Provider Assessment Survey on Support Needed to Participate in the Drug Medi-Cal Organized Delivery System Waiver Program

Dear Providers,

As the deadline is quickly approaching, I am resending the information regarding the Provider Assessment Survey.  Please note the following updates:

  • For your convenience, attached is a Word version of the document
  • The Provider Enrollment consent form is no longer needed
  • The funding amount is of particular importance and will allow for a more complete assessment



  • contract service providers [pdf]
  • provider assessment survey [pdf]
  • readiness survey [doc]


Thank you all,


Daniel Deniz
Interim Chief, Contract Services Division
Substance Abuse Prevention and Control, Contract Services Division
Los Angeles County Department of Public Health
1000 South Fremont Avenue, Building A-9 East, Third Floor
Alhambra, CA 91803
(626) 299-4532 Tel
(626) 299-7226 Fax





Dear Colleagues:


This is to request your participation in Substance Abuse Prevention and Control’s (SAPC) assessment survey.  The Survey will assist SAPC with determining the specific steps needed to take and help preserve existing residential treatment facilities operated by its contracted services network and in building the capabilities of its network providers’ administrative, fiscal, and technology infrastructure in order to fully implement an organized delivery system of Substance Use Disorder services by July 1, 2017.  Please complete the attached survey form and forward to SAPC by Tuesday, December 8, 2015 to:


Substance Abuse Prevention and Control

County of Los Angeles Department of Public Health

1000 South Fremont Avenue, Building A-9 East 3rd Floor, Box 34

Alhambra, California  91803

Attention:  Wayne K. Sugita, Interim Director


In the meantime, if you have any questions or need additional information, please contact Wayne K. Sugita at (626) 299-4571.


Thank you.

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