State submits MTP waiver renewal application to keep improving Apple Health

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State submits MTP waiver renewal application to keep improving Apple Health

Today, the Health Care Authority (HCA) and Department of Social and Health Services (DSHS) submitted the waiver renewal application for the Medicaid Transformation Project (MTP).

What’s MTP and why renew it?

MTP is our state’s Section 1115 Medicaid demonstration waiver, which is an agreement between HCA and the Centers for Medicare & Medicaid Services (CMS). It allows our state to implement new policies and use federal Medicaid funds to improve Apple Health, Washington’s Medicaid program. Work under MTP benefits those enrolled in Apple Health.

We are in the last year of the current MTP waiver, which ends December 31, 2022. If CMS approves our application, MTP will continue for an additional five years—from 2023-2027—to develop innovative projects, activities, and services for Apple Health.

What’s being requested in the renewal?

We are asking for CMS approval to continue the current MTP programs, along with these additional program expansions:

  1. Long-Term Services and Supports (LTSS) supports Washington’s aging population and family caregivers who provide care for their loved ones.
    • Expanding to include rental subsidies, coordinated personal care, guardianship and decision-making supports, and presumptive eligibility. This will provide more support and services for aged, blind, and disabled adults who are applying for and receiving home and community-based services.
  2. Foundational Community Supports (FCS) helps people with complex care needs find stable housing and employment.
    • Expanding the age requirement to “16 and older” so transition-age youth and youth exiting foster care can receive supportive housing services.
    • Expanding the eligibility criteria for those eligible for supported employment services, including individuals exiting a correctional facility or having an “on parole” status.
  3. Substance use disorder (SUD) IMD* helps people with an SUD receive treatment and inpatient services at an IMD*.
    • Expanding to provide contingency management for qualifying adults. (Contingency management is a treatment method for individuals with an SUD. It helps them stop using non-medical drugs and other stimulants.)
  4. Mental health IMD* helps people with a mental health issue receive treatment and inpatient services at an IMD*.
    • Continuing the program without changes.

In addition, we’re asking for CMS approval for these new programs:

  1. Taking Action for Healthier Communities (TAHC), which builds on the work currently named “Initiative 1: transformation through Accountable Communities of Health (ACHs) and Indian health care providers (IHCPs).” Important note: although ACHs and IHCPs are part of the current MTP waiver, TAHC will be a new program under the renewal. ACHs will focus on developing and implementing Community Hubs and health-related services, health equity, and community-based workforce needs within their communities. We will work with Tribes and IHCPs to develop and implement a similar suite of services, tailored by and for Native people.
  2. Continuous Apple Health enrollment for children, where children in Apple Health do not have breaks in coverage because of changes in income through their sixth birthday.
  3. Re-entry coverage for continuity of care, where individuals exiting a correctional or treatment facility have health care coverage immediately upon reentering the community.
  4. Apple Health postpartum coverage extension, where individuals have health care coverage for twelve months (one year) after their pregnancy ends. This program complements postpartum coverage and funding that was first made available through the American Rescue Plan Act.  
  5. Washington Integrated Care Assessment (WA-ICA), which helps assess a provider or clinic’s level of integration for physical and behavioral health care. WA-ICA also provides technical assistance and targeted incentives for providers/practices to begin or continue their efforts in advancing clinical integration.

What’s next?

We hope to hear back from CMS in late 2022 on their decision to renew MTP. Until then, we will work with partners, stakeholders, and others to continue to develop the current and new programs and expansions requested under the MTP waiver renewal.  

Where can I find more information?

*IMD stands for institution for mental diseases. IMDs are defined as hospitals, nursing facilities, or other institutions with more than 16 beds that primarily provide diagnosis, treatment, or care of persons with mental illnesses. This includes medical attention, nursing care, and related services.

We acknowledge the term “mental disease” may be harmful or stigmatizing. We use it in this context only to reflect the legal terminology used in statute.