Expanded access to substance abuse treatment is critical

Amid an opioid and alcohol use disorder crisis exacerbated by the COVID-19 pandemic, California health advocates are calling for the Centers for Medicare and Medicaid (CMS) to expand coverage of Medication Assisted Treatment (MAT) and behavioral health care for Medi-Cal recipients.

Those of us leading statewide mental health and substance use disorder advocacy organizations and nonprofit agencies that employ providers who serve on the frontline of this heartbreaking crisis, applaud the state’s efforts to help the most vulnerable among us.

According to the Commonwealth Fund, California drug overdoses increased by 35% during the first eight months of 2020.

We also highlight how critical it is that CMS approves the state’s California Advancing and Innovating Medi-Cal (CalAIM) Medi-Cal waiver proposal. 

Prior to the pandemic, 8% percent, or nearly 3 million Californians, suffered with substance use disorders, with only about 10% ever receiving treatment. The pandemic has only made things worse in California and around the country.

According to the Commonwealth Fund, California drug overdoses increased by 35% during the first eight months of 2020. And, a national study conducted by nonprofit research institute RTI found that average alcohol consumption increased by up to 39% in the months following the onset of the pandemic, with Blacks and Latinos seeing increases of more than 170%. 

The CalAIM proposal, developed by the California Department of Health Care Services, includes provisions that will provide much-needed support for Californians suffering from addiction and mental illness. These include:

–Enhanced Care Management and In Lieu of Services that will allow providers to go beyond services defined in the Medicaid state plan to address social needs and facilitate improvements in care coordination for people with substance use disorder. It is time we begin treating the whole person.

–Services for incarcerated persons dealing with chronic conditions such as substance abuse disorder or chronic mental health issues for 90 days prior to release, and a 30-day supply of medications, specifically to include MAT, upon release. We should no longer leave justice-involved individuals without the recovery support they need to lead productive lives as they reenter their communities.  

–Medi-Cal coverage of all FDA-approved forms of MAT to treat opioid and alcohol use disorder, such as methadone, buprenorphine, naltrexone, naloxone, and disulfiram, as well as other FDA-approved medications and FDA-licensed biologicals for opioid use and alcohol use disorders. We need to utilize these medications which have been shown to assist in recovery and prevent death. 

Substance use disorder treatment has come a long way in recent years, and we now have MAT and other supports that are proven to aid in recovery. It’s time we expanded access to these treatments, not just during the pandemic, but for good.

The CalAIM proposal will help countless Californians get back on their feet and deserves to be approved by CMS.
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Editor’s Note:  Le Ondra Clark Harvey, Ph.D., is chief executive officer of the California Council of Community Behavioral Health Agencies and executive director of the California Access Coalition.