Agenda

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C. 42

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	August 14, 2018

Contra

Costa

County

Subject:

Application #28-376 with the California Department of Health Care Services

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 08/14/2018

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

ABSENT:

John Gioia, District I Supervisor

Contact:	Fatima Matal Sol, 925-335-3307
cc:	Tasha Scott Marcy Wilhelm

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: August 14, 2018
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Health Services Director, or designee, to submit funding application #28-376 to the California Department of Health Care Services, in an amount not to exceed $25,000, for expansion of medication assisted treatment (MAT) services in the Detention Facilities, for the period from August 1, 2018 through March 31, 2019.

FISCAL IMPACT:

Approval of this application could result in an amount not to exceed $25,000 of funding from the California Department of Health Care Services for expansion of MAT services through March 31, 2019. No County match is required.

BACKGROUND:

Contra Costa has made significant progress in addressing the opioid epidemic including supporting safer prescribing practices, reducing the prevalence of opioids in the community, and reducing overdose rates. Since 2016, the Health Services Department has increased buprenorphine prescriptions in ambulatory care through the Choosing Change Program that is available only outside the jails. When individuals are incarcerated they are forced to withdraw from opioids. Research has demonstrated that this leads to decreased tolerance for opiates and increased cravings, resulting in a 12 fold increase in mortality upon release. Studies indicate that the risk of death due to overdose among released inmates was 129 times higher than compared to the general population. Starting MAT services in jails and providing linkages to patients to community prescribers increases the likelihood that patients will stay in treatment and decreases death by overdose and drug use. Most recently in 2017, Contra Costa became the fifth county that opted into the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver, and expanding MAT access to the three county jail system will help us ensure continuity of care as we link inmates with an Opioid Use Disorder (OUD) to the Choosing Change Program upon release and the rest of the DMC-ODS plan network should they need higher levels of care.

The following outcomes are expected from the expansion of MAT services: 1) Expansion of screening and detection of individuals with OUD; 2) Increase of availability of MAT through Buprenorphine and Methadone for individuals with OUD; 3) Increase of Behavioral Health support to MAT patients; and 4) Increase of MAT education and awareness among criminal justice partners and inside jail.

Approval of this Application #28-376 will allow the County to apply for funding for MAT services, through March 31, 2019.

CONSEQUENCE OF NEGATIVE ACTION:

If this agreement is not approved, County will not be able to provide MAT services in the detention facilities which could lead to an increase in mortality upon release.