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For Low-Income Drug Users, Medi-Cal Offers A Fresh Start

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 mentalhealth 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.