and Human Services, Division of Alcohol and Substance Abuse
September 27, 2013
Report on the Detoxification Services Planning Process and Resulting Recommendations as per the Save Medicaid Access and Resources Together (SMART) Act
Senate Bill 2840- Public Law 97- 0689
The Save Medicaid Access and
Resources Together (SMART) Act (P.A. 97-689) made two changes in the Illinois
Medicaid Program for our clients with substance use disorders who are admitted
to hospitals for in-patient detoxification services.
First, the new law placed
limitations and required concurrent review for every hospital detoxification
stay within 60 days of a previous detoxification stay. Second, it required the
Department of Healthcare and Family Services (HFS), along with our sister
agency, the Division of Alcoholism and Substance Abuse (DASA) of the Department
of Human Services (DHS), to “convene a workgroup to develop recommendations for
quality standards, diversion to other settings, and admission criteria for
patients who need inpatient detoxification”. Pursuant to P.A. 98-104 and
stakeholder involvement, these recommendations are being published.
We understood from the outset
that restrictions on hospital admissions and readmissions would not alone
achieve the State’s goal: to facilitate access to medically appropriate
detoxification services, in the most appropriate setting, with appropriate
linkages to community based substance abuse treatment and recovery support services.
That is why we are working with providers and managed care entities to build
integrated delivery systems around these clients, which will offer a network of
health, behavioral health and social services, with assistance from a care
coordinator to help navigate the system. In the short term, we will test the
effectiveness of these linkages through a demonstration program which partners
hospitals and community-based providers.
This report is the product of a
deliberative process that included representatives from hospitals,
community-based providers, managed care entities and state agencies. We invite
your feedback and comments, as we set about to implement these new policies. We
are convinced that the implementation of new policies, programs and protocols
with greater access to medication assisted treatment, and a cohesive and
coordinated approach to care will improve health outcomes for these clients
with behavioral health needs.
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