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Changes to Behavioral Health Treatment

During the COVID-19 Pandemic

July 7, 2020
Physical distancing measures and temporary stay-at-home orders associated with the Coronavirus Disease
2019 (COVID-19) pandemic have required changes in service delivery for mental health and substance
use (collectively known as behavioral health) treatment. Changes have surrounded relaxing privacy
requirements required by the Health insurance Portability and Accountability Act (HIPAA) Rules and
increasing use of telehealth to deliver behavioral health treatment and services. Some states have also
employed other methods of service delivery-such as mobile units-for treatments that cannot be
administered via telehealth, such as medication-assisted treatment (MAT) for opioid use disorder (OUD).
Typically (i.e., outside of the pandemic), mental health treatment is administered in outpatient settings
where patients visit providers in brick-and-mortar offices, clinics, hospitals, or specialty facilities.
Treatment visits may occur on a regular basis (e.g., weekly, monthly); as a single, one-time visit (such as
for an evaluation); or in discrete episodes as full-day or overnight situations as part of more intensive
service like residential or partial hospitalization programs. As technology has advanced, some behavioral
health treatment providers have utilized telehealth (or telemedicine) modalities such as video
conferencing to deliver services. Some are providing behavioral health services via telehealth
(telebehavioral health) through telehealth modalities such as live video and mobile health.
Substance use disorder treatment works similarly in most instances, with exceptions for interventions
utilizing frequent administration of medications, such as MAT for OUD. In MAT using opioid
replacement therapies such as methadone and buprenorphine, patients are required by law to attend in
person for at least the initial visit for buprenorphine, and daily for methadone. Methadone is administered
on a daily basis in federally certified opioid treatment programs (OTPs; also known as methadone
clinics), with some short-term take-home doses allowed for stable patients.

Changes to Behavioral Health Services During the

COVID-19 Pandemic

Congress and the Administration have initiated changes to behavioral health services in recognition of the
need to continue treatment during the pandemic. The third COVID-19 supplemental appropriations act

                                                                Congressional Research Service

Prepaimed for Mernbei-s and
Committees 4 o.  C- --q .. . . . . . . . ...----------------------------------------------------------------------------------------------------------------------------------------------------------------------

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