Certified Community Behavioral Health Clinics

CCBHCs have described standards for timely and meaningful access to services, outreach and engagement, 24/7 access to crisis services, treatment planning, and acceptance of all patients regardless of ability to pay or place of residence.

CCBHCs are required to develop care coordination agreements across services and providers (e.g., Federally Qualified Health Centers, inpatient and acute care), defining accountable treatment team, health information technology, and care transition guidelines and practices.

CCBHCs are required to provide nine required services. CCBHC services are to be provided in a manner that is person-centered, family-centered, and recovery-oriented care. The nine required services are to be provided directly by the CCBHC but may also be provided through a formal relationship by establishing partnering agencies as Designated Collaborating Organization.

Required CCBHC Services:

• Crisis Services
• Treatment Planning
• Screening, Assessment, Diagnosis & Risk Assessment
• Outpatient Mental Health & Substance Use Services
• Targeted Case Management
• Outpatient Primary Care Screening and Monitoring
• Community-Based Mental Health Care for Veterans
• Peer, Family Support & Counselor Services
• Psychiatric Rehabilitation Service

CCBHCs have site specific required quality measures that must be collected and reported. CCBHCs must also develop a plan for quality improvement and tracking of other program requirements. In addition to site specific required quality measures, states that certify CCBHCs have state specific quality measures that must be collected and reported in addition to the site-specific measures.

CCBHCs are required to serve anyone who requests care for mental health or addiction, regardless of their ability to pay, place of residence, or age - including developmentally appropriate care for children and youth.

CCBHCs will be funded and supported by a prospective payment system or PPS, which provides a sustainable and flexible funding model to support the CCBHC. For more information, view the SAMHSA Prospective Payment System Reference Guide.

The CCBHC model addresses financing shortfalls by paying clinics a Medicaid rate inclusive of their anticipated costs of expanding service lines and serving new consumers. Under the PPS model, each CCBHC receives a fixed, clinic-specific rate for each qualifying visit, regardless of the intensity or quantity of service provided. Through a prospective payment system, the model supports:

• Expanded access to care through an enhanced workforce. CCBHCs’ Medicaid rates cover costs associated with hiring new staff such as licensed counselors or peer support specialists, paying employees a competitive wage in the local market, and training staff in required competencies such as care coordination and evidence-based practices.
• A stronger response to the addiction crisis. Addiction care is embedded throughout the CCBHC range of services, including screening for substance use disorders, detoxification, outpatient addiction services, peer support services, and other addiction recovery services at state discretion. Importantly, most states participating in the CCBHC program have also made medication-assisted treatment (MAT) a required service.
• Enhanced patient outreach, education and engagement. CCBHCs’ Medicaid rates include the cost of activities that have traditionally been near-impossible to reimburse yet play a critical role in behavioral health services.
• Care where people live, work, and play. CCBHCs may receive Medicaid payment for services provided outside the four walls of their clinic; for example, via mobile crisis teams, home visits, outreach workers and, emergency or jail diversion programs.
• Electronic exchange of health information for care coordination purposes. CCBHCs’ Medicaid rates include the cost of purchasing or upgrading electronic systems to support electronic information exchange. The 2014 Excellence in Mental Health Act prioritizes improving the adoption of technological innovations for care, including data collection, quality reporting, and other activities that bolster providers’ ability to care for individuals with co-occurring disorders.
• Sustainable funding for the costs of meeting the community’s needs as they change over time. CCBHC clinic-specific rates are reviewed every three years by first reviewing the community’s needs and then reviewing the cost report template of CCBHC’s costs to meet these needs and adjusting the clinic specific rates accordingly.

Crisis services are a core service requirement for CCBHCs. CCBHCs can provide crisis services directly or through a formal partnership. The developing crisis continuum in the state will interoperate and support the CCBHC crisis services.

Currently, Indiana will be the FIRST STATE to include alignment across the crisis continuum with the 988 Suicide and Crisis Lifeline, creating one unified, 24-hour system of care from a call or text to treatment and recovery.  This approach can also create an interconnected system to support the existing not-for profit and faith-based groups that are working to address these issues on a community level.