Defined for the first time in the Excellence in Mental Health Act, Certified Community Behavioral Health Clinics (CCBHCs) are designed to provide a comprehensive range of mental health and substance use disorder services, particularly to vulnerable individuals with the most complex needs during a federal demonstration program with participating states.
States must certify that each CCBHC offers the following services either directly or through a formal contract with a designated collaborating organization (DCO). Through the demonstration, the following services must be offered and will be paid for even if they are not included in a state’s Medicaid plans:
- Crisis mental health services including 24-hour mobile crisis teams, emergency crisis intervention and crisis stabilization*
- Screening, assessment and diagnosis including risk management*
- Patient-centered treatment planning*
- Outpatient mental health and substance use services*
- Primary care screening and monitoring**
- Targeted case-management**
- Psychiatric rehabilitation services**
- Peer support, counseling services, and family support services**
- Services for members of the armed services and veterans**
- Connections with other providers and systems (criminal justice, foster care, child welfare, education, primary care, hospitals, etc.)**
*CCBHC must directly provide
**May be provided by CCBHC and/or DCO
Why these services, and why together?
The service array is deliberate. CCBHCs provide the comprehensive array of services that are necessary to create access, stabilize people in crisis, and provide the necessary treatment for those with the most serious, complex mental illnesses and addictions. CCBHCs also integrate additional services to ensure an approach to health care that emphasizes recovery, wellness, trauma-informed care, and physical-behavioral health integration. Highlights regarding this comprehensive array include:
- Easy and welcoming access to services regardless of ability to pay or location of residence to ensure those who need services are able to receive them.
- Immediate screening, assessment, and risk assessment for mental health, addictions, and basic primary care needs to ameliorate the chronic co-morbidities that drive poor health outcomes and high costs for those with behavioral health disorders.
- 24/7/365 crisis services to help people stabilize in the most clinically appropriate, least restrictive, least traumatizing, and most cost-effective settings.
- Full clinical, operational, and financial commitment to peer and family support, recognizing these elements as essential for recovery.
- Tailored emphasis on active and veteran military, who have served our country with honor, to ensure they receive the unique health care support they need.
- Expanded coordination with other health care and social service providers, with a focus on whole health and comprehensive access to a full range of medical, behavioral and supportive services.
Who Do CCBHCs Serve?
In short, CCBHCs serve any individual in need of care, regardless of his or her ability to pay. This includes (but is not limited to):
- Adults with serious mental illness
- Children with serious emotional disturbance
- Those with long-term chronic addiction
- Others with mild or moderate mental illness and substance use disorders
- Underserved individuals and families
- Low income individuals and families
- Those who are insured, uninsured or on Medicaid
- Those with complex health profiles
- Members of our armed services and veterans
What is the CCBHC Demonstration Program?
The Excellence Act provides for a funded demonstration of selected CCBHC projects. The demonstration rolls out in two phases. Phase 1 offers states one
-year planning grants to develop their CCBHC program. In October 2015, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded 24 states grants to plan their CCBHC projects over the next year. States will submit to SAMHSA a program proposal by October 23, 2016. In Phase 2, SAMHSA will select at least eight states to carry out their CCBHC projects. The demonstration project grants will fund the selected CCBHCs for at least two years.
What Happens Afterward?
The Centers for Medicare and Medicaid Services (CMS) has committed to helping states explore options for maintaining CCBHC services through such mechanisms as Section 1115 waivers. Meanwhile, the congressional champions of the Excellence Act and the behavioral health advocacy community are working to expand the demonstration to include more states and to extend for more
For more information, please visit the National Council’s CCBHC Resource Hub or contact Rebecca Farley at the National Council (RebeccaF@thenationalcouncil.org).