Demonstration Project to Increase Substance Use Provider Capacity
On October 24, 2018, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act became law. Under section 1003 of the SUPPORT Act, the Centers for Medicare & Medicaid Services (CMS), in consultation with the Substance Abuse and Mental Health Services Administration and the Agency for Healthcare Research and Quality, is conducting a 54-month demonstration project to increase the treatment capacity of Medicaid providers to deliver substance use disorder treatment and recovery services. The demonstration project includes:
- Planning grants awarded to 15 states ($50 million aggregate) for 18 months; and
- 36-month demonstrations with up to 5 states that received planning grants.
States participating in the 36-month demonstration will receive enhanced federal reimbursement for increases in Medicaid expenditures for substance use disorder treatment and recovery services.
SUPPORT Act Section 1003 Demonstration Project
CMS released a Notice of Funding Opportunity to solicit applications for participation in the 36-month post-planning period of the demonstration project to increase the treatment capacity of providers participating under the Medicaid state plan (or a waiver of such plan) to provide substance use disorder (SUD) treatment and recovery services, as originally described in NOFO CMS-2C2-19-001 (Planning Period). Only the 15 states that participated in the planning period were eligible to apply for this funding opportunity.
The following State Medicaid agencies were selected in September 2021 to participate in the 36-month post-planning period: Connecticut, Delaware, Illinois, Nevada, and West Virginia.
The purpose of planning grants was to increase the capacity of Medicaid providers to deliver substance use disorder treatment or recovery services through:
- An ongoing assessment of the substance use disorder treatment needs of the state;
- Recruitment, training, and technical assistance for Medicaid providers that offer substance use disorder treatment or recovery services; and
- Improved reimbursement for and expansion of the number or treatment capacity of Medicaid providers.
The following State Medicaid Agencies were awarded 18-month planning grants in September 2019: Alabama, Connecticut, Delaware, District of Columbia, Illinois, Indiana, Kentucky, Maine, Michigan, Nevada, New Mexico, Rhode Island, Virginia, Washington, and West Virginia.
Reports to Congress
Section 1003 of the SUPPORT Act directs the Administrator of the Centers for Medicare & Medicaid Services (CMS) to issue three Reports to Congress and the Director of the Agency for Healthcare Research and Quality to issue one Report to Congress. CMS has released the Initial Report to Congress which provides details on (1) the states awarded planning grants under the SUPPORT Act section 1003 demonstration, (2) the criteria used to select these states, and (3) initial activities proposed or carried out under the planning grants. Findings are from the first 13 months of the planning period of the demonstration (September 30, 2019–October 31, 2020) and are drawn from state applications and progress reports.
AHRQ in consultation with CMS has released the AHRQ Report to Congress. The AHRQ Report to Congress describes the experiences of states awarded planning grants and the experiences of states selected to participate in the post-planning period through the first four months of the post-planning period (September 30, 2019 – February 1, 2022). Findings are based on state applications, progress reports, stakeholder interviews, and participant feedback on technical assistance.
Substance Abuse and Mental Health Services Administration (SAMHSA) Resources
- Technology Transfer Centers (TTC) Program: The purpose of the Technology Transfer Centers (TTC) is to develop and strengthen the specialized behavioral healthcare and primary healthcare workforce that provides prevention, treatment and recovery support services for substance use disorder (SUD) and mental illness.
- Evidence-Based Practices Resource Center: This new Evidence-Based Practices Resource Center aims to provide communities, clinicians, policy-makers and others in the field with the information and tools they need to incorporate evidence-based practices into their communities or clinical settings. The Resource Center contains a collection of scientifically-based resources for a broad range of audiences, including Treatment Improvement Protocols, toolkits, resource guides, clinical practice guidelines, and other science-based resources.
- Behavioral Health Treatment Services Locator: The Behavioral Health Treatment Services Locator is a confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.
Agency for Health Care Research and Quality (AHRQ) Resources
The AHRQ Academy for Integrating Behavioral Health and Primary Care has developed several resources for providers treating opioid use disorder in primary care practices, including
- Tools and Resources for Implementing Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care, a compendium of over 350 tools and resources available to providers, patients, and communities to help implement MAT in rural primary care and other ambulatory care settings. These tools are categorized by topic and address the full spectrum of needs for patients with or at risk for OUD, including OUD awareness and education prevention, MAT training and education, MAT implementation, and overdose.
- Six Building Blocks is a structured systems-based approach for improving management of patients on chronic opioid therapy. The Six Building Blocks program provides an evidence-based quality improvement roadmap to help primary care teams implement effective, guideline-driven care for their chronic pain and long-term opioid therapy patients.
- AHRQ’s Medication-Assisted Treatment for Opioid Use Disorder (MAT for OUD) Playbook serves as a comprehensive guide for implementing MAT in primary care and other ambulatory care settings. The online, interactive playbook contains the latest guidance, tools and resources to address MAT implementation. Released with the playbook is AHRQ’s Medication-Assisted Treatment Tools and Resources Collection, a searchable resource organized by topic to address a broad spectrum of patient and community needs. Materials in the collection were identified through systematic searches of published and gray literature, as well as searches for specific tools to implement MAT.
For more information about this demonstration project, contact SubstanceUseProviderCapacity@cms.hhs.gov.