A critical component of advancing medication for addiction treatment (MAT) in the CA Bridge model is the use of a substance use navigator (SUN).

SUNs are trained peers, sometimes certified drug and alcohol counselors, who support MAT initiation, provide navigation to ongoing treatment, advocate for their patients, and engage in community outreach to raise awareness of MAT services at the hospital. Current financing for SUNs through state and federal grants is time-limited. Out of the initial 52 hospitals funded by CA Bridge in 2019, only 19 reported that they would be able to maintain the SUN position after the termination of grant funding. CA Bridge is pursuing strategies to create revenue, incentives, or partnerships that would enable more hospitals to fund this position permanently.

Project Activities

Sustainability Options Paper

CA Bridge contracted with DMJ Associates to explore potential models to support the position of the SUN with sustainable funding sources. Interviews were conducted with individuals in a range of settings that have a stake in the delivery of effective services to people with substance use disorder—hospitals, ED staffing groups, managed care plans, and counties—to identify options for ongoing financing of SUN services. Read the report here.

Funded Pilot Sites

Through a request for proposals process, we identified four partnerships to pilot new billing, incentive, or payment arrangements to sustain SUNs. These sites and the strategies they are piloting include:

  • UC Davis Medical Center: Contract with Sacramento County Drug-Medi-Cal Program to reimburse for services in the Emergency Department.
  • Contra Costa Regional Medical Center: Working with Contra Costa Health Plan and Contra Costa Behavioral Health Services to claim for SUN services under Medi-Cal Administrative Activities or Targeted Case Management, demonstrate quality improvement metrics, and explore opportunities under future CalAIM Medi-Cal waiver.
  • Kaweah Delta Medical Center: Billing Anthem Blue Cross for SBIRT in the Emergency Department.
  • Adventist Health Clearlake: Billing Partnership Health Plan for SBIRT in the Emergency Department and exploring value-based payments.

Technical Support

We provide our funded pilot sites with consultation on implementation and data collection from health care finance experts through monthly calls or upon request. We are closely tracking the progress of each funded site to document successes and lessons learned.

Sustainability Advisory Workgroup

This workgroup is dedicated to sharing lessons learned, exploring new avenues for sustainability, and advising CA Bridge on state policy priorities for SUN sustainability.

State Policy

CA Bridge and DMJ Associates track state Medi-Cal policy and engage with the California Department of Health Care Services and other policymakers and stakeholders to identify opportunities to enhance SUN sustainability through state policy changes.

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Sustainability for SUNs