Oregon: CMS approves nation's first Medicaid Mobile Crisis Intervention Services Program

via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced approval of the Oregon Health Authority’s proposal to cover community-based mobile crisis intervention services in Medicaid. Made possible by President Biden’s American Rescue Plan, the new first-in-the-nation Medicaid State plan amendment will allow Oregon to provide community-based stabilization services to individuals experiencing mental health and/or substance use crises throughout the state by connecting them to a behavioral health specialist 24 hours per day, every day of the year. 

The new Medicaid option became available to states in April 2022 and is part of HHS’ latest effort to deliver on President Biden’s comprehensive national strategy to address the nation’s mental health crisis. The option also furthers the goals of the Secretary’s National Tour to Strengthen Mental Health, which was launched the day after the State of the Union to address the mental health challenges that have been exacerbated by the COVID-19 pandemic, including substance use, youth mental health, and suicide.

Finally, the option advances the President’s call to action for state and local leaders to dedicate and deploy more American Rescue Plan funding to make our communities safer. Too often, law enforcement must serve as mental health counselors or social workers, which takes away from their policing work. By mobilizing mental health and substance use professionals to respond to people experiencing mental health or substance use crises, this intervention eases the burden on law enforcement and allows them to do the important work of accountable policing. 

Oregon is the first state to seek and be granted approval for this new Medicaid option, and the Department strongly encourages other states to follow Oregon’s model of expanding access to these vital crisis care services. Helping states integrate behavioral health services into their Medicaid programs is a critical component of establishing a stronger and more sustainable crisis care continuum. That is why the American Rescue Plan also provided $15 million in planning grants to help 20 state Medicaid agencies develop these programs. 

“Prioritizing behavioral health treatment by putting crisis care in reach for more Americans is critical — in Oregon and beyond,” said HHS Secretary Xavier Becerra. “Addressing our nation’s mental health crisis is a top priority of the Biden-Harris Administration, and thanks to President Biden’s American Rescue Plan, Oregon can better provide its residents with the support and stabilization services they need during times of crisis. I encourage all states to take advantage of this opportunity and work with us to expand access to these critical health care services.” 

“I am pleased to approve Oregon’s plan for providing vital resources to people in moments of crisis and connecting them to the care and support needed for long-term recovery,” said CMS Administrator Chiquita Brooks-LaSure. “With this approval, Oregon will be able to connect people to a qualified health professional as the first point of care for someone in crisis, which ensures they get the care they need when and where they need it.” 

The new Medicaid option gives states an opportunity to support community-based mobile crisis intervention services for individuals with Medicaid, including those who have both a mental health and substance use condition, such as opioid use. Mobile crisis intervention services aim to provide individuals who are experiencing mental health and/or substance use crises with screening and assessment; community-based stabilization and de-escalation; and coordination with and referrals to health, social and other services (e.g., life skills training, education about the effects of medication), as needed, by a trained behavioral health professional or paraprofessional. Providing immediate and appropriate care to someone in crisis not only helps reduce the possibility that they will harm themselves, but also helps reduce the need for costly inpatient services.

The new Medicaid option is one of many major actions HHS has taken in recent months to establish a stronger and more sustainable crisis care continuum. On July 16, the U.S. transitioned the 10-digit National Suicide Prevention Lifeline to 988 — an easy-to-remember three-digit number for 24/7 crisis care. The 988 Suicide & Crisis Lifeline (988 Lifeline) is a network of more than 200 state and local call centers supported by HHS through the Substance Abuse and Mental Health Services Administration (SAMHSA). The 988 Lifeline, which also links to the Veterans Crisis Line, follows a three-year joint effort by the U.S. Department of Health and Human Services (HHS), Federal Communications Commission (FCC), and the U.S. Department of Veterans Affairs (VA) to put crisis care more in reach for people in need. Factual information about 988 is included in the Substance Use and Mental Health Administration’s (SAMHSA) online 988 FAQ page.

Since January 2021, the Biden-Harris Administration has made unprecedented investments to support the 988 transition, investing $432 million in FY22 — an 18-fold increase over FY21 —– to scale up crisis center capacity, national back-up center capacity, and to provide special services, including a sub-network for Spanish language speakers — to ensure all Americans have access to help during mental health crises. The $432 million includes $105 million in grant funding to states and territories, provided by the American Rescue Plan, to improve response rates, increase capacity to meet future demand, and ensure calls initiated in states or territories are first routed to local, regional, or state crisis call centers. Prior to this investment, the 988 Lifeline, which has existed since 2005, had been long unfunded and under-resourced.