Background

Los Angeles County’s (LAC) participation in California’s Medi-Cal 2020 1115(a) Waiver Demonstration Project and the substance use disorder (SUD) organized delivery system (ODS) component would prompt significant changes to how SUD treatment services are delivered within the County, and to whom such services will be provided.  It presents the County with an opportunity to demonstrate innovative ideas and test best practices for a vastly strengthened system of care for a larger and more diverse pool of beneficiaries.  Upon approval of the County’s implementation plan by the California Department of Health Care Services (DHCS), the federal Centers for Medicare and Medicaid Services (CMS), and the LAC Board of Supervisors, the Department of Public Health (DPH) Substance Abuse Prevention and Control (SAPC) program will launch a series of transformative steps that include the expansion of reimbursable services under Drug Medi-Cal (DMC) to allow for a more comprehensive continuum of care, establishment of a single SUD benefit package, integration of physical and mental health services with SUD services, and a focus on quality and outcome-based services that meet the clinical needs of beneficiaries. 

The success of this transformation, and ultimately the success of our patients, will depend on our collective ability to design, build and implement this new SUD system of care.  An initial stakeholder process was conducted between August and December 2015 to gather input for the County’s implementation plan application.  The next phase will be to conduct advisory workgroups on the following broad topics:

1.    System of Care (Adults and Youth)
2.    Integration of Care
3.    Quality Assurance and Utilization Management
4.    System Operations
5.    System Innovations and Network Capacity Building

The System of Care Advisory Workgroup will launch first, given the need to define new services and the benefit package before this transformation takes effect (ideally by Summer 2016, assuming County, State and Federal approvals). The primary role of the Advisory Workgroups will be to provide recommendations to SAPC as the County transforms its treatment system of care.  The Advisory Workgroups will be facilitated by a SAPC program manager and/or a guest expert, and will be assisted by a SAPC staff for administrative tasks.   
  
Advisory Member Expectations: SAPC deems all perspectives as important and will need all workgroup members to, at minimum, (1) contribute to meeting discussions, (2) thoroughly review related documents in advance, and (3) provide supplemental research or data, if needed.

The frequency of workgroups will vary, but will most likely be more frequent (e.g., monthly) in the beginning of the implementation process and then quarterly once most system transformation components have been established and maintenance oversight is needed.
 
Meetings will generally last two hours, and will be held at a SAPC conference room unless workgroup members prefer another location.   

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* 1. Please provide your name and contact information below

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* 2. Please rank the following stakeholder workgroups based on your interest in participation (1 greatest interest - 5 least interest)

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* 3. Please indicate your willingness to conduct the following:

Not at all Not likely Somewhat likely Absolutely
Contribute to meeting discussions
Thoroughly review related documents in advance 
Provide supplemental research or data, if needed
Commit to attend meetings regularly, such as once or twice a month

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* 4. To ensure readiness to implement the SUD system transformation upon approval by the DHCS, CMS and the Los Angeles County Board of Supervisors, SAPC needs to define expectations for new services and the benefit package for each level of care as soon as possible.  Therefore, the System of Care Advisory Workgroup will meet on the following topics first, and address other topics later in the next fiscal year.  Please indicate your interest and expertise in participating in workgroups on the following topics (target meeting date listed):

I am very interested in participating I have significant experience in this area and can provide useful input
Beneficiary Access Line
(March 3, 2016)
Client Flow
(March 3, 2016)
Case Management and Care Coordination
(March 24, 2016)
Recovery Support Services
(April 21, 2016)
Outpatient/Intensive Outpatient Benefit
(May 19, 2016)
Opioid Treatment Program and Medication Assisted Treatment Benefit
(May 26, 2016)
Residential (ASAM 3.1, 3.3, 3.5) Benefit 
(June 2, 2016)
Withdrawal Management (ASAM 1-WM, 3.2-WM) Benefit 
(June 16, 2016)
Recovery Residences and Sober Living 
(June 30, 2016)
Field-Based Services at Non-AOD Certified Sites
(July 7, 2016)
Physician Consultation
(July 21, 2016)
Telehealth Services
(August 4, 2016)

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* 5. It is important that the advisory workgroups include individuals that represent the variation in viewpoints that may occur with different professional expertise, between agencies of different size and focus, different locations throughout the County and specialty expertise wherever possible.  The following questions will help SAPC determine if additional outreach is needed to meet this objective when considering those who volunteered to participate.

How many years of experience do you have directly providing and/or managing substance use disorder:

1-5 6-10 11-15 16-20 20+
Treatment Services
Prevention Services

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* 6. How skilled would you describe yourself in providing developmentally appropriate services for the following age populations?

  Highly skilled Somewhat skilled Not skilled
Children (0-11)
Youth (12-17)
Young Adults (18-25)
Adults (26-59)
Older Adults (60+)

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* 7. Do you have any of the following professional qualifications (check all that apply)?

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* 8. What role best describes your position in your organization?

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* 9. Briefly highlight your expertise and experience that would significantly contribute to designing and implementing Los Angeles County’s SUD system transformation.

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* 10. If your agency has contracts with any of the Los Angeles County departments below, please select the approximate contract amount for each.

  Less than $1 million $1.1-5.0 million More than $5 million Don’t Know
Department of Mental Health
Department of Health Services
Department of Public Health, Substance Abuse Prevention and Control (SAPC) Program
Department of Public Health (excluding SAPC)
Department of Public Social Services
Department of Children and Family Services
Probation Department
Sheriff’s Department

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* 11. Does your agency have contracts with other California Counties to provide health, mental health, or SUD services?

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* 12. If you answered yes to the previous question, what is the estimated total contract amount?

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* 13. Does your agency have contracts with the State or State Departments to provide health, mental health, or SUD services?

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* 14. If you answered yes to the previous question, what is the estimated total contract amount?

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* 15. Briefly describe any specific services/programs your agency provides to meet the social, cultural and/or linguistic needs of a particular population/community that would be important to consider in this SUD system transformation?

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* 16. If you have any additional comments, please feel free to share them here:

Thank you for taking the time to complete this survey. 

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