In partnership with California Department of Health Care Services, the Center for Care Innovations (CCI) is launching Addiction Treatment Starts Here: Behavioral Health. Below you will find information about the program and application process. You can also download the Request for Applications and FAQ Sheet.
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The Center for Care Innovations (CCI) is launching Addiction Treatment Starts Here: Behavioral Health, a new program to increase access to medications for addiction treatment (MAT) in mental health and substance use disorder (SUD) settings for patients with opioid use disorder (OUD).
Federal, state, and local attention is focused on combatting opioids, the deadliest drug epidemic in US history. In addition to the devastating effects on the health of communities, OUD is also a major driver of high-cost service utilization, such as inpatient and emergency department care; the result is an enormous economic burden on health systems.
MAT is one approach to manage OUD. It combines psychological and behavioral therapy with FDA-approved medications (e.g., methadone, buprenorphine, or naltrexone). Research shows that using MAT can more than halve the mortality rate among patients with OUD. Despite overwhelming evidence that administration of these medications is considered the gold standard of treatment, only 10 percent of people across the country receive MAT for OUD.
Addiction Treatment Starts Here: Behavioral Health seeks 10 mental health and SUD sites in California to participate in a 15-month learning collaborative, launching in May 2019 and concluding in July 2020. The program will provide funding, methods, tools and hands-on technical assistance to facilitate the implementation of MAT programs.
The curriculum has been designed by state and national experts and is based on CCI’s extensive experience in supporting primary care health centers in designing MAT program as well lessons learned from SUD and mental health settings offering MAT to their patients. For more information on MAT in primary care:
- READ: Treating Addiction In The Primary Care Safety Net: Implementing Medication-Assisted Treatment and the Lessons Learned.
- WATCH: Marin City Health and Wellness Center’s experience participating in CCI’s programming. Learn more about the transformation patients have experienced because of MAT by watching the video below.
Building upon this previous work, Addiction Treatment Starts Here: Behavioral Health is funded by the California Department of Health Care Services. It is one component of California’s MAT expansion efforts. These efforts have the combined goal of increasing access to MAT, reducing unmet treatment need, and reducing opioid overdose-related deaths through prevention, treatment, and recovery activities. More information on the state’s efforts is available through the California Department of Health Care Services MAT Expansion Project.
Addiction Treatment Starts Here: Behavioral Health is designed to support both outpatient mental health and SUD settings that are implementing MAT. While each care setting has unique needs, there are many overlapping program design and implementation considerations. As a result, some content will be delivered in breakouts sessions that are specific to either mental health or SUD, while other content will be shared in larger group learning environments. Participants will be able to select content that best meets their organization’s needs and the needs of their patients.
Project activities will include:
- Three, two-day in-person learning sessions to share and learn from peers and experts.
- Coaching from those with expertise in implementing MAT programs in both mental health and SUD settings; coaching will include site visits and monthly technical assistance calls.
- Case consultations with clinical experts.
- Webinars, including a mix of expert- and peer-led sharing on topics participants identify as challenges.
- An online forum and resource center.
Given the many clinical and operational issues associated with MAT program design and implementation, we have developed a curriculum that will cover many issues that mental health and SUD sites might encounter. Examples of content areas that will be addressed in Addiction Treatment Starts Here: Behavioral Health include:
- MAT Program Development and Operations:
- Understanding the neuroscience of addiction
- Learning about the medications for treatment of OUD
- Models for program design and implementation
- Finding the right level of care – screening, triage, and referrals
- Managing pain and pain behaviors
- MAT, psychosocial and toxicology practices
- How to build a controlled substance review committee
- Managing privacy and regulatory requirements
- Implementing MAT
- Building a case for change in your organization
- Engaging staff and clinicians (e.g., prescriber training, education, addressing stigma)
- Maximizing payment and addressing sustainability
- Working with Patients:
- Strategies for patient populations with varying treatment readiness
- Identifying behavioral support as part of a MAT program
- Higher level of co-occurring disorder care for patients with OUD
- MAT for patients without strong psychosocial stability and treatments to help patients start/stay on MAT
- Managing diversion
- Community MAT Ecosystems:
- Establishing/optimizing referral relationships
- Workflow options for MAT in integrated behavioral health settings and dual diagnosis clinics
- Building partnerships with community providers, including primary care and community programs that address social determinants of health
- Matching patients with the correct resources
|Request for Applications Released||March 5, 2019|
|Informational Webinar||March 15, 2019 (9am -10 am PT) Register|
|Application Deadline||April 5, 2019|
|Cohort Announced & Program Start||May 15, 2019|
|Kick-Off Webinar||May 30, 2019 (12 pm – 1 pm PT)|
|In-Person Learning Session 1||July 10, 2019 – July 11, 2019|
|In-Person Learning Session 2||March 18, 2020 – March 19, 2020|
|In-Person Learning Session 3||July 22, 2020 – July 23, 2020|
|Program End||July 15, 2020|
Grants of $50,000 to offset participation costs and costs associated with developing your program. Funding will be shared with participants using the following disbursement schedule:
- $5,000 at the time you are accepted into the program.
- $15,000 for meeting Deliverable No. 1, which consists of submitting two quarters of data, a program charter, and a project plan.
- $15,000 for meeting Deliverable No. 2, which consists of submitting two quarters of data and a progress report.
- $15,000 at the conclusion of the program for meeting Deliverable No. 3, which consists of submitting the final quarter of data and a brief final report.
Health care organizations in California that offer either Medi-Cal specialty mental health services (or other services funded through the Mental Health Services Act) and/or Medi-Cal specialty SUD services (through Drug Medi-Cal), or the equivalent, to underserved populations are eligible to apply. Organizations must be non-profit and tax-exempt under 501(c)(3) of the Internal Revenue Service Code (IRC) or a governmental, tribal, or public entity.
Organizations that are eligible to apply include:
- Clinics that provide specialty mental health services, including outpatient treatment, Full Service Partnerships, Field Capable Services, Intensive Outpatient Treatment, and/or Partial Hospital Programs.
- Clinics that provide alcohol and drug treatment services (e.g., ASAM 1.0 – ASAM 2.5), including outpatient, intensive outpatient treatment, and/or partial hospital programs.
- Opioid Treatment Programs (also known as Narcotic Treatment Programs).
Please note that the following organizations are not eligible to apply:
- Institutions for mental disease facilities, group homes, and any other variants of residential treatment facilities or inpatient mental health facilities.
- Recovery bridge housing facilities, residential treatment programs, and inpatient withdrawal management programs.
Organizations that do not meet the above criteria but are interested in funding to support MAT-related activities may be eligible for funding through California’s MAT Access Points grants. More information is available here.
If you are part of a community opioid coalition, your coalition may also consider applying to CCI’s sister program, Addiction Treatment Starts Here: Community Partnerships. This new program will equip community opioid coalitions with grants and on-the-ground technical assistance to identify their best opportunities and solutions for curbing the opioid epidemic in their communities. Learn more here.
If you have questions about whether you qualify for Addiction Treatment Starts Here: Behavioral Health, please contact: Tammy Fisher, Senior Director, Center for Care Innovations.
By applying to join Addiction Treatment Starts Here: Behavioral Health applicants agree they will:
- Develop a team of 3-5 individuals who will participate in all program activities and work on implementation. Teams should include at a minimum:
- At least one X-waivered prescriber. (If you do not yet have an X-waivered prescriber, please describe in your application your approach and timing for a prescriber to get the X-waiver, including whether the clinician will have the waiver by June 2019.)
- A clinical leader, such as a behavioral health director, medical director or chief medical officer. The clinical leader can be same person as your X-waivered clinician.
- A program lead who is responsible for the day-to-day activities of your team’s program participation.
- At least one more additional team member. This can include an administrative leader (e.g., chief executive officer, executive director, chief operating officer), frontline care team member (e.g., addiction treatment counselor, nurse, licensed social worker), or another person who is central to designing and/or implementing your MAT program.
- Share challenges, opportunities, bright spots and questions with your fellow program participants. This includes full participation by your team in all three in-person learning sessions and additional sharing opportunities with other teams.
- Prepare and submit a project charter, work plan, and quarterly program updates, describing your progress and challenges in meeting your goals.
- Submit quarterly data on three required measures. A data portal will be available for your team to enter numerator and denominator information for each required measure and for optional measures you track (no patient-level information will be entered into the data portal). See Appendix A of the request for applications for a draft description of the measures. The finalized definitions of program measures, including detailed specifications, will be shared during the program’s Kick-Off Webinar.
What Makes A Strong Applicant?
CCI is looking for applicants with the following characteristics:
- Commitment to design and implement a MAT program at your site.
- A clinician champion who is committed to advocate for and provide clinical support to your site’s Addiction Treatment Starts Here: Behavioral Health program team.
- A strong leadership commitment to support team participation in program activities, as well as ensuring protected time for team members to design and implement a MAT program. This is evidenced by having a senior-level clinical or administrative leader on your team who is present at learning sessions and meets with your team at least monthly.
- Willingness to openly share approaches and lessons learned with other participating teams.
- Ability to submit quarterly data on the required measure set.
FAQs & Informational Webinar
If you have any questions regarding the Addiction Treatment Starts Here: Behavioral Health program and application process, contact Tammy Fisher.