Medicaid officials outline 1115 waiver requests: medical respite, short‑term housing supports and justice‑involved services

Medicaid program staff briefed the council on a package of proposed 1115 demonstration waiver changes intended to expand social and housing supports tied to clinical care.

A Medicaid representative said the department seeks authority for: continuous eligibility measures, nutrition supports, an expanded "community integration services plus" package that would add medical respite and recuperative care, and expanded rental and utility assistance for up to six months. "We're looking for 6 months of utility payment, 6 months of rent, as an authority," the presenter said, noting other states have secured similar approvals.

The waiver request also includes an authority to provide prerelease services for justice‑involved populations to support continuity of care and reentry. The representative described options for attaching Medicaid‑funded providers to prerelease plans and said CMS had signaled interest but that federal review backlogs could push final approvals into early next year; in the interim the state will extend its current waiver to avoid service gaps.

Staff said the changes would enable Medicaid plans and providers to support a broader set of social determinants (housing stability, medical respite after hospitalization and food supports) for people with complex needs. Council members asked implementation questions, including which organizations could provide medical respite and how levels of care would be defined. The presenter described four levels of medical respite ranging from short post‑hospital recovery to longer recuperative care, and said the department is drafting implementation guidance and will route memoranda and guidance documents to health plans and community partners.

No formal action was taken by the council on the waiver update; presenters asked to receive feedback as guidance and regulations are drafted.