CEO Update 248
Shawn Coughlin Retires; Previous NABH President and CEO Mark Covall Named Interim Leader
Shawn Coughlin retired as NABH’s president and CEO this week after nearly six years in the position. The NABH Executive Committee named Mark Covall as interim president and CEO as it engages an executive search firm to find Coughlin’s successor.
Coughlin served previously as the association’s executive vice president of government relations and policy from 2017 until he began his role as president and CEO in January 2020. In all, he has spent 14 years working directly for or with NABH as a leader or consultant.
“It has been an honor to lead the preeminent behavioral healthcare association in the country,” Coughlin said in a statement NABH released this week. “Having started my leadership role with the association during the opioid crisis and guiding it through the Covid-19 pandemic, it is time for me to turn my attentions to other opportunities.”
Covall retired from NABH in December 2019 after more than 35 years with the association and 24 years as its president and CEO. He began his interim role on Oct. 1.
“On behalf of the NABH Board of Trustees, we thank Shawn for his years of service to our association,” NABH Board Chair Jim Shaheen said in the statement. “His passion for lobbying has helped guide our members through some critical times and several legislative and regulatory changes,” he continued. “We all wish Shawn continued success.”
No Major Changes Expected for Behavioral Healthcare Providers as Government Shutdown Continues
The federal government is ending week one of its shutdown and there appears to be no end in sight as negotiations continue.
NABH does not expect legislative or regulatory changes that would affect behavioral healthcare providers’ work during the shutdown. Meanwhile, the NABH Government Relations team continues to contact congressional offices about extending the expiring enhanced Affordable Care Act (ACA) tax credits, eliminating cuts to the Medicaid Disproportionate Share Hospital (DSH) payments, and extending Medicare’s telehealth flexibilities.
The shutdown officially began Wednesday, Oct. 1 at 12:01 a.m. ET after senators rejected competing Democratic and Republican bills to keep the government open. Previously, House lawmakers passed a continuing resolution (CR) that would have funded the government until Nov. 21 and contained several healthcare extenders. In the Senate, lawmakers needed seven Democratic votes to meet a 60-vote threshold for the measure to pass. That didn’t happen after Democrats demanded extending ACA credits and repealing H.R. 1 health policies in exchange for their votes, which the Senate rejected.
In addition to lapsed federal funding, the legal authority allowing Medicare to provide reimbursement for some non-behavioral health telehealth services delivered to patients in their home also lapsed, as well as the Oct. 1 deadline that marks the start of cuts to Medicaid DSH funding. In the past, federal lawmakers reauthorized these programs retroactively after the shutdown ended; however, this practice creates uncertainty in the interim.
In guidance this week, CMS directed all Medicare Administrative Contractors to implement a temporary claims hold. “The hold prevents the need for reprocessing large volumes of claims if Congress acts after the statutory expiration date and should have minimal impact on providers due to the 14-day payment floor,” the guidance noted. Providers may continue to submit claims; however, payment will not be released until the hold is lifted. NABH continues to analyze the guidance and will keep members apprised when we have more information.
Senate Majority Leader John Thune (R-S.D.) this week continued to bring the House CR to a vote on the Senate floor. Although the measure failed repeatedly, several additional Democratic senators supported passing legislation.
Meanwhile, a bipartisan group of senators is working on a deal that would extend ACA credits while simultaneously reducing costs and fraud in federal healthcare programs to reach a compromise. Other lawmakers have proposed extending the subsidies for one year and follow that with a one-year phasedown as a way to return the tax credits to pre-pandemic levels.
Within the federal agencies, HHS has said it has the necessary staff to execute mandatory activities. The shutdown leaves the Centers for Medicare & Medicaid Services (CMS) with only 53% of its workforce, according to HHS’ recently published 2026 contingency plan. The Medicare program will still cover claims during the shutdown; however, the contingency plan notes that enrollment education and outreach will slow down, which would happen just weeks before the Medicare annual enrollment period kicks off.
NABH has learned the Veteran Affairs Department (VA) has not been affected as other federal agencies have because Congress has already provided appropriations for this agency. The VA will continue to process benefits checks, and medical appointments at VA health centers will not be disrupted. However, the VA is closing several support phone services and regional VA benefits offices temporarily during the shutdown.
As NABH noted to members earlier this week, we will continue to keep you informed as we learn new developments. Please contact Andy Dodson if you have questions or face challenges related to federal programs and services.
States Advance Applications for the Rural Health Transformation Program
CMS held a webinar on Tuesday, Sept. 30 to provide states and relevant stakeholders with guidance about the Rural Health Transformation (RHT) Program as all federal offices faced a looming government shutdown at 11:59 p.m. ET that day.
CMS staff said 27 states had submitted optional letters of intent as of Tuesday morning.
The agency said it intends for the RHT Program to provide funding to states and their subrecipient organizations for infrastructure, including investing in workforce, updating technology, and other innovations. States may only use 15% of grant funds for services and those funds cannot be used to supplant current funded services.
CMS said it will allow only up to 5% of total funding to be used to replace an electronic medical record (EMR) system if a previous HITECH-certified EMR system was in place as of Sept. 1, 2025. CMS told attendees they plan to release additional guidance on the program’s funding limitations.
Applications are due Nov. 5, 2025 and CMS plans to send funding announcements to states by Dec. 31, 2025.
CMS has deemed RHT Program staff essential employees during the government shutdown, so they will continue to provide additional guidance and technical assistance to state applicants. To stay up-to-date on the RHT Program, sign up for email updates from CMS.
Mental Health America Releases 2025 Report on Mental Health and Well-Being in the United States
Advocacy group Mental Health America (MHA) this week released The State of Mental Health in America 2025 that highlights the latest national data and provides state-level rankings on mental health and well-being in the United States.
MHA uses national survey data to measure a community’s mental health needs, access to care, and outcomes, regardless of the differences among states and their varied mental health policies.
According to the report, nearly 3 million American youth ages 12-17 have frequent thoughts of suicide and 77% of U.S. adults with substance use disorder did not receive treatment.
The report also included some hopeful news, as survey data showed the percentage of youth ages 12-17 who experienced a major depressive episode decreased to 15.4% in 2024 from 18.1% in 2023, while the percentage of youth ages 12-1 who reported serious thoughts of suicide in the past year decreased to 10.1% in 2024 from 12.30% of youth in 2023.
The 45-page report provides a comprehensive summary of key findings, state rankings, mental health prevalence among adults and youth, access to care for all ages, and mental health workforce availability.
Attention All NABH ‘Unit’ Committee Members: Register Today for NABH’s 2025 Fall Leadership Forum!
To all NABH members who serve on the Behavioral Health Services within General Healthcare Systems Committee (Unit Committee): join your fellow members for the 2025 NABH Fall Leadership Forum in Tampa, Fla. on Thursday, Nov. 6 through Friday, Nov. 7.
NABH thanks our member BayCare Behavioral Health for hosting this two-day meeting, which is designed to provide Unit Committee members with exclusive access to discussions with experts in the field and valuable opportunities for peer-to-peer engagement.
Please contact NABH Operations Coordinator Meghan Barrett at meghan@nabh.org for additional details and meeting agenda.
Fact of the Week
New York, Hawaii, and New Jersey (in that order) scored the best across 17 measures of prevalence of mental illness and access to mental health care, according to MHA’s 2025 report on the state of mental health and well-being in America.
For questions or comments about this CEO Update, please contact Jessica Zigmond.