Behavioral health
We believe behavioral health—which includes care for our minds or bodies when substances are misused—is just as important as physical health care.
Under the Medicaid Transformation Project (MTP) 2.0, these programs support individuals who are receiving services for SUD treatment or serious mental illness. MTP 2.0 also includes SUD and other behavioral health services for people in prisons and jails, with the goal of continued recovery once they reenter the community.
What are IMDs?
IMDs, or "institutions for mental diseases," are defined as hospitals, nursing facilities, or other institutions of more than 16 beds regardless of licensure that are primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, which includes SUD.
SUD IMD program
This program allows Washington State to make improvements and use federal funds participation (FFP) for Medicaid SUD treatment services in IMD facilities. It relaxes restrictions on the use of federal funds to pay for people receiving SUD treatment in a mental health or SUD facility, for an average of 30 days.
- About
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Without this program, Medicaid rules prohibit use of FFP for services to individuals between 21-65 years of age when they are admitted to an IMD. The SUD IMD program allows us to cover more people and for longer.
- Benefits
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- State dollars continue to be matched by federal dollars that are repurposed for treatment.
- Reduced administrative burden for providers, plans, and Washington State.
- Increased availability of medication for opioid use disorder (MOUD) treatment options.
- Managed care organization (MCO) contracts now require providers to provide or make referrals for persons in need of MOUD therapies.
- Rules are changing to ensure that MOUD services and care coordination occur.
- Emergency rules are in place to ensure MOUD access.
Mental health IMD program
This program allows Washington State to purchase acute inpatient services (stays that last no more than 60 days) for Medicaid clients between the ages of 21 and 65 who reside in a participating dedicated large psychiatric facility that qualifies as an IMD.
- About
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The mental health IMD program helps address the ongoing challenge of accessing inpatient care. Access to the full array of mental health treatment options is vital to recovery for individuals experiencing mental illness. A continuum of treatment is important to ensure safe, healthy communities and quality outcomes.
- Benefits
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- Washington State can expand bed capacity, meaning more people can receive inpatient psychiatric care.
- Reduced administrative burdens for providers, plans, and Washington State.
- Providers who provide quality service can reduce costs through larger facilities.
- Facilities that provide care under this initiative can receive Medicaid funds (limited to stays of no more than 60 days).
- Medicaid clients will have access to more health care services at new settings that were previously ineligible.
Contingency management for SUD treatment program
This program is an evidence-based behavioral intervention for stimulant use disorder, opioid use disorder, and alcohol use disorder. Contingency management consists of a series of motivational incentives for meeting treatment goals. The motivational incentives may consist of cash equivalents (e.g., gift cards of low retail value), with restrictions placed on these incentives. The goal is continued progress toward recovery and testing negative for substance use.