Addiction Free CA

Systems of Care

Project Overview

Through the Systems of Care (SOC) initiative, HMA is providing system-wide stakeholder engagement services, coaching and other technical assistance (TA) 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 and appropriate transitions across the continuum of 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. HMA is currently on the third round of funding. 

October 2018 to September 2020 (SOR 1)

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.

October 2020 to September 2022 (SOR 2)

Under SOR 2, HMA invited counties to apply for TA and coaching assistance, and selected six new counties to participate in SOC with some from SOR 1 continuing their efforts. Counties featured in SOR 2 included Amador, Fresno, Imperial, Marin, Orange, Riverside, San Bernardino, Santa Cruz, Santa Barbara, and Siskiyou. This state-funded assistance included 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.

October 2022 to September 2024 (SOR 3)

For SOR 3, HMA invited counties to apply for TA and coaching assistance focused on improving existing programs in Co-Occurring Disorders, Medication Assisted Treatment, and Residential Treatment. The 6 selected counties include: Imperial, Los Angeles, San Diego, Santa Barbara, Santa Cruz, and Yolo County. 

Project Features

SOR 3 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. 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, quarterly check-ins, webinars, resource documents and toolkits, on-demand TA, MAT readiness assessments and workshop, and cross-site learning and connectivity activities.

In addition, HMA continues to update 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. 

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.

Engaged Counties

Current Participating Counties for SOR 3
 
  • Imperial
  • Los Angeles
  • San Diego
  • Santa Barbara
  • Santa Cruz
  • Yolo County

Participating Counties for SOR 2

  • Amador 
  • Fresno
  • Imperial 
  • Marin 
  • Orange
  • Riverside 
  • San Bernardino
  • Santa Cruz
  • Santa Barbara
  • Siskiyou 

Participating Counties for SOR 1

  • Fresno
  • Humboldt
  • Imperial
  • Kern
  • Lake
  • Mendocino
  • Orange
  • Riverside
  • Shasta
  • Ventura


Pregnant and Parenting Women

View the project overview, outcomes, webinars, and resources for the Mother & Baby Substance Exposure Initiative (MBSEI) project

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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Resource Library

Aftercare, Recovery, and Peer Support

Assessment and ASAM Level of Care Determination

Behavioral Health and Co-occuring Conditions

Best Practices and Exemplars

Family and Other Caregivers

Hospitals and General Medical Settings

Pharmacology and Prescribing

Pregnancy

Screening and Identification

Stigma Abatement

Telehealth

Treatment

Youth and Adolescents