A bipartisan bill in Congress would provide long-term federal funding for 988 call centers, mobile crisis teams, crisis stabilization services, and the behavioral health workforce that supports them.

Representatives Brian Fitzpatrick of Pennsylvania and Doris Matsui of California introduced the 988 Implementation Act, H.R. 10280, last month. The bill would authorize $441 million for local 988 call centers and another $100 million for mobile crisis response teams.

The legislation would also make permanent an enhanced 85% federal Medicaid match for 988 call centers and crisis receiving facilities. Another $25 million would support crisis workforce development, while changes to Medicaid rules would allow certain larger crisis stabilization facilities to receive reimbursement for short-term stays.

Counties often help fund or operate crisis response services and absorb costs elsewhere when people cannot access care. Those costs can show up in emergency departments, law enforcement, jails, and other local systems.

The National Association of Counties (NACo) supports the bill and is urging Congress to provide a more stable federal funding structure for 988 and local crisis response.

Maryland has already created a dedicated funding stream for 988. In 2024, the General Assembly passed HB 933/SB 974, establishing a 25-cent monthly fee on 988-accessible service and a separate prepaid wireless fee, with the revenue deposited into the 988 Trust Fund.

Lawmakers followed in 2025 with HB 421/SB 36, which MACo supported. The law allows the Maryland 9-1-1 Trust Fund to pay for limited costs shared by 9-1-1 and 988, including software integration and joint training, while keeping stand-alone 988 expenses outside the 9-1-1 Fund.

MACo has consistently opposed diverting dedicated 9-1-1 revenues away from county and Baltimore City emergency communications systems. Counties rely on the Fund for equipment, technology, infrastructure, cybersecurity, and continued implementation of Next Generation 9-1-1.

Counties are also taking on new costs elsewhere in Maryland’s behavioral health system. The 2026 Budget Reconciliation and Financing Act requires counties where the Maryland Department of Health operates an assisted outpatient treatment program to begin reimbursing the State for those costs in fiscal 2028. The county share starts at 25%, increases to 50% in fiscal 2029 and 75% in fiscal 2030, and reaches 100% in fiscal 2031.

As previously reported on Conduit Street, the final BRFA included a first-year waiver for counties that submit a cost-benefit analysis, but the phased cost shift remains in place.

The 988 Implementation Act would bring additional federal funding into that broader crisis response system without drawing from dedicated 9-1-1 revenues. For counties, that could mean more support for call centers, mobile crisis teams, crisis facilities, and the workforce needed to keep those services operating.

Useful Links

NACo: House Reintroduces 988 Implementation Act to Strengthen Local Mental Health Crisis Response

Previous Conduit Street Coverage: 2026 End of Session Wrap-Up: State Budget & Fiscal Issues

Previous Conduit Street Coverage: Deep Dive: Unpacking Assisted Outpatient Treatment in Maryland