Recent federal policy updates aim to improve access to crisis care

As thought leaders in behavioral health crisis care, Connections Health Solutions (CHS) advocates at all levels of government for an improved and reimagined crisis response system that provides immediate access to high-quality behavioral health crisis care for all who need it when they need it. 
 
As we enter 2023, CHS strives to educate federal, state and local elected and appointed policymakers on the value of its medical care model that serves the highest acuity crisis patients presenting with suicidal behaviors, acute agitation and substance intoxication.   
 
Without a viable option for these high acuity individuals, the crisis continuum is incomplete, and individuals with the most need for specialty crisis care end up routed to emergency rooms and jails. 
 
Updates in federal and state governments will make behavioral health crisis care better and more accessible across the country. From spending increases to updated criteria for clinics to advocacy and more, there’s a lot happening to ensure people can access high-quality, effective behavioral health care. Here’s a highlight of recent events and how Connections Health Solutions will continue to change the crisis care landscape.   

• Behavioral Health Spending Increases by 12% 

• President Biden signed the $1.7 billion omnibus package on December 29. The package: 

• funds the federal government through the current federal fiscal year 
• increases opioid abuse funding by 6% to $4.9 billion 
• increases mental health funding by 18% to $5.27 billion for treatment, prevention, and research initiatives 

• Several items in the package give behavioral health organizations the opportunity to advance payment policy with the Biden Administration: 

• requires the Department of Health and Human Services (HHS) to issue guidance on how to develop an effective crisis continuum of care. These provisions will support expansion of services for people in a mental health, substance use or suicidal crisis. 
• engage the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Health and Human Services on mandates to improve the availability of behavioral health integration in the Medicare program 
• provide states with recommendations and best practices regarding the development of an effective crisis response continuum of care through Medicaid and CHIP 
• establish a technical assistance center to provide support for states in implementing crisis response services 

• SAMHSA’s CCBHC Draft Criteria Update Fosters Partnerships with Specialty Crisis Providers 

• SAMHSA released a revised draft update of the Certified Community Behavioral Health Clinics (CCBHCs) Certification Criteria on December 21. 
• Requirements in the criteria have been amended to align with the National Guidelines and the implementation of 988. They also recognize the varying availability of crisis services.  

• Updates were made in the areas of crisis care and responding to the opioid epidemic 
• Updates also included increased flexibility and clarifications  

• VA Announces Huge Win for Access to Emergency Mental Health Care for Veterans 

• Starting Jan. 17, Veterans in acute suicidal crisis will be able to go to any VA or non-VA health care facility for emergency health care at no cost. 
• This includes inpatient or crisis residential care for up to 30 days and outpatient care for up to 90 days.  
• Veterans do not need to be enrolled in the VA system to use this benefit. 
• The final policy took effect on Jan. 17. 

• It allows the VA to:  

• provide, pay for, or reimburse for treatment of eligible individuals’ emergency suicide care, transportation costs, and follow-up care at a VA or non-VA facility for up to 30 days of inpatient care and 90 days of outpatient care. 
• make appropriate referrals for care following the period of emergency suicide care. 
• determine eligibility for other VA services and benefits. 
• refer eligible individuals for appropriate VA programs and benefits following the period of emergency suicide care. 

• Congress Unwinds Medicaid Continuous Eligibility Starting April 1, 2023  

• On Jan. 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023. 
• A key provision in the recently adopted Consolidation Appropriations Act (CAA) 2023 allows states to start Medicaid eligibility redeterminations and renewals on April 1, 2023.  
• The National Association of Medicaid Directors (NAMD) polled members and 58% of Medicaid agencies plan to start their unwinding period in April, 23% plan to begin in March while 16% begin in February.  
• CMS proposed a rule allowing federal and state marketplaces to implement a special enrollment period for individuals losing their Medicaid coverage.  

• Enrollees can select a marketplace plan 60 days before or 90 days after their loss of Medicaid coverage. 
  

Chris Santarsiero is the Vice President of Government Affairs at Connections Health Solutions.  A strategic leader of the Growth and Development Team, Chris develops and executes federal and state policy outcomes that drive market access, innovative value-based care models, thought leadership, and new business opportunities.  At Connections, Chris advocates for the value of its medically integrated care model that serves the highest acuity crisis patients presenting with suicidal behaviors, acute agitation and substance intoxication. 
  
Chris has 24 years of growth, market access, and profitability-driven government relations, contract procurement, and consulting experience.  Chris recently served as the Government Markets Director at National Strategies (NSI) aligning strategic sales efforts with state and local governments. Chris also brings 15 years of experience advancing federal and state healthcare policy focusing on Medicare, Medicaid, and data interoperability at VITAS Healthcare, the largest end-of-life provider in the country. During this time, he established revolutionary contracts with the Department of Veterans Affairs to meet the unique needs of America’s Veterans and their families. He also led value-based partnerships with major health systems and insurers. 
  
Chris has a B.A. in English and Communications from La Salle University in Philadelphia and an M.B.A. in Finance from the Malcolm Baldrige School of Business at Post University.