Project Overview

Through the Opioid Systems of Care (SOC) initiative, HMA is providing system-wide stakeholder engagement services, coaching and other technical assistance (TA), on behalf of the California Department of Health Care Services (DHCS), to strengthen treatment and recovery ecosystems throughout the state, to develop a predictable and consistent knowledge base, and encourage transitions of care for individuals suffering from SUD. The ultimate goal of SOC is to facilitate the recovery journey of those with SUD by supporting counties to expand access to and provide continuity of treatment as these individuals transition between locations, such as emergency departments, inpatient hospital settings, primary care clinics, jails, prisons, and/or the community at large; and levels of care, such as residential, intensive and other outpatient care. Despite the expansion of the Drug Medi-Cal Organized Delivery System (DMC-ODS), many locales throughout California still grapple with how to build an accessible, high quality treatment and recovery ecosystem, leaving their residents struggling to access, navigate, and realize continuity of services in fragmented systems that can be overwhelming.

Program Funder Background and Opportunity for Counties

The California DHCS received funding for Systems of Care from the Substance Abuse and Mental Health Services Administration (SAMSHA) under State Opioid Response Grants (SOR). The program aims to address the opioid crisis by increasing access to medication for addiction treatment using the three FDA-approved medications for the treatment of opioid use disorder, reducing unmet treatment needs, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder (OUD) (including prescription opioids, heroin and illicit fentanyl and fentanyl analogs). DHCS awarded Health Management Associates (HMA) funds to administer its Systems of Care project. The first-round grant period was October 2018 to September 2020 (SOR 1). The second-round grant period is October 2020 to September 2022 (SOR 2). Under SOR 1, HMA worked intensively in 10 counties: Fresno, Humboldt, Imperial, Kern, Lake, Mendocino, Orange, Riverside, Shasta, and Ventura. Copies of county process improvement reports can be found in the resource library search results at the bottom of the page. These reports summarize activities completed during two-day community wide events held in the SOR 1 counties.

Under SOR 2, HMA has invited counties to apply for TA and coaching assistance, and will select six counties to participate in SOC. This state-funded assistance includes collaboratively conducting a deep dive and a virtual process improvement effort to understand the county’s current ecosystem; providing counties with current value stream maps and an agreed upon future state for their system with appropriate ASAM levels of care; identifying and implementing medications for addiction treatment sites at a range of access points to greatly reduce treatment delays; and building and mobilizing a knowledge base to create consistent vernacular and instill system-wide understanding and use of best practices.

Project Features

Payment for Substance Use Disorder SUD services, identification of patients with SUD, access to SUD care, residential treatment services, and hospital-based services, may look substantially different based on each county’s geographic, cultural and other factors.

To address the specific needs of an individual county’s treatment ecosystem, HMA is providing a cutting-edge program of process improvement, coaching, webinars, and other technical assistance provided by a team with deep subject matter expertise in OUD/SUD, system redesign and performance improvement. The effort focuses on strengthening addiction treatment systems through a multi-pronged approach. HMA, in collaboration with county leaders and stakeholders in addiction treatment of all types, will convene multiple, two-day process improvement events to provide fundamental addiction treatment didactics, county-wide dialogue for the identification of system gaps and barriers, and facilitated consensus-building to develop a blueprint for an improved future state for the treatment system.

Following the two-day events, the HMA team works over the course of a year providing follow-up TA to address the gaps and barriers and conducts direct coaching to increase the number of MAT providers in the county. Through this program’s activities, HMA is helping to build a consistent knowledge base to provide high-touch, evidence-based MAT and behavioral therapies for SUD patients. Specific activities include ongoing monthly one-on-one coaching for sites working to provide/expand MAT, quarterly county-wide check-ins, webinars, resource documents and toolkits, on-demand TA, Systems of Care: DATA 2000 waiver trainings, MAT readiness assessments and workshop, and cross-site learning and connectivity activities.

In addition, HMA launched this comprehensive website of opioid addiction treatment information for California, with durable training material, and an HMA data dashboard with county-level SUD risk and treatment resources. Be sure to scroll down to see upcoming events and live webinars!

The project demonstrates HMA’s ability to tailor this work within a county to mobilize an initiative and garner exceptional engagement of cross-sector partners to design a future state SUD delivery system incorporating evidenced-based best practices, including detailed implementation strategies.

For more information about Systems of Care, please contact John O'Connor at joconnor@healthmanagement.com.

Impact

  • Establish strong consensus on future state of the addiction treatment ecosystems for each county with commitments to work toward safe transitions between levels of care
  • Increase the capacity of MAT prescribing in counties in order to reduce delays in treatment starts
  • High fidelity and predictable practice models for addiction treatment being built in target counties

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Systems of Care Project Resources

Featured Resources

systems-of-care

Trauma Informed Care: Understanding the Impact of Trauma on the Mind, Body and the Whole Being

September 15, 2021 - Webinar/Podcast/Video

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This session will explore the relationship between trauma and toxic stress and a host of physiologic and behavioral changes as well as long term health outcomes. The presenters will discuss Adverse Childhood Experiences (ACE), validated screening for an... learn more

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systems-of-care

Medication Assisted Treatment (MAT) and Addiction Neuroscience 101

9/22/2021 - Webinar/Podcast/Video

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This webinar is intended to support counties in expanding access to Medications for Addiction Treatment (MAT) for persons with justice and/or child welfare system involvement. learn more

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systems-of-care

Medication Assisted Treatment (MAT) and Addiction Neuroscience 101- Slides

9/22/2021 - Presentation Slides

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This webinar is intended to support counties in expanding access to Medications for Addiction Treatment (MAT) for persons with justice and/or child welfare system involvement. learn more

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systems-of-care

Buprenorphine Outpatient Prescriber Handout

FAQ/General Information/Fact Sheet

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One-page prescriber resource describing what providers need to know before starting buprenorphine, how to monitor patients, and adjust treatment plans along with duration of treatment. It also includes quick link to SAMHSA website for submitting notice ... learn more

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All Resources (286)

systems-of-care

Behavioral Treatment Part II: Contingency Management

4/19/22 - Webinar/Podcast/Video

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Presented on 4/19/22 by Dr. Shannon Robinson learn more

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systems-of-care

Behavioral Treatment Part I: Cognitive Behavioral Therapy

March 23, 2022 - Webinar/Podcast/Video

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Cognitive Behavior Therapy (CBT) has been widely studied and shown to be an efficacious approach to many physical, mental, and substance use disorders. Dr. Robinson will share her 25 years of experience learning, teaching, providing and researching CBT,... learn more

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systems-of-care

Relaxation Patient Education Handout

March 23, 2022 - Supplemental Materials

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This one page (2-sided) patient education handout reviews the benefits of relaxation strategies and provides a brief description of meditation, deep breathing, progressive muscle relaxation and visualization/imagery. learn more

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systems-of-care

Cognitive Behavior Therapy (CBT)

1/27/22 - Webinar/Podcast/Video

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Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change maladaptive thought patterns that have a negative influence on behavior and emotions. This short take video will cover the key... learn more

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systems-of-care

Deep Dive into Medication for Opioid Use Disorder Part 3

February 16, 2022 - Webinar/Podcast/Video

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A comprehensive three-part workshop series designed for prescribers and office staff immersed in supporting patients utilizing medications for opioid use disorder (MOUD). Part 3 addresses low barrier care, monitoring and discontinuing treatment, use of ... learn more

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systems-of-care

Deep Dive into Medication for Opioid Use Disorder Part 2

February 9, 2022 - Webinar/Podcast/Video

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A comprehensive three-part workshop series designed for prescribers and office staff immersed in supporting patients utilizing medications for opioid use disorder (MOUD). Part 2 covers MOUD and special populations including pregnant and breastfeeding pe... learn more

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systems-of-care

Pre-appointment Patient Self Assessment for SUD

February 11, 2022 - Report

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This one page patient facing document covers important features for all substance treatment providers, especially for patients on Medications for Addiction Treatment. This is a patient self-assessment to help guide individual and/or group appointments a... learn more

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systems-of-care

Virtual Best Practices for Providers

February 16, 2022 - Best Practice/Policy/Guideline

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This provider-facing one-page document helps providers think through all of the necessary steps prior to starting individual or group therapy appointments, including aspects of lighting, background noise and technical capabilities. Also includes consent... learn more

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systems-of-care

Deep Dive into Medication for Opioid Use Disorder Part 1

February 2, 2022 - Webinar/Podcast/Video

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A comprehensive three-part workshop series designed for prescribers and office staff immersed in supporting patients utilizing medications for opioid use disorder (MOUD). In Part 1, information about all three FDA approved medications, including when ea... learn more

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systems-of-care

Stress Management: Imagery

1/25/2022 - Webinar/Podcast/Video

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This short take video demonstrates how to teach and use guided imagery with your patients/clients for stress management. Guided imagery leverages the mind-body connection to efficiently relax the body through the use of imagination. Presented by: Shanno... learn more

systems-of-care

Stress Management: Deep Breathing/Diaphragmatic Breathing

1/25/2022 - Webinar/Podcast/Video

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This short take video demonstrates how to teach deep breathing techniques to a patient/client as a strategy for stress management. Abdominal breathing is the term often used to describe this breathing technique. The term belly breathing is often used wi... learn more

systems-of-care

Problem Solving Treatment & Tools

1/25/2022 - Webinar/Podcast/Video

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Problem Solving Therapy (PST) provides tools to help individuals identify and solve problems that can have a negative impact on their day-to-day lives. PST improves an individual’s overall quality of life, treats depression and other conditions. It is b... learn more

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