In a series of posts, Myers and Stauffer will highlight parts of the American Rescue Plan Act of 2021 that can have tremendous impact on delivery and financing of services by state health and human services programs.
As part of our series on the American Rescue Plan Act (ARPA) of 2021, this next installment focuses on the additional grant funding provided to the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide additional funds to support persons with mental illness and substance use disorders. The ARPA provided an additional $1.5 billion each for the Mental Health Block Grant (MHBG) and Substance Abuse Prevention and Treatment Block Grant (SABG).
In May, SAMHSA released additional guidance on the funding and the requirements for spending the additional allocations in accordance with the existing block grant rules and the tables with the supplemental grant awards by state. Generally speaking, each of the supplemental awards follows the same general rules. However, SAMHSA indicated that consistent with HHS disaster relief flexibilities, they may waive requirements related to allowable activities, timelines, and reporting.
The MHBG block grant and the supplemental funding require a 10 percent set aside from the grant to pay for first-episode psychosis or early severe mental illness (SMI) programs. However, outside of that requirement, the guidance recommends that states consider using the remaining 90 percent of the grant to further develop behavioral health crisis services that support the needs of anyone, anytime, and anyplace. Specifically, SAMHSA recommends that states focus their additional funding on creating greater partnerships and improving programs that support an inclusive crisis system adept at serving remote areas, underserved communities, youth, older adults, and persons of diverse backgrounds. While the funding is a single supplemental amount, it provides an opportunity to tackle problems that have high start-up or technology costs such as increasing access to broadband, developing and implementing a screening and assessment system, developing new partnerships, implementing electronic bed registries, and strengthening outpatient crisis stabilization and treatment services.
Similar to the MHBG requirements, SABG supplemental funding is required to follow the existing statute and regulations that govern the block grant. The SUD prevention, intervention, treatment, and recovery support services continuum includes evidence-based services and supports for individuals, families, and communities. The SAMHSA guidance specifically highlighted supporting health equity through a priority focus on the provision of SUD services to identified underserved populations.
The SAMHSA guidance also provided recommendations for use of the supplemental funding to enhance and improve the continuum of care for substance use disorders. The guidance provides examples such as:
- Providing increased access through same or next day appointments using low barrier approaches for those in need of SUD treatment.
- Improving information technology infrastructure in rural and frontier areas.
- Adopting and using technology that improves access to and coordination of services.
- Expanding use of telehealth including expanded options such as texting, telephone, and telehealth (although the funds cannot be used to purchase items for consumers/clients).
- Supporting peer-based recovery services.
- Incorporating strategies that address adverse childhood experiences to improve outcomes among all populations but particularly among young adults.
For both grants, SAMHSA is requesting that states provide specific information in their proposal submissions that includes (among other things) identifying needs and gaps in the service continuum, describing the way in which the proposed spending plan will address those gaps, overall progress in meeting goals, and how the state will use or consider health IT standards if using the funding for any IT infrastructure or advancement. The guidance outlines in greater detail the specifics of the requested information by block grant; however, states may wish to start the planning process by considering their overall system gaps and identify initiatives that they may have planned to implement, but set aside due to funding or time constraints. Funding may also be available from multiple sources and states may wish to discuss internally Medicaid, other grant programs, and current general or other revenue funding sources to ensure that they are maximizing all the available funding to support planning and program implementation.
As planning begins, states may wish to consider all available funding from ARPA and determine which source is the best for developing any needed analysis, planning, or infrastructure development, and which would be the best source to support direct services or other needs. For example, SAMHSA also highlighted Certified Community Behavioral Health Clinics and crisis response in its May guidance. We discussed both in prior articles, and the direct funding available for those services. With some planning, states have a significant opportunity to maximize the various funding sources for those and other MH and SA services. If you would like more information about the ARPA or about how Myers and Stauffer can help to implement and leverage grant, Medicaid or other health and human services programs please contact us.
Contact the Contributors:
|Julia Kotchevar, MA
Health Care Senior Manager