In this session, staff presented a draft chapter and recommendations on improving access to mental health services for adult Medicaid beneficiaries. Over the course of the 2020–2021 meeting cycle, the Commission discussed data on prevalence of mental illness among adults in Medicaid and the rates at which they receive treatment. Medicaid beneficiaries with mental illness often do not receive needed care and are involved with the criminal justice system at higher rates than their privately insured peers.
This presentation provided an overview of the draft chapter, including the need for, and use of, mental health services among adults enrolled in Medicaid. It summarizes state coverage of mental health services and difficulties beneficiaries encounter when trying to access these services. The presentation also detailed the consequences of inadequate access to mental health treatment, such as suicide, and high rates of mental health conditions among individuals in jail and prison.
The presentation then outlines current efforts to address behavioral health crises. This includes the implementation of 988, the nationwide three-digit dialing code for the National Suicide Prevention Lifeline, and recent guidelines from the Substance Abuse and Mental Health Services Administration on crisis care. Medicaid’s role in both of these initiatives is discussed, as well as the need for coordination across federal programs to support individuals with serious mental illness.
The Commission approved two recommendations as drafted. The first recommendation calls on the Secretary of the U.S. Department of Health and Human Services (the Secretary) to direct relevant agencies to issue joint subregulatory guidance that addresses how Medicaid and the State Children’s Health Insurance Program can be used to fund a crisis continuum for beneficiaries experiencing behavioral health crises. The second recommendation calls on the Secretary to direct a coordinated effort to provide education, technical assistance, and planning support to expand access to such services.