State of Alabama
09/21/2026 | Press release | Distributed by Public on 09/21/2026 11:55
Intent to Submit 1115 Serious Mental Illness (SMI) Institutions for Mental Disease (IMD) Waiver Renewal Application
Pursuant to 42 CFR ยง431.408, the Alabama Medicaid Agency (Medicaid) notifies the public that it intends to submit a Section 1115 Demonstration waiver renewal application to the Centers for Medicare and Medicaid Services (CMS). Through this renewal application, Medicaid is seeking federal authority to reimburse for acute inpatient stays in IMDs for individuals ages 21-64 diagnosed with a serious mental illness.
Reimbursement will be limited to IMDs operating in Mobile, Washington and Baldwin counties to target the unique inpatient behavioral health access issues in that region. Medicaid beneficiaries will be able to access services via the IMDs participating in the demonstration, regardless of their county of residence. The proposed effective date of the waiver renewal is May 20, 2027, pending CMS approval.
As required by federal regulation, Medicaid will open a formal comment period. A copy of the draft Demonstration proposal will also be available upon request for public review at each county office of the Department of Human Resources, the State Office of the Alabama Department of Mental Health, and the State Office of the Alabama Medicaid Agency. These documents are also available to be viewed at https://medicaid.alabama.gov/content/4.0_Programs/4.2_Medical_Services/4.2.6_Mental_Health/4.2.6.2_SMI_Waiver.aspx.
Written comments concerning the waiver proposal will be accepted starting September 21, 2026, and are due October 21, 2026. Email comments to [email protected] or mail hardcopy comments to: Administrative Secretary, Alabama Medicaid Agency, 501 Dexter Avenue, P.O. Box 5624, Montgomery, Alabama 36103-5624. All written comments will be available for review by the public during normal business hours at the above address.
Demonstration Description and Goals
The demonstration supports a comprehensive continuum of behavioral healthcare for Medicaid-enrolled individuals with SMI. Through this demonstration, Alabama has expanded access to short-term inpatient psychiatric treatment in IMDs while strengthening community-based services, improving care coordination, and enhancing engagement in treatment across care settings. The demonstration is designed to promote access to clinically appropriate care in both inpatient and community-based settings as part of an integrated behavioral health system.
Through this demonstration, Alabama seeks to achieve the following goals:
- Reduced utilization and length of stay in emergency departments (EDs) among Medicaid beneficiaries with SMI while awaiting mental health treatment in specialized settings.
- Reduced preventable readmissions to acute care hospitals and residential settings.
- Improved availability of crisis stabilization services, including services made available through call centers and mobile crisis units, intensive outpatient services, as well as services provided during acute short-term stays in residential crisis stabilization programs, psychiatric hospitals, and residential treatment settings throughout the state.
- Improved access to community-based services to address the chronic mental healthcare needs of beneficiaries with SMI, including through increased integration of primary and behavioral healthcare.
- Improved care coordination, especially continuity of care in the community following episodes of acute care in hospitals and residential treatment facilities.
Public meetings to provide feedback regarding the proposal will be conducted. The scheduled opportunities for public comment will be held:
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Thursday, October 22, 2026 10:00 a.m. - 11:00 a.m. |
To Join Online or by Telephone: https://medicaid.webex.com/medicaid/j.php?MTI D=m269c36ebdfd0ddaf7add2894f543fbd5 Meeting number (access code): 2663 497 0868 Join by Phone: 650-479-3208 Meeting Password: AMA123!! |
To Join In Person: 501 Dexter Avenue Montgomery, AL 36104 |
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Friday, October 23, 2026 10:00 a.m. - 11:00 a.m. |
To Join Online or by Telephone: https://medicaid.webex.com/medicaid/j.php?MTI D=m94250f992771137f0795a4bf6ede7bd7 Meeting number (access code): 2661 530 5289 Join by Phone: 650-479-3208 Meeting Password: AMA123!! |
To Join In-Person: 7400 Roper Lane Daphne, AL 36526 |
State of Alabama published this content on September 21, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on September 21, 2026 at 17:55 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]