For Low-Income Drug Users, Medi-Cal Offers A Fresh Start

cahealth daily

“It would go back to what it was, with these folks dying on the street,” he said.

Thirty-eight of the state’s 58 counties have joined California’s Medi-Cal pilot. Riverside and San Mateo started in February. Other counties, including Los Angeles and San Francisco, have come on board since.

The big increase in the availability of residential care is a significant aspect of the program, since it could reduce the chance of relapse or overdose for those with severe addictions. Previously, Medicaid did not cover treatment in inpatient rehab facilities with more than 16 beds. That resulted in long waiting lists. Inpatient stays typically were paid for by the county, a private insurer or the person being treated.

In Riverside County, Medi-Cal recipients used to wait more than two months for a bed. Now, many of them get one in a day or two, according to Rhyan Miller, the county’s substance abuse services program administrator.

At MFI Recovery’s women’s center in Riverside, known as A Woman’s Place, residents now have access to a licensed vocational nurse, a driver to take them to appointments and a discharge planner. They can stay 90 days (with a possible 30-day extension) and longer if they are pregnant.

Johnson said she was grateful to get in without a long wait. If she hadn’t, the Riverside woman said, “I would either be on the streets or dead.”

Brittany Stearns, another resident, said her parents had paid $48,000 for an earlier stay at a private residential treatment center to treat opioid addiction. When she relapsed three years later, the 32-year-old Palm Springs resident knew her parents wouldn’t pay for it again.

Breann Johnson (left) and Brittany Stearns arrived at A Woman’s Place in Riverside on the same day in May, both determined to get sober. The women, who are both on Medi-Cal, are making plans to go to a sober living facility after leaving the center. (Anna Gorman/KHN)

“I needed help,” said Stearns, whose 2-year-old daughter, Molly, lives with her at the center. “If Medi-Cal didn’t pay for this, I am afraid to think about where I would be.”

Johnson and Stearns both completed their residential treatment and are now getting follow-up outpatient care.

Perez, of the health care department, said that although the project is scheduled to run five years, the state does not intend to return to the old way of doing business. It hopes to persuade the federal government to continue allowing spending flexibility. “This is already impacting not only Medi-Cal but other individuals who are receiving substance abuse disorder services,” she said.

That’s because clinics have made sweeping changes to meet the new Medi-Cal requirements for participation, including the recruitment and training of new employees. Counties are also now using guidelines set by the American Society of Addiction Medicine — another condition of participation.

When the new program started, thousands of people called in to a substance abuse line for screening and referral, said Miller of Riverside County. That was up from fewer than 200 calls the previous month.

“We didn’t expect this,” he said. “It has been absolutely crazy. The sheer numbers of calls completely overwhelmed and also excited us.”

At Whiteside Manor, director Ron Vervick said the additional reimbursement from Medi-Cal enabled him to hire more counselors, drivers, nurses and intake workers. Many of the residents at Whiteside are homeless and mentally ill. In the past, he said, they didn’t get the care they needed.

Kendall Jenkins sought treatment at Whiteside Manor in Riverside after years of heavy drinking and using methamphetamines, heroin and pills. He was relieved when he heard that Medi-Cal would cover his stay at the inpatient drug rehabilitation center. (Anna Gorman/KHN)

One resident of Whiteside Manor, Kendall Jenkins, sought treatment in early May after years of heavy drinking and drug use that included heroin, methamphetamines and pills — “anything I could get my hands on.” A former college golfer and hotel valet, Jenkins, 30, was homeless off and on, and spent stretches living in his car. He recently left the facility, found work at a hotel and is staying in a sober-living home nearby.

Jenkins said that when he learned Medi-Cal would cover his stay at Whiteside, he felt relieved. He was able to participate in individual counseling and group therapy and said the center “saved my life.”

Though he still thinks a lot about using heroin, he knows where he would end up if he did.

“It’s not worth it,” he said. “I know I can do this.”

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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