The $1.9 trillion coronavirus relief package, the American Rescue Plan Act of 2021 (H.R. 1319) was passed by the U.S. House of Representatives and signed into law this week.
The bill is enormous and includes funding and provisions for many facets of the U.S. economy. Specifically, this post will cover the key provisions that support mental health and substance abuse disorders such as youth suicide prevention; to reduce suicide risk, burn out, and behavioral health conditions for health care professionals and students; and a public service campaign.
One of the more widely discussed aspects of the Act is the enhancement to ACA health insurance coverage subsidies. This Act is the largest health insurance coverage expansion since the ACA in 2010.
For two years, the legislation expands ACA health insurance coverage support and should significantly reduce the un- and under-insured rate in the country. By increasing the insured rate, more Americans can receive care and be seen by providers for both chronic and acute mental health conditions.
For example, one expert estimates that a family of four making $85,000 with $25,000 in health insurance coverage costs will pay just $7,000 with this support, by receiving a subsidy of $18,000. The amount of support depends on income levels.
Additionally, the bill allows reduces premiums for individuals to continue COBRA insurance through September 30th, 2021.
Dr. Lorna Breen Health Care Provider Protection Act
This Act aims to prevent suicide, burnout, and behavioral health disorders among health care professionals.
Named after an emergency department doctor, the Act authorizes grants for providers to create behavioral health programs for front-line health care workers. The Act provides $100 million to fund a Behavioral Health Workforce Education and Training Program.
The Act requires the Department of Health and Human Services to research and suggest strategies to address provider burnout and foster resiliency. And it directs the CDC to run a campaign encouraging health care workers to seek assistance when needed.
Community Behavioral Health Services
This section of the Act supports the National Child Traumatic Stress Network, Project AWARE (Advancing Wellness and Resiliency in Education), youth suicide prevention, and Certified Community Behavioral Health Clinics.
For example, the act provides $420 million to Community Behvaioral Health Clinics in which behavioral health is integrated with physical health care, more consistent use of evidence-based practices, and improved access to high-quality care.
One of the reasons mental and behavioral health has been such a tricky issue to solve in health care is how care needs to be locally based in the community. While some areas of health care can be solved by scalable solutions such as electronic health records or innovations in plan design, care delivery is still local.
By supporting community mental and behavioral health services, the Act can make a difference in the lives of millions of Americans.
Pediatric Mental Health
The Act makes available grants to support pediatric mental health access. These grants will be available to promote mental health integration with overall pediatric primary care.
It provides $80 million to the Pediatric Mental Health Care Access Program, funding for grants to states, Indian tribes and tribal organizations to support virtual mental health care access programs.
This is timely given the increases in symptoms of pediatric mental health conditions during COVID and the related lockdowns and shelter in place orders. As we’ve discussed previously, the future of mental health is preventative.
Veteran Medical Care
The Act provides $1 billion to support health care services and support to veterans and the VA through September 2023.
Given the shocking statistic that a veteran dies by suicide ever 22 seconds, the VA is an important component of mental and behavioral health and suicide prevention.
Tribal Health Care
The Act includes $5.4 billion to support Indian Health Services, with $420 million specifically for mental and behavioral health. Other sections, such as $140 million for information technology and telehealth and electronic health records infrastructure may also lead to improvements in mental and behavioral health outcomes among tribal members.
Mobile Crisis Services
The Act supports community-based mobile crisis intervention services. By providing Medicaid support for mobile crisis intervention teams, the Act will encourage states to respond to individuals experiencing a mental health crisis effectively and without unnecessary emergency medical or law enforcement responses.
SAMHSA has identified mobile crisis outreach as a core service and best practices for behavioral health crisis care. This will integrate with the 988 national suicide crisis hotline once it’s operational.
Quotes about the American Rescue Plan Act
“It is essential and heartening that Congress and the administration included funding for our nation’s mental health system in this wave of COVID relief. We are particularly pleased to see support for our front-line physicians and other workers, many of whom have made great sacrifices during this time, and many of whom are hurting.” – APA President Jeffrey Geller, M.D., M.P.H.
“As an organization dedicated to saving lives and bringing hope to those affected by suicide, we would like to thank Congress for their critical work in addressing and providing increased funding for suicide prevention and behavioral health.” – AFSP CEO Robert Gebbia
American Psychiatric Association: APA Praises Inclusion of Mental Health Funding and Provisions in the American Rescue Plan Act of 2021
American Foundation for Suicide Prevention: AFSP Thanks Congress for Prioritizing Mental Health and Suicide Prevention
American Hospital Association: AHA Expresses Support for the Dr. Lorna Breen Health Care Provider Protection Act