Mental Health

Support for establishment of mental health crisis centers, mobile mental health crisis teams

AZ does not have a state wide program, but local EMS agencies are using community paramedicine to refer and transport.

There are approximately 25 bills introduced each year impacting mental health care for ED patients.

Mental health is a key focus of our current administration and legislature. Dozens of bills have been introduced each year for the past several years. Contact COACEP with specific questions.

New 2024 Live Healthy bill (SB 7016) had a companion bill specifically dealing with behavior health teaching hospitals: SB 330 Behavioral Health Teaching Hospitals. HB 7021 Mental Health and Substance Abuse: BAKER & MARCHMAN ACT

Passed legislation regarding mental health parity, adding community service boards. GCEP and Georgia Psych Assoc created a workgroup regarding boarding, and are working to create an oversight board (similar to Trauma).

2022: 988 Program implementation

2021: ICEP legislation (Act 102-0623) approving transport of MH patients to non-ED alternative locations

2023 SB1 Medicaid waiver for funding of services, expansion of community mental health programs, and increasing access to care.

Comprehensive legislation was passed in the last session: Chapter 177 of the Acts of 2022

Summary: Substantially overhauls the delivery of mental health care in the Commonwealth — the conference report mandates insurance coverage of an annual mental health wellness examination from either a mental health professional or primary care provider; establishes online portals to provide real-time information on the availability of psychiatric and substance use disorder inpatient beds to facilitate placement for adults and children in need of care; establishes a complex case interagency review team to collaborate on cases involving youth who are disabled or have complex behavioral health needs and may quality for services from multiple agencies; requires emergency departments to have qualified behavioral health clinicians available during operating hours to evaluate and stabilize a person admitted with a behavioral health presentation; requires insurance to cover medically necessary mental health acute treatment without pre-authorization; directs the health policy commission to develop a standard release form for exchanging confidential mental health and substance use disorder information; directs EOHHS to designate 988 crisis hotline centers to provide crisis intervention services; and establishes an Office of Behavioral Health Promotion.

Legislation in 2018 to establish a state-wide psychiatric bed registry system; being implemented this year.

December 2023 Update: Many bills and budget items.

Mental health is causing a large boarding issue in MN. MNACEP worked with the Minnesota Medical Association to develop a study and best practice concepts on how to assist with this issue. Also, we are supporting bill SF# 3989 in the legislature to assist with boarding by improving the process with DHS, Guardians and up-front placement payments.

During the 2023 session, HB 231 was passed requiring Dept. of Mental Health to create a statewide fentanyl/drug abuse program emphasizing prevention, education, and cessation. We expect continued discussion on mental health issues in the upcoming session.

Recent reimbursement increases and telehealth parity for mental health care.

No Bills filed yet this session; however, mental health will be a big factor in the budget, as forecast by House and Senate leadership.

SB 60 and HB 97 have been introduced to create a new certified mental health assistant profession. Ohio ACEP has created an ED Psych Boarding Workgroup to try to identify and remove barriers to psychiatric consultation and management of patients with psychiatric emergencies in the ED.

Oregon has passed pay parity for Telehealth, new investments over $1B in the BH workforce, reimbursement increases and community mental health services since 2021. This is a priority for Oregon’s governor.

PACEP has engaged both Osteopathic and Allopathic licensing boards to ensure no stigmatizing questions on licensing applications. We're working with various legislators to find novel mental health initiatives.

A bill has been introduced limiting TennCare mental health patients boarding in the ED to 72 hours. SB 2676 has not passed. Another bill requires mental health hospitals post on line bed availability HB 827 has not passed.

UMA supporting legislation to expand care. Last year, multiple new psych residency slots opened, and telehealth expanded.

Supporting development of pediatric mental health centers. Also, working with hospital association to improve Medicaid reimbursement.

Legislation is pending to temporarily lift Certificate of Need for psychiatric hospitals; establish behavioral health crisis relief center access for minors; and to provide housing and other supports to young adults transitioning out of inpatient behavioral health treatment. Funding is proposed in the state operating budget to increase capacity at a number of state-run behavioral health facilities (among other investments).

We expect there to be legislation and provisions in the Governor’s budget related to existing mental health programming, potentially creating more beds and more access to crisis stabilization.