Memorandum
Date: February 27, 2024
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director Behavioral Health Services Department
Subject: Consideration of Resolution of the Lake County Board of Supervisors Authorizing the Lake County Behavioral Health Services Director to Sign the Drug Medi-Cal Organized Delivery System (ODS) Implementation Plan.
Executive Summary:
Lake County Behavioral Health Services Department has been working diligently over the past two years to join the Drug Medi-Cal Organized Delivery System (DMC-ODS). In partnership with the Department of Health Care Services, LCBHS has developed an Implementation Plan for joining DMC-ODS.
The DMC-ODS provides a continuum of care modeled after the American Society of Addiction Medicine (ASAM) Criteria for substance use disorder (SUD) treatment services, enables more local control and accountability, provides greater administrative oversight, creates utilization controls to improve care and efficient use of resources, implements evidenced based practices in SUD treatment, and coordinates with other systems of care.
This approach provides Medi-Cal members with access to the care and system interaction needed in order to achieve sustainable recovery.
In 2015, California's DMC-ODS program was the nation's first SUD treatment demonstration project approved by the Centers for Medicare & Medicaid Services (CMS) under a Medicaid Section 1115 authority. A University of California, Los Angeles (UCLA) evaluation conducted on DMC-ODS found that the pilot program yielded significant improvements in quality of care within counties that opted into the program, when compared with Drug Medi-Cal (DMC) only counties. UCLA found that participating in DMC-ODS led to an increase in access to treatment by 7 percent, as well as enhanced care coordination and integration with physical health services for DMC-ODS counties. Furthermore, 80 percent of DMC-ODS counties have implemented a Beneficiary Access Line connecting individuals to treatment or referrals, compared to 44 percent of DMC counties. Overall, DMC-ODS services have high patient satisfaction, with 93 percent reporting positive ratings of their treatment.
In December 2021, DHCS received approval from CMS to reauthorize DMC-ODS, shifting the managed care authority to the consolidated CalAIM 1915(b) waiver <https://www.dhcs.ca.gov/provgovpart/Pages/CalAIM-1115-and-1915b-Waiver-Renewals.aspx> and using the Medicaid State Plan to authorize the majority of DMC-ODS benefits. Authority to provide reimbursable Medi-Cal services for DMC-ODS members residing in institutions for mental disease (IMDs) remains in the 1115 demonstration <https://www.dhcs.ca.gov/provgovpart/Pages/CalAIM-1115-and-1915b-Waiver-Renewals.aspx> through December 31, 2026.
For more information you may also view this fact sheet: <https://www.chcf.org/wp-content/uploads/2018/11/DrugMediCalOrganizedDeliverySystem.pdf>
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Recommended Action: Adopt Resolution of the Lake County Board of Supervisors Authorizing the Lake County Behavioral Health Services Director to Sign the Drug Medi-Cal Organized Delivery System (ODS) Implementation Plan.