Medicaid plays a critical role in behavioral health care, covering 22 million adults with mental health conditions and/or substance use disorders (SUD). Yet, many members face barriers to accessing care. In 2023, only about half of adults with mental illness and less than a quarter of people with SUD received treatment. Contributing factors include behavioral health care workforce shortages, limited access to community-based services that align with people’s needs and preferences, and challenges navigating a complex behavioral health service system. As the nation’s largest payer of mental health services, Medicaid offers state policymakers a key lever to address access challenges and improve outcomes.

To help states leverage Medicaid to improve access to behavioral health services, the Center for Health Care Strategies (CHCS) is seeking up to four state or U.S. territory teams to join the Advancing Community-Based Care and Expanding Support Systems (ACCESS) in Behavioral Health Learning Collaborative. The 18-month initiative will support Medicaid and behavioral health agencies in developing strategies to expand behavioral health access for adults with mental health conditions or co-occurring mental health and substance use disorders (COD). Please note that this opportunity is open to state agencies, and teams must include members from both the state Medicaid agency and the state behavioral health department/agency/office/authority. Teams may also include representatives of non-state entities, such as provider or community-based organizations. However, applications will only be considered if the required state agency representatives are part of the team.

Participating teams will focus on key opportunities, such as:

• Expanding Medicaid coverage of peer supports and integrating people with lived experience of behavioral health needs into the workforce.
• Increasing low-threshold, community-based behavioral health services that are accessible and person-centered.
• Supporting integrated, multidisciplinary care models, such as Collaborative Care or Certified Community Behavioral Health Clinics.
• Reducing workforce barriers by streamlining licensure processes and addressing other challenges that limit participation in the behavioral health care workforce.

Selected teams will participate in peer learning opportunities and receive individualized technical assistance to support their efforts in expanding access to behavioral health services. To guide their work, teams will be encouraged to meaningfully involve people with lived experience, ensuring their perspectives shape strategies and drive project goals. The ACCESS in Behavioral Health Learning Collaborative builds on a previous CHCS effort that involved partnering with individuals with lived experience to co-develop a series of practical resources aimed at helping states foster authentic, impactful engagement (see “Project Resources” below).