Case Studies
California's Medication Assisted Treatment (MAT) Project | Harbage Consulting

Since 2016, Harbage Consulting has worked closely with the California Department of Health Care Services (DHCS) to provide policy analysis, technical assistance and strategic guidance on developing and implementing the state’s plan for combatting the opioid crisis.  In addition to the state’s Medicaid Section 1115 waiver – the Drug Medi-Cal Organized Delivery System – the state is utilizing the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) State Targeted Response (STR) and State Opioid Response (SOR) grants.  One of the key elements of this effort is to increase access to medication-assisted treatment (MAT) across the state, known as the California MAT Expansion Project.

Harbage Consulting worked with DHCS to develop the plan for the $90 million STR grant that California received, which included the development of a Hub and Spoke System (H&SS). Under the H&SS, Opioid Treatment Providers act as “hubs,” managing complex patients and serving as a source of guidance and support to “spokes,” outpatient primary care and substance use disorder (SUD) providers that extend the reach of the system into rural and underserved areas. With the additional funding that is available under the SAMHSA SOR grant, Harbage Consulting is providing a full range of support to the state as it implements innovative approaches to quickly scale up treatment capacity in emergency departments, prisons and jails, and for specific populations such as native tribal communities, veterans and youth.


Specifically, Harbage Consulting supports DHCS by:


  • Vetting and resolving complex policy issues and providing background information, analysis and recommendations.
  • Providing project management support and facilitating weekly in-person meetings with DHCS leadership to plan and execute deliverables associated with the grant.
  • Engaging stakeholders, via the formation of a steering committee for the H&SS as well as holding webinars and calls with counties, providers and contractors to inform them of the opportunities and requirements of the STR and SOR grants.
  • Developing resources, including Frequently Asked Questions (FAQs) and fact sheets to communicate project information to stakeholders.
  • Designing and drafting toolkits to educate critical players in the opioid space, such as residential treatment providers, about how to provide MAT for opioid use disorders.
  • Assisting leadership in planning for the transition from short-term funding to a long-term, sustainable SUD treatment and prevention system.


California’s MAT Expansion Project is expanding access to treatment in rural and underserved areas of the state that have the highest rates of overdose by targeting populations with the greatest needs (tribal populations, veterans, and youth), and providing seed funding to new, non-traditional entities to establish their capacity for treatment. As a result, the state has established 18 hubs and over 100 spokes, as well as establishing new partnerships with corrections, emergency departments, hospitals, schools and tribal entities—all with the goal of more effectively serving the thousands of Californians with opioid use disorder.