Department of Health & Human Services Division of Behavioral Health Services Alcohol & Drug Services. Uma K. Zykofsky, LCSW Behavioral Health Director

Size: px

Start display at page:

Download "Department of Health & Human Services Division of Behavioral Health Services Alcohol & Drug Services. Uma K. Zykofsky, LCSW Behavioral Health Director"

Sharyl Johnson
5 years ago
Views:

1 Department of Health & Human Services Division of Behavioral Health Services Alcohol & Drug Services April 24, 2017 Presentation to Geographic Managed Care Providers Uma K. Zykofsky, LCSW Behavioral Health Director

Our Values Respect, Compassion, Integrity Client and/or Family Driven Service System Equal Access for Diverse Populations Culturally Competent, Adaptive, Responsive and

2 Our Mission To provide a culturally competent system of care that promotes holistic recovery, optimum health, and resiliency. Our Vision We envision a community where persons from diverse backgrounds across the life continuum have opportunity to experience optimum wellness. Our Values Respect, Compassion, Integrity Client and/or Family Driven Service System Equal Access for Diverse Populations Culturally Competent, Adaptive, Responsive and Meaningful Full Community Integration and Collaboration Coordinated Near Home and in Natural Settings Strength-Based Integrated and Evidence-Based Practices Innovative and Outcome-Driven Practices and Systems Wellness, Recovery, and Resilience Focus

3 Culturally competent and linguistically proficient behavioral health services are provided in many languages, including the following threshold languages: Service Languages Cantonese English Hmong Russian Spanish Vietnamese Bi-lingual/bi-cultural staff or interpreters available at no cost to youth/families Services provided for deaf and hearing impaired at no cost to youth/families

4 Alcohol and Drug Services Continuum of Care Fiscal Year $41,051, contracted providers 6,514 admissions Prevention Services Outpatient Treatment Residential Treatment Medication-Assisted Treatment Detoxification/Withdrawal Management Sober Living Environments Perinatal Services DUI Programs (Driving Under the Influence) Specialty Courts Drug Diversion Programs Handout: Alcohol & Drug Services Continuum of Care Fiscal Year

5 Service Brochures Brochures available on website and in alternate languages at:

for alcohol and drug treatment services Assessment and Referral to alcohol and drug treatment service provider Monday

6 Assessment and Referral Access Points System of Care Sacramento County Jail Probation Department Primary Care Center Guest House Homeless Clinic Juvenile Court Children s Receiving Home Alcohol & Drug Services System of Care Entry point for alcohol and drug treatment services Assessment and Referral to alcohol and drug treatment service provider Monday Friday 8:00 A.M. 5:00 P.M. Last assessment conducted at 4 pm Drop-In 3321 Power Inn Road, Suite 120 Sacramento (916)

7 Recent System Improvements Increased assessment and referral access points Additional access points being explored Mobile Crisis Support Teams and Mental Health Navigators are conducting alcohol and drug screening, preliminary assessments, and referrals throughout the community. Increased service capacity $285,000 grant for ROOM for Dads program to provide after-hours outpatient and drug treatment services to fathers referred to the Sacramento County Family Treatment Drug Courts. $1,035,000 to expand residential treatment and detoxification services. Drug court expansion $280,000 for Early Intervention Family Drug Court expansion to serve an additional 50 families, annually. Co-Occurring Court to address the needs of individuals with serious mental illness who need specialized substance use treatment.

8 Alcohol & Drug Services Current Initiatives

9 Addressing Overdose & Death: Prescription Drugs, Opiates, and Heroin Initiative 1 Decrease high daily dose prescriptions by 25% by 2020 Change other prescribing practices; increase alternative pain management Coordinate prevention across Sacramento County and neighboring jurisdictions, including prescription take-back programs Earlier treatment (reduce switch from prescriptions to heroin)

10 Addressing Methamphetamine, Alcohol, and Other Drug Use/Abuse Initiative 2 Increase access to accurate data related to methamphetamine Increase access to treatment for individuals who misuse/are dependent on methamphetamine Increase community capacity to respond to people who misuse/are addicted to methamphetamine Increase public awareness and professional knowledge about methamphetamine

11 Drug Medi-Cal Organized Delivery System (DMC-ODS) *5-Year State-Wide Waiver Demonstration Project* Initiative 3 Improve Substance Use Disorder Services through an organized service delivery system Full continuum of multiple levels of funded evidence-based services Increase program oversight, compliance and quality assurance Improve coordination with other service systems

12 Two-Phase Process to Opt-in 1. Implementation Plan Develop plan for Board of Supervisor review/approval Submit plan to California Department of Health Care Services by the June 2017 deadline 2. Fiscal Plan Contingent on approval of Implementation Plan Develop Fiscal Plan for Board review/approval Submit Fiscal Plan to Department of Health Care Services by deadline (to be determined)

13 53 Counties Expressed Interest 20 Implementation Plans Submitted 11 Implementation Plans Approved Approved Implementation Plans Bay Area Counties 1. Contra Costa County 2. Marin County 3. Monterey County 4. San Francisco County 5. San Mateo County 6. Santa Clara County 7. Santa Cruz County Southern California Counties 8. Los Angeles County 9. Riverside County 10. Sonoma County 11. Ventura County DMC-ODS Waiver Phased Approach Phase 1 ( in progress) Bay Area Phase 2 (in progress) Southern California Phase 3 (Sacramento County) Central Valley Phase 4 Northern California Phase 5 Tribal Delivery System

DMC-ODS Waiver Existing Drug Medi-Cal Services Client Eligibility Adult Eligibility Drug Medi-Cal beneficiary Reside in participating county Meet medical necessity criteria: One Diagnostic and

14 DMC-ODS Waiver Existing Drug Medi-Cal Services Client Eligibility Adult Eligibility Drug Medi-Cal beneficiary Reside in participating county Meet medical necessity criteria: One Diagnostic and Statistical Manual diagnosis for substance-related and addictive disorders (with the exception of tobacco) Meet ASAM* criteria definition of medical necessity for services Youth Eligibility Drug Medi-Cal beneficiary Reside in participating county Meet medical necessity criteria: Be assessed as to being at risk for developing a substance use disorder Meet ASAM criteria definition of medical necessity for services *American Society of Addiction Medicine

Existing Drug Drug Medi-Cal Services Current Substance Use Disorder (SUD) treatment services include: Outpatient treatment Intensive outpatient treatment Naltrexone (Vivitrol) treatment with

15 Existing Drug Drug Medi-Cal Services Current Substance Use Disorder (SUD) treatment services include: Outpatient treatment Intensive outpatient treatment Naltrexone (Vivitrol) treatment with Treatment Authorization Request Medication-Assisted Treatment/Narcotic Treatment Program Perinatal residential SUD services (limited by IMD exclusion) Detoxification in a hospital with Treatment Authorization Request These benefits will remain available to all Drug Medi-Cal beneficiaries, including those in non-waiver counties

16 Early Intervention Services Services Covered by the Waiver BOLD = New Services Outpatient Treatment Residential Treatment Medication-Assisted Treatment (MAT) Withdrawal Management Additional Medication-Assisted Treatment (MAT) Recovery Services Case Management Physician Consultation Coordination with Criminal Justice and Hospitals Increased Quality Assurance

17 Service Descriptions Residential Services For both perinatal & non-perinatal beneficiaries No bed capacity limit (i.e. 16 bed IMD exclusion does not apply) Provided in California Department of Health Care Services licensed & certified residential facilities that are also designated to meet ASAM treatment criteria. Recovery Services Focus on building beneficiary s self-management skills and linking to community resources. May be accessed after completing course of treatment (if triggered, relapsed, or to prevent relapse) Case Management To assist a beneficiary to access necessary medical, educational, social, prevocational, vocational, rehabilitative, or other community services. Physician Consultation DMC physicians consulting with addiction medicine physicians, addiction psychiatrists, or clinical pharmacists to offer support with complex cases (i.e. medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations). Quality Assurance Increased program oversight, compliance, and quality assurance Evidence-based services ASAM criteria Utilization tools to improve care and manage resources

18 Coordination with Hospitals Waiver counties must describe care coordination plan for achieving seamless transitions of care. Waiver county shall enter into a Memorandum of Understanding (MOU) with any health plan that enrolls beneficiaries served by DMC-ODS. MOU to include: Comprehensive Screening Beneficiary Engagement Shared Plan Development/Treatment Planning Case Management Activities Dispute Resolution Care Coordination/Referral Tracking Navigation Support

Responsibilities for the Waiver County Implementation Plan/Contract with California Department of Health Care Services Selective service provider contracting Authorization for residential treatment

19 Responsibilities for the Waiver County Implementation Plan/Contract with California Department of Health Care Services Selective service provider contracting Authorization for residential treatment 24/7 toll-free beneficiary access phone line Beneficiary informing upon first contact Improved quality assurance & utilization management Improved care coordination with health plans & justice systems

20 Waiver Implementation Challenges Provider readiness Increased compliance, oversight, audits, monitoring, and quality assurance Managing Behavioral Health Realignment match to make the Waiver viable Rate structure development Training on ASAM: Basis of decision-making on all levels of care Need for youth residential treatment facility

Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver

Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver Medi-Cal Managed Care Advisory Committee Uma K. Zykofsky, LCSW Director, Behavioral Health Services Alcohol & Drug Administrator Waiver Authority