Table 3
Section 1115 SDOH & Other DSR Changes - Approved SDOH Provisions
as of December 4, 2025
Click on the buttons to see:
Approved SDOH Provisions
Pending SDOH Provisions
Other Select DSRs (Approved & Pending)
Note: + In March 2025, CMS under the Trump administration rescinded HRSN guidance, which does not negate existing approvals. CMS says it will now consider state applications for services and supports previously covered under the HRSN framework on a “case-by-case” basis. In 2022, CMS announced a Section 1115 demonstration waiver opportunity to expand the tools available to states to address HRSN. In 2023, CMS issued a detailed Medicaid and CHIP HRSN Framework accompanied by an Informational Bulletin, which were updated in 2024. States marked with a “+” have had HRSN services approved by the Biden administration under this framework.
¹ Infrastructure Funding or Delivery System Changes: In addition to funding for new SDOH services, some states have also received approval for infrastructure investments to support implementation and delivery of the new services and/or to make other delivery system changes. Waivers approved under the Biden HRSN framework specify approved infrastructure funding may be used for technology, development of business or operational practices, workforce development, and outreach, education, and stakeholder convening.
² Other supports: Other supports may include (but are not limited to) case management, non-medical transportation, interpersonal violence and toxic stress supports, and postpartum supports.
For definitions, explanation of acronyms, and additional notes, see the Waiver Tracker Definitions Tab.
¹ Infrastructure Funding or Delivery System Changes: In addition to funding for new SDOH services, some states have also received approval for infrastructure investments to support implementation and delivery of the new services and/or to make other delivery system changes. Waivers approved under the Biden HRSN framework specify approved infrastructure funding may be used for technology, development of business or operational practices, workforce development, and outreach, education, and stakeholder convening.
² Other supports: Other supports may include (but are not limited to) case management, non-medical transportation, interpersonal violence and toxic stress supports, and postpartum supports.
For definitions, explanation of acronyms, and additional notes, see the Waiver Tracker Definitions Tab.
.png){kind=small}