Make mobile crisis services mandatory under Medicaid
Recommendation
Congress should make mobile crisis services mandatory under Medicaid. At a minimum, these services should be made a permanent state option available to states eligible for enhanced federal Medicaid match funding.[1]
Background/summary
Mobile crisis teams are a critical part of the mental health and substance use crisis care continuum. The components of these teams can vary but generally involve response coordinators and social workers who can respond to mental health crises. Research examining the impact of mobile crisis programs has shown they are effective in diverting individuals from emergency departments, reducing the need for hospitalization, and lowering law enforcement interventions for individuals experiencing a mental health crisis.[2]
Since the launch of the Crisis Assistance Helping Out On The Streets (CAHOOTS) program in Oregon, more than 35 states have implemented mobile crisis programs using various Medicaid authorities, including waivers and demonstrations.[3] Mobile crisis teams are an indispensable part of the 988 Suicide Prevent and Crisis Lifeline, and states across the country are seeking to build out capacity to ensure the availability of an in-person response for 988 callers who need it. To expand the availability of these programs, Congress created a new state option under Medicaid with an enhanced federal matching rate of 85 percent for mobile crisis services as part of the American Rescue Plan Act (ARPA) of 2021.[2] Congress also provided funding to support state planning grants to ease implementation and support take-up of the new option.[4]
This new option is only temporary and expires in 2027. Given that physical health emergency services are covered by all state Medicaid programs, Congress should make mobile crisis services a mandatory Medicaid benefit. At minimum, Congress should make the the state option with the 85 percent federal matching rate permanent.[1]
citations
1. Senate Finance Committee. “SFC Bipartisan Mental Health Care Provisions”. Last Accessed May 26, 2022.
2. Saunders, Heather, Madeline Guth, Nirmita Panchal. “Behavioral Health Crisis Response: Findings from a Survey of State Medicaid Programs.” Kaiser Family Foundation. Last Updated May 25, 2023.
3. TAC Inc. Mobile Crisis Teams: A State Planning Guide for Medicaid Financed Crisis Response Services. Last Updated January, 2022.
4. The Centers for Medicare and Medicaid Services. State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services. Last Updated December 28, 2021.