LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 305.01 Mental Health Disorders and Co-Occurring Substance Use
 
  PROCEDURES
  1. Establishing Medical Necessity
     
    1. Client assessment must establish medical necessity for Medi-Cal Specialty Mental Health Services per California Department of Health Care Services (DHCS) Behavioral Health Information (BHIN) Notice 21-03.
       
    2. Clients with Co-Occurring Substance Use Disorders shall be treated according to the "no wrong door" approach described in BHIN 22-011 and any further guidance provided by DHCS.
       
    3. DHCS has provided helpful Frequently Asked Questions related to establishing medical necessity for CalAIM Behavioral Health Initiative.
       
  2. All Co-occurring Disorder (COD) interventions provided and claimed to DMH clients must be focused on the clients' identified mental health needs.
     
    1. As part of comprehensive COD treatment, individuals may be offered toxicology screening in accordance with DMH Policy 305.02.
       
  3. Developing a Care Plan for Treatment
     
    1. For direct care services such as psychotherapy, rehabilitation, or medication support services, the care plan should:

      Address the client's identified mental health needs
      Help the treatment team monitor progress
      Make treatment adjustments when necessary. 
    2. For Targeted Case Management services goals and actions may include:

      linking the client to outside substance use treatment or other appropriate services.

      Targeted Case Management services require:

      A documented care plan with specific elements including goals and actions
      Ensuring the active participation of the client/representative in development of goals, and
      Identifying a course of action to respond to the assessed needs
       
  4. Individuals age 12 and older will be screened for substance use using population-appropriate screening tools. Those younger than age 12 may be assessed for substance use based on clinician discretion.
     
  5. Medication Assisted Treatment (MAT) may be provided according to DMH MAT Parameters.
     
  6. Expert consultation and substance use relevant training shall be available on an ongoing basis.