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National Evaluation of Medicaid Demonstration:Home- and Community-Based Alternatives toPsychiatric Residential Treatment Facilities
Implementation Status Report as of October 1, 2008
Final
December 3, 2008
Submitted to:
Effie George, PhDCenters for Medicare & Medicaid ServicesDisabled and Elderly Health Programs GroupDivision of Advocacy & Special Initiatives
Prepared by:
IMPAQ International, LLC10420 Little Patuxent Parkway, Suite 300Columbia, MD 21044Phone: (443) 367-0088Fax: (443) 367-0477On the web: www.impaqint.com
Westat, Inc.1650 Research BoulevardRockville, MD 20850Phone: (301) 251-1500Fax: (301) 610-4820On the web: www.westat.com
Contract Number:
HHSM-500-2006-00007I, Task Order # 2
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Community-Based Alternatives to Psychiatric Residential Treatment FacilitiesImplementation Status ReportDecember 2008
Section PageI Background and Introduction.......................................................................... 1II Planned Demonstration waiver Administration, Services,Funding, and Enrollment, by State.................................................................. 5 Alaska................................................................................................................... 6Georgia................................................................................................................. 15Indiana.................................................................................................................. 25Kansas.................................................................................................................. 35Maryland.............................................................................................................. 43Mississippi............................................................................................................ 53Montana............................................................................................................... 58South Carolina..................................................................................................... 64 Virginia................................................................................................................. 74III Cross State Implementation Status Summary................................................ 80Current Status Table........................................................................................... 8
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Narrative Summary of
Successes, Barriers to Success, and
Lessons Learned.........
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Section I. Background and Introduction
This report provides an overview of the status of the Medicaid Community-based Alternatives toPsychiatric Residential Treatment Facilities Demonstration Program that is currently being implemented in nine States. The structure of the report is as follows: Section I provides thebackground information on the Demonstration waiver program as well as its evaluation. Section IIprovides an overview of the Demonstration waiver program plans for each of the nine States, asdescribed in their approved Demonstration waivers. Section III provides a cross State comparisontable and discusses some of the successes, barriers to success, and lessons learned by the nine Statesduring the planning and beginning implementation stages of their Demonstration waiver programs.
Background
The New Freedom Initiative (NFI) was announced on February 1, 2001, as part of a nationwideeffort to remove barriers to community living for people with disabilities. It represents an importantstep towards ensuring that all Americans have the opportunity to learn and develop skills, engage inproductive work, and choose where to live and participate in community life. The New Freedom Commission on Mental Health (the Commission), created on April 29, 2002, aspart of the NFI, was charged with making recommendations to the President that would enableadults with serious mental illnesses and children and youth with serious emotional disturbances tolive, work, learn, and participate fully in the their communities.On July 26, 2003, the Commission released its final report,
Achieving the Promise: Transforming Mental HealthCare in America.
The final report outlined significant problems associated with providing community-based alternatives to children and youth with serious emotional disturbances. Children,youth, and families typically have little influence over decisions affecting service delivery, planning,and the use of financing to deliver care. When comprehensive community-based options are notavailable children and youth are often placed in out-of-State facilities. The Commission’s final report sought to help remedy these problems by specifically recommending that a demonstration be conducted in order to allow The Centers for Medicare & Medicaid Services(CMS) to develop reliable cost and utilization data to evaluate the impact of MedicaidDemonstration waiver services on the effectiveness of community placements for children and1
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