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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)
VCBH Quality Improvement (QI) is responsible for the coordination, planning, oversight, and communication of quality and process improvement projects, analyses, and findings to achieve the Department’s mission, vision, and goals. The annual Quality Assessment Performance Improvement (QAPI) Work Plan provides a working document to guide the monitoring and evaluation of efforts to improve service quality for both Mental Health and Substance Use programs and services from VCBH.
Quality Improvement Committee
The Quality Improvement Committee (QIC) 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. The central QIC oversees seven subcommittees, each with distinct focus areas of discussion and activity. Members include leadership, operations, and clinical staff throughout VCBH, as well as community partners and advocates. For more information, see the QIC charter below or contact vcbh.quality@venturacounty.gov.
Quality Assurance Performance Improvement Plan
Each year, VCBH submits a written Quality Assurance and Performance Improvement (QAPI) Work Plan which guides and outlines current quality improvement efforts throughout the department. In the same year, VCBH submits an evaluation of the previous Work Plan for monitoring and accountability.
Fiscal Year: 2025–2026
Fiscal Year: 2024–2025
Fiscal Year: 2023–2024
Fiscal Year: 2022–2023
Fiscal Year: 2021–2022
Fiscal Year: 2020–2021
Fiscal Year: 2019–2020
- VCBH QMAC Presentation-Oct 2019 Overview
- FY 2019-20 Quality Assurance Performance Improvement Plan Evaluation
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.
Fiscal Year: 2024–2025
The FY24-25 EQRO was completed by a new EQR contractor. This document outlines changes in review structure, scope and reporting
Performance Measure Validation (PMV)
Network Adequacy Validation (NAV)
Performance Improvement Projects (PIPs)
Fiscal Year: 2023–2024
Fiscal Year: 2022–2023
Fiscal Year: 2021–2022
Fiscal Year: 2020–2021
Fiscal Year: 2019–2020
