Expanding Substance Use Care: Health Plan Teams Up with Seven California Counties
Many Californians experiencing substance use disorders also have co-occurring mental health or physical health conditions. For Californians insured through Medi-Cal, receiving comprehensive care can be extremely challenging, because they must navigate different systems of care. Counties finance and administer substance use disorder (SUD) and specialty mental health services — through separate programs — while Medi-Cal managed care plans finance and administer physical health and non-specialty mental health services.
To address these challenges, seven mostly rural northern California counties (Humboldt, Lassen, Mendocino, Modoc, Shasta, Siskiyou, and Solano) teamed up with Partnership HealthPlan of California, the Medi-Cal managed care plan serving enrollees in these counties. They created the Wellness and Recovery Program, a pilot program to better integrate SUD with physical and non-specialty mental health services.
The program is part of the state’s Drug Medi-Cal Organized Delivery System (DMC-ODS). It regionalizes substance use disorder services across these seven counties, with financial resources provided by counties, program administration provided by Partnership HealthPlan, and services delivered by county and other providers under contract with the plan. With Partnership HealthPlan as the single entity administering all the physical and SUD services provided to a Medi-Cal enrollee, the program has the potential to more readily identify and address gaps in care and ensure that services are coordinated across providers. It is the only instance in the state in which a Medi-Cal managed care plan and a county or counties partner in DMC-ODS.
While it is too soon to state definitively whether the pilot, launched in 2020, has been effective in improving access to care and integrating services, early evidence suggests the program is achieving these goals. A logical question, then, for policymakers and program administrators is whether and to what extent this pilot can serve as a model for future integration efforts, including integrating specialty mental health services with physical health and SUD services.