Case Studies
Drug Medi-Cal Organized Delivery System Case Study | Harbage Consulting

Since 2015, Harbage Consulting has provided technical assistance, strategic guidance, and stakeholder engagement support to the California Department of Health Care Services (DHCS) in the planning and implementation of the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver program. This waiver program aims to test a new paradigm for the organized delivery of health care services for Medicaid beneficiaries with a substance use disorder (SUD), while also demonstrating how organized SUD care can improve outcomes for beneficiaries and decrease overall health care costs.

Building on years of behavioral health expertise and involvement in projects related to delivery system reform, Harbage Consulting provides policy analysis, research, strategic guidance, and project management support to DHCS, including:


  • Vetting and resolving complex policy considerations and providing background, analysis, and proposed recommendations/options for consideration;
  • Providing technical consultation, assistance, and support related to several key policy issues, including federal Certified Public Expenditure (CPE) claiming and settlement protocols, requirements outlined in the terms and conditions of the waiver, and applicability of managed care rules;
  • Developing initial drafts of policy documents focused on various provisions of the Drug Medi-Cal waiver; and
  • Providing project management support and facilitating weekly in-person meetings with the DHCS leadership team to plan and execute the activities associated with the implementation of the approved terms and conditions of the waiver.

Harbage Consulting also provides stakeholder engagement support to the state, including:


  • Developing and executing webinars and legislative briefings to orient stakeholders to the goals and requirements of the DMC-ODS;
  • Developing and executing a comprehensive county engagement and communications strategy that consists of: 1) facilitating, alongside DHCS staff, bi-weekly technical assistance calls with county project leads, 2) facilitating, alongside DHCS staff, a rate-setting working group for prospective pilot counties, and 3) developing and hosting frequent technical assistance webinars focused on administrative and fiscal planning considerations;
  • Developing frequently asked questions (FAQs) and fact sheets on key policy areas to inform and educate stakeholders; and
  • Assisting DHCS in responding to stakeholder inquiries related to the DMC-ODS.


The State of California was the first state in the nation to receive federal approval for a Medicaid section 1115 waiver designed to advance substance use disorder treatment and prevention. The DMC-ODS waiver was the basis for national guidance from the Centers for Medicare & Medicaid Services regarding the opportunity to receive additional federal funding in support of SUD reduction and California is serving as a national leader on the issue.

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At the intersection of health care policy, politics and communications.