Oregon is one of the least prepared among states to serve residents who need and request treatment for substance abuse and addiction. Recently, the federal government approved a “waiver” system to cover treatment for members of the Oregon Health Plan.
After long negotiations, the Oregon Health Authority is preparing to initiate the Substance Use Disorder waiver program.
Steve Allen, Director of Behavioral Health with OHA, describes key things it will cover. “The ability to expand the access to residential treatment programs, so those programs that people would visit and stay in while they got treatment,” he said. “And those transition services for people to help them improve their lives as they move back to their communities.”
Allen says the Substance Use Disorder waiver will begin being implemented by January 2022. There are about 1.25 million people on the Oregon Health Plan.
A waiver is a negotiation with the federal government around how treatment gets paid for.
Centers for Medicaid and Medicare are providers for funding of all kinds of treatment services. Allen says “Oregon negotiated directly with the feds to create real and unique treatment plans that are good for Oregonians.”
Prior to the approval of the SUD waiver, any Institutions for Mental Disease (IMD) could not bill services to Medicaid. IMDs are settings of more than 16 beds that are primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services. The waiver now allows federal funds to match state funds for substance use treatment for Medicaid members in an IMD.
The waiver, which is effective April 8, 2021, through March 31, 2026, will allow Oregon to:
- Expand the continuum of care for people with substance use disorders.
- Improve access to care for substance use disorders, including outreach, initiation, treatment and recovery.
- Reduce use of emergency departments and inpatient hospital settings for treatment.
- Reduce readmissions to the same or higher level of care when the readmission is preventable or medically inappropriate.
- Increase rates of identification, initiation, and engagement in treatment for substance use disorders.
- Include housing support services in the treatment care plan.
