A top NAPHS priority – the “Medicaid Emergency Psychiatric Care Demonstration” – is now underway. NAPHS is now working with members, Congress, and federal agencies on implementation issues.
Starting in July 2012, 11 states and the District of Columbia began implementing the NAPHS-backed Medicaid Emergency Psychiatric Demonstration, which was authorized in the Affordable Care Act. The demonstration is a three-year, $75 million project allowing states selected in March 2012 to cover patients in freestanding psychiatric hospitals and to receive federal Medicaid matching payments for patients ages 21 through 64. The goal of the demonstration is to expand the number of emergency inpatient psychiatric care beds available in communities.
The Medicaid Emergency Psychiatric Demonstration has had widespread support (from groups ranging from NAMI to the Emergency Nurses Association as a way to address a pressing need. The Medicaid program is a vital source of support for people with mental disorders, funding more than 50% of state and local spending on mental health services. Non-governmental community-based psychiatric hospitals could help relieve this access problem; however, due to a Medicaid statutory provision called the Institution for Mental Disease (IMD) exclusion, patients receiving care in these hospitals are not covered for their care if the patients are between the ages of 21-64 and the hospitals cannot get Medicaid federal matching payments for these services.
This demonstration is seeking to present a solution. In a June 1, 2009, Government Accountability Office (GAO) report (GAO-09-347) on hospital emergency departments, it was reported that difficulties in transferring, admitting, or discharging psychiatric patients from the emergency department were a factor contributing to emergency department overcrowding.
We believe that this demonstration can set the stage for positive change for our state and the nation, and it can save money.
S.599, the Improving Access to Emergency Psychiatric Care Act introduced by Sens. Ben Cardin (D-MD), Patrick Toomey (R-PA), and Susan Collins (R-ME) to extend and expand the Medicaid Emergency Psychiatric Demonstration. See Congressional Record statement on S.599 by Sen. Cardin (scroll down to pages S1168-S1170).
NAPHS release: "President’s FY16 Budget Tackles Lingering Discrimination; NAPHS Applauds Proposal to Eliminate the Medicare 190-Day Lifetime Limit, Urges Action to Address Discrimination in Medicaid"
MACPAC presentation at 1.29.15 meeting: "Medicaid’s Role in Behavioral Health: Background and Policy Issues"
NAPHS release: "Millions of Disabled and Poor Americans Encounter Discrimination When They Face Mental or Addictive Disorders, Says NAPHS; NAPHS Applauds House Oversight Hearing on Challenges Facing Families in Mental Health Crisis."
NAPHS letter submitted to House Energy and Commerce Oversight Committee hearing on “Where Have All the Patients Gone? Examining the Psychiatric Bed Shortage.”
Senate Finance Committee "Summary and Overview of Mental Health Recommendations" received in response to their 8.1.13 Open Letter seeking input on how to improve the US mental health system.
CMS notice: "Type of Information Collection Request: New Collection (Request for a new OMB control number); Title of Information Collection: Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation"
National Association of Medicaid Directors letter to Senate HELP Committee: Includes a call for elimination of the IMD exclusion
CMS release: "Affordable Care Act Demonstration to Expand Access to Emergency Psychiatric Care; New Demonstration Program to Help States Improve the Quality of Care for Patients with Psychiatric Emergency." Also see additional information.
NAPHS statement: Reform law includes provisions important to Americans facing mental and addictive disorders. Includes IMD/EMTALA demonstration on emergency psychiatric care. [View]