CHA News Article

DHCS Provides Drug Medi-Cal Organized Delivery System Waiver Update

The California Department of Health Care Services (DHCS) has provided an update on the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver, a voluntary pilot program that offers California counties the opportunity to expand access to care for Medi-Cal enrollees with substance use disorders (SUD). The program’s goal is to demonstrate that 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 modeled after the American Society of Addiction Medicine (ASAM) criteria and are required by the Centers for Medicare & Medicaid Services (CMS) to meet the ASAM requirements, as well as obtain a DHCS-issued ASAM designation.

This approach is expected to provide eligible enrollees with access to the services they need for a sustainable and successful recovery. As of May 8, DHCS has issued 622 ASAM designations identifying levels of care within 368 licensed residential facilities. 

According to DHCS, 21 counties from the first three phases (Bay Area, Southern California and Central California) have submitted implementation plans, 16 of which have been approved by DHCS. DHCS opened implementation for phase four counties (Northern California) on Nov. 1, 2016. DHCS has also approved the interim rates for eight counties. CMS has approved six intergovernmental agreements, and three counties — Marin, Riverside and San Mateo — are already delivering services.  

DHCS is providing technical assistance through contracted services, regional meetings, county-specific sessions and webinars. Additionally, last October DHCS submitted a concept design to CMS to further integrate SUD and physical health services. More information about the DMC-ODS is available on the DHCS website.