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What is a CCBHC?
Certified Community Behavioral Health Clinics (CCBHCs) were created through Section 223 of the Protecting Access to Medicare Act (PAMA), which established a demonstration program based on the Excellence in Mental Health Act. The Excellence in Mental Health Act demonstration program – also known as the Excellence Act or the Section 223 demonstration program – is an initiative to expand Americans’ access to mental health and addiction care in community-based settings.
There are currently 113 CCBHCs operating in 21 states. This includes 66 CCBHCs in the eight states selected for the original Medicaid demonstration program: Minnesota, Missouri, Nevada, New Jersey, New York, Oklahoma, Oregon and Pennsylvania. Since 2018, Congress has appropriated yearly funds for two-year CCBHC Expansion Grants. Sixty-three grantees (including 16 that are also original Medicaid demonstration participants) are currently operating in 21 states: the eight demonstration states plus Colorado, Connecticut, Indiana, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, North Carolina, Rhode Island, Texas and Virginia.
Get the latest information on the funding status of the CCBHC demonstration and grants.
The Excellence Act established a federal definition and criteria for CCBHCs and stipulated that they may receive an enhanced Medicaid reimbursement rate based on their anticipated costs of care. CCBHCs are responsible for directly providing (or contracting with partner organizations to provide) nine required types of services:
- Crisis mental health services
- Screening, assessment and diagnosis, including risk assessment
- Patient-centered treatment planning
- Outpatient mental health and substance use services
- Primary care screening and monitoring of key health indicators/health risk
- Targeted case management
- Psychiatric rehabilitation services
- Peer support and family supports
- Intensive, community-based mental health care for members of the armed forces and veterans
CCBHCs must also meet requirements related to quality reporting, governance, staffing, access to care and care coordination. In return, they receive a Medicaid payment rate based on their anticipated costs of expanding services to meet the need in their communities.
Where Are We Now?
Early results from the demonstration confirm that when community behavioral health clinics are incentivized to provide comprehensive, coordinated, evidence-based care and provided compensation that adequately covers their cost of doing business, they can transform access to care in their communities.
Among other exciting advances, CCBHCs are increasing access to mental health and addiction treatment; expanding capacity to address the opioid crisis; collaborating with partners in hospitals, jails, prisons and schools; and attracting and retaining qualified staff who offer science-based, trauma-informed services – often on the same day patients present for care.
Survey data illustrates the impact of the CCBHC model to date, including:
- Data Highlights from CCBHC Surveys
- Loss of access to care that would result from program expiration
- Impact on access to addiction treatment
- How CCBHCs are making a positive impact on the criminal justice system
- Early impact of CCBHC model, first six months
SAMHSA will release a formal evaluation of the CCBHC program in 2021.
The National Council remains committed to expanding the Excellence Act to all interested states and will continue working with congressional champions in the coming year to expand the scope of this important program. Get the latest news on these efforts.
What Can You Do?
If you would like to see the CCBHC program expand to all 50 states:
- Write a letter to your legislators in favor of the expansion of CCBHCs.
- Sign up for our action alerts for more ways to get involved.
- Register for Hill Day, our annual advocacy event urging legislators to support our policy priorities.
- Contact us with questions about how other states have brought the model to their state.
If you are a current or prospective CCBHC looking to enhance your operations or prepare for certification:
- Visit our FAQs and Resources pages to learn more.
- Ask us about our consulting support.