Providers, recipients, and other interested
individuals will have the opportunity to provide input on the Alabama Medicaid
Agency Section 1115 Institutions for Mental Disease Waiver for Serious Mental
Illness (SMI) 1115(a) Demonstration program during November public forums in
Daphne, AL and Montgomery, AL.
Written comments concerning the 1115 Institutions for
Mental Disease Waiver for Serious Mental Illness (SMI) will be accepted
starting November 7, 2023, and are due December 7, 2023. Send comments to the
following email address: PublicComments@Medicaid.Alabama.gov or mail hard copy to: Administrative Secretary, Alabama
Medicaid Agency, 501 Dexter Avenue,
P.O. Box 5624,
Montgomery, Alabama 36103- 5624. All written comments will be
available for review by the public during normal business hours at the above
address. The scheduled public forum(s) will be held:
Our Mission - to provide
a system of financing health
care for eligible
Alabamians in accordance with established statutes
and Executive Orders.
The annual
forums are a requirement by the Centers for Medicare and Medicaid Services
(CMS) for the 1115 Demonstration Waiver
under which the SMI program
operates. The waiver
was originally approved on May 20, 2022.
The goal of the
SMI Demonstration is to maintain and enhance access to mental health services
and continue delivery system improvements for these services to provide more
coordinated and comprehensive treatment of Medicaid recipients with SMI. This demonstration will provide the state with the authority to provide
high-quality, clinically-appropriate treatment to recipients with SMI while
they are short-term residents in residential and inpatient treatment settings
that qualify as an Institute for Mental Diseases (IMD) in Baldwin and Mobile
counties. Medicaid Alabamians who are eligible for inpatient behavioral health
services will be able to access services via the IMDs participating in the
demonstration, regardless of their county of residence. It will also support
state efforts to enhance provider capacity and improve access to a continuum of
treatments for SMI. During the demonstration period, the state seeks to achieve
the following goals which align with the SMI SMDL #18-011:
- Reduced utilization and lengths of stay in
emergency departments (EDs) among Medicaid beneficiaries with SMI or Serious Emotional
Disturbance (SED) while awaiting mental
health treatment in specialized settings;
- Reduced preventable readmissions to acute care hospitals and residential settings;
- Improved availability of crisis stabilization
services, including services made available through call centers and mobile
crisis units, intensive outpatient services, as well as services provided
during acute short-term stays in residential crisis
stabilization programs, psychiatric hospitals and residential treatment settings
throughout the state;
- Improved access to community-based services
to address the chronic mental health care needs of beneficiaries with SMI or SED,
including through increased integration of primary and behavioral health care;
and
- Improved care coordination, especially continuity of care in the community
following episodes of acute care in hospitals and residential
treatment facilities.
CMS expects the state to achieve the goals on a statewide basis despite
authorizing expenditure authority on less-than-a statewide basis since the
state will concurrently implement initiatives that improve community-based
mental health care.
Information on the Serious
Mental Illness Waiver Program (SMI) is available on the following website: