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The sheer numbers of calls completely overwhelmed and also excited us.”
At Whiteside Manor, director Ron Vervick said the additional reimbursement from Medi-Cal enabled him to hire more counselors, drivers, nurses and intake workers. Many of the residents at Whiteside are homeless and mentally ill. In the past, he said, they didn’t get the care they needed.
Kendall Jenkins sought treatment at Whiteside Manor in Riverside after years of heavy drinking and using methamphetamines, heroin and pills. He was relieved when he heard that Medi-Cal would cover his stay at the inpatient drug rehabilitation center. (Anna Gorman/KHN)
One resident of Whiteside Manor, Kendall Jenkins, sought treatment in early May after years of heavy drinking and drug use that included heroin, methamphetamines and pills — “anything I could get my hands on.” A former college golfer and hotel valet, Jenkins, 30, was homeless off and on, and spent stretches living in his car. He recently left the facility, found work at a hotel and is staying in a sober-living home nearby.
Jenkins said that when he learned Medi-Cal would cover his stay at Whiteside, he felt relieved. He was able to participate in individual counseling and group therapy and said the center “saved my life.”
Though he still thinks a lot about using heroin, he knows where he would end up if he did.
“It’s not worth it,” he said. “I know I can do this.”
The five-year pilot project, which gives the state flexibility in its use of federal money, was approved in 2015 by the agency that oversees Medicaid. The California project officially started earlier this year. Virginia, Massachusetts and Maryland also have federal permission to expand drug treatment for Medicaid members. Other states, including West Virginia and Michigan, are seeking it.
California’s drug rehab overhaul makes it easier for Medi-Cal members to get care and improves their chances of long-term recovery, state health officials said. It also aims to reduce costs by decreasing use of emergency rooms and hospitals and keeping drug-addicted enrollees out of jail and out of the child welfare system.
“It is such a dramatic change to our substance abuse field,” said Marlies Perez, chief of the substance use disorder compliance division at the state Department of Health Care Services. “We turned off one system one day and turned on a whole new system the next.”
Health officials and service providers say that with the federal waiver they are finally able to address addiction as a chronic disease. Instead of simply getting short-term outpatient care, Medi-Cal beneficiaries can receive ongoing treatment from detoxification through recovery, tailored to their specific needs.
“The old traditional way was a rather canned approach to recovery,” said Bruce Copley, director of the Department of Alcohol and Drug Services in Santa Clara County.
The state does not yet know how much the changes will cost, because the program is open-ended: Anyone eligible for the services in the participating counties can receive them. In previous years, the state has spent about $180 million annually on drug rehabilitation for Medi-Cal beneficiaries. Perez said the state is only beginning to receive bills and is hoping to prove to the federal government that the changes will actually reduce overall costs related to substance abuse.
Drug rehab providers still fear for the future of Medicaid given the ongoing debate over health care in Washington, said Tom Eby, clinical director of Whiteside Manor, a nonprofit residential treatment center in Riverside. If his clients lost their Medicaid coverage — or the federal government ended California’s drug rehab program — it could imperil the progress being made, Eby said.