Adopting a Model Program for Addiction Treatment Statewide

It can often take decades to change the culture and treatment practices across large healthcare systems. So the success of PHI’s CA Bridge program is truly remarkable: beginning in just eight hospitals in 2018, by mid-2020 a $20 million pilot project with the California Department of Health Care Services (DHCS) funded more than 200 hospitals, about ⅔ of all hospitals in California, to adopt the CA Bridge model for substance use treatment.

For decades, hospital practices have stigmatized patients with substance use disorders and often fail to provide any hospital-based treatment. People with substance use disorders coming to hospital emergency rooms would typically be given little more than referrals to outpatient treatment programs, and little or no follow-up to see if they were able to access care.

The CA Bridge program was founded to ensure that people with substance use disorder receive 24/7 high-quality care in every California health system by 2025. The approach fully integrates addiction treatment into standard medical practice–even when patients aren’t coming in for substance-related issues–thereby increasing access to treatment and saving lives.

The CA Bridge approach is comprised of three core elements for providing hospital-based care to people who use drugs:

• Treatment: making evidence-based substance use disorder treatment (medication for addiction treatment or “MAT”) accessible in the emergency department and in all other hospital departments. Treatment is provided rapidly & efficiently in response to patient needs.
• Connection: Linkage to ongoing care involves active support and follow up with patients. Outreach to people who use drugs aims to increase access to care, equity, & harm reduction.
• Culture: Hospital culture is welcoming and does not stigmatize substance use. Human interactions that build trust are integral to how substance use disorder treatment is provided.

From the initial eight hospitals in 2018, CA Bridge expanded to fifty-two hospitals across the state, and began demonstrating the success of their approach on a larger scale. By June 2020, the fifty-two hospitals reported:

• more than 12,000 patients had been identified with opioid use disorder
• more than 7,500 patients were provided with treatment in the hospitals
• more than 5,600 patients were prescribed medication for addiction treatment (MAT), and
• nearly 5,000 patients were linked to follow-up care.

Having the CA Bridge program in hospitals also creates ripples throughout the community. Among the 52 pilot hospitals there are:

• 37 collaborating with local EMS for addiction treatment
• 38 collaborating with local law enforcement
• 40 acting as training and mentoring sites for other regional hospitals
• 47 collaborating with local harm reduction organizations

See the August 2020 press release and more impacts from the CA Bridge program on their website.