Bed Waiver Request

If the program will have 16 or more beds, a bed waiver request must be submitted:

Request with number of desired beds
Completed ASAM Application
- If the bed waiver request is for a new facility, answer the application as you anticipate the program will run.
- If you have an existing ASAM certification and your bed waiver request is to increase bed number, but not change the ASAM level, you will complete the bed update under make updates in the DMHA Provider Portal.
- If you have an existing ASAM certification and your bed waiver request is to increase bed number and change ASAM level, you will need to complete a new ASAM application.
Floor plan (with bathrooms/showers/beds indicated)
A list of direct care staff and their credentials (this can be updated in the DMHA Provider Portal if you have completed an application in the system. If not, these will need to be uploaded.)
An organizational chart or staffing plan
Patient to staff ratios
A list of the evidence-based practices that will be utilized in the facility
Anticipated date of first enrollment of the beds

Note: If you are submitting the bed waiver request with the application, you will include this information within your application. If you want to submit a bed waiver after an application has been approved, you will submit bed updates through the make updates tab. Please see the FAQ section under the DMHA Provider Portal section of the DMHA QA QI webpage. This will provide some additional information.

American Society of Addiction Medicine (ASAM) designation – ASAM is the nation’s most widely used and comprehensive set of guidelines for placement, continued stay, and transfer/discharge of patients with addiction and co-occurring conditions. Indiana Medicaid in conjunction with the Division of Mental Health and Addiction is using the ASAM criteria as the foundation of their efforts to improve the addiction treatment system. Currently, DMHA has a designation program for ASAM level 3.1 and 3.5 only. A provider must be certified as a sub-acute stabilization facility to apply for an ASAM 3.1 and/or 3.5 designation. Please refer to the ASAM webpage for additional information: