DMHAS Mental Health Waiver (MHW) Program

This waiver program for individuals with serious mental illness encompasses the recovery orientation adopted by the Department of Mental Health and Addiction Services (DMHAS), but also signals new directions in the community treatment of people with serious psychiatric disabilities because of its emphasis on:

  • Intensive psychiatric rehabilitation provided in the participant’s home, and in other community settings;
  • Attention to both psychiatric and medical needs;
  • Emphasis on wellness and recovery;
  • Person-Centered Planning leading to the development of an individualized Recovery Plan; and
  • Use of peer supports provided by people trained and certified in rehabilitative care, who know from first-hand experience about recovery from mental illness.

The Mental Health Waiver Program, authorized in §1915(c) of the Social Security Act, allows the State to furnish an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutional care. Waiver services complement and/or supplement services available to participants through the Medicaid State plan and other federal, state, and local public programs as well as natural supports that families and communities provide.

The Waiver also serves individuals with mental illness who are currently in nursing facilities or who are at risk for this level of care. The Waiver is operated by DMHAS with oversight by the Department of Social Services (DSS).



CSP consists of mental health and substance abuse rehabilitation supports necessary to assist the individual in achieving and maintaining the highest degree of independent functioning. The service utilizes a team approach to provide intensive, rehabilitative community support, crisis intervention, group and individual psychoeducation, and skill building for activities of daily living. CSP includes a comprehensive array of rehabilitation services, most of which are provided in non-office settings by a mobile team. Community-based treatment enables the team to become intimately familiar with the participant’s surroundings, strengths, and challenges, and to assist the participant in learning skills applicable to their living environment. The team services and interventions are highly individualized and tailored to the needs and preferences of the individual.


Recovery Assistance is a flexible range of support provided face-to-face in accordance with a Waiver Recovery Plan that enables a participant to maintain a home, encourages the use of existing natural supports, and fosters involvement in social and community activities. Service activities include performing household tasks, providing instructive assistance, or cuing to prompt the participant to carry out daily tasks (e.g., meal preparation; routine household chores, cleaning, laundry, shopping, and bill-paying; and participation in social and recreational activities), and providing supportive companionship. The Recovery Assistant may also provide instruction or cuing to prompt the participant to dress appropriately and perform basic hygiene functions; offer supportive assistance and supervision and provide short-term relief in the home for a participant who is unable to care for themself when the primary caregiver is absent or in need of relief.


Transitional case management services are provided to persons residing in institutional settings prior to their transition to a community setting. This may also be provided during the adjustment period immediately following discharge from an institution to stabilize them in the community setting, and to assist them with other aspects of the transition to community life. This often includes helping them gain access to needed waiver and other state plan services, as well as medical, social, housing, educational and other services and supports. The state shall claim the cost of case management services provided to institutionalized persons prior to their transition to the waiver for a period not to exceed 180 days.

Eligibility: To be eligible for the Mental Health Waiver, individuals must be 22 years of age or older, eligible for Medicaid and be diagnosed with a serious mental illness. In addition, they must be living in an institutional setting or meeting the level of care requirement for nursing home care and express an interest in transitioning into the community.

Referrals: DMHAS’ Staff are responsible for determining eligibility and for making referrals to credentialed providers, such as Marrakech, Inc. For more information, call 1-866-548-0265.

Related Websites:

Applied Behavioral Health

DMHAS Mental Health Waiver (MHW) Program Contact Information:

Terri Alford
Senior Director of Clinical Services - DRS
(203) 389-2970, ext. 1348

Jared Arter, LMSW
Vice President of DMHAS Funded Residential Services
(203) 887-2411

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