The Community Clinic Behavioral Health Clinic (CCBHC) model provides comprehensive and integrated services to everyone in the community seeking mental health or addiction treatment, regardless of their diagnosis or ability to pay. CCBHCs are required to provide the following nine core services:
CCBHC is not just another funding source for a provider to deliver “business as usual” services. Instead, it is a foundational shift from the traditional behavioral health care methods, which often involved turning away people in need. CCBHCs offer an opportunity to truly transform community-based behavioral health services, embrace a new direction, and provide comprehensive and sustainable health care to everyone.
The CCBHC transformation is not as simple as it sounds, and organizational structures cannot change overnight. Effective change requires education, data reporting, intentional engagement with systems partners, outreach to underserved populations, and understanding of the funding model.
For agencies that embark on the CCBHC journey, the model can dramatically increase access to mental health and substance use disorder treatment, expand a community’s capacity to address the opioid crisis, and improve relationships with essential community resources like schools, hospitals, and law enforcement.
So you want to fully utilize the CCBHC model, what happens first? The initial phase of becoming a CCBHC focuses on a few key factors: implementing core requirements, ensuring evidence-based practices (EBPs) are in place, monitoring key health indicators, developing continuous quality improvement (CQI) plans, and understanding the CCBHC funding model.
Many CCBHCs have evolved from existing behavioral health providers, but the key difference lies in their obligation to serve all individuals and receive funding accordingly. Simply overlaying CCBHC requirements with old service models will hinder the effectiveness of service delivery.
Instead, CCBHCs must seize the opportunity to address unmet community needs by changing operations and expanding service offerings.
The funding structure for CCBHCs shifts away from traditional capitated models and inadequate fee-for-service rates that don’t cover the cost of care. Instead, CCBHCs operate under two Prospective Payment System (PPS) models:
In capitated systems, new service mandates often require providers to reallocate existing resources. CCBHCs, however, can justify funding based on community needs assessments, allowing for strategic investments and the flexibility to proactively develop services for high-risk and hard-to-reach populations.
Real-time encounter and financial data is a necessity for a CCBHC to be effective in implementation, operations, and growth. One way to gather this essential data is through data dashboards specifically designed for CCBHCs to assist with tracking real-time patient encounters, costs, and compliance. Data dashboards also allow help with tracking reimbursements, revenue cycle management, and quality outcomes, all of which are essential for maximizing funding and making data-driven decisions.
A strong needs assessment is essential for justifying services and guiding resource allocation. CCBHCs must identify underserved populations, evaluate existing services, and develop staffing plans and service delivery methods to address gaps. To ensure a comprehensive approach, input should be gathered from diverse community stakeholders.
A well-functioning CCBHC should regularly review its needs assessment, ensuring it incorporates both qualitative and quantitative data from all community partners. For a CCBHC to be effective, it must take its needs assessment seriously, embrace service expansion, and remain vigilant in analyzing data to inform program growth and improve access to care.
One critical, and often overlooked, CCBHC focus area is justice-involved individuals, who experience disproportionately high rates of mental health and substance use disorders. While many providers collaborate with law enforcement through Crisis Intervention Teams (CIT) and crisis response work, equal attention should be given to individuals on probation and parole, where the majority of justice-involved individuals are engaged.
These underserved populations face significant barriers to care, whether transitioning from jail or prison, engaging in treatment, maintaining medications for opioid use disorders (MOUD), or re-engaging after discontinuing MOUD. Parole and probation departments, often burdened with large caseloads, rely heavily on external treatment providers. This population also frequently receives inadequate care due to the combined stigma of substance use disorders, mental health issues, and past convictions. CCBHCs can bridge this gap by developing targeted interventions and expanding services to meet the community’s needs. CCBHCs can play a pivotal role in supporting justice-involved individuals by:
A core goal of a CCBHC is to increase access and engagement for community members. By increasing engagement and individuals coming in for medically necessary services, program revenue increases. Using this revenue, CCBHCs can strategically fund new service lines by maximizing PPS payments, expanding MOUD and behavioral health services with justice involved individuals, and other identified areas of need. However, if a CCBHC does not reinvest earnings to expand and improve care, the PPS rates will decrease exponentially, disincentivizing continued improvements in service access and program expansion. To stay informed on which programs are performing well and which ones need more investment, CCBHCs must monitor all service areas in real time and know how much money can be reinvested into the community.
By fully leveraging the CCBHC funding model, utilizing robust data analytics, and expanding services based on comprehensive needs assessments, CCBHCs can transform community behavioral health care and improve outcomes for the most vulnerable populations.
