for Integrating Substance Use Disorder Treatment into Care Coordination Processes Darren Urada PhD UCLA Integrated Substance Abuse Programs Gale Bataille CCC CoChair November 12 2014 ID: 562037
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Slide1
1
Opportunities
for
Integrating Substance Use Disorder
Treatment into
Care Coordination Processes
Darren Urada, Ph.D.
UCLA Integrated Substance Abuse
Programs
Gale
Bataille
CCC Co-Chair
November 12, 2014
Slide2
2
Session Description
Update on Drug Medi-Cal Waiver
SBIRT requirements
Challenges for SBIRT implementation
Long term opportunities to address challenges
P
lanning and discussionSlide3
Drug Medi-Cal Waiver
Update
Draft form
,
likely 2015 implementation
Adds services, assessment requirements.
Better rates, more county control
.
Opt in counties would get
A
dditional medication assisted treatment
Residential treatment
W
ithdrawal management
C
ase management
R
ecovery residence (block grant funded)
P
hysician consultation
Draft
(October 16, 2014)
http
://www.dhcs.ca.gov/provgovpart/Documents/2nd-Draft-STCs-for-stakeholders.pdf
Slide4
Reminder: DMC
Waiver text onCoordination with Managed Care Plans and Primary Care
The following elements should be implemented at the point of careComprehensive substance use, physical, and mental health
screening
;
Beneficiary engagement and participation
in an integrated care
program as needed;
Shared
development of
care plans
by the beneficiary, caregivers and
all providers;
Care coordination
and effective communication among providers;
Navigation support for patients and caregivers; and
Facilitation and tracking of referrals between systems.
The participating county shall enter into a memorandum of
understanding (MOU) with any
Medi
-Cal managed care plan that
enrolls beneficiaries served by (Drug
Medi
-Cal).Slide5
5
REQUIREMENTS ALREADY IN EFFECT!
“Beginning
January 1, 2014, MCPs* are responsible to cover and pay for an expanded alcohol screening . . . Also, MCPs shall cover and pay for brief intervention(s). . . Any member identified with possible alcohol use disorders should be referred to the alcohol and drug program in the county where the member resides for evaluation and treatment.”
SBIRT Requirements
Source: DHCS ALL PLAN LETTER 14-004:
http://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2014/APL14-004.pdf
*MCPs -
Medi
-Cal managed care health plans. MCPs must ensure that PCPs carry out the above.Slide6
6
SBIRT Requirements
“When a member answers “yes” to the SHA alcohol pre-screen question, the MCP must ensure that the PCP offers the member an expanded, validated alcohol screening questionnaire
.”
Source: DHCS ALL PLAN LETTER 14-004:
http://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2014/APL14-004.pdf
“PCPs must offer the Staying Healthy Assessment (SHA) or other approved tool within 120 days after enrollment and every three years, with annual reviews of the member’s answers.”Slide7
7
Feedback from Team Lead call
No
access to residential treatment
“Need to educate primary care that even if screening only indicates a little problem, refer them.”
Data
sharing - screenings in paper format, at PC locationSlide8
8
Long-Term Emerging Opportunities
Residential treatment
Drug Medi-Cal Waiver
Educate primary care
SBIRT trainings
DMC Waiver MOUs
Potential expansion
Data sharing
Support for data infrastructure under discussionSlide9
9
D
ISCUSSION!
How is your team integrating or planning to integrate SUD services into your partnership?
If you are not a specialty SUD provider, are you capable of providing brief intervention/brief treatment for alcohol or other SUD conditions at your program? What services do you provide? Do you provide Medication Assisted Treatment (for example
Suboxone
?)
If client/patient requires services beyond brief intervention, how do you make, complete and track referrals to specialty SUD?
What strategies has your CCC team used to share SUD information? If Primary Care Clinic is conducting SBIRT screening, how is that data shared with the other CCC partners?