SLO County drug, alcohol treatment programs to get major expansion

In the coming months, San Luis Obispo County will dramatically expand its substance abuse treatment programs, serving as many as 1,546 new clients a year thanks to an influx of $2 million in new funding and 26 new employees.

The plan will expand substance abuse outpatient treatment services, increase services for drug withdrawal treatment, provide short-term residential treatment and improve overall quality of support, said Anne Robin, county behavioral health administrator.

“This is the most significant change we have seen in drug and alcohol services in 40 years,” she said. “One in 5 folks will experience substance abuse at some point in their lives, so it is huge for us to be able to say there is more access, and people won’t have to be on waitlists.”

The county Board of Supervisors unanimously approved the plan Tuesday.

Funding for the new program will come from the state general fund and Medi-Cal, California’s free or low-cost health coverage for children and adults with limited income. The pilot program is scheduled to run through 2020, but plans are in place to make it permanent.

The 26 new employees will join 76 existing employees in the county’s drug and alcohol services program. The program’s current annual budget is $61 million.

“This is obviously a great enhancement of our drug and alcohol services, and that’s a good and important improvement,” Supervisor Adam Hill said.

Although support for the program was unanimous, Supervisor Lynn Compton said she was concerned the program would be a significant growth in county government.

“It does give me a little heartburn to add 26 new positions, I have to admit,” she said.

The new employees will be a combination of administrators, mental health therapists and drug and alcohol specialists. The goal of the program is to get people into treatment more rapidly, thereby increasing the chances they will stay in treatment, Robin said.

“We have waitlists depending on the program, level of care and location,” she said. “This does not lead to the best outcomes for individuals coming to us for substance abuse treatment.”

The program particularly targets Paso Robles for improved services.

A recent grand jury report noted that drug and alcohol services for Paso Robles are particularly lacking.

Under the new program, the hours people can access walk-in treatment will increase to 20 hours per week from three hours per week. Treatment slots for Paso Robles residents will grow to 87 from 12. Outpatient treatment group hours for Paso Robles will grow to 100 hours from 20.

Inpatient services also will see a significant boost.

Currently, the county only has inpatient services for perinatal women.

Under the new program, inpatient treatment will expand to anyone with Medi-Cal who needs such a high level of treatment.

The new program is part of a state pilot program that overhauls the state’s substance abuse treatment program, called the Drug Medi-Cal Organized Delivery System, for people who are eligible for Medi-Cal. Full implantation is expected by June 2017 with the exception of full residential treatment, which is expected within three years.

The county expects the new program will attract 771 new people who will be screened for substance abuse disorders this fiscal year as a result of the new services provided by the program. That will be an increase of 40 percent.

The main features of the program are waivers that allow the federal government to bypass many existing restrictions regarding drug services. For example, the current system is not a coordinated set of services managed by a single authority.

“There is no systematic transfer of treatment information from one county or provider to another, resulting in delays and duplication of effort in assessment and other clinical and administrative procedures,” Robin wrote in a staff report.

The program comes with a certain amount of financial risk for the county, Robin said. Because the program is a pilot program, the state could decide not to continue it or withdraw funding.

“The funding is not guaranteed at this time,” she said.

When asked by supervisors what would happen if state funding was withdrawn, Dan Buckshi, county administrator, said he would recommend the Board of Supervisors hold a hearing to decide how to proceed.

The state would likely only withhold money for the program if it were in a broader fiscal crisis, and funding for other county programs would also be in danger. A hearing to deal with the fiscal crisis would be necessary in any case, Buckshi said.

Jim Salio, county chief probation officer, said he supports the new program. Drug treatment in the state is moving toward treatment and away from criminalization.

“Our system is antiquated,” he said. “We need better drug and alcohol treatment in this county.”