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DHHS outlines recent Medicaid service additions and waivers: doula care, adult dental, mobile crisis, DRF beds and reentry supports
Summary
In a detailed handout, DHHS reviewed service additions and state plan/waiver changes enacted since 2019 — including adult dental, doula coverage, mobile crisis teams, designated receiving facility (DRF) rate increases and a waiver for transitional reentry supports for people leaving correctional facilities.
Department of Health and Human Services officials told House Finance Division 3 on March 5 that the department has implemented or requested a broad set of Medicaid service additions and waivers since 2019. The department provided a handout that enumerated nearly 39 service or eligibility changes enacted or pursued in recent years; Division members asked about costs, implementation timing and the populations served.
Highlights from the DHHS presentation included: • Adult dental benefit: Implemented April 2023; DHHS said the benefit was intended to include denture coverage for some long‑term settings and to lower emergency‑room use for dental conditions. DHHS prepared a state‑plan amendment to expand access and detailed related cost‑sharing decisions. • Doula and lactation services: The legislature added doula coverage and expanded lactation service settings. DHHS said rulemaking with the Office of Professional Licensure and Certification (OPLC) was required before implementation and that short‑term costs may be offset over time by improved maternal outcomes and reduced emergency‑care use. • Mobile crisis and community behavioral health: DHS described obtaining enhanced federal match opportunities to build mobile crisis teams so communities get an 85% federal match for qualifying services; the program is part of a broader effort to expand community‑based mental‑health supports and reduce inpatient backups. • Designated receiving facilities (DRFs) and transitional housing: The department described targeted rate increases to expand DRF beds and transitional/supportive housing intended to reduce emergency‑room backups and improve discharge options from hospitals and state facilities. • Reentry and discharge supports: DHHS talked about a waiver to provide certain transitional services and discharge prescriptions for people leaving correctional settings. The state intends those targeted, budget‑neutral services to reduce recidivism and emergency‑room use by ensuring timely medications and community provider connections at release. • Home and community‑based presumptive eligibility and other waiver work: DHHS has filed waivers (including an 11‑15 waiver renewal) to expand institutional alternatives and to allow presumptive eligibility for home and community‑based care while formal eligibility paperwork is processed.
Committee members asked about the populations reached, the number of beds and locations for DRFs, and the ability to staff expanded services. DHHS said some capacity is constrained by workforce shortages — particularly behavioral‑health clinicians and home‑care workers — and that sustaining services statewide requires continued investments. DHHS committed to returning with additional data on program counts (beds, targeted populations) and the estimated annualized costs for the notable service additions.
Public commenters and advocates who spoke during the meeting asked the committee to consider the fiscal and access tradeoffs of co‑pays and premiums while preserving gains on mental‑health, maternal and dental coverage.
