The Four Pillars of CCARA

Improve Addiction Treatment Service Access for Californians

California lacks a coherent plan for expanding access and improving services for addiction treatment. Every day Californians who come forward and are determined to have a medical necessity for addiction treatment die waiting for it. Others lose hope and continue to use substances in a manner that results in billions of unnecessary expenditures at emergency rooms; for the treatment of physical health disorders acerbated by abuse; and spending for the justice system and social welfare programming. The state has not integrated a coherent substance abuse treatment strategy into California’s health care, foster care or corrections systems. Currently, treatment is often reserved for the most dependent and is not given to those in the earliest abuse stages, where it can be the most cost-effective.

With the passage of federal parity laws, the Affordable Care Act, and most recently, the Adult Use of Marijuana Act (AUMA), access to treatment for addiction is a statutory requirement. However, the treatment system in California lacks both physical and workforce capacity to deliver it. Consumers and their loved ones face barriers to access that would not be tolerated for similar life-threatening diagnoses.

The addiction treatment reimbursement structure dictates low pay for the treatment workforce, high staff turnover, and inexperienced and undereducated counselors. Workforce shortages and funding gaps across departments and between private and public payer systems result in long wait times that defy “timely access” statutes. The C-CARA focuses policy and funding to drive improvements in the system, creating greater capacity and access. It also places addiction treatment delivery under the same statutes that prohibit unscrupulous business practices, such as patient brokering and kickbacks, which are commonly prohibited in other health-related industries. Increased funding, functional quality improvements, and efforts to reduce stigma are primary drivers of C-CARA policy and priorities.


To create the nation’s first, true, “on demand” addiction treatment system by guaranteeing universal access to treatment when the individual presents a need, and by eradicating waiting lists where Californians die while waiting for treatment.

The Four Pillars of C-CARA

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