DRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM (DMC-ODS) UPDATE - PowerPoint PPT Presentation

DRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM (DMC-ODS) UPDATE Presented by Dr. Nicole Esposito, Asst. Clinical Director, Behavioral Health Services Angela Rowe, Chair, Alcohol and Drug Service Providers Association Tabatha Lang, Chief- Quality Improvement, Behavioral Health Services 1

AGENDA  Current Status of DMC-ODS  Challenges and Successes from the Provider Prospective  New Dashboard and Data Elements 2

OUTCOME MEASURES Housing Support Services Continuity to Reduced Outpatient Justice treatment Involvement (Residential) Self New Born Health Sufficiency Continuity to Recovery Client Services Satisfaction (Outpatient) 3

ADMISSION COMPARISON July 2017 vs July 2018 5,000 4,500 4,000 3,500 3,000 3,392 2,500 2,000 1,500 1,000 660 368 500 580 426 0 July 2017 July 2018 Outpatient Residential OTP 4

SERVICE ENCOUNTERS July 2018 5

CASE MANAGEMENT SERVICES July 2018 6

INDIVIDUAL COUNSELING INDIVIDUAL COUNSELING - OUTPATIENT July 2017 244 Total Encounters July 2018 940 Total Encounters 7

CAPACITY Capacity by Modality Intensive Outpatient 1,180 86 Residential 1,087 244 Withdrawal Management 149 Opioid Treatment Program 1,225 Outpatient Services 5,703 197 - 1,000 2,000 3,000 4,000 5,000 6,000 7,000 Contracted with BHS Non-BHS July 2018 8

PROVIDER PERSPECTIVE WHAT THE LANDSCAPE USED TO LOOK LIKE  San Diego Alcohol and Drug Treatment Providers have been providing good quality services for many years to thousands of San Diegans.  With that being said…our services could improve:  Wait lists for residential programs  Less collaboration between levels of care  Programs doing many services for free (example individual work, case management, aftercare services)  Low reimbursement for programs which affects the programs and staff and ultimately the clients  Lack of housing our clients 9

PROVIDER PERSPECTIVE WHAT THE NEW LANDSCAPE LOOKS LIKE  Intention is for residential programs to not have a wait list  Collaboration between levels of care  Programs can now do many services for reimbursement (example individual work, case management, aftercare services)  Better reimbursement for programs, specifically residential programs  Housing available for some of our clients 10

PROVIDER PERSPECTIVE SOME OF THE PROVIDER CHALLENGES  Initial Data Entry burdens (specifically for Narcotic Treatment Programs)  Staffing challenges  Working out the issues of open bed slots  Billing issues  Documentation challenges  SanWits Challenges  Lost funding of staff hour cost centers  For Residential Programs, the shorter time stays means higher turnover of senior clients  Staff perspectives on new changes  Things we do not know that we do not know 11

PROVIDER PERSPECTIVE GOOD NEWS  County has been responsive to providers’ concerns  Gave us a 3 month time frame of cost reimbursement while the billing issues are being worked out  Quality Improvement has been very active in assisting providers  Recovery Residence Story 12

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QUESTIONS QUESTIONS? • 20