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[MM Curator Summary]: SAMHSA is restarting the CCBHC grants after a 7 year break.
Clipped from: https://bhbusiness.com/2023/03/21/samhsa-gives-1m-to-15-states-competing-for-spot-in-ccbhc-medicaid-demonstration/
States vying for spots in the Medicaid demonstration program for certified community behavioral health clinics (CCBHCs) are getting a financial boost from the federal government.
The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded 15 states $1 million planning grants to help pay for the application and development process required to join a Medicaid demonstration program. The program increases funding for CCBHCs, and creates prospective payment models, giving CCBHCs the needed stability and flexibility to provide comprehensive behavioral health services.
However, only 10 states that get planning grants can join the demonstration program in 2024. This is an application year in the competitive process to join the Medicaid demonstration.
“I think states that see the value in that model of care are really not inclined to wait around four to six years from now,” Rebecca Farley David, a senior advisor for the National Council for Mental Wellbeing, told Behavioral Health Business. “They want to go after it right now. They want to make those transformations. They want to start to see the results.”
Eventually, all states will have the chance to join the demonstration program. However, states that are actively reforming their mental health systems would rather not be left in the cold until the next round of admissions to the program in 2026.
This is the first time the federal government has released these planning grants since 2016.
The states that got the planning grants are Alabama, Delaware, Georgia, Iowa, Kansas, Maine, Mississippi, Montana, North Carolina, New Hampshire, New Mexico, Ohio, Rhode Island, Vermont and West Virginia.
CCBHCs must provide nine core services, which give patients timely access to encompassing and coordinated mental health, addiction treatment and psychiatric services.
The National Council for Mental Wellbeing, a nonprofit advocacy group, tracks more than 500 CCBHCs operating in 46 states plus Puerto Rico, Washington D.C. and Guam.
Only 10 states presently participate in the Medicaid prospective payment demonstration. The Bipartisan Safer Communities Act expanded the demonstration to include 10 new states every two years starting in 2024.
Safety net clinics that become CCBHCs in the first place can serve 900 more people than before receiving the designation, a 23% increase in access to behavioral health services, according to a National Council for Mental Wellbeing.
I think states that see the value in that model of care are really not inclined to wait around four to six years from now.
Rebecca Farley David, senior advisor for the National Council for Mental Wellbeing
The Medicaid demonstration program is meant to give CCBHCs the stability and financial security to provide expansive and coordinated services. After detailed negotiations between states and clinics that are influenced by federal guidance, states establish prospective per-day or per-month payments. In contrast, present Medicaid fee-for-service funding often fails to provide the margins needed to sustain community-focused clinics, David said.
The demonstration program is fundamentally different from the various waiver programs. Waivers are accessible to any state at any time. Demonstration programs are restricted in multiple ways — in this case, by the number of participants or other requirements.
The intensive nature of the demonstration program requires significant resources from states to apply and be ready for it, hence the planning grants from SAMHSA.
“When you look at the CCBHC model and what it requires of clinics and what it requires a state, it really is a very intense and transformative effort,” David said. “It’s not as simple as the states applying for the opportunity to be in the demonstration. They have to do all kinds of work during the planning year in order to become ready to participate in the demonstration should they be chosen.”
The states certify their clinics and then develop new payment rates and models, billing and payment processes and make community needs assessments to measure how and which clinics will face demands for services, David said.
The CCBHC model was created in 2014 via the Excellence in Mental Health Care Act. Since its implementation, CCBHCs have been able to increase staffing levels. In 2022, 450 active CCBHCs hired 11,240 new staffers as of August 2022.
Interest in the model has ballooned in recent years as the coronavirus pandemic revealed and worsened the nation’s behavioral health struggles. CCBHCs have received major backing and expansion from Congress via the most recent omnibus funding bill and the Bipartisan Safer Communities Act, which passed on the heels of the Uvalde, Texas massacre.
The interest in growing the model continues within the Biden administration. The administration’s proposed budget for the federal fiscal year 2024 includes extended funding for CCHBCs and several transformative efforts that total about $656 million.