Kentucky's 1115 Waiver for SUD Incarceration Initiative
Kentucky seeks Medicaid waiver to provide substance abuse treatment for incarcerated individuals, promoting better health outcomes and post-release care coordination. This novel initiative aims to leverage federal Medicaid matching funds to ensure high-risk populations receive necessary treatment within correctional facilities and continuity of care upon release.
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Presentation Transcript
1115 SUD Incarceration Legislation and Medicaid Initiative HB352 Passed Legislation (April 15, 2020) Presented to the Substance Use Recovery Task Force July 14, 2020
HB 352 Substance Abuse Treatment for Incarcerated Individuals - Medicaid Demonstration Waiver: https://apps.legislature.ky.gov/recorddocuments/bill/20RS/hb352/bill.pdf Page 63, within ninety days after the effective date of this Act, the Department for Medicaid Services shall develop and submit an application for an 1115 demonstration waiver under 42 U.S.C. sec. 1315 to provide Medicaid coverage for substance use disorder treatment, including peer support services, to individuals incarcerated for a conviction under KRS Chapter 218A. Upon approval of the waiver, the cost of treatment for a substance use disorder or patient navigation provided by a licensed clinical social worker shall be a covered Medicaid benefit for an incarcerated individual. Page 77, The Department of Corrections is directed to participate and assist in the development. Currently the Centers for Medicare and Medicaid Services (CMS) does not allow for State Medicaid Agencies to cover the cost of services to incarcerated individuals, except when discharged for 24 hours. 1
What is an 1115 Waiver? 1115 Waiver An 1115 waiver is often described as a pilot or demonstration project that is likely assist in promoting the objectives of the Medicaid program. The purpose of the demonstration is to give states additional flexibility to design and improve their programs. An 1115 demonstration project presents an opportunity for states to institute reforms that go beyond just routine medical care, and focus on evidence-based interventions that drive better health outcomes and quality of life improvements. A demonstration must also be "budget neutral" to the Federal government, which means that, during the course of the project, Federal Medicaid expenditures will not be more than Federal spending without the demonstration. 2
Kentuckys 1115 SUD Incarceration Initiative Kentucky is requesting approval from the Centers for Medicare and Medicaid Services (CMS) for an amendment to its Medicaid Substance Abuse Disorder (SUD) 1115 waiver to authorize federal Medicaid matching funds for the provision of SUD treatment to eligible incarcerated individuals. Coverage for these services is requested for persons incarcerated in state and county facilities. The objective of the amendment will be twofold: Provide SUD treatment to eligible incarcerated individuals in order to ensure this high risk population receives needed treatment before release, and to strengthen follow up care with a Medicaid provider after release by paying for SUD treatment while incarcerated; and Allow the recipient s chosen MCO to coordinate aftercare with a Medicaid provider 30 days before release. Kentucky plans to retain and enhance the existing SUD programs in the state and county facilities. Kentucky will be the first state in the nation to request this type of SUD incarceration amendment. The entire initiative will be pending CMS approval. 3
Kentuckys 1115 SUD Incarceration Initiative Progress The Department for Medicaid Services (DMS), Department for Behavioral Health (DBHDID), Office of Inspector General (OIG), and the Department of Corrections (DOC) developed a united team to work on Kentucky s initiative. The team has been meeting on a regular basis since May 2020. The Department for Medicaid Services has been communicating with CMS since May 2020. Next Steps and Estimated Time Frame Submit amendment draft, conference call and revision with CMS in July Post for public comment August 2020 Public comments will be reviewed and receive a response and consideration for revisions in this amendment, September 2020 Final submission to CMS for review and approval September 2020 Timeline for CMS approval has not been determined by CMS due to internal guidance being developed 4
For Additional Information Contact: Leslie Hoffmann Chief Behavioral Health Officer Department for Medicaid Services leslie.hoffmann@ky.gov 5
