The U.S. Department of Health and Human Services recently announced the selection of eight states, including Missouri, for participation in a two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program. This demonstration is part of a comprehensive effort to integrate behavioral health with physical health care, increase consistent use of evidence-based practices, and improve access to high quality care for people with mental and substance use disorders.

The U.S. Department of Health and Human Services recently announced the selection of eight states, including Missouri, for participation in a two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program. This demonstration is part of a comprehensive effort to integrate behavioral health with physical health care, increase consistent use of evidence-based practices, and improve access to high quality care for people with mental and substance use disorders.

Missouri has certified 19 clinics as CCBHCs to serve the nearly the entire state, including a diversity of geographic areas and populations. To qualify for certification, CCBHCs provide core services across the lifespan, utilize evidence-based practices and health information technology, report on quality measures, and coordinate care with primary care providers and hospitals in the community. These programs will provide the following services to treat mental and substance use disorders through the use of evidence based practices such as cognitive behavioral therapy, integrated treatment for co-occurring disorders, dialectical behavior therapy, and counseling and related services to support employment goals. Through the state electronic records system, CCBHCs will have access on data to inform and support continuous quality improvement.

“Missouri and its community clinics have done an incredible job in paving the way for the demonstration program,” said Kana Enomoto, Deputy Assistant Secretary for Mental Health and Substance Use. “We look forward to demonstrating that by balancing incentives and accountability, an enhanced level of accessible, comprehensive and quality care can be provided to all Americans.”

The Missouri demonstration program will use a daily prospective payment system, which means that CMS will reimburse participating CCBHCs at a fixed daily rate for all services provided to a Medicaid beneficiary. Populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long term and serious substance use disorders, as well as others with mental illness and substance use disorders. The demonstration program reflects a broader Administration-wide strategy to create a health care system that results in better care, smarter spending, and healthier people.   

“The demonstration program will improve access to behavioral health services for Medicaid and CHIP beneficiaries, and will help individuals with mental and substance use disorders obtain the health care they need to maintain their health and well-being” said Vikki Wachino, Deputy Administrator of CMS, and Director of the Center for Medicaid and the Children’s Health Insurance Program Services.

In 2015, HHS awarded planning grants to 24 states to support certification of community behavioral health clinics, solicit input from stakeholders, establish prospective payment systems for demonstration reimbursable services, and prepare an application to participate in the demonstration program. At the end of the planning grant year, 19 States submitted applications to participate in the demonstration program.  The applications were reviewed by subject matter experts from the Substance Abuse and Mental Health Services Administration, CMS, and Office of the Assistant Secretary of Planning and Evaluation for strengths and weaknesses. HHS selected eight states for these two-year demonstrations, including Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon, and Pennsylvania. A key consideration in their selection was that participating states represented a diverse selection of geographic areas, including rural and underserved areas.

States have until July 1, 2017 to begin their two-year demonstration programs. The selected states’ demonstration programs will be evaluated based on data from 21 quality measures collected through sources such as program records, Medicaid claims, managed care encounter data, and clinic cost reports. Qualitative data also will be obtained from interviews with state officials and clinic staff. HHS will report on the access, quality and financial performance of the demonstration programs annually beginning December 2017, using data from the evaluation.

Authorized under Section 223 of the Protecting Access to Medicare Act of 2014, this demonstration program is a combined effort by several HHS agencies including CMS, SAMHSA, and the Office of the Assistant Secretary of Planning and Evaluation.