Resolution in Support of the Increasing Behavioral Health Treatment Act (H.R. 2611) and Related Reforms to the Medicaid IMD Exclusion
Adopted at the 90th Annual Meeting in 2022
WHEREAS, the federal Medicaid statute prohibits federal Medicaid payments to states for services provided in institutions for mental disease (IMDs), which are defined as hospitals, nursing facilities, or other institutions of more than 16 beds that are primarily focused on treating mental illness, including substance use disorder; and,
WHEREAS, the IMD payment exclusion has resulted in unintended consequences, including undermining mental health parity for Medicaid beneficiaries, and contributing to critical treatment bed shortages; and,
WHEREAS, despite successful efforts to address these disparities there is still a significant gap in coverage for low-income people who need inpatient or residential mental health treatment because of the long-standing Medicaid IMD exclusion; and,
WHEREAS, America's cities are home to over 80% of the population and, as such, have seen the greatest impact of untreated SMIs and SUDs among their residents, particularly as they pertain to homelessness and crisis situations, while mayors have been called upon to take the lead to address the occurrence and effects of these situations; and,
WHEREAS, the IMD exclusion limits state and local government's ability to develop needed inpatient and residential care for those with SMI or SUD, a situation that often results in individuals who need IMD care instead experiencing repeat hospitalizations, homelessness, and episodes of incarceration; and,
WHEREAS, these problems have only been exacerbated during the COVID-19 pandemic due to the unprecedented strain placed on public behavioral health systems as well as the pandemic's ongoing economic and social impacts.
NOW, THEREFORE, BE IT RESOLVED, that The United States Conference of Mayors urges Congress to:
- Enact the Increasing Behavioral Health Treatment Act (H.R. 2611), which would lift the IMD exclusion for states that have submitted a plan to: increase access to outpatient and community-based behavioral health care; increase the availability of crisis stabilization services; and improve data sharing and coordination between physical health, mental health, and addiction treatment providers and first-responders.
- Temporarily allow states to receive federal Medicaid payment for services provided in IMDs during the COVID-19 public health emergency and for 180 days after the emergency ends.