National Association of Counties and National Association of County Behavioral Health and Disability Directors Applaud President Biden’s Strategy to Address National Mental Health Crisis, Commit to Working with Administration on Implementation

WASHINGTON – The National Association of Counties (NACo) and the National Association of County Behavioral Health and Disability Directors (NACBHDD), sent a letter to U.S. Secretary of Health and Human Services Xavier Becerra expressing gratitude for the release of President Biden’s strategy to address the national mental health crisis. The two organizations particularly support the administration’s efforts to conduct listening sessions to gather more information on how to best implement the strategy and call for the inclusion of county officials and behavioral health and disability directors in these conversations.

An excerpt from the letter reads:

Counties are integral to the nation’s behavioral health system, as both fiscal contributors and coordinators of behavioral health services within county-owned and operated community health facilities. Through 750 behavioral health authorities and community providers, counties plan and operate community-based services for individuals with mental illnesses and substance use conditions. In nearly every state and the District of Columbia, there is at least one mental health facility operated by a county, local or municipal government. Additionally, counties help finance and administer Medicaid services, the largest source of funding for behavioral health services in the United States. By directing resources to community-based treatment and services, counties can better serve residents with behavioral health conditions, reduce reliance on the criminal legal system and direct valuable resources towards improving stability and health.

“The details of president’s mental health strategy parallel that of county behavioral health priorities, which emphasize the need for greater access to and availability of county behavioral health services.”

In the letter, NACo and NACBHDD make the following policy recommendations to further enhance behavioral health care access and availability in counties:

• Increase integration, coordination and access to care by removing exclusion policies that create barriers to treatment services such as the Medicaid Institutions for Mental Diseases (IMD) exclusion and Medicaid Inmate Exclusion Policy (MIEP). Additionally, ensure barriers to Medication Assisted Treatment (MAT) for opioid use disorders are removed from Medicaid policies.
• Improve reimbursement mechanisms and finance behavioral health care enhancements through sustained Medicaid funding for outpatient mental health services, specifically related to the development of local crisis response infrastructures.
• Support rural counties who face unique challenges in sustaining access to prevention, treatment, and recovery-oriented services, including crisis response, and recruiting, training, and sustaining a sufficient workforce.

Read the full letter here.