Policy and Practice | October 2022

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readiness of the various components across the crisis care continuum.

n SAMHSA • Transformation Transfer Initiative • Community Mental Health Services Block Grant • Substance Abuse and Treatment Block Grant • Mental Health Block Grant Set-aside • State Opioid Response Grant • Tribal Opioid Response Grants n American Rescue Plan Act (ARPA) of 2021—for Mobile Crisis and Crisis Line Services n Medicaid • Early and Periodic, Screening, Diagnosis, and Treatment (known as EPSDT) • 1915(a) waivers • 1915(b) waivers • 1115 SMI/SED Service Delivery Waiver The implementation of the 988 Suicide & Crisis Lifeline is critical to supporting the community and meeting their needs at a time when they need community support the most. If you have any questions, please contact BerryDunn’s behavioral health consulting team. 3 We’re here to help. Reference Notes 1. https://www.nashp.org/state-legislation to-fund-and-implement-988-for-the national-suicide-prevention-lifeline/ 2. https://www.samhsa.gov/find-help/988/ faqs#roles-and-funding%C2%A0 3. https://www.berrydunn.com/industries/ behavioral-health#professionals Danielle Stumpf is a Manager in BerryDunn’s State Government Practice Group. Roshani Khatri is a Staff Consultant in BerryDunn’s State Government Practice Group. Laura Perez is a Government Consultant in BerryDunn’s State Government Practice Group. Kat Crumpton is a Senior Consultant in BerryDunn’s State Government Practice Group. Stephanie U’Ren is a Manager in BerryDunn’s State Government Practice Group.

n Workforce. In the current labor market, workforce availability and retention are top concerns for sus tainable and effective 988 Suicide & Crisis Lifeline operations. States are struggling to hire the extra staff needed to launch the 988 Lifeline as well as to recruit qualified persons. To realistically implement the system, innovative workforce development and supporting wages to recruit and retain a specialized workforce are critical considerations for the states. Critical components to include in the assessment should include, but are not limited to: • Training. States should assess the existing training infrastructure to identify ways early on to support the mental health of their 988 Suicide & Crisis Lifeline counselors to reduce the risk for burnout and posttraumatic stress disorder. • Capacity. The assessment should identify the number of qualified workers available for in-person staffing. If states would like to consider remote capabilities for the call centers, it will also be important to assess the available technology necessary, as well as the develop ment of standards and expectations, including strong communication. n Readiness of the crisis care con tinuum. Apprehension about the readiness of the crisis care con tinuum (e.g., mobile crisis teams through diversion services and lower levels of care) exist. Federal officials have stated they expect up to 12 million calls, texts, or chats in the first year of the 988 Suicide & Crisis Lifeline, and research suggests approximately 20 percent of those calls, texts, or chats will require some level of in-person response. States are questioning whether mobile crisis teams are prepared for the increased demand, while also identifying connections and access to upstream services. In addition, states can consider the needs and experiences of the system’s end users to help address equity. The assessment can help determine the

Establish a Strategic Plan of Action to Implement the 988 Suicide & Crisis Lifeline With the implementation of the 988 Suicide & Crisis Lifeline, state agencies have an opportunity to strengthen crisis care. The best way to begin strength ening crisis care is to develop and implement strategic plans that optimize the 988 Lifeline and the following services. Building on the strengths and opportunities identified in the needs assessment and the associated recom mendations, strategic plans can establish priorities and identify sustainable solutions that build capacity, promote equitable access to care, and promote continuous quality improvement. Collaborating with key stakeholders to develop a strategic plan can help identify a roadmap for how the state should approach the implementation, main tenance, and sustainability of the 988 Suicide & Crisis Lifeline, including, but not limited to, the following areas. n Data and performance management n Stakeholder engagement n Health equity Maximize Available Funding Streams The COVID-19 pandemic exacer bated behavioral health challenges for many individuals who are struggling, and highlighted the challenges with the infrastructure and workforce. In the last couple of years, the federal administration has allocated additional funding to supplement existing and ongoing federal funding. States should begin by evaluating the existing federal funding opportunities to support the implementation of the 988 Suicide & Crisis Lifeline. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 988 Convening Playbook for States, Territories, and Tribes, 2 below are a few examples of funding sources that can be leveraged for the implementation of the 988 Suicide & Crisis Lifeline. n Voice of the customer n Financial sustainability

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