(WASHINGTON, DC) – Today, the District announced that it received approval to expand behavioral health services for Medicaid beneficiaries under the District's Medicaid Section 1115 Behavioral Health Transformation Demonstration, which was approved by the federal Centers for Medicare and Medicaid Services (CMS), within the U.S. Department of Health and Human Services. The demonstration, which is expected to provide services for more than 80,000 District residents who are enrolled in Medicaid and have a behavioral health diagnosis, will start on January 1, 2020.
“This first-in-the-nation demonstration shows the District’s commitment to fighting opioid and substance abuse and building a system of care that meets the behavioral health needs of District residents. Through this waiver, the District is transforming behavioral health services by expanding the array of evidence-based services to treat District residents with a serious mental illness or substance use disorder." said Wayne Turnage, Deputy Mayor for Health and Human Services and Director of the Department of Health Care Finance.
The demonstration is part of a broader effort outlined in the District’s Opioid Strategic Plan, Live.Long.DC— with goals to reduce opioid use, misuse and related deaths. The demonstration will expand the range of services offered, improve data collection and transitions, and create a new focus on improving community service delivery for both mental health and Substance Use Disorder (SUD) services. This is a first step in transforming Medicaid’s delivery of behavioral health services toward a more person-centered model focused on treatment, recovery, and whole person care. The demonstration will complement the State Opioid Response grant and the recently-awarded SUPPORT Act planning grant to increase all Medicaid providers’ capacity to diagnose, treat and provide SUD recovery services.
“Today, we are transforming behavioral health services for the Medicaid program, by expanding the array of evidence-based services to treat District residents with a serious mental illness and/or substance use disorders,”said Melisa Byrd, Senior Deputy Director/Medicaid Director of the Department of Health Care Finance (DHCF).
The demonstration will increase services available to District Medicaid beneficiaries by:
- adding residential and inpatient services for adults in Institutions for Mental Disease (IMDs),
- expanding crisis stabilization and mobile outreach services and adding crisis psychiatric treatment,
- adding transition planning services for individuals leaving a hospital, IMD, or other facility,
- providing comprehensive recovery support services (RSS) for individuals with SUDs,
- adding coverage for psychologists and other licensed behavioral health provider services to independently treat individuals diagnosed with SMI/SED and/or SUD,
- adding psychosocial rehabilitative services to assist those with SMI in social networking, independent living, budgeting, self-care, and other skills that affect their ability to live in the community and secure and retain employment,
- providing behavioral health services to complement trauma informed care,
- providing prevocational work training and employment services, and
- eliminating of the $1 copayment for prescriptions for medication assisted treatment (MAT).
“This demonstration helps ensure that residents have access to the behavioral health care and supports they need whether at home, in school or in the community to lead healthy and productive lives,” said Barbara J. Bazron, Ph.D., Director of the Department of Behavioral Health. “It also supports the integration of mental health and substance use disorders into our public health framework.”
The District of Columbia is one of the first states to receive approval of the 1115 Behavioral Health Transformation Demonstration. The Department of Health Care Finance and the Department of Behavioral Health collaborated to submit the District’s Medicaid Section 1115 Behavioral Health Transformation demonstration application. Materials related to the District's approved demonstration, including information on the public comment process, are available on DHCF’s website at: https://dhcf.dc.gov/1115-Waiver-Initiative.
The Department of Health Care Finance is the District’s State Medicaid Agency. The mission of the Department of Health Care Finance is to improve health outcomes by providing access to comprehensive, cost-effective and quality healthcare services for the residents of the District of Columbia.