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Subacute Mental Health Facilities (HB 172)

Last year, House Bill 172 added “subacute mental health facilities” (which include crisis stabilization and crisis residential centers) to the types of entities licensed by Division of Health Care Services (HCS), Health Facilities Licensing & Certification (HFLC). The Department of Health (DOH) is in the process of promulgating regulations to implement the new law.

Once regulations are final, entities that meet the definition of Subacute Mental Health Facilities must become licensed by HFLC and adhere to the crisis center licensing requirements.

DOH is committed to ensuring the continued ability of providers to safely operate existing crisis centers and to stand up new services where appropriate and feasible.

This interim guidance is not a prediction of final regulation content. It is the intent of the Department, however, to ensure that providers experience the smoothest transition possible into final licensing requirements.

Interim Subacute Facility Guidance

Currently operating crisis centers must:

  • continue complying with Division of Behavioral Health (DBH) and 1115 regulatory requirements;
  • submit to HFLC proof of current compliance with the entity’s accrediting body, a copy of the most recent report from the accrediting body, and, if applicable, any current plans of correction; and
  • participate in at least one technical assistance session with HFLC;

Option for a temporary license: Some facilities may want or need documentation of HFLC licensure for their own operational or structural needs. In order to provide support for these entities, HFLC is offering the option to obtain a temporary license. To obtain this temporary license, an entity must:

Frequently Asked Questions

Does HB 172 apply to everyone providing 1115 crisis services?

No. Any approved provider may bill for a crisis service provided according to the 1115 regulations. HB 172 applies to facilities.

Do crisis centers have to obtain the temporary license?

No. The temporary licensure option is offered for facilities that may want an additional layer of structure through an HFLC-specific licensure document. This option is opt-in only.

Does a temporary license have any affect on ability to bill for crisis services or requirements to comply with DBH/1115 regulations?

No. Licensure is separate from billing requirements. In all cases of Medicaid billing, the billing entity must comply with all relevant regulatory requirements for that service.

Does this change tribal exemption to licensure?

No. HB 172 did not address tribal facilities. 7 AAC 12.611(b) is the current regulatory authority:

  • 7 AAC 12.611. Exemptions from licensure. (b) A facility owned and operated by the United States Indian Health Service, or a facility owned and operated by a tribal organization, as defined in 25 U.S.C. 450b( l), under a funding agreement under 25 U.S.C. 458aaa-4 (Indian Self-Determination and Education Assistance Act and Tribal Self-Governance Amendments of 2000) is exempt from the requirement to obtain a license under AS 47.32 and this chapter. However, a facility described in this subsection must meet the applicable licensure requirements set out in AS 47.32 and this chapter.