Mother&Baby Substance Exposure Initiative

Perinatal MAT Expansion: Engaging Communities at Every Level of Intervention

Specifically addressing addiction in the pregnant and/or parenting woman holds both emotional and ethical significance when speaking about stopping the “cycle” of addiction, violence, and poverty.

Health Management Associates (HMA) has implemented its Mother&Baby Substance Use Exposure Initiative in multiple counties across the state. HMA is working hand-in-hand with the California Maternal Quality Care Collaborative (CMQCC) and the California Perinatal Quality Care Collaborative (CPQCC) to deliver state-of-the-art treatment from the prenatal phase to the post-delivery phase.

The goal of the initiative is to increase access to MAT treatment for opioid use disorder (OUD), reducing unmet treatment need and opioid overdose related deaths through the provision of prevention, treatment, and recovery activities for OUD. The aim is to decrease neonatal abstinence syndrome severity and length of stay in the hospital, ensure that plans of safe care are implemented, and to increase the number of mothers in long-term recovery. The initiative has curated and developed patient facing materials as well as resources for providers.

HMA has hosted several county-wide informational events which provide an opportunity for participants to hear from both HMA and local subject matter experts and to discuss county-level opportunities and barriers in supporting moms and babies. Recent events were held in Stanislaus, Sacramento, Orange, San Diego, and San Joaquin counties. Upcoming events include Ventura, Humboldt, and Shasta.

Additionally, CMQCC and CPQCC held its first Quality Improvement Learning Collaborative focused on hospitals. The event linked Shasta, Lake, and Humboldt participants via teleconference thanks to Partnership Health. Upcoming collaboratives will be held in Modesto and Anaheim in September.

To receive timely information on the project, you can subscribe to the Mother&Baby Substance Exposure Initiative newsletter.

The MAT Expansion Project is Working to Increase Access to Substance Use Disorder Treatment

In this ABC 10 Sacramento and Company interview, DHCS’ Marlies Perez highlights the MAT Expansion Project’s efforts to address the opioid epidemic in California. With drug overdoses now the leading cause of death in the US for individuals age 50 and under, these efforts are more important than ever. Substance use disorders are a disease — and treatment is available. To find treatment options near you, visit ChooseMAT.org.

ABC7’s California Spotlight Takes a Look at the Opioid Epidemic in California

In this spotlight by ABC7, Marlies Perez, Division Chief of the Substance Use Disorder Compliance Division at DHCS, explains the role of the MAT Expansion Project in expanding access to treatment for individuals with opioid use disorders and combating the stigma that prevents individuals from seeking treatment. An individual who has overcome a long-standing addiction through the help of MAT stated, “I joined life because methadone helped me.”

California Spotlight: Opioid Epidemic from Harbage Consulting on Vimeo.

Transitions of Care

HMA, a leading independent national health care and human services research and consulting firm with deep expertise in addiction treatment, has launched its Transitions of Care project in multiple counties across the state. The project is surveying treatment systems stakeholders, conducting onsite process improvement events, and launching an ongoing program of technical assistance to increase the overall number of MAT access points and the overall addiction treatment capacity. This project will operate in up to ten counties under the current SOR funding and has rolled out onsite county efforts in Humboldt, Mendocino, Fresno, Kern, Ventura, and Imperial counties.

A summary of the project as well as a report from the first county-level process improvement event which happened in Imperial County can be found here. New reports will be uploaded as they are completed with county stakeholders throughout the summer and into the fall.

AddictionFreeCA.org
In targeting its work, HMA developed a powerful data dashboard to interactively explore data on the county level to understand the epidemic and treatment system landscape in each county. In addition to rich epidemiological data, the dashboard pulls together data on treatment resources, infrastructure, and State Treatment Response (STR) and State Opioid Response (SOR)-funded projects operating throughout California. The ability to overlay various data points in an interactive way is a powerful tool for understanding the state of the epidemic. HMA is happy to make this dashboard publicly available on its new website which will also:

  • Host publicly available educational resources for use by provider entities that need support expanding their addiction treatment capacity;
  • Link site visitors to treatment locators for finding addiction treatment care;
  • Feature detail about HMA’s four opioid addiction treatment programs running in the state and host the programs’ technical assistance resources for program participants; and
  • Communicate the work done by programs built under the STR and SOR grants and link to more detailed information on them.

MAT Toolkits for the SUD Workforce

With support from DHCS, Harbage Consulting is creating a series of MAT Toolkits aimed at educating the SUD workforce about MAT and how it can help the clients they serve.

The first toolkit, released in January, is aimed at informing residential treatment facilities about how they can offer MAT within their facility, either by allowing clients to access their medications during their stay, or by receiving approval from DHCS to provide Incidental Medical Services (IMS). The toolkit contains information about the science behind MAT; process for receiving IMS approval; and how providers can become DATA 2000 waivered to prescribe buprenorphine. The toolkit also contains sample policies and procedures for providing IMS, so that facilities can quickly adopt the necessary measures to safely provide clients medications.

The second toolkit was released in June, and is aimed at helping substance use counselors become familiar with MAT and have conversations with their clients about how MAT can help them. The toolkit contains:

  • A two-part booklet explaining the research supporting MAT, and how counselors can help clients who are receiving MAT as part of their treatment
  • Two quick guide documents to the FDA-approved medications for opioids and alcohol use disorder
  • A quick guide to helping clients find an MAT prescriber
  • An instruction guide to using the overdose reversal drug Narcan
  • A document from the National Council on Challenging Myths about MAT​
  • SAMHSA’s MAT for Opioid Addiction – Facts for Family and Friends

The toolkits can be accessed from the MAT Toolkits Project Page. Email chelsea@harbageconsulting.com if you are interested in receiving printed copies of either toolkit for your organization.

Future toolkits will focus on providing resources for DUI programs and criminal justice settings. Harbage Consulting is also working on a consumer-facing resource to help educate individuals about MAT and how to find treatment within their community.

Resources for Individuals with Opioid Use Disorder: Conversations with DHCS’ Marlies Perez

In two recent radio interviews, Marlies Perez, Division Chief of the Substance Use Disorder Compliance Division at DHCS, highlighted the treatment resources available to those with an opioid use disorder, including a treatment locator available at ChooseMAT.org. Through the California MAT Expansion Project, nearly 30 projects across the state are working to expand access to medication assisted treatment for opioid use disorder. Listen to the interviews on Listen Up Bay Area and Today’s World.

The Use of Buprenorphine to Treat Opioid Use Disorder Quadruples Among Medi-Cal Enrollees

Between 2014 and 2018, the use of buprenorphine to treat opioid use disorder increased nearly four times among Medi-Cal enrollees, according to a recent article from California Healthline. The article also describes California MAT Expansion project efforts including a recent media campaign, Choose Change California and its treatment locator, as well as efforts to inform providers about obtaining a waiver to prescribe buprenorphine and expand MAT for tribal populations.

Tribal MAT

DHCS collaborated with American Indian and Alaska Native community stakeholders to design the California Tribal Medication-Assisted Treatment (MAT) Project. Described by its lead entities as “a unified response to the opioid crisis in California Indian Country,” the Tribal MAT Project is designed to meet the specific opioid use disorder (OUD) prevention, treatment, and recovery needs of California’s Tribal and Urban Indian communities. It was a core component of the original California MAT Expansion Project and is continued through the California MAT Expansion Project 2.0. In close partnership with representatives of the communities being served, DHCS developed the Tribal MAT Project to promote opioid safety, improve the availability and provision of MAT, and facilitate wider access to naloxone with special consideration for Tribal and Urban Indian values, culture, and treatments. For a snapshot of the Tribal MAT Project, take a look at the flyer.

The Tribal MAT Project is well underway. Click here to read more about the organizations implementing complementary initiatives to achieve the goals of the Tribal MAT Project.