Is state Medicaid plan coverage for ancillary/transitional assistance services related to services offered by outpatient programs accepting Medicaid?

Background: Research suggests that access to ancillary services (e.g., childcare, transportation, employment counseling, and housing assistance) and transitional services (discharge planning/aftercare) play a major role in treatment retention/outcomes. Many Medicaid enrollees would likely need additional ancillary services during treatment to facilitate treatment participation/engagement.and transitional services as a part of a treatment completion plan and community re-entry.

Methods: Medicaid plans for each of the 50 states and D.C. were obtained from the Centers for Medicare and Medicaid Services and were coded by two reviewers for inclusion of specific ancillary/transitional assistance services. The Medicaid plan data were linked with data for outpatient programs accepting Medicaid that were obtained from the 2006 National Survey of Substance Abuse Treatment Services. Bivariate and multivariate logistic regression models controlling for state, program, and other system-level factors were estimated to examine the relationship between state Medicaid plan requirements for transitional/ancillary services and program practices.

Findings: Preliminary bivariate analyses indicate that provision of the following services by programs accepting Medicaid were significantly and positively associated with state inclusion of such services in the state Medicaid plan: linkages to social/medical services (p=.01); employment counseling (p<.001); housing assistance (p<.01); transportation assistance (p<.001); and case management (p<.001).

Implications: These data may have important implications for the substance abuse field and provide further insight into the potential role that state policy context may play in affecting the types of services that are offered to programs serving Medicaid clients that relate to positive treatment outcomes.