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Indiana Family and Social Services Administration Office of Medicaid Policy and Planning 1115 SUD Waiver: IHCP Presentation October 19, 2017
Indiana Family and Social Services AdministrationOffice of Medicaid Policy and Planning
1115 SUD Waiver:
IHCP Presentation
October 19, 2017
What the 1115 SUD Waiver Does
• Authorizes stays in institutions for mental disease (IMDs)
– Inpatient : up to 15 calendar days
– Residential: up to an average of 30 calendar days
• Authorizes reimbursement structure for residential level of care
• Coverage of Addiction Recovery Management Services (ARMS) – State Plan Authority
Additional Action Around Waiver
• SUD incentive payments
• Updated Indiana Medicaid rules
• Updated DMHA certification standards
– Adopting American Society of Addiction Medicine (ASAM) standards and quality measures
• Exploration around housing opportunities
IMD Stays: Residential
• ASAM 3.1 – Clinically Managed Low-Intensity Residential Services
• 24- hour Structure with available trained personnel
• At least five hours of clinical service per week
• Prepare for outpatient treatment
• ASAM 3.5 – Clinically Managed High –Intensity Residential Services
• 24-hour care with trained counselors to stabilize multidimensional imminent danger
• May step down to ASAM 3.1 or prepare for outpatient treatment
IMD Stays: Residential
• Included in the rate:
– Individual and Group Therapy
– Skills Training and Development
– Peer Recovery
– Medication Training and support
– Case Management
– Drug Testing
• Excludes room and board
IMD Stays: Residential
• Enrollment:
– Provider Type 35 (Addiction Services)
– Provider Specialty X (Residential Addiction Treatment Facilities)
Examples of ASAM level facilities in Indiana
Addiction Recovery
Management Services (ARMS)
• Services:
– Recovery-focused case management
– Addiction-focused peer recovery support
– Recovery education and relapse prevention
• Available to all (no service package required)
ARMS: Recovery-Focused Case
Management
• Specific services:– Development of a needs assessment focusing on needs identification
of the member in order to determine any medical, educational, social, or other services to assist with a substance use disorder diagnosis
– Development of an individualized integrated care plan to identify the rehabilitative activities and assistance needed to accomplish the objectives of the plan
– Referral or linkage activities that help link the member with services that are capable of providing needed rehabilitative services
– Follow-up with member, family members, nonprofessional
caregivers, providers, or other entities
ARMS: Addiction-Focused
Peer Recovery Support
• Specific services:
– Mentoring or coaching through a one-on-one relationship to encourage, motivate, and support a peer who is seeking to establish or strengthen his or her recovery
– Connecting a peer with professional/nonprofessional services and resources available in the community that can help meet his or her individual needs on the road to recovery
– Facilitating or leading recovery-oriented group activities
ARMS: Recovery Education
and Relapse Prevention
• Specific services:
– Providing substance-use disorder diagnosis patient education services
ARMS: Housing Opportunities
• Specific services:
Contact Information
Rebecca (Becky) BuhnerDeputy Director – Addiction and Forensic Treatment
FSSA/Indiana Division of Mental Health and Addiction402 W. Washington, W353Indianapolis, Indiana 46204317.232.7935
