Medicaid Under the ACCESS Demonstration Program | CASAColumbia

Maximizing the Use of Medicaid Under the ACCESS Demonstration Program: An Opportunity for Experimentation

Maximizing the Use of Medicaid Under the ACCESS Demonstration Program: An Opportunity for Experimentation

Published: April 1993

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Background

In 1993, alcohol and other drug dependency affected an estimated half of the homeless, severely mentally ill population. The Centers for Medicare & Medicaid Services (CMS) in the U.S. Department of Health and Human Services (DHHS) sought to facilitate a more integrated set of services for this population through the ACCESS demonstration projects funded under the Stewart B. McKinney Homeless Assistance Act. This white paper was designed to assess how the Medicaid program might be employed to help pay for needed services.

Methods

CASAColumbia researchers conducted a review of federal and state laws and regulations related to the use of Medicaid to support the provision of integrated health care services—including mental health and addiction services—under the ACCESS demonstration program. 

Results

This report is a resource for state and local officials applying for ACCESS grants to strengthen their systems of treatment, housing and support for homeless people with severe mental illness. It provides summaries of how to use Medicaid to finance health and related services for this population and of relevant restrictions on use of the funds.

Recommendations

Although a variety of alternative approaches are identified as being available to states, states are encouraged to consider not only what is possible, but also what is optimal, and to put together more visionary approaches that push the envelope.

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