(230) Substance Abuse Fund

The SBCBH Substance Abuse Services Division (SA) provides a continuum of care encompassing prevention, intervention and treatment services, including methadone maintenance and other medication assisted treatments. Substance Abuse Outpatient Treatment is available through school-based and community-focused programs and in our main clinic offices and our Esperanza Wellness Center. Substance Abuse Prevention programs are also available to our community through the promotion of events with messaging emphasizing outreach and education to prevent the abuse and addiction to drugs and alcohol. The continuum of services is available for all age groups, from youth to senior citizens.

Alcohol and Drug Counselors provide screening, assessments, treatment planning, individual and group counseling, intensive outpatient treatment programs, information, referral and linkage assistance to other agencies including licensed residential treatment programs and sober living environments.

A specialized Perinatal outpatient treatment component provides focused treatment for the population of pregnant or parenting mothers in need of substance abuse treatment. Transportation and childcare are also provided for eligible clients participating in this program.

The Substance Abuse Services Division provides services for self-referred and mandated clients referred through the criminal justice system and other oversight entities. Some of the services made available through SBCBH SA are provided through our contracted providers who provide residential based treatment services and outpatient Narcotic Treatment and other Medication Assisted Treatment Programs. Incarcerated inmates also receive substance abuse treatment services at the adult and juvenile detention facilities. Many clients are also referred through Child Protective Services.

Substance Abuse Services is the lead agency for the County’s Drug Court Program. The Drug Court Program is an alternative treatment option to incarceration for individuals arrested for minor drug offences. Drug Court is a project involving multiple agencies (Substance Abuse, Probation, District Attorney, Public Defender, and the Superior Court).

• SBCBH SA has been challenged to make system level operations and service delivery changes due to the many restrictions and precautions caused by the COVID-19 Pandemic. It is significant to note that throughout he Pandemic duration SA treatment and prevention services have continued with no cessation of service delivery, nor clinic office closure. It is commendable and deserves recognition of the staff as essential workers who have provided our community the safety net of substance abuse treatment and prevention services.

• SBCBH completed its first implementation year and onto the 2nd year of the complex project of the County discretionary State and Federal Drug MediCal Organized Delivery System pilot program (DMC-ODS). The federal waiver DMC-ODS pilot program is intended to test improvements in the methods and delivery of substance abuse treatment through new and expanded services, also eligible for reimbursement through the state and federal MediCal system. The DMC-ODS pilot program is now implemented in our county and like other counties that opted in to participate, our county is experiencing the growing pains of maneuvering through the new required processes. New types of services and expansions are required each of the 5 years of DMC-ODS pilot project.

• Due to the pandemic staff and clients have had to navigate through the adjustments of minimal in person in the clinic service delivery to many services provided through virtual platforms. SA treatment services for individual and even group sessions have been provided through telephone conferencing and tele-video. Clients and staff involved have adjusted through these alternative means of communicating remarkably well as indicated by measuring units of services delivered that during the beginning 2 months of the Pandemic had been reduced by 40% but transitioned to units of services delivered at pre-Pandemic levels and greater.

• San Benito is in the size category statewide as a small county. Some of the DMC-ODS required service expansions are difficult to support with our local client attendance to substantiate the resources required to build some of the specialized service programs required. As such SBCBH SA must turn to larger out of county contract providers to provide some of the required specialized services. These situations are sometimes not geographically convenient for our client’s access and the out of region providers can be more difficulty for our Quality Improvement staff to monitor contractor accountability and client progress.

• It is a continuing concern that SBCBH SA must deliver culturally relevant and culturally competent services. The threshold language for our county is Spanish and so we must become more capable of having our monolingual or preferred first language Spanish speaking clients have access to an adequate number of SA service providers who have bilingual/bicultural proficiency in English and Spanish.

• On an almost daily basis the State Department of Health Care Services has been issuing their state to counties Behavioral Health Information Notices. The Information Notices (IN’s) convey new requirements and regulations as related to the operations and services delivery for both our SA and Mental Health Divisions. It is an ongoing challenge to keep the pipeline open for acquiring the skilled and degreed professional and credentialed staffs that are equipped with the abilities to help us remain in compliance with the requirements. We must also keep an ongoing flow of other levels of direct service delivery staff who we train to meet the changing and challenging MediCal reimbursement claiming and audit requirements. Small counties, such as San Benito are the staff development and training systems that have difficulty with retention of staff after they have achieved their licenses and other credentials that allow them to move on to more attractive career opportunities in larger counties and higher paying private network provider entities.