Michigan has been significantly impacted by the nation's opioid epidemic, experiencing a per capita opioid overdose death rate (21.2 deaths per 100,000 population [age adjusted]) nearly 1.5 times greater than the national rate (14.9 deaths per 100,000 [age-adjusted]). As a result, the Michigan Department of Health and Human Services (MDHHS) has forged a proactive response centered on prevention, treatment, and recovery. Through interdepartmental collaboration between the Medical Services Administration (the State Medicaid Agency), the Behavioral Health and Developmental Disabilities Administration (the Single State Authority), the Public Health Administration, the Policy and Planning Administration, and other pertinent areas, MDHHS and its stakeholders have implemented myriad initiatives to mitigate the opioid crisis. This includes the development and execution of other federally funded programs, including activities from SAMHSA's State Targeted Response, State Opioid Response, and Substance Abuse Prevention and Treatment Block grants, the CDC's Opioid Surveillance grant, and CMS initiatives including the Section 1115 SUD Demonstration Waiver and Opioid Health Homes. Despite these activities, overdose rates remain high and serious gaps in access to SUD care, including Medication Assisted Treatment, remain. In fact, a recent study found that only 20% of Michiganders with an SUD diagnosis received treatment, clearly demonstrating substantial room for improvement.Building off the strong foundation from the initiatives cited above, MDHHS and its stakeholders have been developing an opioid strategic plan to target opportunities for improvement, including a broad needs assessment. Further, MDHHS has engaged in preliminary gap analysis activities to ascertain where significant barriers to access to and quality of SUD treatment and recovery services exist in the state. As a result of its alignment with this initiative and other CMS-relate
d activities, MDHHS is seeking Section 1003 SUD Demonstration Project cooperative agreement funding with CMS to develop a robust assessment of SUD treatment and recovery provider capacity for Michigan's Medicaid program. If awarded, MDHHS will execute the following key activities:*Conduct/utilize existing research to ascertain Medicaid beneficiary demand for SUD/OUD treatment and recovery services in Michigan*Conduct/utilize existing data and research to create an inventory of payment methodologies, reimbursement rates, administrative requirements, and limitations on capacity by region, Medicaid delivery system, and specific services and provider types to elucidate any relationship between these variables and access to SUD treatment and recovery services*Perform a gap analysis to identify and prioritize opportunities for improvement, including specific Medicaid subpopulations*Conduct/utilize existing research on strategies to increase SUD/OUD provider capacity, including those related to payment, administrative issues, and programs relative to recruitment and retention*Conduct focus groups, stakeholder analyses, and key informant interviews to solicit input on the direction of the overall assessment and for provider surveys*Conduct provider surveys to ascertain provider willingness and barriers to provide SUD treatment and recovery services in addition to assessing the level of coordination between SUD treatment and recovery services and other aspects of healthcare (e.g., primary care, mental health care, etc.)*Analyze the impact of training and education activities on SUD provider capacity*Create an algorithm to determine the effect of various policy levers on SUD provider capacityThrough the aforementioned assessment and planning activities, the ultimate goal of this project is to create a targeted and prioritized strategic plan to increase SUD treatment and recovery provider capacity for Medicaid-enrolled beneficiaries. Michigan estimates a total pr