Health Agency | Behavioral Health

Drug Medi-Cal Outpatient Delivery System (ODS)

The State Department of Health Care Services (DHCS) has provided an opportunity for counties to submit an Implementation Plan to participate in the Drug Medi-Cal Organized Delivery System (DMC-ODS). Under DMC-ODS, the federal government has waived many of the currently existing restrictions regarding available substance use disorder treatment services. At the same time, increases in quality assurance, monitoring, and accountability are put into place. The new services available to Medi-Cal beneficiaries under the waiver are: residential treatment, case management, recovery support services, and medication assisted treatment. The funding under DMC-ODS also changes the funding mechanism for drug and alcohol services from a fee for service model to a cost reimbursement model. This will allow the County to set the reimbursement rates to reflect the actual cost of providing such services. The accountability measures being put into place include:

• Selective contracting with providers
• County monitoring
• State External Quality Review Organization (EQRO) annual audits, and
• Evidence-based practices.

The DMC-ODS provides a continuum of care modeled after the American Society of Addiction Medicine Criteria for substance use disorder 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 substance abuse treatment, and coordinates with other systems of care. DMC-ODS is a demonstration project through 2020, but is currently planned for extension in the year 2020. The overall goal of the DMC-ODS waiver is to increase services to Medi-Cal individuals suffering from substance use disorders. Additionally, the waiver increases oversight, monitoring and accountability of Drug Medi-Cal programs.
 
County of San Luis Obispo's Implementation Plan was submitted to the State DHCS for review on July 8, 2016. 

To view a copy of the County of San Luis Obispo’s Draft DMC-ODS Implementation Plan, please visit:

• Drug Medi-Cal Implementation Plan (Draft)
• Attachments to the Implementation Plan