Managed Care Operations
Ventura County Behavioral Health (VCBH), a department of the Ventura County Health Care Agency (HCA), provides a system of coordinated services to address the specialty mental health and substance use treatment needs of Ventura County. The Department is committed to excellence through “best practices” and a consumer-driven and culturally competent approach to service delivery. VCBH staff are dedicated to reducing suffering and enhancing recovery from mental illness and/or substance use issues. VCBH believes that consumer and family member involvement is critical to meeting our commitment to excellence and for profound change in consumers’ lives. VCBH is dedicated to integrating consumers and family members across the Department’s organization and activities.
Managed Care Operations (MCO) Program
The VCBH Managed Care Operations Program is accountable to the VCBH Director, resides within the Administration Division and is overseen by the Administration Division Chief and the Managed Care Operations Chief. MCO is focused on the successful implementation of the Behavioral Health Department’s stated mission and goals and is responsible for reviewing the quality of behavioral health services provided to Medi-Cal beneficiaries and ensuring compliance with contract requirements and relevant Federal and State regulations.
Quality Assurance (QA)
QA activities include ensuring and monitoring compliance with contract requirements, Federal and State regulations, and Department policies and procedures.
Additional Resources
Mental Health Implementation Plan for Medi-Cal Specialty Mental Health Services
As the Mental Health Plan responsible for provision of Specialty Mental Health Services (SMHS) for eligible Ventura County Medi-Cal beneficiaries, VCBH is required to maintain a current Implementation Plan describing services provided and protocols implemented to ensure compliance with State and Federal rules and regulations (CCR, tit. 9, §§ 1810.310).
Quality Improvement (QI)
The VCBH Quality Improvement unit is responsible for the coordination, planning, oversight, and communication of quality improvement projects, analyses, and findings to achieve the Department’s mission, vision, and goals. The QI team monitors and evaluates Mental Health Services and Substance Use Services that are provided by VCBH; the annual Quality Assessment Performance Improvement (QAPI) work plan and evaluation guide QI activities.
Quality Management Action Committee (QMAC)
The QMAC reviews, evaluates, and advises on VCBH’s QAPI and other quality management activities to support improved access, quality of care, and outcomes of the service delivery system. Representation includes practitioners, community providers, consumers, and family members. QMAC meets quarterly for an all-member session and ad hoc committees are convened on a time-limited basis for specific discussions to related to QAPI activities. If you are interested in participating the QMAC, contact vcbh.quality@ventura.org.
- FY 2022-2023 Quality Assessment Performance Improvement Work Plan
- FY 2021-2022 Quality Assessment Performance Improvement Work Plan Evaluation
- FY 2020-2021 Quality Assurance Performance Improvement Plan Evaluation
- FY 2021-2022 Quality Assessment and Performance Improvement Work Plan
- VCBH QMAC Presentation-Oct 2019 Overview
- FY 2019-20 Quality Assurance Performance Improvement Plan Evaluation
- FY 2020-21 Quality Assurance Performance Work Plan, March 2021 Update
External Quality Review Reports
An External Quality Review (EQR) is the annual analysis and evaluation by an External Quality Review Organization (EQRO) of aggregated information on quality, timeliness, and access to the health care services that a managed care plan, or its contractors, furnish to Medicaid beneficiaries. “Quality of Care External Quality Review.” Medicaid.gov, Centers for Medicare & Medicaid Services.
The External Quality Review reports below present the most recent fiscal year EQR findings for Ventura County Mental Health and Drug Medi-Cal Organized Delivery System programs.
- Ventura MHP EQR Final Report FY 2022-23
- Ventura DMC-ODS Final EQR Report FY 2022-23
- Ventura MHP EQRO Final Report FY 2021-22
- Ventura DMC-ODS Final EQRO Report FY 2021-22
- Ventura MHP EQRO Final Report FY 2020-21
- Ventura DMC-ODS Final Report FY 2020-21
- Ventura MHP EQRO Final Report FY 2019-20
- Ventura DMC-ODS Final EQRO Report FY 2019-20
