Overview

• From July 2022 through December 2023, the initiative operated in 252 hospitals covering over 80% of California emergency departments, with more than 165,000 navigator encounters and nearly 45,000 buprenorphine treatments.
• The state invested $40 million, including typical $120,000 grants per hospital, with $36 million flowing to sites and $4 million supporting administration, training, and monitoring.
• Performance varied by setting, with public hospitals recording about 80% higher patient engagement and roughly 50% higher buprenorphine provision than private hospitals.
• In 2022 statewide, 119,271 people received buprenorphine prescriptions, 4.3% from emergency clinicians; among first-time recipients, 5.3% were started in the ED, and 1,737 unique ED prescribers were identified with about 22% new to prescribing.
• Continuity indicators showed about 36% received a follow-up prescription within 40 days and a median 58 days of uninterrupted treatment, as authors call for sustainable financing, standardized quality metrics, and study of high-performing sites to guide wider adoption.