Today, U.S. Senator Kirsten Gillibrand (D-NY) and Congressman Dan Goldman (D-NY-10) are announcing the Strengthening Medicaid for Serious Mental Illness Act to provide desperately needed mental health support to the 14 million adults in the U.S. living with a serious mental illness (SMI), such as schizophrenia, bipolar illness, and major depressive disorder. Too many individuals living with SMI are stuck in a devastating cycle moving between hospitals, jails, and housing instability due to lack of access to community-based treatment. In 2021, over 1/3 of individuals with SMI did not receive any form of mental health treatment. In New York City, a number of subway deaths have highlighted the need for access to intense and immediate mental health support. This bill creates a new package of services under Medicaid targeted specifically to individuals living with SMI, sets a national standard for SMI care, and incentivizes states to provide intensive community-based services to treat SMI.
“People living with serious mental illnesses need treatment and resources in order to lead healthy, full lives,” said Senator Gillibrand. “New Yorkers have seen firsthand the devastating impact of untreated mental illness in our communities and we must do more to support everyone in our state. Community-based services for adults with SMI have a proven track record of helping individuals thrive in their own homes and communities. I’m working with Congressman Goldman to pass the Strengthening Medicaid for Serious Mental Illness Act to help provide comprehensive care to adults living with SMI.”
“Every American deserves access to affordable, high-quality mental health care, and it is unconscionable that so many of those with serious mental illness are unable to get the help they need,” Congressman Dan Goldman said. “It is imperative that we strengthen Medicaid to ensure that we are protecting the most vulnerable among us through community based mental health services. Supporting those living with serious mental illnesses is an obligation we have to guarantee adequate care for every one of our neighbors.”
“The Bazelon Center for Mental Health Law strongly supports the “Strengthening Medicaid for Serious Mental Illness Act,” a critical improvement to the Medicaid program. The legislation, introduced on the 24th anniversary of the Supreme Court’s landmark decision in Olmstead v. L.C. (Lois Curtis), will incentivize states to provide a robust array of intensive community-based services for adults with mental health disabilities. These services—including Assertive Community Treatment (ACT), housing-related services, supported employment, peer support services, and mobile crisis services–have been proven to help individuals with disabilities live successfully in their own homes and communities. The services help people avoid unnecessary institutionalization in hospitals and other facilities, which under Olmstead constitutes disability-based discrimination. This bill will help states comply with their legal obligations and save taxpayer dollars that would otherwise pay for costly institutional care. The Bazelon Center is very grateful to Senator Gillibrand and Representative Goldman for taking this action to meet the huge unmet need across the country for intensive community mental health services. We look forward to working with them to help this important bill become law.” – Holly O’Donnell, President & CEO, Bazelon Center for Mental Health Law
“The National Health Law Program wholeheartedly supports the Strengthening Medicaid for Serious Mental Illness Act. Nearly one-third of adults with serious mental illness go without any treatment. This legislation will provide incentives to states, encouraging them to offer intensive and high-quality services that have a proven track record. On the occasion of Olmstead’s anniversary, we are particularly pleased with the efforts made by Senator Gillibrand’s office in showcasing a path forward to ensure that individuals with serious mental health illnesses have the necessary services and supports to live and thrive within their communities. The National Health Law Program takes pride in having contributed to the shaping of this bill and ensuring that its policies align with the needs of those who rely on Medicaid for health care. We call on the members of the U.S. Senate and the House of Representatives to pass the Strengthening Medicaid for Serious Mental Illness Act.” – National Health Law Program
Specifically, the Strengthening Medicaid for Serious Mental Illness Act would:
1. Create a new waiver program granting Medicaid authority to provide states with an option to offer a package of services targeted specifically to individuals with SMI. The package would include:
· Assertive community treatment, an evidence-based, highly individualized team-based service designed to support adults with the most intensive mental health needs;
· Supported employment to help individuals get and keep a job;
· Peer support services from individuals who have lived or living experiences with mental health conditions;
· Mobile crisis intervention teams that can help de-escalate situations and link individuals to other community-based services;
· Intensive case management; and
· Housing-related activities and services to support individuals with transitioning to and maintaining housing.
2. Require states to adhere to certain standards, like tracking disparities in treatment, to ensure services are delivered with care to all in need.
3. Create a tiered Federal Medical Assistance Percentage (FMAP) increase to incentivize states to provide intensive community-based services to individuals with SMI. This means that states could receive an increase up to 25% in funds allocated by the federal government for their Medicaid programs.