§1396w–7 — Title 42 The Public Health and Welfare | U.S. Code

Summary

By July 1, 2025, the Secretary of Health and Human Services, working with the Centers for Medicare & Medicaid Services and the Assistant Secretary for Mental Health and Substance Use, must give states clear guidance on how to use Medicaid and CHIP to build and improve a range of crisis services. The guidance will recommend things like 988 and other crisis call centers, mobile teams, in‑home and community care, residential and hospital care, and links to follow‑up mental health, substance use, and social supports. It will push for quick, appropriate care in the least restrictive place, culturally aware and trauma‑informed approaches, suicide risk screening, ways to pay for services under Medicaid and CHIP, using admin funding and IT tools to support statewide hotlines, help for children and youth, ways to serve different communities (urban, rural, various ages and cultures, people with disabilities or co‑occurring conditions), using telehealth and 24/7 coverage, allowing access without a diagnosis or with presumptive eligibility, coordinating with other payors and federal funds, connecting to follow‑up services, working with managed care or fee‑for‑service systems, and measuring use and outcomes. Also by July 1, 2025, the Secretary must set up a technical assistance center to help states design, run, or improve these crisis services. The center will help states use Medicaid and CHIP money, coordinate other federal funds, and adopt the guidance’s best practices. The Secretary will keep a public list of best practices and update it each year as needed. Congress provided $8,000,000 to carry out these tasks. "Secretary" means the Secretary of Health and Human Services. "State" means the 50 States, the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.

Title 42, §1396w–7

The Public Health and Welfare — Source: USLM XML via OLRC

(a)Not later than July 1, 2025, the Secretary, in coordination with the Administrator of the Centers for Medicare & Medicaid Services and the Assistant Secretary for Mental Health and Substance Use, shall issue guidance to States regarding Medicaid and CHIP that includes the following:

(1)Provides, in consultation with health care providers and stakeholders with expertise in mental health and substance use disorder crisis response services, recommendations for an effective continuum of crisis response services that—

(A)includes crisis call centers, including 988 crisis services hotlines, mobile crisis teams, crisis response services delivered in home, community, residential facility, and hospital settings, and coordination with follow-on mental health and substance use disorder services, such as intensive outpatient and partial hospitalization programs, as well as connections to social services and supports;

(B)promotes access to appropriate and timely mental health and substance use disorder crisis response services in the least restrictive setting appropriate to an individual’s needs; and

(C)promotes culturally competent, trauma-informed care, and crisis de-escalation.

(2)Outlines the Federal authorities through which States may finance and enhance under Medicaid and CHIP the availability of crisis response services across each stage of the continuum of crisis response services.

(3)Addresses how States under Medicaid and CHIP may support the ongoing implementation of crisis call centers, including 988 crisis services hotlines, and how Medicaid administrative funding, including enhanced matching, and the Medicaid Information Technology Architecture 3.0 framework, may be used to establish or enhance regional or statewide crisis call centers, including 988 crisis services hotlines, that coordinate in real time.

(4)Identifies how States under Medicaid and CHIP may support access to crisis response services that are responsive to the needs of children, youth, and families, including through CHIP health services initiatives, behavioral disorder-specific crisis response, trained peer support services, and establishing or enhancing crisis call centers that are youth-focused.

(5)Identifies policies and practices to meet the need for crisis response services with respect to differing patient populations, including urban, rural, and frontier communities, differing age groups, cultural and linguistic minorities, individuals with co-occurring mental health and substance use disorder conditions, and individuals with disabilities.

(6)Identifies policies and practices to promote evidence-based suicide risk screenings and assessments.

(7)Identifies strategies to facilitate timely provision of crisis response services, including how States can enable access to crisis response services without requiring a diagnosis, the use of presumptive eligibility at different stages of the continuum of crisis response services, the use of telehealth to deliver crisis response services, strategies to make crisis response services available 24/7 in medically underserved regions, and best practices used by States and health providers for maximizing capacity to deliver crisis response services, such as identifying and repurposing available beds, space, and staff for crisis response services.

(8)Describes best practices for coordinating Medicaid and CHIP funding with other payors and sources of Federal funding for mental health and substance use disorder crisis response services, and best practices for Medicaid and CHIP financing when the continuum of crisis response services serves individuals regardless of payor.

(9)Describes best practices for establishing effective connections with follow-on mental health and substance use disorder services, as well as with social services and supports.

(10)Describes best practices for coordinating and financing a continuum of crisis response services through Medicaid managed care organizations, prepaid inpatient health plans, prepaid ambulatory health plans, and fee-for-service delivery systems, including when States carve-out from delivery through Medicaid managed care organizations, prepaid inpatient health plans, prepaid ambulatory health plans, or fee-for-service systems, mental health or substance use disorder benefits or a subset of such services.

(11)Identifies strategies and best practices for measuring and monitoring utilization of, and outcomes related to, crisis response services.

(b)(1)Not later than July 1, 2025, the Secretary, in coordination with the Administrator of the Centers for Medicare & Medicaid Services and the Assistant Secretary for Mental Health and Substance Use, shall establish a technical assistance center to help States under Medicaid and CHIP design, implement, or enhance a continuum of crisis response services for children, youth, and adults. Such technical assistance shall, at least in part, provide support to States in—

(A)leveraging the Federal authorities through which Medicaid and CHIP may finance mental health and substance use disorder crisis response services;

(B)coordinating Medicaid and CHIP funds with other sources of Federal funding for mental health and substance use disorder crisis response services; and

(C)after the guidance described in subsection (a) is issued, adopting the best practices and strategies identified in such guidance.

(2)The Secretary shall develop and maintain a publicly available compendium of best practices for the successful operation under Medicaid and CHIP of a continuum of crisis response services. The Secretary annually shall review the information available through the compendium and shall update such information when appropriate.

(c)There is appropriated to the Secretary, out of any funds in the Treasury not otherwise appropriated, to remain available until expended for purposes of carrying out subsections (a) and (b), $8,000,000.

(d)In this section:

(1)The term “Secretary” means the Secretary of Health and Human Services.

(2)The term “State” means each of the 50 States, the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.

Notes & Related Subsidiaries

Editorial Notes

Codification Section was enacted as part of the Health Extenders, Improving Access to Medicare, Medicaid, and CHIP, and Strengthening Public Health Act of 2022 and also as part of the Consolidated Appropriations Act, 2023, and not as part of the Social Security Act which comprises this chapter.

§1396w–7 Supporting access to a continuum of crisis response services under Medicaid and CHIP

Summary

Title 42, §1396w–7

Notes & Related Subsidiaries

Editorial Notes

Citations & Metadata