In November of 2019, the Department of Health Care Finance (DHCF) and the Department of Behavioral Health (DBH) proposed a multi-year approach to transform behavioral health care in the District of Columbia. The two agencies began this initiative with a shared vision of establishing a whole-person, population-based, integrated Medicaid behavioral health system. The end goal is to build a system that is comprehensive, coordinated, high quality, culturally competent, and equitable. This work is being carried out in three phases: behavioral health service expansion (Phase I), managed care integration (Phase II), and integrated care payment models (Phase III).
Phase I of the District’s Medicaid behavioral health transformation efforts was initiated in 2019 with DHCF and DBH’s collaboration and joint development of the Section 1115 Waiver. The waiver is intended to provide a broader continuum of behavioral health services and supports for individuals with serious mental illness, substance use disorder, and or other behavioral health needs. Ten new benefits were added over the fiscal year through the waiver program.
DHCF and DBH embarked on Phase II with a primary goal of seamlessly integrating the continuum of behavioral health services into our managed care program. Effective February 2024, DHCF, in partnership with DBH, paused the planning for the April 1, 2024, carve-in of behavioral health services into managed care.
Behavioral health services continue to be available to all Medicaid and Alliance beneficiaries.
The expanded mental health and substance use disorder (SUD) service array, revised rates, and new reimbursement methodologies are not impacted by the decision to pause the carve-in. DHCF and DBH remain committed to improving the accessibility to high quality behavioral health services, including a range of evidence-based practices for Medicaid and Alliance beneficiaries.
The Integrated Care Forum meetings will resume in May 2024.
How can you stay informed?
Consider this page a one-stop shop for sharing information on Medicaid behavioral health transformation.
Both agencies will be posting informational bulletins, transmittals, Director Letters, etc. Below for your convenience as well on their respective websites.
Informational Bulletins
- Behavioral Health Integration Update: Authorizations and Standardized Tools [PDF]
- Behavioral Health Integration Update: Carve-In Date and Bridge Policies [PDF]
- Community Support [PDF]
Stakeholder Meetings
DHCF and DBH host monthly stakeholder meetings to share information, solicit feedback and offer training opportunities.
- Public Forum on Integrated Care where the public is welcome.
- Provider Meetings aimed at specific DBH providers.
Helpful Resources
- Glossary
- Frequently Asked Questions (FAQ) from consumers/enrollees/patients and their families - Coming Soon!
- Frequently Asked Questions (FAQ) from behavioral health care providers - Coming Soon!
- Integrated Care DC – A Learning Community for DC Medicaid Providers
For more information about this integration, contact DHCF and DBH at [email protected]