Section 1115 Demonstration Waiver for Substance Use Disorder (SUD) Treatment

1115 Monitoring and Evaluation

Section 1115 of the Social Security Act provides the Secretary of Health and Human Services authority to approve exploratory, pilot, or demonstration projects that will support and promote the objectives of the Medicaid program and also requires that federal regulations specify requirements for demonstration monitoring and evaluation. Title 42 CFR 431.424 outlines general evaluation requirements and evaluation design components such as hypotheses, data sources, and comparison strategies. It also outlines requirements for including initial evaluation designs and evaluation reports in applications for new demonstrations and extensions of existing demonstrations as well as for monitoring activities. Special terms and conditions for each state further specify CMS’ expectations for the contents and timing of evaluation designs and interim and summative evaluation reports as well as monitoring activities. The Connecticut 1115 SUD waiver monitoring and evaluation requirements are detailed in the Special Terms and Conditions (STCs) of the demonstration, the Monitoring Protocol and the Evaluation Design Plan.

1115 Monitoring and Reporting

The Monitoring Protocol describes what the state will report on a quarterly basis and is developed collaboratively between CMS and the state. Connecticut submitted the Monitoring Protocol on May 22, 2023 and it was approved by CMS on June 23, 2023.

CT SUD Monitoring Protocol

Connecticut is also required to report quarterly and annually on demonstration progress. Connecticut submitted the 1115 SUD waiver annual report to CMS on June 21, 2023.

CT SUD Annual Report

1115 SUD Evaluation

The evaluation design and subsequent reports must be conducted and prepared by an independent evaluator and are intended to gauge a demonstrations effectiveness in achieving demonstration goals. Connecticut submitted its draft SUD Evaluation Design consistent with federal requirements and the approved STCs and received approval from CMS on May 22, 2023.

CT 1115 Waiver Evaluation Design with Approval Letter