The state seeks to address the mental health, substance use, and housing crises
Vermont Business Magazine On April 30, Vermont’s Agency of Human Services (AHS) submitted a request to the federal Centers for Medicare and Medicaid Services (CMS) to amend its Global Commitment to Health (Global Commitment) demonstration. This agreement grants Vermont flexibility in utilizing Medicaid dollars.
Since its approval in 2005, the Global Commitment demonstration has played a pivotal role in broadening access to health care coverage, strengthening Vermont’s public health and health-related services infrastructure, and driving reforms in health care payment and delivery. Through this amendment request, Vermont aims to expand access to care for Vermonters with mental health conditions and substance use disorders (SUD), provide housing and other supports to promote whole-person health, and implement a new payment model for hospitals.
Vermont’s proposed amendment includes the following features:
· Make Community Rehabilitation and Treatment (CRT) and Mental Health Under 22 benefits entitlements. CRT and Mental Health Under 22 offer mental health benefits to Vermonters with serious mental illness (SMI) and serious emotional disturbance (SED). Vermont has requested to transition these benefits to being entitlements under the Medicaid program so that they are more easily accessible to Medicaid enrollees with SMI and SED.
· Cover all costs for residential mental health and SUD treatment. Current federal rules prohibit Medicaid from covering room and board for most stays at residential mental health and SUD treatment facilities. Vermont is requesting to cover room and board for the duration of Medicaid enrollees’ medically necessary treatment at residential mental health and SUD facilities, excluding facilities that the federal government designates as institutions for mental diseases.
· Provide new medical respite and rent/temporary housing benefits. Vermont seeks to offer up to six months of medical respite and rent/temporary housing, as clinically indicated, to Medicaid enrollees with a history of homelessness (including if they are currently or formerly homeless) or who are at risk of homelessness and meet other clinical eligibility criteria.
· Support capacity building among community-based organizations, social services providers, other community partners, and the state so that they can successfully deliver new Medicaid-covered housing services.
· Add an environmental and assistive adaptations benefit to the Developmental Disabilities Services benefit package.
· Implement an innovative new way to pay hospitals for Vermonters enrolled in Medicaid.
Vermont is also seeking Medicaid funding for justice-involved reentry services prior to release from a correctional facility, however, that authority will be approved through a separate process over the next several months. Vermonters can learn more about this and other Medicaid policy updates by emailing [email protected] to join the Global Commitment Register listserv or by visiting the Vermont Global Commitment Register website.
AHS will work with CMS to reach an agreement on this proposal over the next year. If approved, implementation will take additional years to complete. While time-consuming, this agreement remains one of Vermont’s most powerful tools to invest in health and wellbeing for Vermonters.
Source: 5.2.2024. Waterbury, VT – Agency of Human Services humanservices.vermont.gov
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