ST. GEORGE – The Centers for Medicare & Medicaid Services on Wednesday announced approval of a 2016 Medicaid waiver for Utah that allows the state to expand services to the homeless and those in-need.
The waiver is a part of a new policy from the federal agency to allow states to design demonstration projects that increase access to treatment for opioid use disorder and other substance use disorders.
The policies are seen as a part of President Donald Trump’s recent directive and provides states with greater flexibility to design programs that improve access to high-quality, clinically appropriate treatment.
The waiver allows Utah to expand Medicaid coverage to 4,000 – 6,000 Utah adults without dependent children. The approval also includes authority to use federal funds to provide residential substance abuse treatment services to Medicaid recipients.
The limited Medicaid expansion is seen as a critical part of the ongoing Operation Rio Grande taking place in Salt Lake City as many of those eligible under the waiver are a part of the area’s homeless population.
Phase two of Operation Rio Grande focuses on bringing additional treatment beds into the system to support individuals in recovery. The waiver approval will encourage treatment centers to begin offering services for Medicaid members. In anticipation of this waiver approval, multiple centers are planning to add roughly 180 beds within the next year.
Fox 13 News reports that more than 1,000 people have been arrested during operations to clean up the Rio Grande area, yet many of those arrested have been pushed toward treatment beds for substance abuse and mental illness.
“We are excited to announce approval of Utah’s waiver that will expand access to substance use disorder treatment,” said CMS Administrator Seema Verma. “I applaud Gov. Herbert for taking this critical step to address the opioid crisis and look forward to continuing to support Utah in their efforts.”
Previously, states had been required to build out their entire delivery system for SUD treatment while also meeting rigid CMS standards before Medicaid demonstration approvals could be granted. The new policy will allow states to provide greater treatment options while improving their continuum of care over time.
Utah’s program is part of a broader delivery system reform effort to address the needs of individuals with SUD, individuals who are chronically homeless and individuals within the justice system. The demonstration will also expand access to SUD treatment to a more complete continuum of services, including previously excluded residential treatment sites.
“I’ve always maintained the role of the federal government should be to provide states with the flexibility to be innovative in how they operate their Medicaid programs. Nobody knows how to address the unique challenges we face as a state better than we do,” Gov. Gary R. Herbert said.
“Today’s announcement from the Centers for Medicare and Medicaid Services will allow us to address a specific challenge – extending health care coverage, including substance abuse and mental health services, to the homeless population,” he said. “I applaud CMS for approving our waiver request and look forward to getting to work on providing these critical services.”
According to Fox 13 News, Utah will cover 30 percent of the costs while the federal government covers the remaining 70 percent.
While the waiver will be able to help up to 6,000 adults without children, a recent study from the Kaiser Family Foundation noted that an estimated 46,000 Utahns are caught the overall coverage gap.
Utah’s GOP-majority Legislature has rejected going to full Medicaid expansion as members argue that doing so would be a burden on taxpayers.
To be eligible, individuals may not earn more than 5 percent of the federal poverty level and must be chronically homeless or involved in the justice system through probation, parole or court-ordered substance abuse or mental health treatment.
Historically, substance abuse treatment through Medicaid was limited to facilities with 16 beds or fewer. Under the waiver, the bed capacity limit will be lifted, allowing more treatment centers the ability to provide care to Medicaid members with substance use disorders.
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