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      1115 Behavioral Health Medicaid Waiver 

      Program Summary

      The Alaska Department of Health and Social Services (DHSS) has submitted a Section 1115 Behavioral Health Demonstration Waiver application to the Centers for Medicare & Medicaid Services (CMS) to develop a data-driven, integrated behavioral health system of care for children, youth, and adults with serious mental illness, severe emotional disturbance, and/or substance use disorders. The demonstration project also seeks to increase services for at-risk families in order to support the healthy development of children and adults through increased outreach and prevention and early intervention supports.

      Goals and Objectives

      The Alaska Behavioral Health 1115 Demonstration seeks to provide Alaskans with a comprehensive suite of cost-effective, high quality behavioral health services designed to ensure access to the right services at the right time in the right setting. The goals and objectives of the application are:

        Goal 1: Rebalance the current behavioral health system of care to reduce Alaska’s over-reliance on acute, institutional care and shift to more community- or regional-based care

        • Decrease use of inpatient hospital and emergency department care episodes.
        • Decrease use of residential out-of-home placements.
        • Increase regionally-based capacity for a continuum of intensive outpatient, day treatment, intensive case management, community and recovery support, home-based family, assertive community treatment, and ambulatory withdrawal management services.
        • Develop community-based, culturally appropriate behavioral health workforce capacity (i.e., implement additional Medicaid-reimbursed behavioral health provider types) to address existing workforce deficits.

        Goal 2: Intervene as early as possible in the lives of Alaskans to address behavioral health symptoms before symptoms cascade into functional impairments:

        • Provide universal screening to identify symptoms.
        • Provide brief, solution-focused interventions to prevent acute care.
        • Provide care as close as possible to the homes or regional-hub communities of Alaskans.

        Goal 3: Improve the overall behavioral health system accountability by reforming the existing system of care:

        • Contract with an Administrative Services Organization (ASO) to manage Alaska’s existing system of behavioral health care.
        • Improve the consistency of screening, assessment, and service/placement decisions through use of evidence-based and evidence-informed tools.
        • Standardize and streamline documentation requirements to reduce duplication of effort and facilitate coordination of care across all providers.
        • Support provider development of infrastructures necessary to coordinate care, report and achieve performance/quality measures, report per capita BH costs, and improve participant outcomes.

      Summary of Public Comment

      Alaska Section 1115 Demonstration Project Waiver Application

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