Financing and Medicaid Division

The Financing and Medicaid Division (FMD) of NASMHPD is established to support NASMHPD on issues relating to financing mental health services in the states. Because Medicaid provides significant financial support for mental health services, Medicaid legislation, rules, and budget will be a central focus of the Division. The Division provides its members with the opportunity to exchange ideas and information on financing mental health services for both children and adults. It evaluates the impact of changes in financing on the quality and accessibility of mental health services.

In 2007, the NASMHPD Commissioners established the Financing and Medicaid Division by transferring the Adult Services Division and assigning its work related to financing to the new Division. The primary focus of the Division is to enhance NASMHPD's influence on financing issues through policy analysis, information sharing, and advocacy. At the federal level, the Division will seek to impact the policies and programs of the Centers for Medicare and Medicaid Services (CMS), especially those services that provide significant financial support to the states for mental health services such as Medicaid's rehabilitation and case management programs. The Medicare benefit for mental health as well as financing for Part D prescription drugs, partial hospitalization, and other programs also will be a focus of the Division. In addition, the Division will address other federal programs that provide flexible funding and serve to leverage other resources (e.g., the maintenance of effort requirements of Substance Abuse and Mental Health Services Administration's Mental Health Block Grant Program).

The Division will address topics immediately relevant to state mental health authorities and will concentrate its work plan on the action steps necessary for states to implement high priority topics within the President's New Freedom Commission Report. It will identify financing strategies that encourage the development of community treatment systems and foster an array of services in the most cost-effective and appropriate settings. The Division will address ways for mental health departments to forge cooperative and productive working relationships with the states' Medicaid offices and other units of state government that finance mental health services.

The FMD will examine financing strategies to develop, expand, and stabilize community support services for people with serious mental illness as well as funding strategies for prevention and early intervention to reduce the burden of mental disorders in our population.

Since many of the issues addressed by the Financing and Medicaid Division are of direct significance to the day-to-day operations of state mental health authorities, the FMD maintains a close working relationship with agency directors and commissioners through its Commissioner Division Advisor and also acts as a networking facilitator for issues which cut across NASMHPD's divisions.

Financing & Medicaid Division New Releases

Delivering Behavioral Health Services in the Community

Financing the Integration of Behavioral Health: Three Cases Studies: Texas, Oklahoma and Georgia

NASMHPD has released an issue brief entitled "The Oklahoma Enhanced Tier Payment System: Leveraging Medicaid to Improve Mental Health Provider Performance and Outcomes." The report documents a benchmark incentive payment system designed to improve quality and outcomes in the state's public mental health system. The program was implemented in 2009 through a Medicaid state plan amendment and has resulted in improved quality and an increase in the number of people served.

The final report from the second Pillars of Peer Support meeting is now available. Additional information is available at the Pillars of Peer Support website.

NASMHPD's Financing and Mediciad Division released its survey results on the use of Medicaid to reimburse for peer support programs.

NASMHPD's Financing and Medicaid Division conducted a nationwide survey on the use of peer support services by the States and Medicaid reimbursement for those services. The goal of the study was to identify how States have designed their peer support services programs and to share this information among the States. The survey focused on three broad categories:
- the authority to receive Medicaid reimbursement of peer services;
- the types of services, settings and payment rates for peer services; and
- qualifications and training for peer specialists.

The survey was administered from October 1 to 14, 2010. Division member Ellie Shea-Delaney, Assistant Commissioner for Program Development and Interagency Planning, Massachusetts Department of Mental Health, presented the survey's findings at the Pillars of Peer Support Services Summit II held at the Carter Center on October 18-19, 2010. A final report on the Summit can be downloaded at the website of Pillars of Peer Support .

Please contact Christy Lentz at or (703) 682-5184 with questions or for additional information.


Financing & Medicaid Division Webinars

"How Medicaid Funding Can Support Recovery-Oriented Systems of Care" Brenda Jackson, consultant; June 30, 2014

"Oklahoma Enhanced Tier Payment System (ETPS) " Terri White (OK), Carrie Slatton-Hodges (OK), Wendy Larsen (OK), Mark Reynolds (OK), July 26, 2012

"Money Follows the Person" Dena Stoner (TX), Laurel Reagan (CT), Jamie Buchenauer (PA), Ron Hendler (CMS), September 20, 2011

"Missouri's Efforts to Integrate Care for Individuals with Serious Mental Illness: A Catalyst for Other States" Dr. Joe Parks, MD, Chief Clinical Officer, Missouri Department of Mental Health, May 24, 2011

"CMS' Demonstration to Maintain Independence and Employment (DMIE) " Dena Stoner (TX) and MaryAlice Mowry (MN), February 15, 2011