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Community Clinic Association of Los Angeles County

Tarzana Treatment Centers: Partnering to Lower the Cost of Care by Treating Chronic Mental Health and Substance Use Disorders

Tarzana Treatment CentersFounded in 1972, Tarzana Treatment Centers’ (TTC) is a 501(c)3 non-profit that has developed an innovative combination of integrated services that is not replicated in the same comprehensive manner by any other provider in California. TTC offers treatment for substance use and mental health disorders including medication assisted treatment with buprenorphine, methadone and injectable naltrexone, HIV/AIDS, Hepatitis C, and primary care for other chronic physical health conditions, recovery housing, and domestic violence services for victims and batterers. TTC operates a 60 bed acute psychiatric hospital and has 316 residential beds and extensive outpatient services for adults and youth with substance use and, frequently, co-occurring mental health disorders. TTC operates six primary care clinics that are integrated with behavioral health services. All of TTC’s facilities are located in Los Angeles County but we serve patients from throughout California with increasing application of telehealth.

TTC integrates behavioral health with primary care first for the benefit of the patient but also because we know integrated care will lead to lower costs. As a member of Health Care LA IPA lower health care costs are critical to TTC because we in the IPA are collectively at risk for the total cost of care. We know too that the total costs of care for patients with chronic physical health conditions like diabetes are greater if those patients also have mental health and/or substance use disorders. For example, annual Medi-Cal costs for patients with diabetes, serious mental illness and substance use disorders are more than double the cost of care for patients with diabetes alone.

When Chronic Illness and Mental/Behavioral Illness combine.

Patients with these comorbid conditions have been able to get care for diabetes through health plans but rely on county departments to provide treatment for mental illness and substance use disorders   Prior to this year, patients referred for mental health treatment were much more likely to find treatment than were patients with substance use disorders.  There were insufficient funds available to provide SUD treatment to all who needed it leading to waiting lists, especially for residential treatment.

Tarzana Front Office

With the implementation of the Drug Medi-Cal Organized Delivery System Waiver (DMC ODS) on July 1, Los Angeles County Medi-Cal beneficiaries will have access to a much expanded benefit and funding constraints on treatment will be greatly reduced and, while demand for services will still outstrip the supply of facilities, staff, and other resources, patients won’t be turned away because funds to pay for treatment are exhausted.  County administrators and SUD treatment providers are preparing for a torrent of referrals beginning July 1.   The Division of Substance Abuse Prevention and Control will staff a Beneficiary Access Line to link patients to care.  Organizations like TTC are working to expand their ability to handle greater patient volumes.

Adequate access to treatment is critical to recovery but substance use disorders as chronic conditions require that each patient have a care plan designed for the long run.  Each patient’s primary care provider should be a partner in the development and execution of that plan of care.  Fortunately, the DMC ODS waiver gives SUD treatment providers like TTC funding for case management and recovery support services that can fund the effort to link a discharging SUD patient with their primary care provider.  TTC is designing procedures and allocating resources to staff this linkage.  Research shows that patients who are linked to primary care following discharge from SUD treatment are more likely to succeed in recovery.

As the DMC ODS waiver is implemented in LA County, we look forward to partnering with our sister clinics both in accepting referrals for treatment and in linking discharged patients back to their primary care providers.  For further information about TTC please visit www.tarzanatc.org.