Your voice in Washington

Nationwide CCBHC Expansion in Bipartisan Safer Communities Act

S. 2938

Certified Community Behavioral Health Clinics (CCBHCs) coordinate and manage care across the spectrum of health services for positive outcomes. Netsmart is a technology partner to CCBHCs nationwide, and a strong advocate for sustained funding for CCBHC expansion alongside the National Council for Mental Wellbeing and other key associations.

This landmark bill, signed into law in June 2022, includes $8.5 billion for extension and expansion of the successful CCBHC Medicaid state financing demonstration program:

• Adds 10 new states to the demonstration program beginning in July 2024 and 10 additional states every two years
• Provides planning grants to help new states develop proposals to participate in the CCBHC demonstration program
• Extends enhanced match for the original 8 demo states through Sept. 2025
• Provides Kentucky and Michigan (the 2 newest demo states) funding for 6 additional years beyond their launch dates

More Information
National Council for Mental Wellbeing 2022 CCBHC Impact Report
Netsmart comment filing: SAMHSA CCBHC Certification Criteria
Speak with a Netsmart CCBHC Specialist

42 CFR Part 2 Reform

• Netsmart played a key role in passage of the Protecting Jessica Grubb’s Legacy Act (the Legacy Act) as part of the CARES Act in 2020
• The Legacy Act made significant amendments to the decades-old 42 CFR Part 2 substance use disorder (SUD) privacy statute to align it more fully with HIPAA for the purposes of treatment, payment and healthcare operations (TPO)
• This closer alignment with HIPAA enables appropriate access to a patient’s SUD treatment records, with patient consent, for only healthcare TPO to help ensure accurate diagnosis, effective treatment, and enable coordinated, “whole-person” care in an integrated healthcare ecosystem
• The law also strengthens protections against the use of SUD records in civil, criminal, administrative, or legislative proceedings, and retains strong penalties for information breaches
• The Legacy Act will be actuated upon issuance of a SAMHSA Final Rule, expected in late 2023
• Netsmart filed comments to the SAMHSA Notice of Proposed Rulemaking (NPRM) to help assure that the Final Rule closely aligns with the CARES Act statutory language
• Other commenters included the Partnership to Amend 42 CFR Part 2, a consortium of behavioral healthcare providers, patients, patient advocate organizations, clinicians, hospitals, payers and others, including technology providers (Netsmart is a founding member)

More Information
Netsmart Summary: The Legacy Act
Netsmart comment filing: SAMHSA Part 2 NPRM
Partnership to Amend 42 CFR Part 2 comment filing: SAMHSA Part 2 NPRM

9-8-8 Implementation Act of 2022

H.R. 7116

• Authorizes funding through a variety of sources to help states, counties and community providers facilitate 988 response and a related continuum of services
• Supports the full continuum of local crisis response efforts including call centers, mobile crisis teams and crisis centers, all of which would connect persons in crisis with trained first responders and mental health providers
• Potential for reintroduction in 118th Congress

More Information
News Release – Cong. Tony Cárdenas (D-CA-29), Lead Sponsor

Medicaid Inmate Exclusion Policy (MIEP)

The National Association of Counties reports that nearly 11 million arrested and detained individuals pass through more than 3,000 local jails each year, with an average stay of 25 days. NACo data also show that approximately 44% of jail inmates have a diagnosed mental illness, and almost 2/3 have co-occurring substance use disorders.

Counties are required by federal law to provided adequate healthcare for inmates, including the NACo-reported six of ten that are incarcerated and not yet adjudicated. However, Section 1905(a)(A) of the Social Security Act prohibits Medicaid matching funds from being used to pay for inmate medical care, even if they are eligible or enrolled. This Medicaid Inmate Exclusion Policy (MIEP) results in discontinuity of care for persons after release because of the time it take to reenroll and for benefits to be restored after re-entry into the community. The significant cost of inmate medical care is the single largest line item in some counties’ budgets.

Netsmart is the technology partner to more than 250 county behavioral health, public health and other human services departments and authorities. We join NACo and the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) in supporting legislation to allow reimbursement of jail healthcare costs for Medicaid-eligible individuals.

More Information
NACo Policy Brief: Improving Health Services for Justice-Involved Individuals

Choose Home Care Act of 2021

S. 2562
H.R. 5514

• Gives qualified Medicare patients the choice to receive a range of services in their home for up to 30 days after discharge from a hospital
• Provides add-on payments for therapy, skilled nursing, primary care, personal care, continuous remote patient monitoring, meals, home adaptations and non-emergency transportation
• Eligible patients would be referred to a Home-Based Extended Care-qualified Home Health Agency that offers the Choose Home benefit
• Home health-specific services could continue beyond the initial 30 days as clinically indicated
• Provides an opportunity for market expansion and further diversification of services by Netsmart post-acute clients
• Potential reintroduction in 118th Congress

More Information
NAHC/PQHH Issue Brief

EVV in 21^st Century Cures 2.0 Act

H.R. 6000

• The CURES 2.0 Act includes a change to Medicaid electronic visit verification (EVV) requirements that would maintain the mandate (and associated penalties) for states to require an electronic visit verification for personal care and home health care services but would prohibit geolocation and biometrics as part of such systems.
  • An evaluation by ADvancing States indicates this would force states with GPS/geolocation or biometric components in their EVV systems to dismantle their existing systems and build new ones or, at a minimum, make significant changes to their current IT system
• Netsmart’s position is to continue to advocate for the use of point-in-time data capture leveraging EVV

More Information
Joint Letter about Cures 2.0 EVV provision