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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

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112. SUD Program Benefits. Effective upon CMS’s approval of the SUD Implementation Plan, in Attachment C, the demonstration benefit package for Medicaid beneficiaries will include SUD treatment services, including services provided in residential and inpatient treatment settings that qualify as an IMD, which are not otherwise matchable expenditures under section 1903 of the Act. The state will be eligible to receive FFP for Medicaid beneficiaries who are short-term residents in IMDs under the terms of this demonstration for coverage of medical assistance, including OUD/SUD services, that would otherwise be matchable if the beneficiary were not residing in an IMD once CMS approves the state’s Implementation Plan. CMS approved the SUD Implementation Plan on July 10, 2018. The state will aim for a statewide average length of stay of 30 days or less in residential treatment settings, to be monitored pursuant to the Monitoring Protocol as outlined in STC 57, to ensure short- term residential stays.

Under this demonstration beneficiaries will have access to high quality, evidence-based OUD/SUD treatment services across a comprehensive continuum of care, ranging from residential and inpatient treatment to ongoing chronic care for these conditions in cost- effective community-based settings.

113. Recovery Residence Support Services. RRSS are non-clinical activities necessary to support beneficiaries recovering with SUD, which support their independence in the community through skills training and coaching. RRSS removes barriers to recovery of SUD and support continued engagement in the SUD recovery process.

a. RRSS Eligibility: Individuals eligible for RRSS must be individuals who are ages 18 or older, enrolled in Medicaid either through a Medicaid state plan eligibility group or through the FFCY demonstration population. Individuals must also meet the following eligibility criteria:

i. Be participating in a Behavioral Health Conditional Dismissal Program (BHCDP) or have received pre-release services under the Reentry demonstration initiative;

ii. Reside in an approved Recovery Residence;

iii. Meet American Society of Addiction Medicine (ASAM) Level of Care 2.7 or less, and

iv. Be experiencing homelessness, unemployment, or have a history of criminal justice involvement.

b. RRSS Services: Beneficiaries may receive RRSS for up to 90 days per rolling year. Activities and services included in RRSS are outlined in the RRSS Service Description Attachment J. Components of the RRSS Service Description include a list of the services covered under the RRSS program, and the associated service descriptions.