Section 5124 of the Consolidated Appropriations Act of 2023 (CAA, 2023; P.L. 117-328) directed CMS and SAMHSA to develop guidance to promote access to the continuum of crisis care in Medicaid and CHIP and to establish a technical assistance center to help states develop an evidence-based continuum of crisis care. The following published documents and tools are intended to advance this initiative:

1. On September 5th, 2025 CMS & SAMHSA published a State Health Official letter to provide a practical guide for states and other stakeholders on effective practices in crisis services as well as the federal authorities under which states can finance and enhance the availability of crisis response services in Medicaid and CHIP. It highlights effective strategies for crisis response services, describes specific Medicaid and CHIP authorities and flexibilities to support the full continuum of crisis services, and provides an overview of strategies for measuring and monitoring crisis response services.
2. This SHO letter aligns with SAMHSA’s recently updated, National Guidelines and Model Definitions. Together, these resources set forth a framework for reshaping community crisis care systems and ensuring timely access to care.
3. CMS established a National Technical Assistance Center (NTAC) to help states develop an Evidence-Based Continuum of Crisis Care. CMS is offering technical assistance to states through the NTAC focused on enabling states to address gaps in their Behavioral Health Coordinated Systems of Crisis Care (BHCSCC) to ensure that individuals experiencing behavioral health crises receive timely, coordinated, and effective care. For questions or feedback, please contact CMS directly at CrisisTACenter@cms.hhs.gov States may also request technical assistance through their CMS State Lead.

Congressional Update

SUPPORT Act Heads to the President Trump’s Desk 
On September 18th, the Senate passed the SUPPORT Act, reauthorizing several Department of Health and Human Services (HHS) programs addressing behavioral health and substance use disorders. Building on the original 2018 law, the 2025 reauthorization extends existing programs updates include continued funding for comprehensive opioid recovery centers, protection of the 9-8-8 Suicide Prevention Lifeline from cybersecurity threats, and renewal of the CAREER Act which helps individuals in recovery reenter the workforce. The bill is awaiting President Trump’s signature to become law (he’s expected to sign it).

Bi-Partisan Crisis Response Access and Response Expansion ‘CARE” for Behavioral  Health Act

Contact your Congressman and ask them to support the bipartisan - HR 10419 ‘‘Crisis Care Access and Response Expansion for Behavioral Health Act of 2024” or the ‘‘CARE for Behavioral Health Act of 2024. It was introduced by Congressman David Schweikert (AZ-1-R), Congressman Marc Veasey (TX-33-D) and Congressman Brian Fitzpatrick (PA-1-R). The legislation:
• Would establish a pilot for Medicare coverage for crisis services to ensure access to 
these psychiatric emergency services for every American.
• Medicare coverage would help serve more unmet communities throughout the 
country. Medicare, which covers over 64 million people, and often drives private 
insurance company decisions (covers 160 million; including children), provides little to-no coverage for community-based crisis services.
• Supported by Connections Health Solutions, RI International, National Association of 
State Mental Health Program Directors (NASMHPD), Meadows Mental Health Policy 
Institute and the National Association for County Behavioral Health/Developmental 
Disability Directors (NACBHDD).

Federal Funding Update - Shutdown or Not
Regarding federal funding, President Trump has agreed to meet with Congressional leaders 
Monday September 29th at 2 PM EST. Based on the outcome of the meeting, and the press 
afterwards, whether or not there will be a federal government shutdown on October 1st may
become more clear.

➢ Throughout the budget process, please engage your Congressional members as Congressional approval is required as part of the budget appropriations process.

Key facts:

House Appropriations Committee Also Approves Slight Increase to Mental Health Services Block Grant
On Sept. 9, the House Appropriations Committee marked up the fiscal year 2026 (FY26) Labor, Health and Human Services, Education and Related Agencies Appropriations Act without the Trump Administration’s announced restructuring of HHS to create an Administration for a Healthy America. It proposed a slight increase $1.017B for Community Mental Health Services Block Grant, level funding for CCBHCs, slight increase of $2.013B for Substance Use Prevention, Treatment and Recovery Services Block Grant, level funding of $1.575B for State Opioid Response grants and $519M (level) for 988 Suicide & Crisis Lifeline.

➢ That means both House and Senate Committees have now voted to maintain MHBG 
funding, which puts us on solid footing once Congressional leaders start serious bipartisan 
negotiations with the Trump Administration on FY funding for 2026

Senate Appropriations Committee Votes to Maintain the Mental Health Services Block Grant to Biden-Level Funding
On July 31st, a bipartisan vote, the Senate Appropriations Committee restored the Mental 
Health Block Grant to $1,007,571,000. While early in the budget process, it also ignored the 
SAMHSA reorganization and fully restored $1.6 billion for the State Opioid Response Grants and $1.9 billion for the Substance Use Prevention, Treatment, and Recovery Services Block Grant. The budget slightly increased funding for the 988-Suicide and Crisis Lifeline to $534.6 million (from $520 million) and maintained $385.5 million for CCBHCs.

President’s Budget Proposes to Consolidate Mental Health Services Block Grant into 
Innovation Fund
President Trump’s proposed budget recommends the consolidation of Community Mental 
Health Services Block Grant, Substance Use Prevention, Treatment and Recovery Support 
Services Block Grant, and State Opioid Response into the Behavioral Health Innovation Block Grant and Combatting the Opioid Crisis. The funding is proposed at $4.126 billion, but those 
respective funds totaled $4,590,650,000 in FY ’23. The budget maintains $520 million for the 988-Suicide and Crisis Lifeline. It also includes $385 million for CCBHCs.

For more information, answer any questions, tips and tricks you can contact Connections 
Health Solutions’ Vice-President of Government Affairs Chris Santarsiero at chris.santarsiero@connectionshs.com

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