On Thursday, California’s Department of Health Care Services (DHCS) announced it has awarded almost $2.4 million from the general fund to 29 counties as part of the Medication Assisted Treatment (MAT) in Jails and Drug Courts Project, which is a continued effort to address the opioid crisis.
The grants and stipends are being given to counties to support the development and the expansion of access to MAT for opioid use disorders (OUD) in jails and drug court systems. This project will also support the implementation of California Advancing and Innovating Medi-Cal’s (CalAIM) justice-involved initiative, which offers targeted Medicaid services, including MAT, to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release.
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“DHCS is committed to ensuring that justice-impacted individuals, those residing in DHCS-licensed facilities, and Native groups receive evidence-based MAT,” Director Michelle Baass said. “These projects assist county jails and drug courts, substance use disorder facilities, and Tribal and Indian health programs with applying promising practices to engage individuals with an OUD and provide MAT.”
MAT uses medications, in combination with counseling and behavioral therapies, as an effective treatment of OUD. The medication aspect of MAT is designed to alleviate physiological cravings, and the US Food and Drug Administration offers three approved medications for the treatment of opioid dependence: buprenorphine, methadone, and naltrexone. Data from California’s MAT Expansion Project shows that over 140,000 new patients with OUD have received MAT, and that two million units of naloxone were distributed across the state, which revered 131,000 overdoses.
The $2.4 million in funding will be a key resource in supporting correctional facilities to offer MAT and facilitate warm hand-offs to community-based MAT providers. The MAT in Jails and Drug Courts Project is part of the California MAT Expansion Project, which focuses on increasing access to MAT, reducing unmet treatment needs, and reducing opioid overdose deaths by investing in OUD and substance use disorder (SUD) services. The MAT Expansion Project currently supports 30 projects in the state.
Participating counties will receive technical assistance through individualized monthly coaching, topic-specific webinars, and quarterly learning collaborations. Funding for the MAT in Jails and Drug Courts Project will continue through June of 2025.
The project also makes funds available to California Tribal and urban Indian health programs to implement the Native MAT Network for Healing and Recovery. The program has received funding from May 1st, 2023, until May 31st, 2024.
“When the community sees that the local MAT program incorporates the importance of culture and consistently integrates Native context into the service approach, they may be more likely to reach out for help,” Chief of the Community Services Division Marlies Perez said.
There are approximately 110 federally recognized Indian tribes in the state, some of which have lands that cross state boundaries, and about 81 groups are seeking federal recognition. American Indians and Alaskan Natives (AIANs) experience disproportionate rates of SUD and homelessness, which are influenced by numerous risk factors, including disparities and social injustices.
The Journal of Ethnicity in Substance Abuse conducted a small study of 19 Native American or Alaskan Native participants and found that the mean age that participants first started consuming substances was 15 years, and all of the participants reported consuming large amounts of alcohol or other drugs in the past.
Experiencing trauma in the form of family separation and loss was a trigger that led to substance abuse for eight of the participants. The National Indian Child Welfare Association states that American Indian and Alaskan Native children are two-to-three times more likely to be removed from their home when compared to white and non-Hispanic children.
These populations also experienced historic childhood removal through governmental policies, including mandated boarding school attendance, which attempted to strip Native culture from Native children. Mental health disorders, such as depression and anxiety, contributed to SUD and homelessness for 12 of the participants.
California’s Tribal and urban Indian health programs may apply to receive up to $150,000 to develop, implement, sustain, and enhance MAT services for OUD. DHCS funding is intended for these groups that reflect the racial, ethnic and cultural community they intend to serve, which can develop culturally responsive services that are tailored and individualized to populations of focus.
The primary goal of this funding is to improve and expand on MAT for people with OUD in DHCS-licensed residential SUD facilities, and will support costs associated with recruitment, mentorship, training, and other activities to increase provider knowledge and comfort with providing MAT services through collaborative learning.
Funding opportunities will be available to incorporate MAT services into facilities that are not already providing MAT, will expand on MAT services in facilities that already provide MAT, and create the MAT “Centers for Excellence” to provide mentorship and technical assistance to other facilities and projects funded through this opportunity.
“Through these efforts, our state and county partners will be better positioned to support the delivery of MAT during the pre-release period and improve care coordination so that individuals can continue MAT care and receive the services they need as they re-enter the community,” State Medicaid Director Jacey Cooper said.