Developing the Infrastructure to Transition to an SUD Managed Care System
Elizabeth Stanley-Salazar, MPH
With the support of the Blue Shield of California Foundation, the
CIBHS DMC-ODS WAIVER FORUM creates a collaborative think tank to
support county behavioral health and substance use disorder
leaders in the planning and implementation of the Drug Medi-Cal
Organized Delivery System. Working with the CBHDA SAPT
Committee, the first FORUM was held in September 2016 and focused
on the transition from the current county alcohol and drug
services administration to a specialty managed care organization.
Ron Kercheval of Advocates for Human Potential (AHP), Inc kicked
off the Forum with an overview of the elements of an effective
Managed Care Organization. He outlined the functional
administration and the operating environment for a public agency
as a manager of benefits, payment, and quality control.
Rama Kahlsa, Ph.D. of Behavioral Health Concepts, Inc. (the
Department of Health Care Services’ EQRO subcontractor for the
DMC-ODS Waiver) presented an overview of the administrative
components of quality improvement and the role of the local
administrator in improvement vs. compliance management.
The Forum participants broke into two small groups facilitated by
county leaders who have been successful in the submission and
negotiation of their county implementation plans. The counties
identified strengths that exist in the current opt-in counties to
one degree or another. Those counties that have opted into the
Waiver have built the ODS Implementation Plan using these
strengths. The summary of the county discussions that follows
sheds light onto the challenges, barriers and the possible
enhancements needed for success.