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SAE has written numerous successful CCBHC grants to date and supported our clients to millions of dollars in federal funding. This year, we are proud to have added 15 new successes to our record.
SAMHSA’s (Substance Abuse And Mental Health Services Administration)’s Criteria for the Demonstration Program to Improve Community Mental Health Centers and to Establish Certified Community Behavioral Health Clinics are as follows.
The “Introduction” and “Criteria” noted below are excerpted from the larger sixty-eight-page document excerpted from the SAMHSA website that can be fully accessed from the following link:
https://www.samhsa.gov/sites/default/files/programs_campaigns/ccbhc-criteria.pdf
Introduction
On April 1, 2014, the Protecting Access to Medicare Act of 2014 (hereinafter “PAMA” or “the statute”) was signed into law. Among other things, PAMA requires the establishment of demonstration programs to improve community behavioral health services, to be funded as part of Medicaid (PAMA, § 223).
PAMA specifies criteria for certified community behavioral health clinics to participate in demonstration programs. These criteria fall into six areas:
- (1) staffing,
- (2) availability and accessibility of services,
- (3) care coordination,
- (4) scope of services,
- (5) quality and other reporting, and
- (6) organizational authority.
The behavioral health clinics participating in this demonstration program and meeting criteria will be known as Certified Community Behavioral Health Clinics (CCBHCs).
The CCBHCs represent an opportunity for states to improve the behavioral health of their citizens by:
- providing community-based mental and substance use disorder services;
- advancing integration of behavioral health with physical health care;
- assimilating and utilizing evidence-based practices on a more consistent basis; and
- promoting improved access to high quality care.
Care coordination is the linchpin holding these aspects of CCBHC care together and ensuring CCBHC care is, indeed, an improvement over existing service. Enhanced federal matching funds made available through this demonstration for services delivered to Medicaid beneficiaries offer states the opportunity to expand access to care and improve the quality of behavioral health services.
PAMA is clear that, regardless of condition, CCBHCs are to provide services to all who seek help, but it is anticipated the CCBHCs will prove particularly valuable for:
- individuals with serious mental illness (SMI),
- those with severe substance use disorders,
- children and adolescents with serious emotional disturbance (SED), and
- those with co-occurring mental, substance use or physical health disorders.
Those who are most in need of coordinated, integrated quality care will receive it from CCBHCs.
CCBHC or Clinic? CCBHC and Clinic are used interchangeably to refer to Certified Community Behavioral Health Clinics as certified by states in accordance with these criteria and with the requirements of PAMA. A CCBHC may offer services in different locations. For multi-site organizations, however, only clinics eligible pursuant to these criteria and PAMA may be certified as CCBHCs.
CCBHC directly provides: When the term, “CCBHC directly provides” is used within these criteria it means employees or contract employees within the management structure and under the direct supervision of the CCBHC deliver the service.”
Program Requirements
- Criteria 1.A: General Staffing Requirements
- Criteria 1.B: Licensure and Credentialing of Providers
- Criteria 1.C: Cultural Competence and Other Training
- Criteria 1.D: Linguistic Competence
- Criteria 2.A: General Requirements of Access and Availability
- Criteria 2.B: Requirements for Timely Access to Services and Initial and Comprehensive Evaluation for New Consumers
- Criteria 2.C: 24/7 Access to Crisis Management Services
- Criteria 2.D: No Refusal of Services due to Inability to Pay
- Criteria 2.E: Provision of Services Regardless of Residence
- Criteria 3.A: General Requirements of Care Coordination
- Criteria 3.B: Care Coordination and Other Health Information Systems
- Criteria 3.C: Care Coordination Agreements
- Criteria 3.D: Treatment Team, Treatment Planning and Care Coordination Activities
- Criteria 4.A: General Service Provisions
- Criteria 4.B: Requirement of Person-Centered and Family-Centered Care
- Criteria 4.C: Crisis Behavioral Health Services
- Criteria 4.D: Screening, Assessment, and Diagnosis
- Criteria 4.E: Person-Centered and Family-Centered Treatment Planning
- Criteria 4.F: Outpatient Mental Health and Substance Use Services
- Criteria 4.G: Outpatient Clinic Primary Care Screening and Monitoring
- Criteria 4.H: Targeted Case Management Services
- Criteria 4.I: Psychiatric Rehabilitation Services
- Criteria 4.J: Peer Supports, Peer Counseling and Family/Caregiver Supports
- Criteria 4.K: Intensive, Community-Based Mental Health Care for Members of the Armed Forces and Veterans
- Criteria 5.A: Data Collection, Reporting and Tracking
- Criteria 5.B: Continuous Quality Improvement (CQI) Plan
- Criteria 6.A: General Requirements of Organizational Authority and Finances
- Criteria 6.B: Governance
- Criteria 6.C: Accreditation
WHO WE ARE
We are a behavioral health consulting firm providing solution tools that help provider agencies implement changes to emerging critical issues, overcome operational barriers, ensure improved patient care outcomes, and maximize reimbursement.
We work closely with the agency’s executive team to stay innovative, increase resources, and operationalize cost-effective strategies and programs on behalf of the most vulnerable populations of focus.
In short, we help you help your communities to thrive.
