Strengthening Medicaid for Serious Mental Illness Act
Sponsored By: Representative Goldman (NY)
Introduced
Summary
Boosts Medicaid funding for intensive community mental health services. This bill would create a new Medicaid state-plan option that raises the federal match for states that offer a defined set of intensive community-based services for adults with serious mental illness and promotes community care instead of hospitalization or institutionalization.
Show full summary
- Adults with serious mental illness: Eligible people would be age 21 or older and have income at or below 150 percent of the poverty line, and could receive services like assertive community treatment, supported employment, peer support, mobile crisis response, intensive case management, and housing-related supports.
- States: States that meet quality, integrated-setting, and reporting rules could receive an increased Federal Medical Assistance Percentage. The match boost scales by tiers up to 25 percentage points depending on how many service categories a State offers, and the bill provides $20 million in federal planning grants for States.
- Providers and communities: The bill defines staffing and service standards for multidisciplinary teams, 24/7 mobile crisis response, peer specialists, and housing-focused activities to expand community-based capacity.
*This bill would increase federal spending by raising the Medicaid matching rate for covered services and by appropriating $20 million for state planning grants.*
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
Higher federal match for intensive services
If enacted, starting January 1, 2026, states that meet the rules could get a higher federal match for these intensive services. The increase would depend on how many service categories the state offers that quarter: 1 = +3 points; 2 = +7; 3 = +12; 4 = +18; 5 or more = +25. The federal share could not exceed 100%. The extra match would only apply in quarters when states follow quality, integrated-setting, and data reporting rules.
New Medicaid option for intensive mental health care
If enacted, starting January 1, 2026, states could add a Medicaid option for adults with serious mental illness. It would cover intensive community-based services, not room and board, in the most integrated setting. Services could include assertive community treatment, supported employment, peer support, mobile crisis teams, case management, and housing-related help. Quality rules would include 24/7 ACT teams with about 1 staff per 10 clients, case managers meeting at least 4 times a month with caseloads near 1 to 12, supported jobs paying at least the state minimum and customary wages and benefits, and 24/7 mobile crisis teams. This bill would not limit children’s EPSDT rights to these services.
Grants to help states build services
If enacted, the government would provide $20 million for state planning grants. Funds would be available until spent. States could use the money to plan Medicaid amendments, build data systems and staffing, set service quality rules, and work with housing partners. Grants would be offered as soon as practicable.
Sponsors & CoSponsors
Sponsor
Goldman (NY)
NY • D
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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