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County renews agreement for substance use treatment services

Thursday, December 16, 2021 by Seth Smalley

On Tuesday, the Travis County Commissioners Court approved and ratified an amendment to the substance use disorder managed services agreement for the 2022 fiscal year. The interlocal agreement between the city, the county and Integral Care is aimed at contracting for substance use treatment services, and has been in effect since 1999.

“It was developed to contract for substance use treatment services using the managed service organization approach,” said Laura Peveto, division director for Travis County Health and Human Services, in the Office of Children Services. “It was one of the first contracts in which we use this method of interacting with the community and funding services for community members.”

Managed service organizations (MSOs) are generally used to help health care professionals such as physicians or other providers with the administrative and non-clinical aspects of the business. Typically, MSOs allow the contracting organization to focus its efforts on providing for the health care needs of clients.

“The goal of the MSO approach was and is to improve a client outcome. So the idea was, we’re moving to this MSO model. Within that approach, we will be able to increase access to services and satisfaction for the county by increasing cost effectiveness and cost containment, and then improve the continuum for individuals in the community,” Peveto said.

One distinction between Austin and Travis County’s contributions to the Integral Care interlocal agreement is that Austin’s funds were restricted to only apply to individuals that are part of the Downtown Austin Community Court program, whereas the county funds apply to all qualifying individuals in the county. In the current interlocal agreement, the city contributes $672,000 and the county contributes a little over $1 million, which goes to substance use disorder treatment.

A county Substance Abuse and Mental Health Services Administration (SAMHSA) grant also contributes $218,000 designated specifically to individuals enrolled in the parenting and recovery family drug treatment court.

“We wanted to create a No Wrong Door approach so that individuals can appeal, go to the service provider of their interest, and then seek services from them. And then that provider can seek reimbursement for services through the MSO,” Peveto said.

Louise Lynch with Integral Care outlined the various roles provided by Integral Care to commissioners, including non-clinical services, recruiting, training and technical assistance, as well as sober living and recovery coaching.

Two-thirds of Integral Care’s clients were male, 18 percent were African American and over half of the clients were white.

“We are constantly, through this contract, trying to improve services to individuals,” Lynch said.

Commissioner Brigid Shea asked whether the county’s contribution to the contract this year had increased from previous years. (The Travis County General Fund contribution did not increase, but its contribution to medication-assisted treatment services did increase from $75,000 last year to $150,000 this year.)

“It’s alarming to me that we haven’t increased our investment since 2018 when headline after headline after headline is about overdoses and inability to access treatment,” Commissioner Ann Howard said. “I think this is going to be a cost driver for the county in the coming years.”

Commissioners voted unanimously to renew the contract.

Photo by Larry D. Moore, CC BY-SA 4.0, via Wikimedia Commons.

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