H.R. 3320: Strengthening Medicaid for Serious Mental Illness Act

This bill, known as the "Strengthening Medicaid for Serious Mental Illness Act," aims to improve Medicaid support for states that provide intensive community-based services for adults suffering from serious mental illness. Here’s a breakdown of what the bill proposes:

Purposes of the Act

• Increase federal Medicaid funding for states that offer intensive community-based services to adults with serious mental illnesses.
• Enhance access to these services in environments that integrate individuals into their communities.
• Avoid unnecessary hospitalizations or institutional care.
• Ensure continuous care for young adults transitioning from Medicaid services when they turn 21.

Increased Funding for Community-Based Services

The bill proposes that starting January 1, 2026, states can offer medical assistance for intensive community-based services for eligible individuals without needing to prove that these services would prevent hospitalization or institutional care. States must comply with specific requirements to qualify for increased federal funding.

Definition of Services and Eligibility

The bill defines various types of services that fall under "intensive community-based services," including:

• Assertive community treatment
• Supported employment
• Peer support services
• Community-based mobile crisis intervention services
• Intensive case management
• Housing-related activities

To be eligible for these services, individuals must meet specific criteria, including being 21 or older, having a serious mental illness, and having an income that does not exceed 150% of the poverty line.

Increased Federal Medical Assistance Percentage (FMAP)

States that meet the established criteria will receive an increase in the federal medical assistance percentage for expenses related to the intensive community-based services they provide. The amount of this increase will depend on how many categories of services the state offers.

Quality of Services

To ensure high standards of service, the bill mandates that states follow quality criteria set by the Secretary of Health and Human Services. This is to ensure services effectively prevent unnecessary hospitalizations and obtain desired health outcomes for individuals with serious mental illnesses.

Data Collection and Reporting

The bill also requires states to collect and report data every two years regarding the access and outcomes of services provided, focusing on various demographics and the efficacy of the services offered.

State Planning Grants

A provision in the bill allocates $20 million for the Secretary to distribute planning grants to states. These grants will aid states in developing the necessary infrastructure, quality criteria, and collaborative activities with service providers to implement the necessary amendments for the community-based services.

Rule of Construction

The bill clarifies that its provisions do not limit the existing rights of children and youth under Medicaid to receive intensive community-based services that are currently available through existing benefits.

Relevant Companies

None found