Optional services allow States to tailor their Medicaid programs to meet specific State objectives. States have chosen to use coverage for optional services in varied ways to support substance abuse services. Optional services that are particularly relevant include clinic services, rehabilitation services, other practitioners services, therapy services, prescribed drugs, personal care services, transportation services, case management services, inpatient psychiatric services for under age 21, and IMD services for over age 65.
Options available under Medicaid allow States to support many of the elements of substance abuse services that have been demonstrated to be cost-effective alternatives to inpatient care. This is most clearly the case for outpatient alcohol and drug treatment, which can be provided as clinic or rehabilitative services. In addition, other optional services, such as services of psychologists and psychiatric social workers, occupational therapy, personal care, transportation, and targeted case management, can be used to support such programs.
Additionally, States may provide home and community-based waiver services to individuals who would otherwise be institutionalized. These services are designed to maintain persons in their communities. They may include those, such as respite care, that are not normally available under the Medicaid program or to other enrollees within the State.