Medi-Cal moves addiction treatment into the mainstream: early lessons from the Drug Medi-Cal Organized Delivery System pilots
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (California HealthCare Foundation)
- Author(s):
- Brassil, Molly, author Backstrom, Carol, author Jones, Erynne, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, Calif.] : California Health Care Foundation, August 2018
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Pilot Projects Substance-Related Disorders -- therapy Criminal Law Eligibility Determination Medicaid Mental Health Services Opiate Substitution Treatment Quality of Health Care Rate Setting and Review Social Stigma State Government Substance-Related Disorders -- drug therapy Humans United States
- Genre(s):
- Technical Report
- Abstract:
- Any time of the day or night, seven days a week, residents of Riverside County looking for help with a substance use disorder (SUD) can call a toll-free number to access Medi-Cal SUD treatment services. Language interpretation is available. By making this call, Medi-Cal beneficiaries can get an initial screening over the phone or be referred to the nearest clinic if they want to come in person for an assessment. Friends and family members of people with an SUD can get information about how to help. It sounds basic, but it's new. Since opening in February 2017, the Riverside County SUD screening and assessment call center has received an average of 4,000 calls per month, compared to 200 per month when the county first tested it three years ago. Riverside is one of 40 California counties taking part in the Drug Medi-Cal Organized Delivery System (DMC-ODS) pilot program (see Figure 1). These counties have joined in California's effort to expand, improve, and reorganize treatment of SUDs in Medi-Cal under California's Medicaid Section 1115 waiver. The DMC-ODS pilot program establishes that counties must: (1) Use a benefit design modeled after the American Society for Addiction Medicine (ASAM) Criteria, covering a broad continuum of SUD treatment and support services (2) Specify standards for quality and access (3) Require providers to deliver evidence-based care, including medication management (4) Coordinate with physical and mental health services (5) Act as a managed care plan for SUD treatment services As of July 2018, 19 counties were implementing plans and providing services under the pilot. These counties represented nearly 75% of the Medi-Cal population statewide. When the remaining 21 counties that have submitted implementation plans for approval by the Department of Health Care Services (DHCS) and the Centers for Medicare & Medicaid Services (CMS) begin services, over 97% of Medi-Cal enrollees will have access to DMC-ODS pilot programs. The Tribal and Urban Indian Health Programs are scheduled to begin implementation in the summer of 2019. To provide interested counties and states with a view of the pilot counties' experiences and challenges, this paper highlights four early adopter counties: Los Angeles, Marin, Riverside, and Santa Clara. Its contents are based on interviews with county SUD program administrators and behavioral health directors which took place throughout February and March of 2018. While acknowledging the considerable effort required by counties and providers to implement the DMC-ODS pilot program locally, the interviewees expressed strong support for and optimism about the program's potential to improve access to high-quality SUD treatment and services
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (12 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101744533 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101744533