The Senate on Thursday passed a two-month extension of a Medicaid demonstration enabling innovative mental health centers in eight states to offer broad, coordinated services for serious mental illness and substance use disorders.
Advocates hope the House will approve the temporary funding measure next week as a routine, consent calendar item.
The Senate bill, sponsored by Sen. Roy Blunt (R-Mo.), would provide about $60 million to the program through Sept. 13. It previously was delayed by holds by Republican senators. Two-year funding for the $1 billion certified community behavioral health clinic (CCBHC) ended on July 14.
Centers in Minnesota, Missouri, Nevada, New Jersey, New York, Oklahoma, Oregon and Pennsylvania have notified staff and patients about layoffs and service cuts. But none of the programs have shut down yet, according to the National Council for Behavioral Health.
Blunt and Sen. Debbie Stabenow (D-Mich.), the original sponsors of the CCBHC demonstration program, have pushed to renew the program and expand it to 11 additional states, including California and Texas. Advocates hope longer-term funding will be included in a broader government spending package in the fall.
Earlier this month, Blunt said the CCBHC program in Missouri has helped in preventing patients from having to go to emergency departments to deal with mental health crises. He urged Congress to extend the program through the end of the current fiscal year because it's helping reduce overall healthcare costs.
CCBHCs received enhanced, cost-based reimbursement from Medicaid through a global payment per patient model, while reporting 22 quality measures.
The enhanced funding enabled the clinics to cover the costs of support services such as outreach, case management, housing, legal and employment services. The Substance Abuse and Mental Health Services Administration projected that the current 67 CCBHCs would serve more than 380,000 people at 372 sites.
A funding cut-off would mean that nearly 3,000 staff at 67 CCBHCs around the country could lose their jobs and more than 9,000 patients receiving medication-assisted treatment for substance abuse could lose access to that treatment, the National Council for Behavioral Health has estimated.
The CCBHC demonstration, created by the Excellence in Mental Health Act of 2014, was the biggest federal investment in many years in improving community-based mental healthcare.
The demonstration tested a new, multidisciplinary model for delivering community-based mental health and addiction treatment. Participating clinics were required to provide nine types of evidence-based services, including 24-hour crisis care, substance abuse services such as medication-assisted treatment and detox, care coordination and integration with physical healthcare.
A key benefit of the CCBHC model is offering a broad range of services in a single setting, so patients with disabling disorders don't have to navigate the system on their own.
Experts say it's critical to expand and strengthen community-based behavioral and addiction services as a proactive alternative to the current patchwork of treating patients with advanced serious mental illness in emergency departments, jails or prisons.
