Substance use disorder reform

DHS has been leading a multi-year process of bringing our substance use disorder (SUD) treatment system into the future. We know that,

• Treatment works. Most people who enter treatment complete it and show considerable improvement in substance use, employment housing, criminal behavior and participation in recovery support groups.
• Over 50,000 Minnesotans were admitted to chemical dependency treatment in 2015. However,
• Nine out of 10 adults with a substance use disorder didn’t receive treatment.

Our understanding of SUD and how best to provide treatment continues to progress, with new research, new medications, and new approaches to providing services. Now we know that:

• We need to reframe treatment away from thinking it is a “one and done” cure, to being part of care for a long term, chronic disease.
• We need services for the whole person. Treatment is but one piece of the services puzzle; people may need a wide array of services such as housing, employment, legal and family issues.
• Long waits for assessment and treatment is unacceptable. Timely access to a thorough assessment followed by receiving the right services can literally mean the difference between life and death.

We must update our policies and practices to align with current understanding of SUD and how we can meet the needs of all those who need services.

Substance use disorder reform was passed during the 2017 legislative session. The 2017 SUD Reform recommendations are the result of a process starting with a legislative mandate in 2012, leading to community input from across the state, to providers coming at the table to work together to find solutions. The result is a set of policy recommendations designed to not only improve outcomes, but to also insure program sustainability and invest scarce resources wisely.

• 2012 Model of Care Report (PDF) 
  The 2012 Minnesota Legislature directed DHS to collaborate with counties, tribes, and other stakeholders to “develop a model of care to improve the effectiveness and efficiency of Minnesota’s current service continuum for chemically dependent individuals.”

• 2015 Listening Session Summary Report (PDF) 
  In 2015, substance use disorder listening sessions gathered input from people across the state to improve our model of care for SUD and the prevention of substance abuse.

• Policy Recommendations Report (PDF) 
  In the summer of 2016, the Alcohol and Drug Abuse Division (ADAD) of the Minnesota Department of Human Services convened a core stakeholder workgroup for the first of five 3-hour work sessions to continue efforts to modernize Minnesota’s substance use disorder (SUD) treatment system. The ADAD Stakeholder Engagement plan offered an overview of the system to begin the process.

The larger CD reform efforts are happening in parallel with the IMD criteria conversation, including exploration and implementation of available options to allow for exceptions to the federal Institutions for Mental Diseases (IMD) exclusion for medically necessary, rehabilitative, substance use disorder treatment provided in the most integrated and least restrictive setting. We will continue to provide communication updates related to these parallel efforts.

For more information see E-Memo #16-23. Please view our updated January 22, 2016 frequently asked questions (FAQ’s) (PDF). Updated Institutions for Mental Disease (IMD’s) List as of May 8, 2017: IMD List (PDF)

Other Related IMD E-Memos and Documents: #15-57; IMD Medicaid Manual; #15-58; #15-59; #15-61; #15-62; #15-63; #16-03; #16-15; #16-24 and #16-24 correction