What's New in Planning for the Wellness and Recovery Benefit Model?
Regional Model for Substance Use Treatment System (aka "Wellness and Recovery"): with federal approval, California is enacting a Medi-Cal Waiver Demonstration Project that will provide the full continuum of substance use care for Medi-Cal enrollees. The new benefit will go beyond the current network of limited outpatient; intensive outpatient; and narcotic treatment (methadone) programs to include withdrawal management; medication-assisted treatment; residential care and case management services. Services will be available to all Medi-Cal recipients who meet the medical necessity criteria as determined by the American Society of Addiction Management (ASAM) scale. This would include:
- Outpatient treatment (licensed professional or certified counselor, provide nine hours per week for adults)
- Intensive outpatient treatment for individuals with greater treatment needs (licensed professional or certified counselor, structured programming, nine-19 hours per week for adults)
- Detoxification services (withdrawal management)
- Residential treatment (One ASAM level, DHCS licensed facility, certified staff)
- Medically assisted treatment (methadone, buprenorphine, disulfiram, naloxone)
Have questions? Join PHC's calls with potential providers and interested parties on the first Monday of each month. Email email@example.com for details.
Provider Resources: State of California DMC-ODS website Contact Us: DrugMediCalPHC@partnershiphp.org