The Substance Abuse and Mental Health Services Administration (SAMHSA), in conjunction with the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Planning and Evaluation (ASPE), awarded on October 19th a total of $22.9 million in planning grants to support states throughout the nation in their efforts to improve behavioral health of their citizens by providing community-based mental and substance use disorder treatment. Twenty-four states received awards. Illinois was awarded $982,373; while several states received this amount no state received more.
The planning grants are designed to help states strengthen payment for behavioral health services for Medicaid and CHIP beneficiaries, and will help individuals with mental and substance use disorders obtain the health care they need to maintain their health and well-being. They are authorized under Section 223 of the Protecting Access to Medicare Act of 2014. The planning grants are part of a comprehensive effort to integrate behavioral health with physical health care, utilize evidence-based practices on a more consistent basis, and improve access to high quality care. The planning grants are to be used to support states to certify community behavioral health clinics, solicit input from stakeholders, establish prospective payment systems for demonstration reimbursable services, and prepare an application to participate in the demonstration program. The criteria used to certify community behavioral health clinics emphasize high quality and evidence based practices. Populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long term and serious substance use disorders, as well as others with mental illness and substance use disorders.
At this point the Department of Human Services Division of Mental Health (DHS/DMH), the DHS Division of Alcoholism and Substance Abuse (DHS/DASA), and the Illinois Department of Healthcare and Family Services (HFS), are collectively beginning to work on the next steps for administration and implementation of the grant. Initial tasks will include establishing a steering committee (comprised of both state and private entities, as well as persons with lived experience and mental health advocates) and multiple state-level working groups. The timeframe for this planning grant is particularly fast, and once these groups are formed DMH and its other state partners expect to quickly produce a process where providers may apply to participate in this effort - the expectation is that this application process will be created and rolled out within the next 1-3 months. Pursuant to federal guidance for this project, at least two Illinois providers participating in the application process will be selected for certification; one operating in an urban setting and one in a rural setting. The certification process includes meeting requirements regarding provider staffing, licensing/credentialing, cultural competence of staffing, training on topics such as suicide, peer support and evidence-based practices, as well as a focus on service quality requirements such as the timeliness of services (particularly crisis services), care coordination, and requirements for electronic health records. Eligible providers must be able to provide a broad person-centered, trauma-informed, array of services (ranging from outpatient services to screening to peer/family supports) to be provided to an equally broad population (from children/adolescents and adults to specialty populations such as veterans and their families). SAMHSA has provided some of the basic details of the certification process on this webpage: http://www.samhsa.gov/section-223/certification-resource-guides. Further state and provider activity will then be contingent on Phase II of this project.
When the planning grant phase ends in October 2016, the 24 state awardees will apply to participate in a two-year demonstration program that will begin January 2017. Under the federal demonstration program, no more than eight states with their newly certified community behavioral health clinics will then be able to provide behavioral health services to eligible beneficiaries and be paid using an approved prospective payment system (also to be created) under this grant.
A link to the SAMHSA announcement: HHS Awards up to $22.9 million in Planning Grants for Certified Community Behavioral Health Clinics http://www.samhsa.gov/newsroom/press-announcements/201510191200
For more information on the Planning Grants for Certified Community Behavioral Health Clinics, visit:
Justin C. Harding
Project Principal Investigator
Division of Mental Health