New Medicaid Option Promotes Enhanced Mental Health, Substance Use Crisis Care

December 28, 2021

The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is working with states to promote access to Medicaid services for people with mental health and substance use disorder (SUD) crises. Authorized under President Biden's American Rescue Plan (ARP), states have a new option for supporting community-based mobile crisis intervention services for individuals with Medicaid. Mobile crisis intervention services are essential tools to meet people in crisis where they are and rapidly provide critical services to people experiencing mental health or substance use crises by connecting then to a behavioral health specialist 24 hours per day, 365 days a year. This new option will help states integrate these services into their Medicaid programs, a critical component in establishing a sustainable and public health-focused support network.

"The Biden-Harris Administration is committed to tackling behavioral health challenges relying on proven methods," said HHS Secretary Xavier Becerra. "Thanks to resources provided by the American Rescue Plan, states now have an opportunity through their Medicaid programs to expand behavioral health support in their communities. Where needed, behavioral health experts, not law enforcement, should be the first responders to mental health and substance misuse crises."

"These services are a vital resource for people in moments of crisis, and also connect individuals to the behavioral health services and support needed for long-term recovery," said CMS Administrator Chiquita Brooks-LaSure. "Effective mobile crisis intervention services ensure a qualified health professional is the first point of care for someone in crisis while helping to avoid unnecessary emergency room use and hospitalizations."

While several states have community-based mobile crisis intervention services in place, the ARP grants CMS new authority to provide states with additional resources and tools to enhance these programs. The ARP provides additional federal funding to states for qualifying mobile crisis intervention services for three years. This new Medicaid option also offers flexibility for states to design programs that work for their communities, allowing states to apply for this new option under several Medicaid authorities.

Community-based mobile crisis intervention services, usually comprised of professional and paraprofessional staff, are able to respond quickly to crisis situations and provide individual assessment and crisis resolution. This new option will help states expand access to behavioral health professionals as the initial contact for someone in crisis. Providing immediate and appropriate care to someone in crisis may reduce the need for costly inpatient services.

The new Medicaid option requires that crisis response teams include one qualified behavioral health care professional who is able to provide an assessment within scope of practice requirements under state law. States can add other professionals and paraprofessionals with expertise in substance use and/or mental health crisis response. The teams are tasked with providing screening and assessment; stabilization and de-escalation; and coordination with and referrals to health, social and other services, as needed.

This guidance is part of Biden-Harris Administration's ongoing efforts to make critical investments in behavioral health and crisis care services, and follows HHS' announcement made by the Substance Abuse and Mental Health Services Administration (SAMHSA) earlier of $282 million in ARP and Fiscal Year 2022 appropriations to help transition access to the National Suicide Prevention Lifeline exit disclaimer icon from its current 10-digit number to a three-digit dialing code - 988. The Lifeline currently helps thousands of people overcome crisis situations every day. The 988 dialing code will provide the public with easier access to life-saving services and will be available nationally for call, text or chat beginning in July 2022.