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Behavioral Health System Reform

1115 Medicaid Behavioral Health Waiver  Get more details HERE​.

Behavioral Health Administrative Services Organization: Get more details HERE.

SB 74 included a series of measures aimed at reforming the behavioral health system.

  • AS 47.05.270(b) requires the department to develop and manage a comprehensive and integrated behavioral health program that uses evidence-based, data-driven practices to achieve positive outcomes for people with mental health or substance abuse disorders and children with severe emotional disturbances.
  • AS 47.07.036(f) requires the department to apply for a section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration projects focused on improving the state’s behavioral health system for Medicaid beneficiaries.
  • AS 47.07.900(4) was amended to remove the requirement that community mental health clinics be a state behavioral health grantee in order to enroll as a Medicaid provider.

A focus on behavioral health system reform was included as part of the Medicaid reform legislation because there is a shortage of psychiatric inpatient beds and residential substance use disorder (SUD) treatment programs in Alaska, a fragmented system of community-based behavioral health providers, and insufficient treatment services of any kind in rural areas. These shortages place a heavy burden on hospitals in urban areas, as well as the entire health care system, and severely limits access to care. Inadequate access to the appropriate level of care at the preventive, early intervention, and lower acuity end of the continuum of care, as well as the facility-based treatment end of the continuum, not only limits access for patients and burdens providers, it drives higher costs for the Medicaid program overall.

The 1115 waiver mandated by SB 74 will establish a network of behavioral health services at the community and regional level to reduce the need for crisis-driven and urban-based emergency, acute, and residential care by supporting development of missing components of the care continuum.

As the department explained in the SB 74 fiscal notes, the statutory requirement to develop and manage an integrated behavioral health program that uses evidence-based practices and improves accountability will be achieved through a contract with an Administrative Services Organization (ASO). The ASO will support all publicly funded behavioral health services administered by the department, including but not limited to the 1115 waiver services.

      Transforming Behavioral Health in Alaska:
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Updated 12/03/18