Title
Health and Human Services Agency recommending the Board receive and file an update on the Federal 1115 Waiver for a Drug Medi-Cal Organized Delivery System implementation pilot project.
FUNDING: Drug Medi-Cal.
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DEPARTMENT RECOMMENDATION:
Health and Human Services Agency (HHSA) recommending the Board receive an update on the “opt-in” process related to the Federal 1115 Waiver for a Drug Medi-Cal Organized Delivery System (DMC-ODS) pilot project through the development and submission of a preliminary DMC-ODS implementation plan and subsequent negotiations with the State Department of Health Care Services.
DISCUSSION / BACKGROUND:
On May 23, 2017, the Board authorized the HHSA Director to opt in to the Federal 1115 Waiver for a DMC-ODS and to continue to develop opportunities for expanding the local continuum of care for substance use treatment (File ID: 17-0525; Item 13). Accordingly, HHSA has held meetings with community stakeholders and providers, and developed and submitted a preliminary plan and proposed rate structure to the State of California. HHSA has received input from the State review and plans to move forward with negotiating changes to the proposed plan, resulting in a draft contract which will be brought back to the Board for approval.
The DMC-ODS is a voluntary pilot program that offers California counties the opportunity to expand access to quality care for Medi-Cal enrollees with substance use disorders (SUD). The goal of the program is to demonstrate how organized SUD care improves beneficiary health outcomes, while decreasing system-wide health care costs. Counties that choose to participate in the DMC-ODS are required to provide access to a full continuum of SUD benefits utilizing the American Society of Addiction Medicine (ASAM) Criteria. This approach is expected to provide eligible enrollees with access to the care and services they need for a sustainable and successful recovery.
The ASAM Criteria is a proven mod...
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