Alaska DHSS submits 1115 Waiver

Alaska Department of Health and Social Services submitted its 1115 Waiver to CMS last week.

According to the executive summary of the application, the goal is:

“to create a data-driven, integrated behavioral health system of care for Alaskans with serious mental illness, severe emotional disturbance, and/or substance use disorders. Because behavioral health challenges often stem from childhood trauma and other adverse experiences and have downstream effects on entire families that translate to higher costs associated with subsequent acute care and chronic health needs, this proposal also aims to establish networks of support for individuals and family members. The state will achieve these goals by creating a more robust continuum of behavioral health care services with emphasis on early interventions, community-based outpatient services, inpatient residential treatment when appropriate, and enhanced peer recovery supports.”

The waiver identifies three target populations who would receive an enhanced set of benefits

  1. Children, adolescents and their parents or caretakers with, or at risk of, mental health and substance use disorders
  2. Transitional age youth and adults with acute mental health needs
  3. Adolescents and adults with substance use disorders

The new Medicaid services for these target populations would include screening and assessment services, community-based outpatient services, acute intensive services, and recovery support services. The services would be tailored to the target population, as seen in the table below.

The services would be implemented in a three-year phase in plan.

Under the waiver, DHSS will contract with an Administrative Services Organization to manage Alaska’s behavioral health care system, but the exact services the ACO will provide are not yet finalized.

The application includes a fiscal projection conducted by Milliman of DHSS expenditures with and without the waiver. The projection shows just over $56 million in savings with the waiver. That analysis can be viewed here.

The Behavioral Health Demonstration waiver is currently available for public comments until March 17th.