In November of 2019, the Department of Health Care Finance (DHCF) and the Department of Behavioral Health (DBH) proposed a multi-year approach to transform behavioral health care in the District of Columbia. The two agencies began this initiative with a shared vision of establishing a whole-person, population-based, integrated Medicaid behavioral health system. The end goal is to build a system that is comprehensive, coordinated, high quality, culturally competent, and equitable. This work is being carried out in three phases: behavioral health service expansion (Phase I), managed care integration (Phase II), and integrated care payment models (Phase III).
Phase I of the District’s Medicaid behavioral health transformation efforts was initiated in 2019 with DHCF and DBH’s collaboration and joint development of the Section 1115 Waiver. The waiver is intended to provide a broader continuum of behavioral health services and supports for individuals with serious mental illness, substance use disorder, and or other behavioral health needs. Ten new benefits were added over the fiscal year through the waiver program.
Now that the waiver is operational, the focus has shifted to integrating the continuum of behavioral health services into our managed care program, effective April 1, 2024. Integrating services into the managed care plans allows the plans to see the complete picture of the beneficiary/consumer needs, allowing them to better coordinate care. Planning and development efforts are underway as we focus on assessing provider and managed care plan readiness, completing a behavioral health services rate study, providing tailored technical assistance to behavioral health providers, and identifying the department-level changes necessary for DHCF and DBH.
How can you stay informed?
Consider this page a one-stop shop sharing information that comes out of Phase II Managed Care Integration. Both agencies will be posting informational bulletins, transmittals, Director Letters, etc. Below for your convenience as well on their respective websites.
- Behavioral Health Integration Update: Authorizations and Standardized Tools [PDF]
- Behavioral Health Integration Update: Carve-In Date and Bridge Policies [PDF]
- Community Support [PDF]
DHCF and DBH host monthly stakeholder meetings to share information, solicit feedback and offer training opportunities.
- Public Forum on Integrated Care where the public is welcome.
- Provider Meetings aimed at specific DBH providers.
- Frequently Asked Questions (FAQ) from consumers/enrollees/patients and their families - Coming Soon!
- Frequently Asked Questions (FAQ) from behavioral health care providers - Coming Soon!
- Integrated Care DC – A Learning Community for DC Medicaid Providers
For more information about this integration, contact DHCF and DBH at [email protected]