CCBHCs! That’s Certified Community Behavioral Health Centers, for those not familiar with the billion dollar investment that the Substance Abuse and Mental Health Services Administration (SAMHSA) will soon make to state behavioral health systems. In 2014, Congress passed the Protecting Access to Medicare Act (H.R. 4302), which included a demonstration program based on the Excellence in Mental Health Act. The Act does the following:
- Created criteria for CCBHCs as entities designed to serve individuals with serious mental illnesses and substance use disorders that provide intensive, person-centered, multidisciplinary, evidence-based screening, assessment, diagnostics, treatment, prevention, and wellness services;
- Provided $25,000,000 to states as planning grants, which were handed out last fall;
- Required participating states to develop a Prospective Payment System (PPS) for reimbursing CCBHCs for required services provided. States will receive an enhanced Medicaid match for all required services provided by the CCHCs.
From SAMHSA: The awarding of CCBHCs Planning Grants is the first phase of a two-phase process. Phase I provides funds for one year to states to:
1) Certify community behavioral health clinics,
2) Establish a PPS for Medicaid reimbursable behavioral health services provided by the certified clinics, and
3) Prepare an application to participate in a two-year demonstration program.
Up to eight states that participated in the CCBHC Planning Grants will be selected to participate in Phase II, which is the actual two-year demonstration. The eight selected states will bill Medicaid under an established, CMS-approved PPS for behavioral health services provided to individuals eligible for medical assistance under the state Medicaid program.
These are essentially care coordination and service hubs for people with severe and persistent mental illness. The requirements for both service delivery and coordination, as well as cost reporting, are significant, and based on many providers’ comments at #NatCon16, it is clear that many states and providers will struggle to meet the tight October 2016 deadline for the full grant submission.
PCG has partnered with states to support all three planning grant requirements, including:
1) Behavioral Health Community Needs Assessments – PCG’s two-pronged approach will include a population needs gap analysis, comparing population needs with current service offerings. Our goal is to help DBHDS identify the potential CCBHC populations, the populations’ needs, and how the potential providers can meet the requirements of the CCBHC to meet those needs;
2) PPS development, including completion of cost reports – SAMHSA worked with CMS to develop a CCBHC-specific cost report that helps to calculate per visit prospective payments. PCG brings 30 years of cost reporting experience to providers and we have begun the data collection phase of the project.
3) Drafting the CCBHC Grant – Finally, once the needs assessment and PPS calculations are complete, PCG will help the state to draft its CCBHC application.
Whether you’re a state policy maker or a behavioral health provider in need of assistance, please contact PCG Health to find out how we can help you.
