Substance Abuse Prevention and Control
Incentives Initiative
The Los Angeles County Department of Public Health’s Bureau of Substance Abuse Prevention and Control (SAPC) designed an Incentive payment structure to begin to move the specialty SUD system to a more outcomes- and value-based reimbursement structure for specialty substance use disorder (SUD) systems. This will require defining performance metrics that are designed to incentivize outcome-focused services that translate to value-based and better care. Metrics are outlined for Workforce Development, Reaching the 95% (R95), Medications for Addiction Treatment (MAT), Optimizing Care Coordination, and Enhancing Data Reporting. 1.Workforce Development- 1a. SUD Counselors Certified
Metric: 40% of all SUD Counselors providing direct services according to NACT employed agency-wide by June 2024- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
- 1b. LPHA-to-SUD Counselor Ratio
Metric: 1 Full Time (F/T) LPHA for every 15 SUD Counselors agency-wide ratio by June 30, 2024- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
2. Reaching the 95% Champion Criteria
- 2a. Access to Care
Metric: Implement 2C-1, 2C-2, 2D-1, and 2D-2 + one other FULL R95 Capacity Building Criteria in the Capacity Building Category (example: all items (2) under 2F-Bidirectional referrals). Include proof of completion of above with invoice.- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
3. Medications for Addiction Treatment (MAT)
- 3a.
Metric: At least 50% of clients agency-wide with opioid (OUD) and/or alcohol (AUD) use disorder within the fiscal year either receive MAT education and/or Medication Services that include MAT*.
NOTE: OTP settings must ensure at least 50% AUD either receive MAT for AUD Education and/or Medication Services that include MAT for AUD.*
*See Applicable Service Codes, pg. 2
- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
- 3b.
Metric: At least 50% of clients agency-wide receive naloxone- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
4. Optimizing Care Coordination
- 4a.
Metric: At least 75% of clients served agency-wide have a signed Release of Information (ROI) form to share information with internal (other SUD) or external entities (e.g., physical or mental health entities)
- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
- 4b.
Metric: At least 30% of clients within a given agency are referred and admitted to another level of SUD care within 30 days at discharge- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
5A. Enhancing Data Reporting
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Metric: At least 30% of CalOMS admission and discharge records agency-wide within the fiscal year are submitted timely and are 100% complete as reported to DHCS.
- Invoice 3-Incentives VerificationDue 06/30/24
- Invoice 3-Incentives Verification
