Senate Releases Bipartisan Safer Communities Act, Includes Medicaid Mental Health Provisions

As we wrote about last week, the Senate has been actively working to advance an agreement on a gun safety bill that includes a number of provisions related to mental health. On Tuesday evening this week, they officially released the text of the Bipartisan Safer Communities Act. Notably, it includes a number of Medicaid provisions, including those focused on children and youth.

For our readers of Say Ahhh! that have been following our updates on recent Congressional mental health action, here’s a rundown of the Medicaid and CHIP provisions included in the Bipartisan Safer Communities Act:

  • Expands the Medicaid Certified Community Behavioral Health Center (CCBHC) demonstration program nationally under a phased-in approach over a period of years. As we wrote about last week, about 23 percent of CCBHC clients were children or adolescents (ranging from 8% to 27% depending on the demonstration state), according to a report by HHS on the existing Medicaid demonstration. The Medicaid demonstration is currently limited to 10 states.
  • Requires the Secretary of HHS to provide technical assistance and issue guidance to states on improving access to telehealth under Medicaid and CHIP including best practices to support services delivered via telehealth in schools and strategies to promote the delivery of accessible and culturally competent care via telehealth.
  • Requires the Secretary of HHS, in consultation with the Secretary of Education, to issue guidance to state Medicaid agencies, local education agencies, and school-based entities to support the delivery of services to children covered by Medicaid and CHIP in school-based settings. As we’ve written about previously, Medicaid can play an important role in supporting school-based services and additional guidance could help advance such efforts. The bill also creates a technical assistance center focused on school-based Medicaid to assist and expand capacity of states, local education agencies, and school-based entities including a focus on small and rural schools. It also provides $50 million in funding for grants to states to implement, enhance, or expand school-based services under Medicaid and CHIP.
  • Requires the Secretary of HHS to do regular reviews of state implementation of the requirements for providing early and periodic screening, diagnostic, and treatment (EPSDT) services under Medicaid (including with the respect to the provision of such services by managed care plans), identify gaps and definficies, provide technical assistance to states to address gaps and and deficiencies, issue guidance to states on Medicaid coverage requirements for such services, and provide a report to Congress on the findings. It also requires the Government Accountability Office to study and issue a report on state implementation of the EPSDT benefit including with respect to state oversight of managed care plans.

The Bipartisan Safer Communities Act also includes a number of provisions outside of Medicaid and CHIP that provide additional funding for school-based and pediatric-focused programs including $500 million through the School Based Mental Health Services Grant Program to increase the number of qualified mental health service providers, $500 million in funding to the School Based Mental Health Service Professionals Demonstration Grant, $60 million for primary care training and enhancement, and $80 million to support the pediatric mental health care access program.

So far, the Bipartisan Safer Communities Act passed a procedural vote and is expected to be voted on as soon as the end of this week. The full Senate bill text can be found here.

Also this week on the mental health front, the House passed the Restoring Hope for Mental Health and Well-Being Act of 2022, which as we’ve highlighted, was amended to include a number of Medicaid and CHIP provisions with an emphasis on Medicaid and school-based services, review of state EPSDT implementation, screenings and services for youth in the juvenile justice system, and mandated HHS guidance and best practices on various topics related to youth behavioral health and Medicaid. The House bill text and amendments can be found here.

 

Anne Dwyer is an Associate Research Professor of the Practice at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.

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