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Health and Human Services Agency, recommending the Board:
1) Approve and authorize the Health and Human Services Agency (HHSA) Director to “opt in” to the Federal 1115 Waiver for a Drug Medi-Cal Organized Delivery System (DMC Waiver), thereby allowing HHSA to continue evaluation of the feasibility of participating in this pilot project;
2) Authorize the HHSA Director to begin the negotiation process with the State Department of Health Care Services for a DMC Waiver agreement;
3) Authorize the HHSA Director to continue development of opportunities for expanding the local continuum of care for substance use treatment; and
4) Authorize the HHSA Director to assess the viability of this pilot project for the County of El Dorado and return to the Board with a recommendation.
FUNDING: Federal Medi-Cal, with match funding from 2011 Behavioral Health Realignment.
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DEPARTMENT RECOMMENDATION:
Health and Human Services Agency (HHSA) recommending the Board authorize the Agency to “opt in” to participation in the Drug Medi-Cal Organized Delivery System (DMC-ODS) pilot program, thereby allowing HHSA to continue evaluation of this program. Following evaluation and possible negotiation with the State Department of Health Care Services (DHCS) for rates, HHSA would return to the Board with a recommendation to either pursue implementation of the pilot program, or “opt out” of the program.
DISCUSSION / BACKGROUND:
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 DMC-ODS 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 provi...
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