CMS Approves First State for New ARPA Medicaid Mobile Crisis Services Option, Additional States Express Interest 

Two women hugging in group therapy

This week, the Centers for Medicare & Medicaid Services announced approval of Oregon’s plan to cover community-based mobile crisis intervention services for individuals experiencing mental health or substance use crises under a new Medicaid state option.

As we’ve previously highlighted on Say Ahhh!, the American Rescue Plan Act (ARPA), passed in March 2021, included a provision to allow state Medicaid programs to provide community-based mobile crisis intervention services for individuals in crisis while receiving an enhanced federal matching rate for the first three years of the program. In order to receive the enhanced funding made available under the new option, states must meet a number of requirements including that services are available 24/7 and that the funds are geared towards expanding services by supplementing, not supplanting, state spending on mobile crisis services.

Last September, CMS awarded $15 million in planning grants to 20 states to support expanding access to community-based mobile crisis services and in December released guidance on the new ARPA Medicaid state option. The option was officially made available to states in April and currently extends through March 31, 2027.

Oregon is the first state to receive federal approval to provide community-based mobile crisis services under the new Medicaid state option. According to Oregon’s plan, the services are provided under a team-based approach and must be person and family centered. The plan also discusses the provision of crisis and stabilization services such as short-term stabilization services for individuals and families as well as individual, group, and family level rehabilitative therapy. The plan does not speak to how the specific needs of children will be met, however, it notes that crisis and stabilization services follow an integrated and culturally, linguistically, and developmentally appropriate trauma-informed approach.

In its announcement of the approval, HHS “strongly encourages” other states to follow Oregon’s model in support of establishing a stronger and more sustainable crisis care continuum. While not yet formally approved, in July, West Virginia provided notice of filing of a state plan amendment to provide community-based mobile crisis intervention services and in August, California released a request for information to inform planning, launch, and implementation of mobile crisis services and noting its intent to submit a state plan amendment under the ARPA option effective as soon as January 1, 2023.

The new option comes at a key time with the launch of 988 – the new three-digit mental health crisis and suicide prevention number. According to data released by HHS last week, over the first full month, there was a 45% increase in overall volume compared to the same time a year earlier. As discussed on the blog, Medicaid can play a critical role in supporting 988 and the crisis care continuum, however, states must act in order to take full advantage of these opportunities.

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