Drug Medi-Cal Organized Delivery System
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The Drug Medi-Cal Organized Delivery System (DMC-ODS) is a program for the organized delivery of substance use disorder (SUD) treatment services to eligible Medi-Cal members with SUDs by providing a continuum of care modeled after the American Society of Addiction Medicine (ASAM) Criteria for SUD treatment services. As a county opt-in program, DMC-ODS also 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 SUD treatment, and coordinates with other systems of care.
This approach provides Medi-Cal members with access to the care and system interaction needed in order to achieve sustainable recovery.
Background
In 2015, California's DMC-ODS program was the nation's first SUD treatment demonstration project approved by the Centers for Medicare & Medicaid Services (CMS) under a Medicaid Section 1115 authority. A University of California, Los Angeles (UCLA) evaluation conducted on DMC-ODS found that the pilot program yielded significant improvements in quality of care within counties that opted into the program, when compared with Drug Medi-Cal (DMC) only counties. UCLA found that participating in DMC-ODS led to an increase in access to treatment by 7 percent, as well as enhanced care coordination and integration with physical health services for DMC-ODS counties. Furthermore, 80 percent of DMC-ODS counties have implemented a Beneficiary Access Line connecting individuals to treatment or referrals, compared to 44 percent of DMC counties. Overall, DMC-ODS services have high patient satisfaction, with 93 percent reporting positive ratings of their treatment.
In December 2021, DHCS received approval from CMS to reauthorize DMC-ODS, shifting the managed care authority to the consolidated CalAIM 1915(b) waiver and using the Medicaid State Plan to authorize the majority of DMC-ODS benefits. Authority to provide reimbursable Medi-Cal services for DMC-ODS members residing in institutions for mental disease (IMDs) remains in the 1115 demonstration through December 31, 2026. To learn more about DMC-ODS program and updates pursuant to CalAIM, please see BHIN 24-001 .
Additional resources for DMC-ODS counties, including free assessment tools, can be found on the County Resources page. Questions about the DMC-ODS program can be sent to CountySupport@dhcs.ca.gov.
Evaluation
The University of California, Los Angeles, Integrated Substance Abuse Programs (UCLA ISAP) conducts an annual evaluation to measure and monitor outcomes of the DMC-ODS, using information gathered from existing state data sources, as well as new data collected specifically for the DMC-ODS evaluation. Quantitative methods are used to analyze trends, while qualitative methods are used to interpret quantitative data.
DMC-ODS 2021 Evaluation Report
DMC-ODS 2020 Evaluation Report
DMC-ODS 2019 Evaluation Report
DMC-ODS 2018 Evaluation Report
Information about the DMC-ODS Evaluation is available on the UCLA ISAP webpage.
SUD Non-Emergency Treatment Referral Line
The Department of Health Care Services provides an automated non-emergency SUD referral line for anyone seeking SUD treatment services in California. To reach the referral line, please call the following telephone numbers:
- (800) 879-2772 – Statewide Toll-Free, or
- (916) 327-3728 – Outside California.
The referral line has language options for English or Spanish. Once connected, callers will be prompted to select the county in which they are seeking services, and the automated system will connect them to the county office for SUD services. Resources can also be found on the Directories for Substance Use Disorder Services webpage.