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San Luis Obispo County, California

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January 2017

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medicalThe County is working toward expanding its substance use disorder treatment services and other behavioral health services for community residents who have Medi-Cal insurance.

On Tuesday, Aug. 9, the County Board of Supervisors reviewed plans to expand the treatment services and approved an additional 26.5 full-time positions. The expanded services are expected to cost about $2 million per year. This plan will be part of the Drug Medi-Cal Organized Delivery System, which allows the federal government to waive many existing restrictions regarding these services.

“We have had wait lists, depending on the program, level of care, and location,” said Behavioral Health Administrator Anne Robin. “This doesn’t lead to the best outcomes for individuals coming to us for substance use treatment. When people seek services, the more rapidly they can get into care the more likely they are to stay in treatment. This change in how we provide services will allow us to better meet the needs of our community.”

The new plan would expand the County’s substance abuse outpatient treatment services, increase treatment services for drug withdrawal, increase case management and recovery support services, provide short-term residential treatment, and improve overall quality of support. The County anticipates a 40 percent increase (771 additional individuals) in people screened for substance use disorders in this fiscal year as a result of new services the waiver would allow. This expansion would improve access to treatment services throughout the county by increasing the number of available outpatient treatment slots.

Full implementation is expected by June 2017, with the exception of full residential treatment, which is expected to occur within three years. Costs will mainly be reimbursed through Medi-Cal revenue and state general funds, but there is some financial risk to the County if the state does not allocate the necessary funds. The funding is not guaranteed at this time.

“Ultimately, the changes in the Drug Medi-Cal system will provide for better care, better outcomes and, pending growth in state funds, will allow us to increase services throughout the County.” Robin said.

Community Benefits

The County is working toward expanding its substance use disorder treatment services and other behavioral health services to community residents who benefit from Medi-Cal.

Outpatient Treatment Expansion:

  • Serve 1,546 new clients annually (numbers listed below are not unduplicated, as it counts the number of new clients in each program):
    • New clients receiving treatment in the Paso Robles clinic 220
    • New youth and family clients screening and provide treatment 75
    • Increased Screenings and Access (all clinics) 771
    • New Case Managers will provide services to new clients 480
  • Increase the current available walk-in access hours from 3 hours per week to 20 hours per week in Paso Robles.
  • Increase the number of outpatient treatment group hours from 20 hours per week to 100 per week in Paso Robles.
  • Increase access to clients living in the Paso Robles area by increasing treatment slots from 12 to 87.
  • Increase successful treatment completions from 40% (from baseline FY14-15) to 50%.
  • 100% of those completing the program will have at least 90 days of abstinence prior to completion, complete all individualized treatment plan goals, and be engaged in a long-term community based support programs, such as a 12-step program, community based counseling, faith-based services, or Recovery Support Services.
  • Youth and families participating in Drug Medi-Cal activities at San Luis Obispo city site (South St.) will demonstrate the following outcomes:
    • Seventy-five (75) youth and their families will be served through the South Street clinic.
    • Participants will reduce 30-day self-reported alcohol and other drug (AOD) use.
    • Participants will report an increase in perceived harm and knowledge of AOD consequences.
    • Participants will report improved parental communication and family quality.
    • Participants will report reduced feelings of depression and other behavioral health indicators, including reduced suicidal ideations.

Withdrawal Management and Medication Assisted Treatment:

  • Serve 200 clients annually.
  • Maintain an average length of stay of 80 days in order to achieve stabilization of detoxification symptoms in clients.
  • The rate of re-admission to detoxification services within one year will be less than 10%.
  • The number of clients who complete detoxification will be 70%.
  • Client satisfaction with the medication assisted treatment program.

Case Management and Recovery Support Services:

  • The total of new clients served with Case Management services will be 480 individuals per year.
  • Increased average length of stay in treatment from 95 days to 150 days.
  • Reduce unemployment days for those clients who complete or have sufficient progress in substance use disorder treatment services by 60 days.
  • Two hundred (200) clients will participate in the Recovery Support Services per year

 

Read the staff report.

Review the plan.

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