House reintroduces 988 Implementation Act to strengthen local mental health crisis response

Key Takeaways

On Sept. 3, Reps. Brian Fitzpatrick (R-Pa.) and Doris Matsui (D-Calif.) introduced the 988 Implementation Act (H.R. 10280). This bipartisan legislation strengthens the nationwide 988 system by providing long-term federal funding to counties, which often serve as frontline administrators of local mental health crisis services.

Launched nationwide in 2022, the 988 Suicide & Crisis Lifeline was created to offer 911-style emergency response specifically for mental health emergencies. Historically, when behavioral health care has been inaccessible, counties have often served as the provider of last resort and absorb heavy financial burdens across local emergency departments, housing programs, and the justice system. 

In response, more and more counties are building mobile crisis response teams, which are comprised of multidisciplinary mental health professionals that rapidly respond to off-site mental health crisis calls and connect individuals to care. Approximately 1,245 counties in the U.S. have at least one mobile crisis response team. 

What would the bill accomplish?

To sustain and expand these local efforts, federal support is critical as initial grant funding and temporary Medicaid match rates near expiration. The 988 Implementation Act would:

• Authorize $441 million in dedicated funding for technology upgrades, staff training and operations at over 250 local 988 call centers to ensure adequate crisis response.
• Direct $100 million for mobile crisis response teams.
• Permanently secure an enhanced 85 percent Medicaid Federal Medical Assistance Percentage (FMAP) for 988 call centers and crisis receiving facilities, offering states a massive financial incentive to build out their 988 infrastructure.
• Authorize $25 million for crisis workforce development across the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) programs and expands National Health Service Corps eligibility to clinicians and specialists working in crisis call centers, mobile teams and stabilization facilities.
• Create an exception to the Institution for Mental Diseases (IMD) exclusion, which refuses Medicaid payments to mental health facilities with more than 16 beds. Because modern crisis receiving and stabilization centers often have more than 16 beds, this legislation would allow them to bill Medicaid for brief stays regardless of their bed size.

Importance to counties

Counties are key implementers of the 988 system, and stable federal funding directly affects their ability to sustain crisis response services. Sufficient investment in local 988 infrastructure allows counties to:

• Divert individuals experiencing a mental health crisis from emergency rooms and jails.
• Protect local budgets that would otherwise absorb the cost of inadequate crisis response.
• Build out mobile crisis teams and stabilization facilities that reduce reliance on higher-cost, higher-acuity care.

NACo urges members to reach out to their House members and request that they cosponsor and support the swift passage of the 988 Implementation Act. Securing this bipartisan legislation will ensure that counties have the stable funding, workforce and federal flexibility needed to divert individuals from emergency rooms and jails, protect local budgets and save lives in every community.