WSR 19-21-041

HEALTH CARE AUTHORITY

[Filed October 9, 2019, 6:41 a.m.]

Title or Subject: Section 1915(b) Behavioral Health Waiver Amendment.

Effective Date: January 1, 2020.

Description: The health care authority (the agency) is submitting an amendment to the 1915(b) waiver to reflect the next implementation of the integration of mental health and substance use disorder services (collectively known as "behavioral health") into an integrated managed care (IMC) program under contract with apple health managed care organizations (MCO).

On January 1, 2020, the agency will implement IMC in the remaining regional service areas (RSA), which include Great Rivers, Salish and Thurston Mason. These RSAs consist of Thurston, Mason, Lewis, Grays Harbor, Wahkiakum, Cowlitz, Pacific, Kitsap, Jefferson, and Clallam counties. At this time, coverage previously provided by behavioral health organizations (BHO) for specialty behavioral health services will be transferred to MCOs across all regions of the state.

Once IMC is statewide, a waiver will no longer be necessary for BHOs. This amendment removes BHO program elements from the waiver. The waiver will continue to authorize enrollment into the behavioral health services only program for individuals who are not mandatorily enrolled in IMC. These remaining enrollees will continue to receive physical health medical services through other delivery systems, such as the agency's fee-for-service system, medicare, or primary care case management.

This waiver is expected to increase annual aggregate expenditures by four percent. Total expenditures for years one through five of the waiver are anticipated to be $2,733,962,207.

For additional information, contact Jessica Diaz, Managed Care Programs, 626 8th Avenue S.E., Olympia, WA 98501, phone 360-725-1177, TRS 711, email jessica.diaz@hca.wa.gov.