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, Alabama and Montgomery, Alabama.
Written comments concerning the 1115 Institutions for Mental
Disease Waiver for SMI will be accepted starting November 7, 2024, and are due
December 7, 2024. Send comments to the following email address: PublicComment@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:
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 inpatient treatment
settings that qualify as an Institute for Mental Diseases (IMD) in Baldwin and
Mobile counties. Medicaid Alabamians who are eligible for inpatient psychiatric
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:
https://medicaid.alabama.gov/content/4.0_Programs/4.2_Medical_Services/4.2.6_Mental_Health/4.2.6.2_SMI_Waiver.aspx