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How Medi-Cal expanded substance use treatment and access to care: a close look at drug Medi-Cal organized delivery system pilots
How Medi-Cal expanded substance use treatment and access to care: a close look at drug Medi-Cal organized delivery system pilots
In 2015 California set out an ambitious, first-in-the-nation experiment to provide organized and comprehensive substance use disorder care for Medicaid enrollees--while reducing overall health care costs. California received the country's first Medicaid Section 1115 waiver to expand access to substance use disorder services and launched the Drug Medi-Cal Organized Delivery System (DMCODS). While county participation in the program is voluntary, uptake has been strong. As of August 2020, 37 of California's 58 counties are actively implementing DMC-ODS, representing 96% of the Medi-Cal population statewide (see Figure 1). The California Health Care Foundation's 2018 paper Medi-Cal Moves Addiction Treatment into the Mainstream highlighted the initial experiences of four Counties--Los Angeles, Marin, Riverside, and Santa Clara--that were early adopters of DMC-ODS. For this paper, the authors interviewed county substance use disorder (SUD) program administrators and behavioral health directors in the original four counties plus five additional counties representing various population sizes and geographic areas throughout the state: Nevada, San Francisco, San Luis Obispo, San Mateo, and Santa Cruz.
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