Feds OK State’s Drug Medi-Cal Waiver

CMS officials last week approved California’s Drug Medi-Cal waiver, opening the door for the state to dramatically change the way mental health services are delivered in Medi-Cal.

“The goal of the waiver is to support an integrated safety-net delivery system by better coordinating substance use disorder, physical and mental health services,” officials from the Department of Health Care Services said in a written statement.

“The waiver plans to accomplish this goal by offering a coordinated continuum of services to all Medi-Cal members based on the American Society for Addiction Medicine criteria,” the statement said, “offering counties the option to selectively contract with providers; and providing more administrative oversight.”

The official name of the ambitious plan to improve mental health services and substance use treatment is the Drug Medi-Cal Organized Delivery System. State officials hope a more seamless continuum of care and an integrated system of treatment will improve the success rate for substance use disorder treatment. The goal is to get treatment to people who need it and to follow their progress through the system to ensure they don’t fall out of treatment.

“This waiver gives Medi-Cal members who need help with substance use disorders a much better opportunity to get successful treatment for their individual needs,” said Jennifer Kent, director of DHCS, in a written statement. 

“Importantly, organizing how we deliver services to increase the success of treatment can help reduce other health care costs associated with substance use disorders,” Kent said.

Services within the new waiver include narcotic treatment programs, residential services, withdrawal management, medication-assisted treatment, recovery services and case management. The plan also includes expansion of residential treatment centers.

According to DHCS officials, the waiver will:

  • Focus more on evidence-based treatment practices;
  • Transfer more control and accountability to the counties;
  • Promote stronger oversight; and
  • Use resources more efficiently, in part by better coordination with other systems of care.

California is the first state in the nation to receive federal approval of this type of waiver, according to DHCS officials.

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Capitol Desk Medi-Cal Mental Health