California is improving access to mental health and substance use disorder services through emergency departments

Bridge Navigator Program Overview

CA Bridge is administering the CalBridge Behavioral Health Navigator Program (Bridge Navigator Program) to support emergency departments (EDs) to become primary access points for the treatment of substance use disorders and co-occurring mental health conditions. Hospitals participating in the Bridge Navigator Program will address substance use disorder as a treatable medical emergency, utilizing trained navigators to identify patients who would benefit from initiating medication for addiction treatment (MAT) or mental health services. Through this program, the Department of Health Care Services aims to make treatment of substance use and mental health conditions the standard of care in all California EDs.

The Bridge Navigator Program provides all participating hospitals with access to materials, training, and technical assistance for navigators, clinicians, nurses, and other hospital staff and stakeholders. All participating hospital EDs receive support to:

  • Hire or maintain an ED-based navigator

  • Identify, screen, interview, and link patients with substance use disorder and co-occurring mental health conditions to appropriate treatment

  • Educate providers about MAT

  • Build a stigma-free environment that welcomes disclosure of substance use and provides rapid, evidence-based treatment

  • Navigate patients with co-occurring mental health conditions to outpatient treatment

Bridge Navigator Program Applications

The application period is now closed. Existing applicants may review the following:

Supplemental Funding Applications

CA Bridge announces the opportunity to strengthen the sustainability of the Bridge Navigator Program with supplemental funding for participating hospitals. The application deadline is February 15, 2023, at 11:59 pm. Learn more.

Awardee Information

Hundreds of hospitals throughout California are participating in the Bridge Navigator Program. 

View the Hospital Award Update 

(as of 11/30/22)

Training Registration

The Bridge Navigator Program Training Series provides education and resources to hospital teams implementing medication for addiction treatment (MAT) programs in the acute care setting. Participating hospitals are required to have one clinical champion and navigator attend a training to fulfill Bridge Navigator Program requirements. Please look for specific Bridge Navigator Program training opportunities via the training registration page linked below.

Data Reporting

Hospitals that are a part of the Bridge Navigator Program are required to submit monthly aggregate data. Please start preparing for your Bridge Navigator Program monthly data submissions via the submission portal below (you will find instructions in the portal). Questions? contact data@cabridge.org

Frequently Asked Questions (FAQs)

DELIVERABLES

What is a deliverable?

A deliverable is a result that a hospital must achieve to meet the terms of the Bridge Navigator Program contract, such as having hired a Navigator for at least 50% FTE or having submitted monthly data metrics. Each phase of implementation has a specified set of deliverables. See section V. Program Plan and Deliverables in the RFA for a complete list. 

Where can I find a copy of the deliverables?

See section V. Program Plan and Deliverables in the RFA for a complete list. They are contained within the RFA and in your contract with PHI/CA Bridge. 

What is the Deliverables Report?

The Deliverables Report is the mechanism for you to confirm that your hospital has met the required deliverables. Each Deliverables Report will have a set of questions regarding the results required for achievement of that implementation phase.

Who is responsible for submitting the Deliverables Report?

Hospital teams should establish a workflow for monthly data submission and deliverables reporting at the six-month and twelve-month marks to remain in compliance with the Bridge Navigator Program requirements. We recommend that this administrative work be completed by a dedicated project coordinator, the navigator, or a dedicated team member who can liaise between the hospital team and the CA Bridge team. 

Do you offer onsite training to support meeting the training-related deliverables? 

Yes, an Implementation Leader will be available to come onsite to train the MAT team. Consider what provider education looks like at your site and what steps you might need to take now to get any trainings set up. (Added August 31st, 2022)

As a navigator, what is my role in achieving the deliverables?

The most important thing is to help patients access treatment for substance use disorder (SUD). We want MAT teams to empower the navigator to have what they need to make sure services are being provided. The Blueprint for Hospital Opioid Use Disorder Treatment gives an overview of what the navigator needs. It is different for each hospital. Sometimes navigators submit data but it depends on the hospital. Now is the time to meet with the supervisor and clinical champion. What is going to be needed for this program? (Added August 31st, 2022)

My hospital has still not signed the contract and my Phase 2 deliverables are due. What should I do?

Please reach out to navigatorprogram@cabridge.org for assistance. 

What should I do if my Phase 2 deliverables are not complete by the due date listed in the contract? 

Submit your Deliverables Report as soon as your deliverables are complete. 

What if some – but not all – of my deliverables are complete, should I still submit the Deliverables Report?

Submit your Deliverables Report as soon as your deliverables are complete. 

What happens if I’m late submitting my Phase 2 Deliverables Report?

Phase 2 payment is contingent on PHI/CA Bridge approval of a Deliverables Report for each hospital, an invoice, and up-to-date monthly data submissions. A hospital/hospital system/staffing agency will not receive payment until all of these items have been completed, submitted, and approved by PHI/CA Bridge. Delays in submitting your Phase 2 Deliverables Report could impact your ability to submit your Phase 3 Deliverables Report on time, which is essential to the fulfillment of the contract terms.

What happens if I’m late submitting my Phase 3 Deliverables Report?

PHI/CA Bridge must receive your Phase 3 Deliverables Report by the end date of your contract. We cannot make payments on Deliverables Reports received after this date. Reach out to us via the Technical Assistance Request Form to ensure that you’re receiving the support you need to complete your Phase 3 deliverables by the end date of your contract.

What about my monthly data? If I’m not up to date on data, what should I do?

Work with your hospital team members to get caught up on monthly data submissions. Payment for the deliverables is contingent on up to date data submissions.

What should I do after I submit my Phase 1 deliverables?

What should I do after I submit my Phase 2 Deliverables Report?

  • Ensure your monthly data submissions are up to date.
  • Ensure your invoice has also been submitted via the Deliverables Report or to navigatorprogram@cabridge.org
  • Start planning for your Phase 3 deliverables, which are due 12 months after the start of your contract.

Who do I contact for help to meet the deliverables?

We want to ensure your program succeeds. If there is anything that you would like additional support with, whether to meet a deliverable or improve your program, reach out to us via the Technical Assistance Request Form.

Can I save my Phase 2 Deliverables Report and go back later to finish it?

Yes, you can save the Deliverables Report and go back later to finish it. You will receive an email with a link to return to the saved form.

Does my kick-off meeting with my CA Bridge liaison count as a training opportunity for the Phase 2 deliverables reporting period?

No, the kick-off meeting does not count towards meeting the Phase 2 deliverables requirements. There are many other options to meet this deliverable such as attending an in-person or virtual training, watching a recorded video on the CA Bridge Youtube channel, listening to CA Bridge Emerging Trends podcast, or meeting with CA Bridge clinical leader.

PAYMENT PROCESS

What is the payment process once deliverables are met?

Once the subcontract is fully executed, the applicant will submit their first Deliverables Report and invoice to navigatorprogram@cabridge.org. Once the Deliverables Report is approved, the invoice will be submitted for processing and payment. For multi-hospital systems, we will pay the portion of the invoice corresponding to the number of hospitals that have submitted their Phase 2 Deliverables Report and monthly data.

Where will the funds be sent?

Checks will be sent to the accounts receivable address provided in the funding application. If you want to opt into receiving funds via direct deposit, you must email the W-9, Attachment 5: Authorization Agreement for Direct Deposit Form, and bank confirmation letter (See Attachment 4: Sample Bank Confirmation Letter) to payments@phi.org.

Can you provide an example of an invoice that will need to be submitted?

We will provide a sample invoice with the contract.

DATA REPORTING

If there are two or more navigators in the ED, does the hospital only report data for the one navigator funded by the Bridge Navigator Program?

Please report data for all patients, regardless of which navigator engaged with the patient. (Updated May 19th, 2022)

What if we have one navigator in the ED and another on the inpatient medical floor, do we need to report that differently or combine it all together?

Please report data for all patients, regardless of which department saw the patient. (Updated May 19th, 2022)

How can we track the new referrals metric (# of ED/hospital encounters where a patient was discharged with a scheduled or drop-in appointment with an outpatient SUD provider within a week)?

We are only asking the hospital to track if the patient was referred. We are not asking the hospital to follow up to determine whether or not the patient utilized the referral. Some sites can get this information from a discharge summary. (Added June 1st)

Will we keep reporting data for the current BHPP grant, or will this all be combined into a new monthly data reporting process?

All BHPP data is due by July 8th through the current data portal. New data reporting requirements will take effect according to your new agreement start date. (Added June 1st)

NAVIGATOR ROLE

What qualifications should the navigator have?

We strongly recommend hospitals hire a navigator with lived experience, either from personal experience or that of a family member. However, a navigator can be a social worker, drug/alcohol counselor, or anyone motivated to do this work who has a passion for working with substance use disorder patients and harm reduction in the emergency room. See our resources Navigator Hiring Guide and Navigator Job Description for additional information about the navigator position. (Updated on May 19th, 2022)

Can CA Bridge advocate for a standardized level of pay for navigators?

Please see the Navigator Hiring Guide for guidance on pay ranges for this position. We encourage you to research the salary of other patient navigators at your hospital and within your region. The CA Bridge team is also available to provide technical assistance on setting the salary for this position upon receiving your award. 

Can CA Bridge provide a sample navigator job description?

Yes, this Navigator Job Description is available along with many other helpful resources on the CA Bridge program’s website. 

Can we split-fund and cross-train navigators on infectious disease linkages to care among people with substance use disorders?

As long as there is a navigator supporting the hospital’s Bridge Navigator Program for at least 0.5 FTE, we support additional training for navigators to provide support to people with substance use disorder. (Added May 19th, 2022)

If the navigator is only a 0.5 FTE to 1 FTE role, then the navigator is only available to the ED during the navigator’s shift. What does the ED do if there is no navigator on shift?

If the navigator is not on shift, the provider or staff person who assisted the patient should get the patient’s contact information and provide it to the navigator when they come on shift. The navigator would see the patient record and reach out to the patient to refer them to treatment in the community or extend their buprenorphine. Navigators may be able to use their EHR to find who to follow up with. (Added May 31st, 2022)

BUDGET & FUNDING

Is the funding federal? 

Yes, the Bridge Navigator Program is federally funded.

Who can be a clinical champion?

The MAT Clinical Champion is the individual leading the implementation of MAT at the hospital and should be a MD/DO, PA, or NP. (Added May 9th, 2022)

Is the funding only to be used for the navigator’s salary?

No, the funds can be used for a variety of purposes to support the activities listed in the deliverables. Each hospital will provide a budget as part of the application detailing the planned use of funds.

Are benefits for the navigator position an allowable expense?

Yes, the $120K budget can include salary and fringe benefits. (Added August 31st, 2022)

What are allowable costs beyond salary and fringe?

Each hospital will provide a budget for $120,000. See Attachment 1: Application Preview for more information. In the “Other Expenses” section, applicants can budget for items such as outreach materials, patient transportation vouchers, and other expenses needed to run a well-supported program.

Is travel within California an allowable expense?

Yes, travel within California is allowable, but costs must remain within the CalHR Travel rates. (Added November 7th, 2022)

Is travel outside of CA an allowable expense?

No, Bridge Navigator Program funds may not be used for travel outside of CA. (Added November 7th, 2022)

Is funding the same for all hospitals?

Yes, subcontractors will receive $120,000 in total per hospital, divided into three payments that are contingent on meeting deliverables and submitting an invoice to CA Bridge. See Bridge Navigator Program Request for Applications (RFA).

How long do we have to spend the award?

The third deliverable must be completed within one year of the subcontract start date.

What happens if we don’t spend the funds within the contract period?

As the subcontract will be a fixed-price, deliverables-based agreement, there will be no financial reporting requirements. 

Does my budget have to include the cost of the navigator?

The Bridge Navigator Program requires engagement of a Navigator for at least 0.5 FTE; however, you can use any source of funding to support the position. (Added May 9th, 2022)

Can the funding be used to support other members of the substance use treatment team besides the navigator and clinical champion?

The funding can support costs necessary for the hospital to meet the Bridge Navigator Program deliverables as long as there is a navigator supporting the program at least 0.5 FTE. Enter this information under “Other Expenses” and provide information in the Budget Comments and Notes box. (Added May 19th, 2022)

Are indirect costs allowed?

Yes, indirect costs are an allowable expense. (Added May 19th, 2022)

How do I calculate the indirect cost?

The Indirect Cost rate is a percentage of Direct Costs. Direct Costs are the sum of (Navigator + Clinical Champion + Other Expenses. The calculation is: [Direct Costs] + [Direct Costs x IDC] = $120,000.

For example, if the Indirect Cost rate is 10%, Direct Costs (Navigator + Clinical Champion + Other Expenses) would be $109,091. [$109,091 x 10% = $10,909] [$109,091 + $10,909 = $120,000] (Added May 19th, 2022)

My hospital has a navigator already. Can we use the funds to grow our program to add additional navigators?

Yes, we encourage you to continue your program and fund an existing navigator or bring on a new navigator. (Added August 31st, 2022)

Will there be additional funding after the 1st year?

No, the Bridge Navigator Program funds are only for 1 year. (Added August 31st, 2022)

After the Bridge Navigator Program funding ends, does the hospital have to cover the cost of continuing the program?

We hope that after the Bridge Navigator Program funding ends, the hospital will continue funding for the navigator. CA Bridge will work with sites to consider strategies to sustain the program. We are also looking at other opportunities at the state level that we can access for additional funding for this work. (Added August 31st, 2022)

I have submitted my application, but our spending plans have changed. What do we do to update the budget?

If you haven’t signed your contract, please send an updated budget as soon as possible to navigatorprogram@cabridge.org

Once we’ve signed your contract, we have accepted the submitted budget as final. We will not be monitoring the budget. We assume subcontractors are fulfilling their contract terms and spending their budget based on their plan and adjusting as needed to fulfill the deliverables. (Added August 31st, 2022)

What is the status of billing insurance for navigator services? Will the navigator be covered under the legislative changes that are related to community health workers? 

Based on what we understand so far, the new Medi-Cal certifications for community health workers and the ability of providers to bill for navigator services will cover the services of the navigator. We don’t know the units of service or the reimbursement rate. We’re advocating for policies for strong reimbursement, but this depends on the particular hospitals. The qualifications for community health workers are well within the role of the navigator. There is a requirement for certification but also a grandfathering of the role. We will keep people up to date as we get more information. (Added August 31st, 2022)

CONTRACT PROCESS

Will there be a formal contract?

Yes, a subcontract will be executed between the Applicant Entity (hospital, health system, hospital foundation, staffing agency, or other entity) and PHI/CA Bridge.

What type of contract will we receive? 

PHI/CA Bridge will issue a fixed-price, deliverables-based subcontract with a one-year term. 

Does the contract need to be notarized?

No. (Added August 31st, 2022)

How do we know if the contract has been sent to the appropriate person at my hospital?

Contracts will be sent to the Primary Contact, Contracting Representative, and Authorized Signatory as listed in the application. Reach out to navigatorgrapm@cabridge.org if you have questions about the status of the award and who the contract or notification of award has been sent to. (Added August 31st, 2022)

Are the federal requirements negotiable? If we don’t have the capacity to comply should we not sign the agreement?

Typically federal requirements are not negotiable, but PHI/CA Bridge are open to discussion on the individual circumstances. If you have questions about a particular clause, reach out to navigatorprogram@cabridge.org. Hospitals can also reach out to their own legal counsel to see if the federal requirements are applicable to their institution. (Added August 31st, 2022)

Once we receive our contract, what are the next steps for clinical staff? 

Once the contract is signed, CA Bridge will send the site the Phase 1 Deliverables Report. The site should complete the deliverables and invoice for the first payment. If your hospital was funded under BHPP, make sure your data is up to date. 

Following the signature of the contract, the hospital MAT clinical team will be assigned an Implementation Leader (formerly known as a Regional Director). To prepare for the start of your program, review the Blueprint for Hospital Opioid Use Disorder Treatment. (Added August 31st, 2022)

What is the effective date of the contract? Will it be different for each applicant?

Yes, it will depend on when you submit your application. Each round will have a different start date, which is typically two months after the round’s deadline. (Added August 31st, 2022)