MAT/MOUD Expansion for Underserved Populations - LA

Health Care Access

Expand existing project, program, or initiative

In 2021, LAC recorded 3,316 Emergency Room visits, 898 hospitalizations, and 2,957,817 prescriptions related to opioid overdose, according to the 2021 California Overdose Surveillance Dashboard. The 1,573 opioid overdose deaths recorded in LAC in 2021 accounted for 22% of all drug overdose deaths in the entire state. Outpatient SUD services provide key access to preventive care, diagnostic assessments, therapy, and treatment modalities for youth and adults with SUD. But, 54% of SUD patients in LAC report their primary care physician did not address their substance abuse (LAC Public Health, 2019). Moreover, there is a shortage of providers of SUD outpatient services, particularly for individuals with Med-Cal. Most outpatient facilities are also not equipped to serve youth. The number of licensed SUD providers in LAC is only 4.5 providers per 10,000 residents (CDPH, 2022). Additionally, only 74 patients in CNHF's LAC service area received SUD services in 2021, which is extremely low.

The troubling rates of opioid overdose in LAC necessitate a robust response that includes evidence-based overdose prevention, harm reduction, and linkage to care strategies and services. CNHF will increase equity in access to outpatient SUD and Medication-assisted treatment (MAT) services for 750 new Black Indigenous People of Color (BIPOC) patients in LAC (250 each year) with SUD and risk of a drug overdose. The 3-year capacity building initiative will run from September 1, 2023, through August 31, 2026. CNHF aims to increase its staffing capacity by adding 15 full-time MAT Case Managers (CMs) to its current behavioral health staffing plan. Each CM will manage an annual caseload of 50 clients and will coordinate MAT and SUD services at six CNHF clinic sites in LAC. The CMs will increase community outreach, engagement, and education around MAT; coordinate care for participants - including MAT, SUD services, mental health services, primary care, and social services; and linkages to other SUD services - including harm reduction treatment. MAT/SUD services will be provided by highly qualified CNHF staff - including a MAT prescriber, supporting medical staff, two LCSWs, and a SUD counselor. CNHF will establish MOUs with three community partners (community-based health organizations, Local Syringe Service Providers, and other CBOs) in LAC to shepherd PWUD and PWSUD to harm reduction services, peer support, treatment and recovery support, and other wraparound services.

By 9/30/26, CNHF will deliver evidence-based MAT/SUD services to 750 new patients (PWUD and PSUD who are at risk of overdose) in LAC through carefully coordinated care that is facilitated by MAT CMs. These behavioral health services will be provided at six CNHF clinic sites - including two sites in Long Beach, two sites in the City of Los Angeles, one site in Inglewood, and another in Norwalk - as well as through targeted outreach. CNHF will prioritize BIPOC populations and subpopulations at higher risk of a drug overdose, including persons experiencing homelessness, justice-impacted people, Transition Age Youth (TAY), LGBTQIA+ individuals, low-income persons, persons with little or no health coverage, and persons with co-occurring disorders. To increase access for these populations, MAT and other services will be provided during outreach and through telemedicine. In the first year, CNHF will serve 250 patients/clients with the help of four new MAT Case Managers.

CNHF launched the MAT/SUD program in January 2023, guided by the county's need data and direct knowledge of service gaps in existing patients and the community. CNHF evaluates and tracks the success of the program using the Electronic Health Record system (IMS). IMS generates monthly reports of patient health records and patient registries. CNHF also administers patient surveys to track patient satisfaction and service access. Clients' access to MAT services, case management, and supportive services is tracked using appointment logs, attendance/participation sheets, service logs, etc. During outreach, client engagement data is tracked using an Excel spreadsheet on iPads or laptops. All data collection is conducted by the appropriate MAT staff and tracked by the CNHF data specialists. The project is evaluated by the Vice President of IT, the Project Director, and the Chief Administration Officer. The QA Manager also conducts ongoing evaluations of the clinic workflow.