Preparing for Increasing Need for Services, Providers Get Boost from Stimulus

The $2 trillion coronavirus (COVID-19) relief bill signed on Friday by President Donald Trump includes several provisions that will directly support the nation’s behavioral healthcare infrastructure.

The stress being created by the COVID-19 pandemic could have long-lasting mental health impacts, from healthcare workers on the front lines to vulnerable populations sheltering in place at home, and it will be critical for behavioral health providers to stay afloat and be ready for a surge in need for their services, says Charles Ingoglia, MSW, president and CEO of the National Council for Behavioral Health.

“Most immediately, what I’m worried about is the ongoing viability of the community behavioral health organizations, many of whom don’t have a lot of cash on hand and even with the switch to telehealth are experiencing reductions in utilization and therefore reimbursement,” Ingoglia tells BHE. “Our most immediate action is to seek more fiscal relief for community behavioral health organizations from the federal and state governments.

“If we can maintain our services 60 or 90 days… Everybody who has thought about this has indicated that between effects of social isolation and just the economic uncertainty our nation is facing, we should experience an increase in need for behavioral health services, whether people have anxiety, depression or suicidal thoughts. What I’m concerned about is making sure we have enough system capacity to be there to respond when we see that spike.”

Among the allocations included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act that will affect healthcare providers:

$425 million for Substance Abuse and Mental Health Administration (SAMHSA) programs, including $250 million for Certified Community Behavioral Health Clinics (CCBHCs), $50 million for suicide prevention programs, $15 million for tribes, and another $100 million in general funds for other SAMHSA programs. Ingoglia says National Council is working to determine how and when funds for CCBHCs will be disbursed.

$350 billion for a Paycheck Protection Program, to be administered by the Small Business Administration, for organizations with 500 or fewer employees. This includes Medicaid providers, who were excluded in an earlier version of the bill. National Council was one of several organizations to advocate for their inclusion, Ingoglia says.

“That provision was removed so that mental health and addiction treatment organizations can apply for small business loans,” he says. “We know that most behavioral health organizations are small organizations, so hopefully they can take advantage of that.”

$200 million to support telehealth. Grants to healthcare organizations investing in telehealth technologies, including broadband and devices, will be administered by the Federal Communications Commission. With the emergence of the COVID-19 pandemic, Ingoglia credited federal and state officials for quickly pivoting to make telehealth more accessible for a wide variety of practitioners, helping organizations maintain their outpatient operations.

“It’s great that, in a way, policy is finally catching up with technology. Much of our lives is supported through technology like cell phones and computers,” Ingoglia says. “I think telehealth interventions are a natural support to that. It will take some getting used to, both for clinicians and practitioners as well as clients interacting in this new medium. … The bigger question is when this does end, how do we make sure that some of the policy changes that have been implemented on a temporary basis remain in place? What would be even worse is going back to what we had before, which was very limited access to reimbursement for technology supports.”