HHS approves Medicaid funding for Oregon's mobile crisis intervention program, encourages other states to follow suit

The Biden administration has approved a first-in-the-nation Medicaid plan amendment allowing Oregon to connect those experiencing a mental health or substance use crisis with community-based stabilization services, rather than law enforcement.

The new Medicaid option was created through the American Rescue Plan as part of the “whole-of-government” push to flesh out the nation’s mental healthcare infrastructure, Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure said Monday afternoon.

Applications for the option have been open to all states since April, according to the administration, and other states are “strongly” encouraged to use the federal funding to expand their own mental health services.

“We hope that other states follow Oregon’s lead,” Brooks-LaSure said. “CMS and our state partners have an immense ability and opportunity to help people living with behavioral health conditions. Medicaid covers behavioral health services for millions in the U.S. and we will continue to strengthen and expand access to these critical services.”

Oregon Gov. Kate Brown and Sen. Ron Wyden, D-Oregon, said the state’s program is modeled after the city of Eugene, Oregon’s Crisis Assistance Helping Out On The Streets (CAHOOTS) mobile crisis intervention program.

Staffed by community clinic personnel, the team screens emergency calls—including those placed through the nation’s new 988 Suicide & Crisis Lifeline—and can dispatch a trained crisis intervention team to the individual’s location 24/7. The service can also coordinate and refer individuals to subsequent health, social and other services as needed.

Less than 1% of the “thousands” of crisis calls handled by the program in 2019 required escalation to law enforcement, Wyden said.

“I am going to continue to push to make this funding that we got in the [American] Rescue Plan a permanent part of Medicaid, and that of course will bring certainty to states and communities that this funding is going to be around on a permanent basis,” Wyden said. “This is a life-saving breakthrough.”

The administration painted the program’s approval as its latest push toward strengthening the country’s mental health care resources amid a pandemic-driven spike in mental health and substance abuse.

This includes the $432 million devoted to the 988 transition in fiscal year 2022. The Department of Health and Human Services (HHS) said Friday it has seen a 45% increase in overall volume and “substantial” improvement in answer rates and wait times compared to a year ago.

“Prioritizing behavioral health treatment by putting crisis care in reach for more Americans is critical—in Oregon and beyond,” HHS Secretary Xavier Becerra said in a press release. “Addressing our nation’s mental health crisis is a top priority of the Biden-Harris Administration, and thanks to President Biden’s American Rescue Plan, Oregon can better provide its residents with the support and stabilization services they need during times of crisis. I encourage all states to take advantage of this opportunity and work with us to expand access to these critical health care services.”