On September 23, 2026, Centers for Medicare & Medicaid Services (CMS) approved a five-year renewal of the District of Columbia’s Whole-Person Care Transformation 1115 Demonstration Waiver (Project Number 11-W-00331/3), effective October 1, 2026 through September 30, 2031.This approval enables DHCF to continue coverage of substance use disorder (SUD) and serious mental illness (SMI) treatment services delivered during short-term stays in residential and inpatient treatment settings. It also grants new authority for DHCF to cover pre-release services that support care transitions for individuals leaving incarceration and returning to the community.

1115 Waiver Approval Materials: 

Whole-Person Care Transformation 1115 Waiver Renewal Approval 

1115 Waiver Renewal Application Materials:

Final 1115 Renewal Application - Submitted to CMS 6.6.24  - (pdf) 
Cover letter – DC 1115 Renewal - (pdf) 
DRAFT 1115 Renewal Application- For Public Comment - (pdf) 
1115 Waiver Renewal Public Comment Presentation – (pdf)
Draft Interim Evaluation Report 4.1.24 - (pdf) 

For further information, please contact: [email protected].

1115 Renewal Community Engagement

The Health System Redesign (HSR) Subcommittee of the MCAC serves as the forum for focused community engagement on the 1115 waiver renewal. The HSR Subcommittee meets monthly, typically on the second Thursday of the month from 2-4pm. The HSR Subcommittee meetings are an open group and anyone is invited to attend. Materials from each meeting will be provided on this page. To receive a monthly calendar invite and join the 1115 listserv, please contact [email protected].
 

HSR Meeting Materials

• June 2026

HSR 06.25.26 Agenda 
HSR 06.25.26 Presentation with Notes 

• May 2026

HSR 05.14.26 Agenda 
HSR 05.14.26 Presentation with Notes 

• March 2026

HSR 03.05.26 Agenda 
HSR 03.05.26 Presentation 
HSR 03.05.26 Meeting Notes 

• December 2025

HSR 12.11.25 Agenda
HSR 12.11.25 Presentation
Final Screening, Referral, Technology Recommendations Proposed to MCAC
Final Care Coordination Recommendations Proposed to MCAC

• November 2025

HSR 11.13.25 Agenda
HSR 11.13.25 Presentation_With Notes
HSR 11.13.25 Breakout Group 1 Notes
HSR 11.13.25 Breakout Group 2 Notes

• October 2025

HSR 10.16.25 Agenda
HSR 10.16.25 Presentation
Screening, Referral, Technology – originally proposed recommendations
Screening, Referral, Technology – with edits

• September 2025

HSR 9.11.25 Agenda
HSR 9.11.25 Presentation_With Notes
HSR 9.11.25 Breakout Group 1 Notes
HSR 9.11.25 Breakout Group 2 Notes

• August 2025 - there was no HSR meeting during August

•   HSR Proposal Documents presented at July 30, 2025 MCAC Meeting

HSR Subcommittee Proposal – 1115 Waiver Housing
HSR Subcommittee Proposal – 1115 Waiver Nutrition
HSR Subcommittee Proposal – 1115 Waiver Reentry
Compilation of 1115 Services Framework

•   July 2025

HSR 7.17.25 Agenda
HSR 7.17.25 Presentation_With Notes
HSR Subcommittee Proposal – 1115 Waiver Housing DRAFT 7.17.25
HSR Subcommittee Proposal – 1115 Waiver Nutrition DRAFT 7.17.25
HSR Subcommittee Proposal – 1115 Waiver Reentry DRAFT 7.17.25

•   June 2025

HSR 6.12.25 Agenda
HSR 6.12.25 Presentation_With Notes
HSR Housing Recommendations Discussion DRAFT June 2025_With Notes
HSR Nutrition Recommendations Discussion DRAFT June 2025_With Notes
HSR Reentry Recommendations Discussion DRAFT June 2025_With Notes

•   May 2025

HSR 5.8.25 Agenda
DRAFT Compilation of 1115 Services_HSR Subcommittee
HSR 5.8.25 Presentation With Notes

•   April 2025

HSR 4.10.25 Agenda
HSR 4.10.25 Presentation_With Notes

•   March 2025

HSR 3.13.25 Agenda
HSR 3.13.25 Presentation_With Notes
1115 Waiver Services Framework_HSR 3.13.25 Notes

•   February 2025

HSR 2.13.25 Agenda
HSR 2.13.25 Presentation With Notes
1115 Waiver Services Framework HSR 2.13.25 Notes

•   January 2025

HSR 1.9.25 Agenda
HSR 1.9.25 Presentation_With Notes
1115 Waiver Services Framework_HSR 1.9.25 Notes

•    December 2024

HSR 12.12.24 Agenda
HSR 12.12.24 Presentation_With Notes
1115 Waiver Services Framework_HSR 12.12.24 Notes

•    November 2024

HSR 11.14.24 Agenda
HSR 11.14.24 Presentation_With Notes
1115 Waiver Services Framework _HSR 11.14.24 Notes

•    October 2024

HSR 10.10.24 Agenda
HSR 10.10.24 Presentation_With Notes
1115 Waiver Services Framework_HSR 10.10.24 Notes

•    September 2024

HSR 9.12.24 Agenda
HSR 9.12.24 Presentation_With Notes
1115 Waiver Services Framework_HSR 9.12.24 Notes

•    August 2024

HSR 8.8.24 Agenda
HSR 8.8.24 Presentation_With Notes

•    July 2024

HSR 7.22.24 Agenda
HSR 7.22.24 Presentation_With Notes

District of Columbia’s 1115 Waiver History

On November 6, 2019, CMS approved the District of Columbia’s Behavioral Health Transformation Section 1115 Demonstration (Project No. 11-W-00331/3) which allowed the District to begin receiving federal financial participation effective January 1, 2020, through December 31, 2024, to provide services to address gaps in the behavioral health delivery system for serious mental illness (SMI), serious emotional disturbances (SED), and substance use disorder (SUD).

Since implementation in January 2020, the District has hosted annual Post Award Forums to allow the public an opportunity to provide meaningful comment on the implementation on the demonstration. Recordings of the annual Post Award Forums, as well as additional materials related to the Behavioral Health Transformation Demonstration, can be found here.