PacifiCare Wins Deal to Treat Medi-Cal Recipients

SANTA ANA —  PacifiCare Health Systems Inc. said Monday it has received a contract to administer a program that provides outpatient mental health services to Orange County residents on government assistance.

The Santa Ana-based managed care company said the three-year contract, beginning Jan. 1, will refer Medi-Cal recipients who occasionally need mental health services to outpatient providers.

These patients, both in Orange County and throughout the state, are being transferred from a state-run program that pays providers a fee for their services. Under the new system, the patients will be treated in managed care programs being set up by individual counties. The change is intended to contain health care costs.

Orange County’s mental health department decided to retain an outside administrator to oversee programs for recipients who need services from time to time. County health officials, however, will continue to administer care of seriously emotionally disturbed youths and adults who require more extensive services.

A unit of the giant HMO, PacifiCare Behavioral Health of California, will coordinate treatment with Cal-OPTIMA, the program that provides general medical care to county residents on Medi-Cal.

Overall, PacifiCare’s contract will cover about 290,000 individuals on Medi-Cal across the county--though only a small percentage require mental health services. The county expects to receive about $2 million in state and federal funds to cover those services.

Terms of the contract between the county and PacifiCare were not disclosed.