Recent Regulatory Efforts

ACEP continues to ask Congress and the Centers for Medicare & Medicaid Services (CMS) to expand Medicare coverage of emergency telehealth services, including tele-psychiatry services.

• April 2018: ACEP members met with CMS to share how innovative psychiatric ED models throughout the country have improved coordination among appropriate providers to improve care for patients experiencing a psychiatric emergency and helped reduce the prevalence of psychiatric boarding.
• June 2018: ACEP members shared the aforementioned psychiatric ED models with key members of Congress.
• December 2018: ACEP responded to a request for comments from the Federal Communications Commission (FCC) related to the National Suicide Hotline Improvement Act of 2018. We supported creating a new three-digit dialing code for mental health emergencies because it could improve access to appropriate care and reduce psychiatric boarding. In August 2019, the FCC issued a formal report to Congress recommending the creation of such a three-digit number.
• April 2019: ACEP responded to a request for information from the bipartisan Congressional Telehealth Caucus. We asked Congress to expand the use of emergency telehealth services, including tele-psychiatry in the emergency department, and we provided several recommendations for upcoming telehealth legislation.
• August 2019: ACEP and the Society for Academic Emergency Medicine responded to the National Institutes of Health’s request seeking input from the community about their use of telehealth in general hospital emergency medical care settings to facilitate the care of individuals with suicide risk.

View these comments in full.

State Advocacy Efforts

As emergency departments deal with issues related to the inability to transfer psychiatric patients out of the emergency department, many states have sought legislative solutions. The State Legislative/Regulatory Committee set out to help chapters with legislative efforts in states that grant emergency physicians authority to involuntarily hold and/or transfer psychiatric patients to an appropriate facility when medically indicated. The committee developed a document that details four legislative approaches to remove barriers and expedite evaluation of psychiatric patients in the emergency department. This resource focuses on involuntary holds, detailing criteria and time limits, along with emergency physician authority and liability.

That document and a variety of other resources including current state bills related to psychiatric holds are available.

Clinical Resources for Managing Mental Health Patients

As our advocacy team has been working to improve patient access to mental health care through legislative and regulatory channels, ACEP’s clinical affairs department has been focused on helping emergency physicians manage mental health patients.