A $15 million grant program could kickstart a new approach to behavioral healthcare delivery in U.S. nursing homes, the Department of Health and Human Services announced Monday.
Over three years, one grant recipient would be expected to build a national Center of Excellence that will increase facilities’ capacity to provide high-quality mental health and substance abuse care. The center is expected to provide direct consultation to staff to increase understanding of and reduce stigmatization of behavioral healthcare for residents. It also will ensure access to training and technical assistance focused on mental health disorder identification, treatment and recovery support services.
The Centers for Medicare & Medicaid Services will use Civil Money Penalty funds imposed against nursing homes to fund the new center. Applications are due in June, and HHS expects to select a grant recipient by the end of this fiscal year.
“Physical health and mental health are equally important and should be treated as such, including in our nation’s nursing homes and other long-term care facilities,” HHS Secretary Xavier Becerra said in a statement announcing the grant’s application period. “The program’s goal reflects two commitments of the Biden-Harris Administration — to transform our mental health and crisis care systems so this type of care is provided holistically and equitably, and to improve the quality of our nursing homes and other long-term care facilities so the people living there get the care they deserve.”
Federal officials said the program, a joint effort of the Centers for Medicare & Medicaid Services and the Substance Abuse and Mental Health Services Administration, would expand on the administration’s efforts to reform nursing home care.
Eleanor Feldman Barbera, Ph.D., a licensed psychologist and long-term care industry expert, called Monday’s announcement a “good step in the right direction.”
“Geropsychologists have a great deal to offer the industry and I’d like to see their involvement in the development of these efforts,” said Barbera, who recently used a recent McKnight’s column to outline her desire for change in the way nursing home psychology services are utilized and reimbursed. “I’m hoping for a shift from fee-for-service payments for individual residents to a payment model that promotes well-being through groups for residents and families, ongoing training and support for staff, and attends to team functioning.”
Better training in the offing?
Many providers have acknowledged seniors’ growing behavioral healthcare needs both prior to and during the pandemic. While some are turning to telehealth as a first step, experts have called for more robust solutions that are built into routine care and more often delivered in person.
Deborah Davis, Ph.D., is a former 20-year nursing home administrator now serving as a California-based consultant to nursing homes and assisted living facilities. She said some nursing homes have served as holding facilities for residents with skilled needs and mental health disorders, even when their staff members are not prepared to care for such residents.
She hopes a new national approach will help destigmatize diagnoses and provide more multidisciplinary training opportunities, access to psychologists and psychiatrists, and better financing for behavioral health care in the SNF setting. She noted that in California, a differential for special treatment programs provides just $5.72 per patient per day — a rate that’s been stagnant since 1972.
In some states, regulations are already pushing the pursuit of improved behavioral programs. But with behavioral health disorders increasing across demographics and across the country, Davis sees investing in quality mental health and substance abuse care as a way for nursing homes to achieve long-term viability.
“I see some of the more aware nursing home chains that see the trends, they see that they need to get in front of providing mental health services,” she told McKnight’s on Monday. “Folks that are more open to trying new things and new ways of doing them will be more successful.”
CMS Administrator Chiquita Brooks-LaSure added that a nationwide approach also should provide better access to prevention and treatment for substance use issues, crisis intervention and pain care.
“Making behavioral healthcare a priority in nursing homes and other long-term care facilities supports a person’s whole emotional and mental well-being, promotes person-centered behavioral health care, and advances our CMS behavioral health strategy,” she said in the HHS press release.
