Virginia's Application for Section 1003 Demonstration Project: Increase Substance Use Provider Capacity - Medicaid members are disproportionately affected by substance use disorder (SUD), highlighting the importance of Medicaid-based interventions to support individuals with SUD. Virginia Medicaid, known as the Department of Medical Assistance Services (DMAS), has encountered enormous financial costs as a result: in 2016, the Commonwealth of Virginia (Commonwealth) spent over $150 million on Medicaid members with a primary or secondary diagnosis of SUD who were admitted to hospitals or seen in emergency departments. In response to the need for SUD services in the Commonwealth, in 2017 the DMAS created an enhanced SUD benefit package known as the Addiction and Recovery Treatment Services (ARTS), which is among the most comprehensive Medicaid SUD benefits in the nation. The implementation of ARTS has led to an increase in integrated care services, buprenorphine-waivered physicians, and treatment uptake among Medicaid members. The successes of ARTS, as well as the expansion of Medicaid in January 2019, gives DMAS a unique opportunity to evaluate how increased reimbursement and an influx of eligible Medicaid members has affected SUD provider capacity, as well as to assess the willingness of providers to treat members, especially among subpopulations whose may require more complex treatment and support services.The Section 1003 Demonstration Project to Increase Substance Use Provider Capacity Planning Phase will accomplish the following:1)A comprehensive analysis of the current capacity, barriers, and gaps of the SUD treatment network in Virginia, with a focus on pregnant and postpartum women and individuals with a recent history of incarceration who have a SUD. These subpopulations represent Virginians that face additional barriers to treatment such as increased overdose risk, transportation barriers, and stigmatization.2) A strengths-based analysis of Virginia communities that show promising health outcomes surrounding SUD treatment and other health
outcomes of people with a history of substance use, such as HIV and Hepatitis C prevention and treatment. This strengths-based assessment will give insight into solutions communities in the Commonwealth have already found to overcome barriers to SUD treatment.3)Provide technical assistance, training, and analysis of reimbursement and service delivery models to enable providers to deliver evidence-based, person-centered and integrated care for Medicaid members with SUD, including subpopulations of interest. Virginia?s Section 1003 Demonstration Project to Increase Substance Use Provider Capacity will address barriers to treatment from both person- and systems-levels to increase the accessibility of providing and receiving SUD treatment. To complete the planning phase activities, DMAS is requesting $4,992,142 in funding from the Centers for Medicaid and Medicare Services, which will be used for staff salary and fringe benefits, travel, general office supplies, and to fund subcontractors to conduct needs and strengths assessments, policy analysis, provide technical assistance and training for areas of high need.
