Individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage - and those accessing behavioral health services - will not experience a disruption in care due to the federal government shutdown. In addition, health care providers will continue to be paid for the services they provide. We will continue to monitor the situation closely and share updates if anything changes.
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. Read an IMD brochure to learn more.
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.
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.
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.
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.
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.
