Fentanyl is 30 to 50 times more potent than heroin: Just 2 or 3 milligrams can kill. A kilo of heroin nets a dealer $60,000. A kilo of fentanyl: $1.2 million.

9. California MAT Expansion Project
California will strategically focus on three populations to improve MAT services:
1. Counties without a NTP in the geographic area.
2. Increase the availability and utilization of buprenorphine statewide.
3. Improve MAT access for CA’s American Indian and Native Alaskan tribal communities through the IHP-MAT Project.

10. Network # & Hub location
Yuba
Yolo
Ventura
Napa
Tuolumne
Monterey
Tulare
Mono
Trinity
Modoc
Tehama
Merced
Sutter
Mendocino
Stanislaus
Mariposa
Sonoma
Marin
Solano
Madera
Siskiyou
Los Angeles
Sierra
Lassen
Shasta
Lake
Santa Cruz
Kings
Santa Clara
Kern
Santa Barbara
Inyo
San Mateo
Imperial
San Luis Obispo
Humboldt
San Joaquin
Glenn
San Francisco
Fresno
San Diego
El Dorado
San Bernardino
Del Norte
San Benito
Contra Costa
Sacramento
Colusa
Riverside
Calaveras
Plumas
Butte
Placer
Amador
Orange
Alpine
Nevada
Alameda 8 1 2 3 4 5 6 7 9 11 12 13 14 15 16 10 18 17 19
CA H&SS
Hubs and Spokes
Network # & Hub location
Spokes 1
Lake County (1)
Mendocino County (2)
Nevada County (1) 2
Siskiou County (2)
Trinity County (1)
Del Norte County (1) 3
El Dorado County (1)
Placer County (1) 4
Butte County (2)
Lassen County (1)
Tehama County (1)
Plumas County (1) 5
Humboldt County (6) 6
San Joaquin County (1)
Stanislaus County (1) 7
Contra Costa County (TBD) 8
San Francisco County (TBD) 9
Sonoma County (1)
Yolo County (1)
Colusa County (1)
Napa County (1) 10
Los Angeles County (10) 11
Marin County (8) 12
Yolo County (2)
Sacramento County (1) 13
Santa Cruz - N County (6) 14
Santa Cruz - S County (4)
San Benito County (1)
Monterey County (1) 15
Fresno County (TBD) 16
Solano County (TBD) 17
San Diego County (7) 18 19
San Bernadino County (1)
Riverside County (6)
San Diego County (2)

11. CALIFORNIA H&SS UNPRECEDENTED OPPORTUNITY
To save lives and to foster recovery
To succeed or fail as care providers
To innovate or do more of the same
To destroy stigma and discrimination for persons who suffer addiction
To bring care of addiction into the “big house” of health care
To develop practices, processes and relationships that last---

12. Other SUD Priorities Services for justice-involved populations
Adolescent Treatment
Statewide Youth Treatment Summit – November 8-9
Services for justice-involved populations
Collaboration with DUI programs
Proposition 64 – Marijuana Legalization
Prevention/Early Intervention/Treatment