LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 252.01 Medi-Cal Managed Care Plans: Clinical Consultation
 
Policy Category:  Clinical
Distribution Level:  Directly Operated and Contractors
Responsible Party:  Health Access and Integration
 
Approved by Jaclyn Baucum, Senior Deputy Director, Health Access and Integration, on Apr 03, 2025
 
I. PURPOSE:

To establish standards for clinical consultations between Los Angeles County Department of Mental Health (DMH) workforce members and contracted agencies (referred to as DMH Providers) who provide direct and indirect Member care with the Member’s assigned LA County Medi-Cal Managed Care Plan (MCP). 

Contracted agencies shall develop an internal policy and associated procedures that are consistent with their organizational practices and meet the requirements set forth in this policy.


II.  DEFINITIONS:

Managed Care Plan (MCP): State contracted health plan that delivers Medi-Cal benefits to enrollees under a managed care network of providers. 

Member: An eligible Medi-Cal beneficiary who is enrolled in a Medi-Cal Managed Care Plan (MCP).

Mental Health Plan (MHP): A County Mental Health Plan that is responsible for providing specialty mental health services.

 
III.  POLICY
 
DMH shall ensure timely coordination of care and services for shared Members served by DMH, the local mental health plan, as well as an LA County Medi-Cal MCP according to State requirements.
  • Collaboration and Consultation with contracted Medi-Cal MCPs:
  1. DMH and DMH Providers will be able to provide clinical consultations regarding a Member’s mental illness, including consultation on diagnosis, treatment, and medications for Members assigned to an LA County Medi-Cal MCP.
  2. DMH and DMH Providers will be available to provide clinical consultations regarding reviews and updates to a Member’s problem list as clinically indicated (e.g., following crisis intervention or hospitalization, including when the care plan or problem list must be updated; and coordinating with outpatient mental health network providers).
IV.  PROCEDURES
 
There are no procedures associated with this policy.
 
V.  AUTHORITIES
 
VI.  ATTACHMENTS
 

There are no attachments associated with this policy.