Over 19 million Americans battle with substance use disorders (SUDs) every year. Of those that suffer, a significant percentage suffer from opioid use disorder (OUD). For many of these people, alcohol, mental illness, and physical issues all play a key role in their substance abuse patterns and behaviors. But for many others, addiction comes as a side effect of their regular prescription. The National Institute on Drug Abuse (NIDS) reports that receiving a legitimate prescription to opioids during adolescence significantly increases the likelihood of opioid abuse, especially for youth with no history of drug misuse.

Unfortunately, COVID-19 has the very real potential to not only exacerbate the abuse patterns of existing substance use disorders, but social distancing, shelter-in-place systems and the general anxiety atmosphere surrounding health may result in an increase in the overall SUD population — especially when it comes to opioid misuse.

For those dealing with substance abuse disorders, COVID-19 has disrupted virtually all of their regular lines of support. Stay-at-home orders have made going to clinics for psychological treatment and replacement drugs incredibly difficult — leading to some new temporary rules regarding telemedicine and buprenorphine prescribing. On top of that, opioid users are already at an increased risk of suffering serious complications from COVID-19 due to hypoxemia and potential organ damage — not to mention that upper respiratory diseases increase the chance of overdose. This has left many of those suffering from opioid substance abuse disorders scared to leave their homes, and anxious.

During this pandemic, substance use and behavioral health facilities and practitioners are more critical than ever. But, between forced shutdowns and reduced patient loads, many behavioral health specialists are under immense financial pressure. In the period where patients need you most, you may be struggling to stay financially viable.

COVID-19 and Substance Abuse: An Evolving Financial Ecosyste

Social distancing guidelines and shutdowns have directly impacted many facilities, regardless of their location. Combined with patient fears of going outside of their home environments, these shutdowns have reduced patient loads significantly. From treatment centers to outpatient substance abuse facilities, finances have become a common concern.

But the behavioral health sector isn’t without federal, state, and local support. Blanket waivers, blanket exemptions for take-home medications, and unprecedented new standards that allow narcotic treatment programs (NTPs) to deliver medications to homes have all helped ease the burden. But what about direct funds?

Luckily, the recent CARES Act is offering critical reprieve to many practitioners in the behavioral health sector. The Substance Abuse and Mental Health Services Administration (SAMHSA) received $425 million from the CARES ACT, which it has been distributing in grants. The following grants are all centered around mental health and/or substance abuse:

Since opioid use falls into both mental health and substance abuse categories, we’ll discuss these three particular grants in detail to help you discover if there are any grant options available for your treatment center, NTP, or behavioral health facility. That being stated, there are also Suicide Prevention Lifeline Crisis Center Follow-Up (CCF-COVID) Expansion Grants and Suicide Lifeline/Disaster Distress Helpline (SPH COVID) supplementations available — though we won’t cover these as they aren’t necessarily intrinsically connected to opioid use disorders (OUDs).

Emergency Grants to Address Mental and Substance Use Disorders During COVID-19

SAMSHA is asking treatment centers to brace for an “anticipated increase in substance misuse as lives are impacted for individuals and families” during the COVID-19 crisis. To help substance abuse programs meet this anticipated increase in volume during a period where operational costs are disrupted by the pandemic, SAMSHA is releasing an estimated $110 million in first-round grants to facilities across the nation.

Currently, SAMSHA is offering $2 million per state and up to $500,000 per territory or tribe under the Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 (Emergency COVID-19) program. This program was created to “specifically to address the needs of individuals with serious mental illness, individuals with substance use disorders, and/or individuals with co-occurring serious mental illness and substance use disorders.”

To qualify for this grant, you must be willing to distribute the funds in the following manner:

  • 70% of the grant funds must be used towards direct services for individuals with one (or more) of the following, with restrictions:
    • Substance use disorders (SUDs)
    • Serious mental illnesses (SMIs)
    • 10% of the grant funds must be used towards healthcare practitioners with mental illness (severe or otherwise) due to COVID-19
    • 20% of the grant funds must be used towards individuals with mental illness less severe than SMIs

In addition, applicants for these loans must be able to specifically note the populations they will be serving, and they must implement ALL of the following:

  • You must develop a comprehensive, evidence-based plan to treat substance abuse disorders (such as opioid addiction) or mental illness due to COVID-19. A quick note here: you must develop this plan with a specific population in mind. SAMSHA is heavily interested in how you are serving specific populations. For example, treatments may include FDA-approved medications like buprenorphine for OUDs, followed by Telehealth-oriented medication management, outpatient treatment plans, and recovery housing.
  • You must screen and access patients for SIMs and SUDs (or both). You must then use that information to develop appropriate, evidence-based treatment approaches.
  • You must provide recovery support services (e.g., childcare, individual support services, faith-based support services, vocational services, connecting individuals with housing services). In addition, you must be able to provide these services virtually — though the grant funds can be used to implement virtual solutions.
  • You must develop and implement crisis mental health services — including emergency crisis intervention services, medication administration, crisis stabilization, and 24-hour mobile crisis teams.

Note: project implementation is expected to begin four months after the administration of the grant funds.

To learn more about Emergency COVID-19 grants, click here.

Certified Community Behavioral Health Clinics (CCBHC COVID) Expansion Grants

CCBHC grants have been awarded by SAMSHA multiple times in the past. In January – March, there were CCBHC grants on the table for Certified Community Behavioral Health Clinics. However, due to COVID-19, SAMSHA announced another round of CCBHC grants — which now continue until November. The primary purpose of these CCBHC grants is to improve the quality of mental and substance abuse centers.

Certified community behavioral health clinics (or clinics that can get certified within four months) are eligible for the grants.  According to SAMSHA, all 50 states qualify for the loans. However, the original CCBHC (before the COVID-19 pandemic extension) gave priority to states that had previously received CCBHC grants (i.e., Iowa, Illinois, Indiana, Michigan, Kentucky, Nevada, Oregon, California, Pennsylvania, New York, Rhode Island, Massachusetts, Virginia, Maryland, Washington D.C., New Jersey, Texas, Oklahoma, New Mexico, Connecticut, Missouri, Minnesota, and Pennsylvania.)

However, in light of the recent pandemic, this may change. SAMSHA has a large list of requirements for these grants here. In a nutshell, this is an extension of the already established CCBHC grants due to COVID-19 — allowing community behavioral health clinics to access up to $2 million annually. For clarification, SAMSHA specifically mentions opioid use disorder as a primary service that these grants will be going towards.

Tribal Behavioral Health (TBH COVID) Grants

The CARES Act also set aside $15 million for substance abuse treatment in tribes. The supplemental funding will go directly towards the 154 current Tribal Behavioral Health (TBH) grant recipients. That’s around $90,000 per grant recipient. This is pretty straight-forward. If you already qualified for the TBH grant back in 2019, you will receive supplemental funds during the COVID-19 crisis.

The OUD Grant Landscape During COVID-19

As it currently stands, these are the primary SAMSHA grants for opioid use disorders that arose from funds granted to SAMSHA via the CARES Act. However, as we continue to press onward into this pandemic, we may see additional government stimulus solutions aimed at substance abuse disorders. Of course, post-pandemic, we may see a rise in OUDs, which could signal a long-winded grant ecosystem over the coming years.

For now, we strongly recommend that any behavioral or treatment center working with OUDs during this pandemic carefully review their grant options. This money can help you set up robust, evidence-based treatment plans that can serve your patients and the community at large.

If you’re looking for other ways to increase your revenue-per-patient and bring more liquidity into your treatment center during these unprecedented times, we can help. Procentive’s ONC-certified EHR solution can help you maximize your operations by providing critical assistance with daily workflows. From integrating electronic health records to streamlined billing and unparalleled practice reporting, Procentive can help you navigate these complex times. Contact us to learn more.