Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT)) for Patient - Delaware is in the midst of an unprecedented public health crisis related to opioids. In 2018, 400 deaths were attributed to overdose, and in 2019 to date, there have already been 148 suspected overdose related deaths. As a major payer for healthcare, Delaware's Division of Medicaid and Medical Assistance (DMMA) has recognized its important role in addressing the opioid epidemic and other substance use disorder. In addition to working closely with other state agencies, providers, and community organizations on an overall opioid use disorder (OUD) response strategy, DMMA has made changes to address barriers to care directly for our population. We have eliminated copays and prior authorizations for medication-assisted therapy (MAT), as well as the lifesaving opioid reversal drug naloxone via a universal preferred drug list. Our recently approved 1115 SUD waiver approval allows coverage for SUD services delivered in institute for mental disease (IMD) settings. Despite these changes, Delaware recognizes the need to improve OUD and other SUD treatment and recovery services for Delawareans receiving Medicaid. Through the proposed assessment and infrastructure activities, DMMA in close collaboration with the Division of Substance Abuse and Mental Health (DSAMH) aims to understand the scope of SUD among Medicaid beneficiaries, improve the Medicaid SUD provider pipeline and implement new payment models to increase the available OUD and other SUD recovery services for Delawareans receiving Medicaid. We will use a mixed methods assessment process that incorporates stakeholder feedback to understand potential gaps in our system. Claims data, in conjunction with other quantitative sources of information about SUD, will be analyzed to better understand the need for SUD treatment services. In parallel, we will be working to document the extent of our SUD provider workforce so we can identify where there is mismatch of treatment need and resources.We wi ll address known infrastructure challenges that limit the success of our treatment efforts, as well as any new barriers that we identify during the assessment process. Previous work has identified reimbursement levels and provider knowledge as limitations. Through rate review, payment redesign, and provider training efforts we plan to expand the availability of treatment services to improve the health and quality of life of Delawareans affected by SUD.
