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Supporting Provider Capacity to Deliver High Quality Substance Use Treatment and Recovery Services in the District of Columbia

Award Number: 2C2CMS331739
ORGANIZATION: HEALTH CARE FINANCING ADMINISTRATION, OFFICE OF ACQUISITION AND GRANTS
OPDIV: CMS
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: DEMONSTRATION

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The Department of Health Care Finance (DHCF), the District of Columbia's Single State Agency for Medicaid, is submitting a 18-month planning grant application in response to the Centers for Medicare and Medicaid notice of funding opportunity, "Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act: Section 1003 Demonstration Project to Increase Substance Use Provider Capacity (CMS 2C2 19 001)." The impact of substance use disorder (SUD) in the District is profound. The District has the highest percentage of residents 12 and older reporting substance use disorder in the past year (11.2%), compared to all states. The District also has the highest reported levels of unmet need for SUD (10.4%); the highest age-adjusted opioid death rate per capita among all urban counties, and the third highest opioid death rate in the nation. The District's Medicaid SUD provider capacity planning grant aims to 1. understand and 2. build provider capacity to diagnose SUD and provide treatment and recovery services in a manner that integrates physical and behavioral health. This planning grant focuses on three sub-populations: individuals with co-occurring mental health conditions; dual-eligibles; and individuals with co-morbid physical health conditions participating in Health Homes. The District's proposal complements activities as part of the District of Columbia Opioid Response (DCOR) program and the District's joint SUD and SMI/SED 1115 demonstration waiver application. The activities will not duplicate any ongoing efforts. If awarded, the proposed Medicaid SUD provider capacity grant will support the District's overall objective of providing a more seamless experience of care that integrates behavioral and physical health, improves treatment rates for SUD, and promotes healthier lives for District residents. Proposed activities include: 1. A comprehensive needs assessment of Medicaid provider capacity to diagnose and treat SUD. The needs assessment will build on the District's 1115 waiver application and enable consideration of payment redesign options to increase and sustain provider capacity to address SUD; 2. Education and technical assistance among Medicaid providers to build capacity to treat individuals with SUD in community settings. This effort will include education to reduce the impact of negative treatment bias among community providers and a competency-based approach to enhance Medicaid providers' ability to diagnose and treat SUD; 3. Infrastructure to enable structured data collection and communication with District behavioral health providers, as well as the development and implementation of consent management tools to facilitate appropriate exchange of 42 CFR Part 2. Using the comprehensive needs assessment as a baseline, the District will assess growth in District Medicaid provider capacity to diagnose SUD and provide treatment and recovery services. Metrics will include the number of Medicaid providers treating patients with SUD; an increase in the proportion of providers authorized to treat opioid dependence with buprenorphine who prescribe; and an increase in acuity of core competencies for chronic care management with an emphasis on SUD best-practice defined by the ASAM criteria. DHCF has assembled a strong project team under the leadership of Dr. Erin Holve, Director of DHCF's Health Care Reform and Innovation Administration (HCRIA). Ms. Jordan Kiszla is an experienced project manager and policy expert who will serve as full time project director until DHCF hires a full time project director. DHCF will also hire contract support for data and policy analysis. The District team will include subject matter experts at DHCF and DBH including Mr. Javon Oliver. DHCF's behavioral health coordinator. District subject matter experts will serve as advisers, reviewers, and liaisons to key stake holder communities through


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = -$538,766 )
2023	2021	HEALTH CARE FINANCE, DEPARTMENT OF	441 4TH ST NW STE 900 S	WASHINGTON	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	05	1	4/17/2023	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$148,251
2023	2019	HEALTH CARE FINANCE, DEPARTMENT OF	441 4TH ST NW STE 900 S	WASHINGTON	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	05	1	4/17/2023	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$390,515
														Subtotal = -$538,766

Issue Date FY: 2021 ( Subtotal = $148,251 )
2021	2021	Health Care Finance, Department Of	441 4th St Nw Ste 900 S	Washington	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	04	1	9/30/2021	EXTENSION WITH OR WITHOUT FUNDS	$0
2021	2021	Health Care Finance, Department Of	441 4th St Nw Ste 900 S	Washington	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	03	1	3/24/2021	SUPPLEMENT FOR EXPANSION	$148,251
														Subtotal = $148,251

Issue Date FY: 2020 ( Subtotal = $0 )
2020	2019	Health Care Finance, Department Of	441 4th St Nw Ste 900 S	Washington	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	02	1	7/23/2020	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2020	2019	Health Care Finance, Department Of	441 4th St Nw Ste 900 S	Washington	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	01	1	6/16/2020	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $0

Issue Date FY: 2019 ( Subtotal = $4,616,075 )
2019	2019	Health Care Finance, Department Of	441 4th St Nw Ste 900 S	Washington	DC	20001	DISTRICT OF COLUMBIA	USA	Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act	00	1	9/18/2019	NEW	$4,616,075
														Subtotal = $4,616,075

Grand Total All Awards = $4,225,560

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Supporting Provider Capacity to Deliver High Quality Substance Use Treatment and Recovery Services in the District of Columbia

Award Number: 2C2CMS331739

ORGANIZATION: HEALTH CARE FINANCING ADMINISTRATION, OFFICE OF ACQUISITION AND GRANTS

OPDIV: CMS

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: DEMONSTRATION

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