What They’re Watching: Gennifer Moreau, DHSS

Gennifer Moreau is the Director of the DHSS Division of Behavioral Health. She joins us in this edition of “What They’re Watching” to discuss Alaska’s Section 1115 waiver and behavioral health reform in the state.


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“I am spending most of my time on the Section 1115 waiver demonstration project for the state of Alaska to reform the behavioral health system under the Medicaid authority. On a positive note, the Section 1115 waiver allows states to innovate and be more creative in developing their Medicaid systems because it removes the constraints of the Medicaid state plan. So, on a positive note, it is the right thing for behavioral health. Behavioral health typically struggles under the Medicaid state plan rules because it’s a very medical model. So, [the 1115 waiver] is the right tool for behavioral health.

The challenges are that it’s extremely complex. It’s also emergent. There are crises that are on our street that are related to behavioral health that need immediate fixes. And this is a long, and arduous, and complicated process, so sometimes it’s hard to keep up the pace with the need, but it is the right fix.

What we’re doing, the innovation is we are targeting groups that tend to be served at the acute end of care — which is also the expensive end of care. That’s how the system was originally developed under Medicaid because that’s where we landed with the Medicaid state plan rules. So, the innovation is to identify those groups — and so we have our three target populations — and develop Continuums of Care that are designed around the needs of those populations. So, for example, our at-risk youth and their families are identified through social determinants that come from the Alaska longitudinal child abuse and neglect study. So, we used an Alaskan study out of the division of public health — Dr. Jerry Parrish is the epidemiologist — and we used the data from his study to develop the social determinants which are the criteria for those services. So, that’s unique and an Alaskan innovation that meets the needs of our most vulnerable population.”