February 24, 2025
Over the weekend, we shared a summary of a recent National Council Public Policy Committee meeting in which the discussion was largely focused on the immediate crisis facing the Medicaid Program, and other related threats to critical safety net programs/services. At the conclusion of this discussion, we moved back to a discussion of other National Council priorities that speak to the future of our systems of care to include legislation the National Council will support as the legislation comes before the 119th Congress. The National Council will be working to introduce / support four federal bills on the following topics:
- Excellence in Mental Health Act 3.0 (this is an unofficial bill title) with provisions for the CCBHC Program, version 3.0
- Residential Recovery for Seniors Act
- Behavioral Health Teaching Centers
- First Episode Psychosis
A brief summary of the bills the National Council will prioritize is below, for your information. We will discuss these bills in greater detail in the weeks and months to come:
CCBHC 3.0 (unofficial bill title)
– The next iteration of the Ensuring Excellence in Mental Health Act, this bill would:
· Create a definition for CCBHCs within Medicare.
· Establish a PPS methodology for CCBHCs within Medicare.
· Provide operating grants for CCBHCs to strengthen the workforce, establish community partnerships, and build capacity for evidence-based practices.
· Provide grants for technical assistance.
· Provide funds to create a data reporting infrastructure program.
· Give CCBHCs the option to offer primary care services.
· Allow HHS to establish an accreditation procedure for CCBHCs and recognize nonprofit entities as accreditation bodies.
· Provide liability protections for providers working at CCBHCs through the Federal Tort Claims Act.
· Establish an exemption for CCBHCs similar to the one in place for FQHCs which exempts them from federal regs prohibiting wraparound payments.
· Allow for specialty CCBHC designations created for organizations that serve specialty populations, specifically organizations serving children/youth and those serving veterans.
First Episode Psychosis (unofficial bill title)
– This legislation would create a new category of Medicaid eligibility for uninsured children/youth (under age 21) who have been diagnosed with schizophrenia spectrum or other psychotic disorders, or who have been determined to be at high risk of first-episode psychosis. Eligibility would be included in a state plan at the state’s option (modeled after existing categorical eligibility provisions for individuals diagnosed with breast cancer, cervical cancer, and tuberculosis). Specifically, the legislation would:
· Create a new category of Medicaid eligibility to provide coordinated specialty care for first-episode psychosis available for children and youth at risk for first-episode psychosis.
· Create a Medicaid wraparound benefit for children/youth who have commercial or other health coverage (coordinated specialty care is the only benefit for which individuals in this group are eligible).
· Establish presumptive eligibility for the groups described above.
· Allow coverage for the Medicaid and wraparound benefit to extend to the full duration of needed treatment, but in no case less than 3 years or beyond the age of 26.
Residential Recovery for Seniors Act
– This legislation was introduced in the last Congress and will likely be reintroduced sometime this year. It would create a new Medicare Part A benefit for residential addiction treatment programs (i.e., ASAM Level 3) meeting nationally recognized standards.
o Eligible programs must offer a planned and structured regimen of twenty-four‑hour care. Specifically, the new benefit would cover the following adult patient programs:
§ Level 3.1: Clinically Managed Low-intensity Residential Treatment;
§ Level 3.5: Clinically Managed High-intensity Residential Treatment; and
§ Level 3.7: Medically Managed Residential Treatment.
o Additionally, the bill would establish a new PPS for covered residential addiction treatment services.
o A one-pager on the bill can be found here, and the bill text (from the previous Congress) can be found here.
Behavioral Teaching Health Centers (unofficial bill title)
– This legislation is modeled closely after the primary care Teaching Health Center program. It creates a grant program through HHS for community-based clinics to establish or expand behavioral health clinician training programs.
– The grants can be used to cover the costs of:
· Curriculum development;
· Recruitment, training and retention of clinicians-in-training and faculty;
· Faculty salaries during the development phase; and
· Technical assistance
– Clinics provide training to “behavioral health trainees” which are defined as professionals who are prelicensure candidates gaining the supervision and supervised experience necessary to be a fully licensed behavioral health professional.
– The amount of the grants has not been determined yet, but the grants will be awarded for a period of three years.