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The guidance is split into two parts: drafting statements of assurance and filling Table 1 milestone criteria. It specifies how to describe health IT infrastructure sufficiency, alignment with related Medicaid and behavioral health IT plans, and inclusion of ONC interoperability standards and 45 CFR 170 Subpart B in subsequent amendments or re-procurements. It also explains how to document current and future health IT functionality and summarize actions, owners, timeframes, and monitoring measures.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/section-1115-a-serious-mental-illness-smi-and-serious-emotional-disturbance-sed-instructions-for-completing-the-template-for-smised-health-information-technology-it-plan/353916/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/section-1115-a-serious-mental-illness-smi-and-serious-emotional-disturbance-sed-instructions-for-completing-the-template-for-smised-health-information-technology-it-plan/353916.png","ImageObject",442,249,{"name":88,"@type":89},"Maya Linwood","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-22","2026-09-22",true,{"@type":98,"interactionType":99,"userInteractionCount":76},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the purpose of the template instructions for the SMI/SED Health IT Plan?","Question",{"text":108,"@type":109},"The instructions explain how states can complete Section 6 of the HIT Plan within the SMI/SED Implementation Plan, including guidance for assurance statements and Table 1 milestones.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What should the state address in the statements of assurance?",{"text":113,"@type":109},"The state should describe whether it has sufficient health IT infrastructure at appropriate levels, whether its SMI/SED plan is aligned with broader related Medicaid and behavioral health IT plans, and how it will include ONC interoperability standards and 45 CFR 170 Subpart B in later contract amendments or re-procurements.",{"name":115,"@type":106,"acceptedAnswer":116},"How should Table 1 milestone criteria be completed?",{"text":117,"@type":109},"For each milestone row, the state should describe how current state health IT functionality meets the milestone, then describe the future state and the actions needed to move from current capabilities to future capability, including responsible entities, milestones, and timeframes.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},353916,1792232138,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":76,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":8,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":79},962084928432,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Section 1115 (a) Serious Mental Illness (SMI) and Serious Emotional Disturbance (SED)  \nDemonstration:  \nInstructions for Completing the Template for SMI/SED Health Information Technology  \n(IT) Plan  \nThis section provides guidance on how states can complete Section 6 of the HIT Plan of the SMI/SED Implementation Plan. The following guidance is presented in two parts: 1) guidance for completing statements of assurance and 2) instructions and guidance for completing Table 1.  \nIf the state is pursuing a concurrent SUD/SMI/SED demonstration, this template should be an amendment to the existing SUD health IT plan template.  \nPart 1: Guidance for Completing Statements of Assurance  \nPlease review each statement of assurance below. Below each statement are key topics for the state to consider while drafting their response.  \nStatement 1: Indicate whether the state has sufficient health IT infrastructure/ “ecosystem” at every appropriate level (i.e. state, delivery system, health plan/MCO and individual provider) to achieve the goals of the demonstration.  \n• The state should clearly define what they consider as “sufficient” based on the goals of their demonstration.  \n• Based on this analysis, if the state finds that sufficient health IT infrastructure is not in place, please indicate the timeframe, milestones and entity responsible for completion.  \nStatement 2: Indicate whether the state’s SMI/SED Health IT Plan is “aligned with the state’s broader State Medicaid Health IT Plan (SMHP) and if applicable, the state’s Behavioral Health (BH) Health IT Plan” and the Substance Use Disorder/Opioid Use Disorder Health IT Plan.  \n• If the statement reflects that plans have not yet been aligned, please indicate the timeframe for beginning these discussions and a process to ensure that the state will harmonize with all the other relevant health IT plans in the state.  \nStatement 3: Indicate that the state will include appropriate standards referenced in the ONC Interoperability Standards Advisory (ISA) ([https://www.healthit.gov/isa/](https://www.healthit.gov/isa/)) and 45 CFR 170 Subpart B in subsequent MCO contract amendments or Medicaid funded MCO/ Health Care Plan re-procurements.  \n• Some relevant examples of specific health IT standards referenced in the ISA are:  \no Electronic Prescribing – A Prescriber’s Ability to Obtain a Patient’s Medication History from a Prescription Drug Monitoring Program (Section II-I)  \no “Direct” transport standards  \no Documenting and Sharing Care Plans-Care Plan standards (HL7 C-CDA R2.1)  \no Sending a Notification of a Patient’s Admission, Discharge and/or Transfer Status to Other Providers-ADT Alerting and Messaging  \no Clinical Quality Measurement and Reporting  \no Identity management-Patient demographic record matching (chapter 3), exchanging patient identification management within a community (see section 2.5.1)  \nPart 2: Instructions and Guidance for Completing Table 1  \n1. Please review Table 1 with the 7 sections containing 15 milestone criteria located on page 13-14 of the SMI 1115 Implementation Plan:  \n2. In each row (milestone criteria), under the second column, Current State, enter a response on how the state is currently using state health IT functionality to meet the milestone.  \n3. In each row (milestone criteria), under the third column, Future State, enter a response and describe the future state of the health IT functionality to meet the milestone.  \na. The responses for each row under column 3, should build on the gaps identified in the responses included for that row in column 2. The state should indicate what the envisioned health IT functionality is for the state with respect to each milestone.  \nb. For example, in Criterion 1, should the state indicate there is no or minimal activity to link PDMPs to state health IT systems, then the response for row 2, column 3, should indicate what the PDMP integration end-state goal is for the state. This could be, for example, to integrate t","cbCaifKc27uunBO5","https://ap.wps.com/l/cbCaifKc27uunBO5","pdf",552160,"English","# Demonstration\n## Instructions for Completing the Template for SMI/SED Health IT Plan\n## Part 1: Guidance for Completing Statements of Assurance\n## Part 2: Instructions and Guidance for Completing Table 1\n## Additional Guidance and Resources\n### Section 1: Closed Loop Referrals and e-Referrals","[{\"question\":\"What is the purpose of the template instructions for the SMI/SED Health IT Plan?\",\"answer\":\"The instructions explain how states can complete Section 6 of the HIT Plan within the SMI/SED Implementation Plan, including guidance for assurance statements and Table 1 milestones.\"},{\"question\":\"What should the state address in the statements of assurance?\",\"answer\":\"The state should describe whether it has sufficient health IT infrastructure at appropriate levels, whether its SMI/SED plan is aligned with broader related Medicaid and behavioral health IT plans, and how it will include ONC interoperability standards and 45 CFR 170 Subpart B in later contract amendments or re-procurements.\"},{\"question\":\"How should Table 1 milestone criteria be completed?\",\"answer\":\"For each milestone row, the state should describe how current state health IT functionality meets the milestone, then describe the future state and the actions needed to move from current capabilities to future capability, including responsible entities, milestones, and timeframes.\"}]","Section 1115 (a) Serious Mental Illness (SMI) and Serious Emotional Disturbance (SED) - Instructions for Completing the Template for SMI/SED Health Information Technology (IT) Plan | PDF",1790107890]