On March 31, 2014, Congress passed the Protecting Access to Medicare Act (H.R. 4302), which included a demonstration program based on the Excellence in Mental Health Act. The Excellence Act will increase Americans’ access to community mental health and substance use treatment services while improving Medicaid reimbursement for these services. When fully implemented, the Excellence Act will infuse over $1 billion into the behavioral health system, making it the biggest federal investment in mental health and addiction services in generations.
On October 19, 2015, the Substance Abuse and Mental Health Services Administration announced the 24 states that will receive funding as part to prepare for possible participation in the demonstration program. The National Council for Behavioral Health congratulates these states receiving funding as part of the $22.9 million grant announcement. States have now embarked on a one-year planning period.
PRESS RELEASE: HHS awards up to $22.9 million in Planning Grants for Certified Community Behavioral Health Clinics (Click the link to view a list of the 24 states.)
components of the Excellence in Mental Health Act
- Creates criteria for “Certified Community Behavioral Health Clinics” as entities designed to serve individuals with serious mental illnesses and substance use disorders that provide intensive, person-centered, multidisciplinary, evidence-based screening, assessment, diagnostics, treatment, prevention, and wellness services. Federal guidance on the CCBHC criteria is available here.
- Provides funding that will be available to states as planning grants to develop applications to participate in the 2-year pilot. Through a competitive process, in October 2015 SAMHSA awarded grants to 24 states to begin putting together their certification processes and developing their payment methodologies. Only states that have received a planning grant will be eligible to apply to participate in the pilot.
- Stipulates that eight (8) states will be selected to participate in the 2-year pilot program. The match rate for Certified Community Behavioral Health Clinic services is either the Enhanced FMAP/CHIP rate or, for newly eligible “expansion” Medicaid beneficiaries, the current FMAP for that population – which is 100% now and moves down to 90% by 2020.
- Requires participating states to develop a Prospective Payment System (See Appendix III of the linked document) for reimbursing Certified Community Behavioral Health Clinics for required services provided by these entities.
- Requires Certified Community Behavioral Health Clinics to engage in partnerships with a variety of health system partners, from primary care to hospitals, VA centers, and more. The emphasis on these partnerships reflects the need for health care organizations to work together to demonstrate concrete health outcomes and high-value care.
- Improves behavioral health resources for public safety by providing a much-needed infusion of funding into the addiction and mental health system, expanding treatment capacity and alleviating the burden on public safety officers.
May, 2015: The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare and Medicaid Services (CMS) released guidance on how they will be implementing the Excellence in Mental Health Act, including certification criteria, prospective payment guidance, and the planning grant applications.
August 5, 2015: Deadline for states to submit planning grant applications to SAMHSA. Only states that apply will be eligible to receive federal funding for planning grants. Only states that have received a planning grant are eligible to apply for and participate in the two-year demonstration program.
October 19, 2015: 24 planning grant awards were announced. The one-year planning grant funds can be used to support states as they determine how CCBHCs best fit within current system redesign efforts. States can leverage this opportunity plan and implement other delivery and payment reform efforts.
October 23, 2016: Deadline for states to submit their applications to participate in the demonstration. The demonstration program includes provisions that will provide CCBHCs with the financial footing to deliver these required services.
January, 2017: Deadline for the Secretary to select the states that will participate in the demonstration program. Only states that have received a planning grant are eligible to participate. The states will be selected through a competitive application process and must represent a diverse selection of geographic areas, including rural and underserved areas.
FOR MORE INFORMATION AND RESOURCES
- Stay up to date on the latest Excellence Act news on our blog, Capitol Connector.
- Please don’t hesitate to contact Chuck Ingoglia or Rebecca Farley on our staff with questions about the Excellence Act and Certified Community Behavioral Health Clinics.
- Want to explore what it takes to be a CCBHC? Head over to our CCBHC Readiness page.