A Medicaid rule that's been on the books since the program was created bars states from using federal money on care provided in many residential mental health and substance use treatment facilities with more than 16 beds.
That presents a dilemma for New Hampshire, where officials want to open up a 36-bed adolescent treatment program at the Sununu Youth Center in Manchester. So now, the state is asking the federal government to make an exception to this so-called “IMD exclusion” in hopes that doing so would let it move forward with its existing plans to expand addiction treatment services.
“We can open up 16 [beds] without the waiver, but in order to open up the sixteenth through the thirty-sixth beds, we need this waiver in place,” says DHHS Commissioner Jeff Meyers.
Meyers says he’s been in ongoing conversations with federal officials about New Hampshire’s waiver application and is optimistic that it will get approved. If it goes through, he says it could pave the way for more treatment options beyond just the Sununu Center.
“This waiver will open up the possibility not only for example, at the new 36-bed unit at the Sununu Center, but private companies as well to obtain Medicaid reimbursement,” Meyers said. “By opening up this funding stream, it really increases the potential to add capacity for treatment services in New Hampshire because there’s new federal money that is helping to pay for some of these services.”
In its application to the federal government, New Hampshire notes that many young people end up being sent out of state or get in trouble with the law because they can’t get the treatment they need closer to home.
The application also reports that some 7,500 people, on a quarterly basis, receive treatment for substance use disorders through the state’s Medicaid expansion program.