Drug Medi-Cal Organized Delivery System

Welcome to the County of San Diego’s Behavioral Health Services (BHS) Drug Medi-Cal Organized Delivery System (DMC-ODS) document library. From this site you will be able to access any communications, forms, and manuals that BHS has sent out to providers. If you are looking for more general information regarding DMC-ODS, please visit the BHS DMC-ODS website by clicking here.  

Training

If you are provider and are looking for a comprehensive list of required provider trainings for DMC-ODS, click here to visit the DMC-ODS Training site.

Questions & Answers Bank

BHS have put together a Questions and Answers website for purposes of DMC-ODS. Questions on the website are categorized by type (e.g. billing, outcomes, training etc.). In the event that you are unable to locate the answer to your question(s), please submit your question(s) to their DMC-ODS email inbox at Info-DMC-ODS.HHSA@sdcounty.ca.gov. Emails will be responded to as soon as possible. Click here to visit their Questions and Answers page.

Communications

Name Description Date
* Info Notice - FY 17-18 DMC-ODS Enhancement Budget-Invoice Process.pdf
Issued April 5 2018 2018-06-06
* Info Notice - FY 17-18 DMC-ODS Enhancement Budget-Invoice Process - Attachment 1.pdf
Issued May 17 2018 2018-06-06
* Info Notice - FY 17-18 DMC-ODS Enhancement Budget-Invoice Process - Attachment 2.xlsx
Issued April 5 2018 2018-06-06
* Info Notice - FY 17-18 DMC-ODS Enhancement Budget-Invoice Process - Attachment 3.xlsx
Issued April 5 2018 2018-06-06
* Info Notice - FY 17-18 Start-up Cost Amendment.pdf
Issued Jan 12 2018 2018-06-06
* Info Notice - FY 17-18 Start-up Cost Amendment - Attachment 1.xlsx
Issued Jan 12 2018 2018-06-06
* Info Notice - FY 17-18 Start-up Cost Amendment - Attachment 2.xlsx
Issued Jan 12 2018 2018-06-06
* Info Notice - Start-up Enhancements for FY 17-18 and FY 17-18.pdf
Issued Jan 31 2018 2018-06-06
* Info Notice - Start-up Enhancements for FY 17-18 and FY 17-18 - Attachment 1.xlsx
Issued Jan 31 2018 2018-06-06
* Letter - Preparing for Contracting under the DMC-ODS.pdf
Issued Oct 24 2017 2018-06-06
* Letter - Updates on the BHS DMC-ODS Implementation.pdf
Issued Dec 7 2017 2018-06-06
* Info Notice - DMC-ODS Court Ordered Residential Treatment.pdf
Issued May 17 2018 2018-06-06
* Info Notice - DMC-ODS Training Requirements and Waiver Resources.pdf
Issued March 19 2018 2018-06-06
* Info Notice - DMC-ODS Court Ordered Residential Treatment - Follow-Up.pdf
Issued Jun 12 2018 2018-06-12
* Info Notice - Reentry and Drug Courts SUD Treatment Services.pdf
Issued Jun 13 2018 2018-06-15

Forms

Name Description Date
* DMC Application Table of Contents - Revised.pdf
2018-05-25
* DMC Certification for SUD Providers” Webinar Material Descriptions (pdf)
2017-11-03
* PowerPoint Presentation
General Overview 2017-11-03
* “DMC Certification Process Checklist” (pdf)
2017-11-03
* “DMC Site Visit Documents” (pdf)
2017-11-03

Manuals

Name Description Date
* Changes in STC 6-1-17 (pdf)
2017-11-03
* STC 6-1-17 (pdf)
2017-11-09

ASAM

SUDPOH

Name Description Date
* SUDPOH Appendix K.3 - Multiple Billing Override Certification Form DHCS 6700.pdf
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix I.2 - Serious Incident Report SIR 04 01 17.doc
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix I.3 - Serious Incident Report of Findings SIROF 04 01 17.doc
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix I.4 - Root Cause Analysis RCA WORKSHEET 1-1-11.doc
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix C.2 - Waitlist Tracking Log 4-1-17.docx
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix D.2 - Program Accessibility Assessment 9-14-17.xlsx
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix G.2 - Gift Card Approval Form 7-21-14.xlsx
For Use Until June 30 2018 2017-10-16
* SUDPOH Appendix I.1 - SUD Complaint Report Form 8-30-17.docx
For Use Until June 30 2018 2017-10-16
* Substance Use Disorder Provider Operations Handbook (pdf)
For Use Until June 30 2018 2017-10-10
* Substance Use Disorder Provider Operations Handbook - SUDPOH (pdf)
NEW - For Use After Jul 1 2018 2018-06-20
* Substance Use Disorder Provider Operations Updates Sept. 2017 (pdf)
For Use Until June 30 2018 2017-10-10

SUDURM

Name Description Date
* 00 - SUD Uniform Record Manual (pdf)
2018-06-05
* 01 - Uniform Record Manual (pdf)
2018-03-09
* 02 - Client File Order (pdf)
2018-03-09
* 03 - Section 1 Detail (pdf)
2018-02-01
* 04 - 101 Instruction DMC Tracking Form 04-12-17.pdf
2017-05-01
* 05 - 101 DMC Tracking Form (pdf)
2017-04-27
* 06 - 101a-placement-non medi-cal tracking.pdf
2017-05-01
* 07 - 102a Instruction QAR Initial Review Form 4-12-17.pdf
2017-05-01
* 08 - 102a QAR Initial Review Form (pdf)
2018-06-05
* 09 - 102b Instruction QAR Extention-Stay-Discharge Form 4-12-17.pdf
2017-05-01
* 10-102b SUD Extension QAR Review Form (pdf)
2018-06-05
* 12 - 103 Instruction Medi-Cal Eligibility Printout 4-12-17.pdf
2017-05-01
* 13 - 104a Instruction Supplement Minor Children 04-12-17.pdf
2018-01-24
* 14 - 104a Minor Children Form 04-12-17.pdf
2018-01-24
* 15a - 104b Instructions Brief ASAM Phone Screening 1-22-18.pdf
2018-01-24
* 15b - 104b Brief ASAM Phone Screening 1-22-18.pdf
2018-01-24
* 15c - 104b Form Fill Brief ASAM Phone Screening 01-22-18.docx
2018-01-24
* 16a -104c Instructions Intake Adult ASAM Screening 1-22-18.pdf
2018-01-24
* 16b - 104c Intake Adult ASAM Screening 1-22-18.pdf
2018-01-24
* 16c - 104c Form Fill Intake Adult ASAM Screening 01-22-18.docx
2018-01-24
* 17a - 104d Instructions Intake Adolescent ASAM Screening 1-22-18.pdf
2018-01-24
* 17b - 104d Intake Adolescent ASAM Screening 01-22-18.pdf
2018-01-24
* 17c - 104d Form Fill Intake Adolescent ASAM Screening 01-22-18.docx
2018-01-24
* 18a - 104e Instructions Intake Parent ASAM Screening 1-22-18.pdf
2018-01-24
* 18b - 104e Intake Parent ASAM Screening 1-22-18.pdf
2018-01-24
* 18c - 104e Form Fill Intake Parent ASAM Screening 01-22-18.docx
2018-01-24
* 21 - 105-placement-fee collection 4-12-17.pdf
2017-05-01
* 23 - 106-placement-ID-SS-cards 4-12-17.pdf
2017-05-01
* 25 - 107-placement-Medi Cal Card 4-12-17.pdf
2017-05-01
* 26 - 108 Instruction Financial Responsibility and Info Form 4-12-17.pdf
2017-05-01
* 27 - 108 Financial Responsibility and Information Form (pdf)
2017-04-27
* 27a - S109 Instruction CalOMS Profile rev 3-2017.pdf
2017-05-01
* 27b - S109A CalOMS Profile (pdf)
2017-04-27
* 27c - S109B CalOMS Profile Collateral Contacts (pdf)
2017-05-01
* 28 - S110 Instruction SanWITS Intake rev 3-2017.pdf
2017-05-01
* 28a - S110 SanWITS Intake (pdf)
2017-05-01
* 29 - S111 Instruction CalOMS Admission rev 3-2017.pdf
2017-05-01
* 29a - S111 CalOMS Admission 5-17.pdf
2017-05-23
* 30 - S112 Instruction CalOMS Annual Update 3-2017.pdf
2017-05-01
* 31 - S112 CalOMS Annual Update 5-17.pdf
2017-05-23
* 32 - Section 2 Detail 4-12-17.pdf
2017-05-01
* 33 - 201-placement-consent to release 4-12-17.pdf
2017-05-01
* 34 - 202-placement-Admissions Agreement-Consent to Treatment 4-12-17.pdf
2017-05-01
* 35 - 203 Instruction Client Personal Rights 8-30-17.pdf
2017-10-19
* 36 - 203 Client Personal Rights 8-29-17.pdf
2017-10-19
* 37 - 204 Instruction Title 22 Fair Hearing Rights 4-12-17.pdf
2017-04-27
* 38 - 204 Title 22 Fair Hearing Rights 4-12-17.pdf
2017-04-27
* 39 - 205-placement-Notice of Privacy-HIPAA 4-12-17.pdf
2017-05-01
* 40 - 206-placement-Consent to Follow up 4-12-17.pdf
2017-05-01
* 41 - 207-placement-Consent for photo-tv-video 4-12-17.pdf
2017-05-01
* 42 - 208 Instruction Coordination of Care 4-12-17.pdf
2017-05-01
* 43 - 208 Coordination of Physical Behavioral Health (pdf)
2017-05-01
* 44 - Form Fill - 208 Coordination of Physical Behavioral Health.doc
2017-05-01
* 45 - Section 3 Detail (pdf)
2018-03-09
* 46 - 301 Instruction Stay Review 4-12-17.pdf
2017-05-01
* 47 - 301 Stay Review Form 4-12-17.pdf
2017-05-01
* 47a - Form Fill - 301 Stay Review Form 4-12-17.docx
2017-05-01
* 48 - 302 Instruction Alcohol and Drug Hx 4-12-17.pdf
2017-05-01
* 50 - 302 Alcohol and Drug History Form 4-12-17.pdf
2017-05-01
* 51 - 303 Instruction ASI-YAI 4-12-17.pdf
2017-05-01
* 52 - 303 ASI Lite.pdf
2017-04-27
* 53 - 303a YAI.pdf
2017-05-01
* 54 - 304 Instruction Co-occurring Form 4-12-17.pdf
2017-05-01
* 55 - 304 Co-occurring Screening Form 4-12-17.pdf
2017-04-27
* 56 - Form Fill - 304 Co-occurring Screening Form 4-12-17.doc
2017-04-27
* 57 - 305a Instruction HRA (pdf)
2018-02-01
* 58 - 305a High Risk Assessment 4-12-17.pdf
2017-05-01
* 59 - Form Fill - 305a High Risk Assessment 4-12-17.docx
2017-05-01
* 60 - 305b Instruction HRI 4-12-17.pdf
2017-05-01
* 61 - 305b High Risk Index 4-12-17.pdf
2017-05-01
* 62 - Form Fill - 305b High Risk Index 4-12-17.docx
2017-05-01
* 62a - 306 Instructions ASAM LOC Recomendation (pdf)
2018-03-09
* 62b - 306 ASAM LOC Recommendation (pdf)
2018-03-09
* 62c - 306 Form Fill ASAM LOC Recommendation (docx)
2018-03-09
* 63 - Section 4 Detail.pdf
2017-05-01
* 64 - 401 Instruction Client 12-hr Intensive Observation Log Detox 4-12-17.pdf
2017-05-01
* 65 - 401 12 Hours Observation Log-Detox.pdf
2017-04-27
* 66 - 402 Instruction Centrally Stored Medication & Destruction Record 4-12-17.pdf
2017-05-01
* 67 - 402 Centrally Stored Medication and Destruction Record.pdf
2017-04-27
* 68 - 403 Instruction Health Questionnaire Form 4-12-17.pdf
2017-05-01
* 69 - 403 Health questionnaire 4-12-17.pdf
2017-05-01
* 69a - 403 - Form Fill Health Questionnaire.pdf
2017-05-01
* 70 - 404 Instruction TB questionnaire 4-12-17.pdf
2017-05-01
* 71 - 404 TB screening form 4-12-17.pdf
2017-05-01
* 74 - 406 Instruction Physician Direction form 4-12-17.pdf
2017-05-01
* 75 - 406 Physician Direction Form 4-12-17.pdf
2017-05-01
* 76 - 407 MD Recomendation to client 4-12-17.pdf
2017-05-01
* 78 - 408-placement-proof of pregnancy 4-12-17.pdf
2017-05-01
* 79 - 409 Instruction Diagnosis Determination Note 4-20-17.pdf
2017-05-01
* 80 - 409 Diagnosis Determination Note (pdf)
2017-04-27
* 80a - Form Fill - 409 Diagnosis Determination Note (docx)
2017-05-10
* 81 - Section 5 Detail (pdf)
2018-03-09
* 82a - 501 Instructions Inital Treatment Plan (pdf)
2018-03-09
* 82b - 501 Initial Treatment Plan (pdf)
2018-03-09
* 82c - 501 Form Fill Initial Treatment Plan (docx)
2018-03-09
* 83 - 501 Treatment Plan 4-12-17.pdf
2017-05-01
* 83a - 502 Instructions Updated Treatment Plan (pdf)
2018-03-09
* 83b - 502 Updated Treatment Plan (pdf)
2018-03-09
* 83c - 502 Form Fill Updated Treatment Plan (docx)
2018-03-09
* 84a - 503 Instructions Addendum Treatment Plan (pdf)
2018-03-09
* 84b - 503 Addendum Treatment Plan (pdf)
2018-03-09
* 84c - 503 Form Fill Addendum Treatment Plan (docx)
2018-03-09
* 85 - Section 6 Detail.pdf
2017-05-01
* 86 - 601a b Instruction Progress Note 5-23-17.pdf
2017-05-30
* 87 - 601a Progress Notes 4-12-17.pdf
2017-04-27
* 87a - Form Fill - 601a Progress Notes 5-8-17.docx
2017-05-10
* 88 - 601b Weekly Progress Notes 4-12-17.pdf
2017-04-27
* 88a - 601b - Form Fill - Weekly Progress Notes 4-12-17.docx
2017-05-10
* 89 - Section 7 Detail.pdf
2017-05-01
* 90 - 701 Instruction Discharge Summary 4-12-17.pdf
2017-05-01
* 91 - 701 Discharge Summary Form 4-12-17.pdf
2017-04-27
* 91a-79-Form Fill - Discharge Summary 5-19-17.docx
2017-05-22
* 92 - 702 Instruction 10 Day Letter to Client 4-12-17.pdf
2017-05-01
* 93 - 702 10 Day Letter to Client 4-12-17.pdf
2017-04-27
* 94 - S703 Instruction CalOMS Discharge 3-2017.pdf
2017-05-01
* 95 - S703 CalOMS Discharge 5-17.pdf
2017-05-23
* 96 - 704 Instruction Client Discharge Plan 4-12-17.pdf
2017-05-01
* 97 - 704 Client Discharge Plan 4-12-17.pdf
2017-04-27
* 97a - 704 Form Fill Client Discharge Plan 4-12-17.docx
2017-05-01
* 98 - Section 8 Detail 4-12-17.pdf
2017-05-01
* 99 - 801 Instruction Drug Test and Results Log.pdf
2017-05-01
* 99a - 801 Drug Test and Result Log Form.pdf
2017-05-01
* 99b - 802 placement Drug Test Results From Lab 4-12-17.pdf
2017-05-01
* 99c - 803 placement Progress Reports.pdf
2017-05-01
* 99d - 804 placement Case Management Notes-Plans.pdf
2017-05-01
* 99e - 805 placement Referral Source Documents.pdf
2017-05-01
* Uniform Record Manual (pdf)
2017-05-01

Toolbox

Name Description Date
* One-Pager - Case Management in the DMC-ODS.pdf
Updated Jun 8 2018 2018-06-12
* One-Pager - DMC-ODS Required Policies and Procedures.pdf
Updated Jun 8 2018 2018-06-12
* One-Pager - Programs with Multiple Contracts.pdf
Updated May 14 2018 2018-06-15
* One-Pager - Recovery Services in the DMC-ODS.pdf
Updated Oct 17 2017 2018-06-15
* One-Pager - Recovery Residences - Supplemental Funding Guidelines.pdf
Updated Jun 18 2018 2018-06-20
* Minimum Quality Drug Treatment Standards for DMC/SABG (pdf)
Updated Jun 12 2018 2018-06-20
* One-Pager DMC-ODS Documentation Changes (pdf)
Updated Jun 18 2018 2018-06-20
* One-Pager General Outpatient Tx Assumptions (pdf)
Updated Jun 19 2018 2018-06-20
* One-Pager General Residential Tx Assumptions (pdf)
Updated Jun 19 2018 2018-06-20
* Quick Guide - Case Management Activities (pdf)
Updated May 14 2018 2018-06-20
* Quick Guide - SUD Residential Clinical Documentation and Authorization (pdf)
Updated May 14 2018 2018-06-20

Beneficiary

Name Description Date
* Beneficiary Handbook - English.pdf
For use after Jul 1 2018 2018-06-15
* Beneficiary Handbook - English - Large Print.pdf
For use after Jul 1 2018 2018-06-15
* Audio Quick Guide - DMC-ODS Services in San Diego - Arabic.mp3
For use after Jul 1 2018 2018-06-20
* Audio Quick Guide - DMC-ODS Services in San Diego - English.mp3
For use after Jul 1 2018 2018-06-20
* Audio Quick Guide - DMC-ODS Services in San Diego - Farsi.mp3
For use after Jul 1 2018 2018-06-20
* Audio Quick Guide - DMC-ODS Services in San Diego - Spanish.mp3
For use after Jul 1 2018 2018-06-20
* Audio Quick Guide - DMC-ODS Services in San Diego - Tagalog.mp3
For use after Jul 1 2018 2018-06-20
* Audio Quick Guide - DMC-ODS Services in San Diego - Vietnamese.mp3
For use after Jul 1 2018 2018-06-20