Benefit depends on the County – there are several models within Partnership's 14-County network
Overview of Regional Model
A key feature of the Regional Model will be assurance that the full range of health care services – physical health care as well as mental health and addiction treatment – are fully integrated. The full integration of services will fulfill the purposes of the Waiver, best serve clients, and better realize the potential of the state's ambitious efforts, not only to expand alcohol and drug treatment services, but to provide comprehensive, patient-centered care to the safety net population. In addition to developing the substance use services model prescribed by the Waiver, the regional model will facilitate the interactions among physical health, mental health, and substance use providers that are key to the effective treatment of the complex and chronic conditions that are often associated with substance abuse.
Expanded Medi-Cal Substance Use Disorder services will only be available in counties that "opt in."
Status of PHC Counties: To date, four of Partnership's 14 counties – Marin, Sonoma, Napa, and Yolo – are working on the plans and structures to administer the benefit in their counties. Marin County services began April 1, 2017; Napa services started December 15, 2017. The other two counties are working towards the final state and federal approvals to start to provide the benefit. These PHC counties will have a memorandum of understanding (MOU) with PHC that governs the relationships and referral strategies for the care of PHC members who also are receiving county-administered drug and alcohol services.
Eight of PHC's counties – Humboldt, Mendocino, Trinity, Shasta, Siskiyou, Solano, Modoc, and Lassen– are working with PHC to develop a regional model administered by PHC. The model will provide "no wrong door" access for individuals or providers to either call a central assessment line for intake and entry into the appropriate level of care and/or allow for individual providers to assess clients and refer them to the appropriate level of care.
PHC's approved DMC-ODS Regional Implementation Plan is available here.
Timeline and Related Activities
Implementation date: Implementation depends on the speed of state and federal approvals; PHC continues to work with the State to secure approval of our fiscal plan and is hoping for an implementation date of January 2019. In the interim, the Plan is focusing on ensuring the availiability of addiction treatment expertise for current members with physical or mental health needs that are accompanied by substance use problems. This 'addiction integration' of our current system will be in place by July 1, 2018.
Grants to Increase Capacity for DMC
About $2 million has been awarded to ten organizations that will be part of the new Wellness and Recovery Benefit, to increase and improve services. The status of the grantees work will be updated on this website in early 2018.
The California Hub and Spoke System (CA H&SS) - expansion of medication assisted treatment services
The California Department of Health Care Services awarded nineteen grants to narcotic treatment program (NTP) providers for opioid treatment; several of these grants are for services in PHC counties.