San Bernardino / Riverside Medi-Cal Drug Treatment

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Dear Sir/Madam,

                          Hello esteemed leaders, we (the authors of this letter) are registered in the State of California as Certified Addictions Treatment Counselors and/or Certified Alcohol and Drug Counselors and currently working in non-profit substance use treatment.  Many individuals with which we work also have co-occurring disorders. Thank you for taking the time to read this letter about our concerns regarding the recent change in funding streams for substance use disorder treatment in the San Bernardino and Riverside County areas. These regions are, mostly, typical regarding the needs for substance use treatment as these areas are not known for affluence. They are inner-city and suburban communities with high numbers of poverty stricken residents in need of basic services, one of which is commonly, substance use treatment. In these two counties, we have a high number of residents on AB109 probation and/or parole, working with child and family services, or receiving other services from other county mental health agencies. Many of these individuals are also from “the streets” and experiencing different levels of homelessness and poverty in addition to their addiction. What used to happen when an individual was seeking services with alcoholism and/or addiction is they use to have to personally search for facilities with open beds (usually, but not always, prompted by one of the aforementioned agencies), get on a waiting list, utilize daily call backs to renew intentions to seek services, and when there was an opening in the facility with which they were in contact, they would be scheduled for an intake and the process would begin usually quickly and easily. The various aforementioned agencies would then be notified that their referrals had been admitted and funding would begin.

                            This is what happens now… The individuals seeking services are now all funded by Medi-Cal and can no longer seek individualized programs. There are screenings conducted, by the county, over the phone, with questions regarding the individual’s treatment needs with no face to face of the individual’s emotional disposition. These are only as accurate as the consumer is honest and/or able to discern the meaning of the questions, and many times there are discrepancies once the consumer actually reaches the treatment facility; it appears a lot of relevant information is lost in the “over the phone” process. Once the consumer is screened they are put on a waiting list and must still call (the relevant county) for indicating continued interest in treatment. Many times this call is only met with an automated system to leave a message or a transfer to a voice mail and, again, no real feeling for the individual’s emotional disposition can be discerned. In the meantime, the county (hopefully in diligence) searches its local agencies for bed availability; if a bed is found, the county will notify the consumer that their referral has been sent to the facility (very often it is not the most conveniently located facility). The facility only receives the referral’s referral code (an ID number) and when the consumer responds to the facility with the appropriate number we get a match and bring them in for “hopefully” an intake, providing another face to face assessment reveals they are appropriate for that level of treatment. If they are not, they are recycled and their treatment is again delayed.

                             These delays leave open, available beds (at times) for several days with NO ONE receiving ANY services. The counties have also indicated, when asked, that they have no standard policy for “no shows” to a referral that has been processed. This also leaves open, available beds (at times) again for several days. Then, very often, we will experience individuals who are eligible, who can be appropriately assessed, and will call on their own initiative to see if a referral has been received. Unfortunately the answer is usually no and they are directed to wait until the roster of “no shows” plays out before their number comes up (no pun intended). This leaves us to flounder, as treatment providers, with no options to fill available beds with willing, eligible consumers while waiting on the county’s process to lead us to a dead end (pun intended) with a willing consumer’s relapse while watching an available bed linger just out of their reach. This appears, to us, to have been a failure to improve the availability of this type of treatment. It has instead delayed proper assessments, delayed access to healthcare services, and delayed funding streams which are meant to be universally accessible to eligible individuals in need. Our question is if there is any hope for a better protocol? Or at least an assessment of the glitches which are painfully present in the systems with which the counties appear unable to navigate successfully?

                             This petition is intended to prompt  a new policy for streamlining the red tape and delays in this treatment availability; or at least prompt a review of the current policies which hold eligible consumers hostage while waiting for red tape and bureaucracy to work out the kinks in this painfully flawed system. 



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