The Centers for Medicare and Medicaid Services announced its approval of a 2016 request from the state of Utah to expand Medicaid services 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.
This limited expansion of Medicaid is a critical element of Operation Rio Grande, as many of the newly eligible recipients will be members of the homeless population. Phase two of the operation 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.
“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 the Utah in their efforts.”
The program will begin enrolling newly eligible members immediately.
“I've always said that the federal government should give states the flexibility to innovate in how they operate their Medicaid programs,” explained Gov. Gary R. Herbert. “Nobody knows how to address the unique challenges we face as a state better than we do. Today's announcement allows us to address the specific challenge of extending health care coverage — including substance abuse and mental health services — to the homeless population. I commend the Trump administration for approving our waiver request, and look forward to providing these critical services.”
"The approval of this waiver is significant for the most vulnerable people in our communities,” said Senate President Wayne Niederhauser. “It will empower more effective solutions to help those experiencing poverty and homelessness. I appreciate the current administration for recognizing the merits of our objectives."
In order to be eligible, individuals may not earn more than five 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.
“We appreciate the Trump administration’s effort to approve these waivers based on our requested timeline,” said Utah House Speaker Greg Hughes. “In all our conversations, they have recognized our needs and the importance of this critical step to help the neediest in our society. These waivers will help further our execution of Operation Rio Grande and the implementation of the Justice Reinvestment Initiative. I’m proud of the unprecedented partnerships we have formed through our multi-jurisdictional effort and look forward to our continued collaboration and success in changing people’s lives by giving them a hand up.”
The Utah Department of Health (UDOH) submitted the waiver for CMS consideration on July 1, 2016. Elements of the request were outlined in legislation sponsored by Rep. Jim Dunnigan and passed during the 2016 legislative session.
“After working on this issue for the past several years, I'm excited for CMS to have finally signed off on our plan,” said Rep. Dunnigan. “This was a bipartisan effort, and there was broad support for the legislation that lead us here today. I look forward to continuing to work with all the parties involved to now implement this important program.”
This waiver approval does not include the proposed amendments that were submitted to CMS in August 2017 which included a work requirement and limitation on eligible months of coverage. The Utah Department of Health will continue to work with CMS to obtain authorization for these additional flexibilities in order to ensure expansion efforts are sustainable.