SCR 2: Supporting an all-payer crisis continuum of care and Medicaid reform; and urging the Governor to direct the Department of Health and the division of insurance to develop recommendations for an all-payer model for crisis care.
00 SENATE CONCURRENT RESOLUTION NO. 2 01 Supporting an all-payer crisis continuum of care and Medicaid reform; and urging the 02 Governor to direct the Department of Health and the division of insurance to develop 03 recommendations for an all-payer model for crisis care. 04 BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 WHEREAS, statewide and locally, the state has implemented effective crisis 06 continuum services that have the potential to work in both urban and rural communities, as 07 evidenced by mobile crisis teams meeting or exceeding national benchmarks for community 08 stabilization; and 09 WHEREAS crisis continuum services, which include crisis call lines, mobile crisis 10 teams, 23-hour crisis stabilization centers, and short-term crisis residential centers, benefit the 11 public by increasing public safety and improving acute behavioral health outcomes; and 12 WHEREAS, while the state's Medicaid State Plan services and Section 1115 13 Behavioral Health and Substance Use Disorder waiver services reimburse some of the costs of 14 crisis care, not all components of care are billable to Medicaid, including transportation to 15 subacute mental health facilities and medication dispensed in 23-hour crisis stabilization
01 centers; and 02 WHEREAS, while the state's Medicaid does reimburse many crisis services through 03 its 1115 waiver, the reimbursement often does not adequately cover the cost of operations for 04 mobile crisis teams and crisis stabilization services; and 05 WHEREAS funding streams for crisis continuum services that are not covered by 06 Medicaid, including crisis call center costs and capital costs of constructing inpatient and 07 outpatient facilities, are not adequate to cover the cost of care; and 08 WHEREAS certain health insurance plans are required by the federal Paul Wellstone 09 and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and the No 10 Surprises Act of 2021 to comply with federal parity laws, including coverage of crisis 11 services, and the state lacks a mechanism to assess and report on compliance with those laws; 12 and 13 WHEREAS crisis care providers must rely on short-term, unstable grant funding to 14 provide essential behavioral health services; and 15 WHEREAS, because of the uncertain funding mechanisms and billing-related 16 administrative barriers for the cost of care, some providers in the state have discontinued vital 17 crisis services or paused planning for the services; and 18 WHEREAS innovative, evidence-based policy solutions that help remove 19 administrative red tape and bring all insurers to the table must be considered to ensure the 20 sustainability of crucial crisis services; and 21 WHEREAS policy changes to maximize Medicaid funds and reduce administrative 22 barriers could include updates to the state's Medicaid State Plan, including rolling appropriate 23 1115 waiver services into the State Plan and updating the State Plan to include crisis services 24 offered 24 hours a day and seven days a week and to allow for a wider range of crisis 25 providers; and 26 WHEREAS, to help ensure the sustainability of crisis services with commercial 27 insurers while avoiding an unnecessary burden for providers to contract individually with 28 plans, the state may consider establishing a small assessment on commercial health insurers 29 for each member each month instead of requiring commercial health insurers to cover mobile 30 crisis response, and the state may also consider implementing a 988 telecommunications 31 surcharge, similar to the 911 surcharge, to fund the state's 988 crisis lifeline;
01 BE IT RESOLVED that the Alaska State Legislature supports an all-payer crisis 02 continuum of care and Medicaid reform to ensure that 03 (1) all payers support essential crisis services; 04 (2) red tape and inefficiencies are removed; and 05 (3) flexible solutions that work for local communities, providers, and the 06 people providers serve are prioritized; and be it 07 FURTHER RESOLVED that the Alaska State Legislature urges the Governor to 08 direct the Department of Health and the division of insurance to convene public and private 09 payers, key stakeholders, and legislative leaders to develop recommendations for an all-payer 10 model for crisis care.