As more and more states become eligible for Certified Community Behavioral Health Clinic (CCBHC) certification and funding, many healthcare organizations are considering becoming CCBHCs. And, as opportunities continue to expand for CCBHCs, it’s in your organization’s best interest to consider whether getting certified makes sense for you. The certification process can be labor-intensive but is often worth the effort for the sake of your organization and patients.
In this piece, we’ll discuss the requirements for, challenges to, and benefits of becoming a CCHBC.
What is a Certified Community Behavioral Health Clinic (CCBHC)?
The CCBHC program began in 2014 to identify healthcare organizations with exceptional, comprehensive care and provide them with additional funding to increase access to services. It’s grown since then, and Congress has appropriated annual funds for CCBHC expansion grants since 2018 — allowing CCBHCs to expand access to care. However, existing funds are not intended for long-term sustainability, and states are working to expand the state CCBHC model within state Medicaid programs to account for long-term growth. Bipartisan federal legislation was introduced in 2020 to extend CCBHC programs to new states and expand the reach of currently existing CCBHCs.
The fact that both state and federal governments are prioritizing CCBHCs is a testament to their success and essential work in the community. And, CCBHCs distinguish themselves from more traditional care models in a number of ways, including:
- Their emphasis on increasing access to care
- Their “open-door policy,” which requires them to serve anyone needing care while partnering with local primary care facilities and hospitals and integrating with physical health care to serve patients’ mental and physical health needs
- Their tailored care for active-duty military and veterans and commitment to involving peers and family in care processes
- And more
CCBHCs can provide these comprehensive services by the additional funding they receive, allowing them to serve everyone without any limitations on geographic location or ability to pay.
How do logistics for CCBHCs differ from other mental health providers?
You’ll notice shorter wait times at CCBHCs than other mental health providers. CCBHCs aim for a five-day wait time for new intakes, and most also have walk-in clinics. Some CCBHCs even provide same-day access.
CCBHCs are also required to provide 24/7/365 access to crisis care, including mobile crisis teams and crisis hotlines.
On top of shorter wait times, a few other CCBHC requirements include:
- Evidence-based practices: As a CCBHC, you must maintain an additional level of quality by using evidence-based practices for every process.
- MAT: You’ll need a care coordinator who offers medication-assisted treatment (MAT) for substance use disorders.
- Payment: You’ll have to establish a sustainable payment program that allows the practice to exist even without grants or additional government funding.
Who is eligible to become a CCBHC?
All nonprofit health centers are eligible to become CCBHCs. Many organizations fall into the nonprofit category, including:
- Community Mental Health Centers (CMHCs)
- Federally Qualified Health Centers (FQHCs)
- State mental health clinics
- Tribal health organizations
- Other nonprofit health centers
While for-profit clinics cannot individually be certified as CCBHCs, they can be certified collaborating partners of a CCBHC system.
What are the pros and cons of being a CCBHC, and what does the certification process entail?
Of course, there are pros and cons to certification. Benefits of certification include the fact that your organization is held to a higher standard and thus provides better care for patients and eligibility for more funding even beyond the CCBHC grants. Cons include the lengthy and involved process and the fact that you’ll need a dedicated implementation team to become certified.
If you decide the pros outweigh the cons, your next step will be a three-part process to prepare your organization for certification.
You’ll first set expectations for your team, then review your policies and procedures while simultaneously evaluating your MAT protocol. We’ll review each of these steps below.
- Set expectations: As you’re considering the process, set expectations within your organization. It can take up to a year to get off the ground as a CCBHC and will be an involved process. Large organizations may be able to move through the process more easily, as they may already be providing many of the services required for CCBHC certification. Smaller organizations may take a couple of years to increase staffing to a point that will make them viable CCBHC candidates.
- Review policies and procedures: CCBHCs must accept all patients and use evidence-based practices. You’ll need to review all of your policies and procedures to ensure every action you currently take is deliberate and documented. If your clinic uses the “we’ve always done it this way” mentality, your policies will not hold up under scrutiny by accreditors. Reviewing policies is a major task, as it means policies ranging from how you prescribe medications to cleaning processes for the laundry room must be documented. Today, Electronic Medical Records (EMRs) make it easier to track the number of patients served, services they receive, follow-up times for crisis calls, and more. While many health centers are already capturing this data for internal purposes, it’s important to ensure data is captured consistently and reported to external auditors.
- MAT protocol: Clinics who aren’t already offering medication-assisted treatment (MAT) may find the MAT requirement a barrier as they consider certification. Consider what your center currently offers, and remember your clinic does not have to be a full free-standing methadone or suboxone clinic but does need to provide evidence-based MAT.
Fortunately, you don’t have to reinvent the wheel! Many other clinics have gone through the process, and templates for policies and procedures reduce some of the work. Don’t be afraid to ask for help and use the resources available; there are databases across the country for clinics to share resources.
What other challenges could I encounter?
The process for becoming a CCBHC is constantly in motion. Staff turnover is one of the biggest challenges you could face during implementation. If your staff turns over during the quality management phase, you may lose progress and crucial internal knowledge.
To account for this, make sure you have a reliable point person, usually the clinic’s director of quality management, to lead the project and be the final point of contact. Once certified, your quality management team will also have to prepare for audits and answer auditors’ questions on demand.
Be proactive, not reactive
We hope this discussion has given you some insight into the world of CCBHCs. Just as hospitals were striving for joint commission certification years ago, we believe nonprofit health centers will soon need to move toward CCBHC certification to ensure they’re providing the best quality care. Leaders in the field can influence the future of community mental health care by being CCBHC certified early instead of being forced to become certified in the future.
- TheNationalCouncil.Org CCBHC Success Center: This site has templates and information about program requirements
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- YouTube Resources: See this video from the Georgia Department of Behavioral Health and Developmental Disabilities CCBHC kickoff and search for others
Also, remember that other healthcare organizations — within your state and across the country — have gone through this process can be valuable resources.