Feb 9, 2022

In late January, Gov. Charlie Baker released his proposed FY23 budget for the state of Massachusetts. How did behavioral health care fare? MAMH has a summary.

On January 26, 2022, the Baker-Polito administration filed its fiscal year 2023 (FY23) budget for the state of Massachusetts. The $48.5 billion plan reflects the administration’s prioritization of behavioral health. A cornerstone of the budget, the Roadmap for Behavioral Health Reform – which the Executive Office of Health and Human Services (EOHHS) released in early 2021 – informs a $115M commitment to expand outpatient and urgent behavioral health services. Additional increases in spending and new initiatives address homelessness, health care, mental health crisis reform, and criminal legal system reform. These expenditures, coupled with other investments, are crucial to ensuring Commonwealth residents have access to the care they need when they need it.

Here’s a breakdown of behavioral health-related budget items:

"Blurry Hospital Hallway"

Emergency department diversion

The administration’s proposed FY23 budget transfers $10M from EOHHS to the Department of Mental Health (DMH) to mitigate emergency department (ED) boarding and stabilize patients facing behavioral health crises. Known as the “Hospital Emergency Department Diversion Program,” this program moves those experiencing a behavioral health crisis out of EDs and gets them the intensive services they need in community-based settings or in their own homes. This care is available regardless of health insurance coverage or age.

Homelessness

The FY23 budget funds three new Safe Havens created in FY22, in Western, Southeast, and Northeast Massachusetts for a full year. This is achieved through a $453,000 increase in the DMH budget over FY22 allocations. The budget also includes funding in the Department of Housing and Community Development budget: a $26M increase for shelter diversion and housing first programs, and $5M for permanent supportive housing units in the newly created Sponsor-based Permanent Supportive Housing account. The latter will help to mitigate overcrowding in shelters.

Health care and behavioral health crisis reform

There are two new health and behavioral health care-related trust funds created by Gov. Baker’s proposed budget: a Behavioral Health Access and Crisis Intervention Trust Fund and a Population Health Investment Trust Fund (see outside section 21). Respectively, these funds will support a statewide, payor-agnostic community behavioral health crisis system (including delivering crisis intervention services 24/7 in mobile and community-based settings) and certain health care delivery system reform activities (including addressing health-related social needs and supporting complex care management).

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Criminal legal system reform

Set aside by the administration in FY23 is $1M in the EOHHS budget to establish a Middlesex County Restoration Center – a key development for understanding and implementing crisis response options that keep individuals from unnecessary arrest or ED admittance. Additionally, the proposed DMH budget includes one year of funding for the Men’s Recovery from Addictions Program (MRAP), a new 75-bed program at Taunton State Hospital. Currently, men who are involuntarily committed for alcohol and other substance use treatment are largely sent to Department of Corrections (DOC) facilities. This program will allow some men who are civilly committed to receive inpatient therapy-based treatment at the Taunton hospital.

These investments will promote accessible, appropriate behavioral health care for residents of the Commonwealth. We applaud the administration’s commitment to new initiatives and will also advocate to encourage further investment. Network of Care Massachusetts, an integral part of the new “front door” to behavioral health services in the Commonwealth; statewide expansion of the Safe Haven program; and expansion of Elder Mental Health Outreach Teams (EMHOTs) across our cities and towns are also important facets of a comprehensive behavioral health care system. These programs, coupled with federal emergency COVID-19 relief funding, and proposed spending in the governor’s FY23 budget, will help contribute to our collective mental health recovery post-pandemic.

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