Skip to content

1115 Behavioral Health Medicaid Waiver 

1115 Waiver for Substance Use Disorder (SUD) Services Approved by CMS

Approval of the 1115 Waiver for SUD Services allows the state to waive certain federal Medicaid rules to increase coverage of SUD treatment services. Under the 1115 Waiver, more community-based outpatient treatment options as well as new screening and intervention services will be available. Medication assisted treatment care coordination will also be covered. In addition, residential treatment facilities with more than 16 beds, prohibited from billing Medicaid under federal rules, will now be eligible for reimbursement. This will make approximately 66 more treatment beds available to Alaska Medicaid recipients suffering from an addiction.

Alaska Section 1115 Demonstration Project Waiver Application

1115 Waiver General Program Summary

The Alaska Department of Health and Social Services (DHSS) submitted a Section 1115 Behavioral Health Demonstration Waiver application to the Centers for Medicare & Medicaid Services (CMS) in January 2018. The purpose of the demonstration project is 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

Documents/resources related to Alaska’s Behavioral Health System Reform:

      Transforming Behavioral Health in Alaska:
      Innovation in Access, Quality & Cost

<<Back to Healthy Alaska Redesign News