On March 31, 2014, Congress passed the Protecting Access to Medicare Act (H.R. 4302), which included a demonstration program based on the Excellence in Mental Health Act. The Excellence Act will increase Americans’ access to community mental health and substance use treatment services while improving Medicaid reimbursement for these services. This legislation:
- Creates criteria for “Certified Community Behavioral Health Clinics” as entities designed to serve individuals with serious mental illnesses and substance use disorders that provide intensive, person-centered, multidisciplinary, evidence-based screening, assessment, diagnostics, treatment, prevention, and wellness services. The Secretary of the Department of Health and Human Services is directed to establish a process for selecting states to participate in a 2-year pilot program.
- Provides $25 million that will be available to states as planning grants to develop applications to participate in the 2-year pilot. Only states that have received a planning grant will be eligible to apply to participate in the pilot.
- Stipulates that eight (8) states will be selected to participate in the 2-year pilot program. The match rate for Certified Community Behavioral Health Clinic services is either the Enhanced FMAP/CHIP rate or, for newly eligible “expansion” Medicaid beneficiaries, the current FMAP for that population – which is 100% now and moves down to 90% by 2020.
- Requires participating states to develop a Prospective Payment System for reimbursing Certified Behavioral Health Clinics for required services provided by these entities.
September 1, 2015: Deadline for the Secretary of Health and Human Services to publish: a) criteria for a clinic to be certified by a State as a certified community behavioral health clinic; and b) guidance for states on the establishment of a prospective payment system for certified clinics participating in the demonstration program.
January 1, 2016: Deadline for the Secretary to award planning grants to states for the purpose of developing proposals to participate in the demonstration program.
September 1, 2017: Deadline for the Secretary to select the states that will participate in the demonstration program. Only states that have received a planning grant are eligible to participate. The states will be selected through a competitive application process and must represent a diverse selection of geographic areas, including rural and underserved areas.
FOR MORE INFORMATION
- Read our comprehensive fact sheet, including a description of CCBHC criteria and the state planning process.
- Stay up to date on the latest Excellence Act news on our blog, Capitol Connector.
- Need an Excellence Act one pager? Click here.
HOW WILL THE EXCELLENCE IN MENTAL HEALTH ACT HELP?
Community behavioral health organizations help the eight million Americans they serve — children and adults with serious mental illnesses and addictions — recover and lead productive lives in their communities. These healthcare organizations are on the front lines of improving health outcomes, providing crisis response and suicide prevention; alcohol and drug abuse treatment; comprehensive outpatient mental health services; and helping special populations like veterans and children. And, they stand ready to do more.
Unfortunately, after decades of budget cuts, our nation’s community behavioral health centers struggle to expand their services and aid all Americans in need of help. Far too many people lack access to the evidence-based treatments, robust support services, and community partnerships proven to produce better health outcomes. As a result, people with mental illnesses and addictions often end up with inadequate care provided in emergency rooms or jails, while federal and state governments face extra costs in schools, on the roads, and in courtrooms.
The bipartisan Excellence in Mental Health Act (S. 264/H.R. 1263), introduced by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO) and Representatives Doris Matsui (D-CA) and Leonard Lance (R-NJ), would help community behavioral health organizations meet the increased demand for robust services.
The National Council thanks Senator Stabenow, Senator Blunt, Congresswoman Matsui, and Congressman Lance for their tireless support and leadership on behalf of the Excellence in Mental Health Act. This Act represents the largest single federal investment in community-based mental and substance use treatment in well over a generation – an infusion of desperately needed resources into our nation’s community behavioral health and substance use treatment system.