The Centers for Medicare and Medicaid Services (CMS) has authorized the Utah Department of Health (UDOH) to use federal Medicaid funds to cover individuals receiving residential treatment as part of their care for substance use disorders. Previously, Medicaid coverage in these treatment facilities was blocked by federal Medicaid rules. These rules created a critical gap in Medicaid’s continuum of care.
Historically, substance abuse treatment through Medicaid was limited to facilities with 16 beds or fewer. With this authorization, the bed capacity limit is lifted allowing more treatment centers the ability to provide care to Medicaid members with substance use disorders. Many individuals coping with challenges like chronic homelessness or incarceration need substance use treatment. Additionally, they often benefit from a structured environment to receive services until they can get back on their feet. By authorizing Utah to expand the network of residential treatment providers, it inevitably increases the opportunities for members to access the care they need.
One example of individuals served by the new services are those who have successfully completed substance use treatment in jail and will soon be released. The Department of Workforce Services (DWS) has worked with Salt Lake County and its treatment program operator, Odyssey House, to establish the following process to help these individuals enroll in Medicaid and receive the appropriate level of treatment (which may include residential treatment):
- For individuals with an estimated release date within 30 days, Odyssey House can email an application and referral form to DWS for an individual in treatment.
- DWS will hold the application until release.
- Upon the individual’s release, Odyssey House staff will email DWS again, which will trigger the application to be processed.
With the addition of federal Medicaid funding, groups like Odyssey House, First Step House, and Valley Behavioral Health are considering how many treatment beds they can add to their programs. It is estimated that there may be approximately 250 treatment beds available early 2018.