CCBHC Adoption
Washington is facing a community behavioral health care crisis. Funding that requires annual stopgap rate increases and still doesn’t compensate for many essential services, compounded by 30-40% increases in service requests and continually escalating operational costs have put unsustainable pressures on what should be a thriving system.
We need a sustainable, long-term solution.
Introducing Certified Community Behavioral Health Clinics or CCBHCs:
What are Certified Community Behavioral Health Clinics?
CCBHCs encompass several important elements that make it more effective and sustainable than our current system:
- Holistic clinical model – CCBHCs integrate mental and physical health services to promote whole-person care by delivering comprehensive behavioral health services and substance use treatment and prioritizing care coordination to connect clients to physical health care services, as well.
- Sustainable payment structure – The distinctive funding model under which CCBHCs operate enables providers to forecast community needs and secure adequate funding for all services provided, including preventive and engagement services that providers are currently delivering for free because there’s no billing code for them.
- Robust quality-of-care reporting – CCBHCs establish a pipeline of data reporting that supports population-wide visibility into trends and interventions to support more informed decision-making at a large scale.
CCBHCs provide a central access point for mental health care, substance use treatment and screenings on the social determinants of care. They mirror Federally Qualified Health Centers (FQHCs), which for decades have successfully delivered medical care to low-income community members who qualify for Medicaid benefits.
By creating parity between our behavioral health and medical system, the CCBHC model helps to ensure everyone in our communities with access to the care they need, regardless of their ability to pay or the severity of their diagnosis.
Why are CCBHCs the solution for Washington state?
The CCBHC model offers a promising solution for Washington because it will help to:
Demonstrated Success Nationwide
The CCBHC model has yielded game-changing results in early-adopter states.
On average, the 12 states that have implemented the CCBHC model statewide are:
- Serving 25% more behavioral health clients
- Eliminating waitlists and expanding service lines
- Hiring and retaining enough staff to keep pace with demand
The Prospective Payment System Difference
Currently, most providers are compensated on a “fee-for-service” model -which is retrospective, and doesn’t reimburse providers for all the services they deliver. The CCBHC funding mechanism – the Prospective Payment System (PPS) – takes a real-world approach, enabling providers to forecast community needs and secure adequate funding to meet them.
Importantly, PPS funds programs and roles that are simply not accounted for under our current system – because there’s no billing code for them. This means that, through CCBHCs, essential activities that providers are currently delivering for free, including engagement and preventive services, would not only be appropriately funded, but highly encouraged as they promote whole-person health.
For example, in Central Washington, Comprehensive Healthcare has used its CCBHC planning, demonstration and implementation (PDI) grant funding to hire engagement specialists to help ensure clients remain connected to services as they’re leaving inpatient or crisis care. Research shows this is an especially critical time: poor care transitions increase the risk for death by suicide by 200 times in the first month after discharge, and 300 times in the first week. Comprehensive Healthcare’s engagement specialists address barriers that might prevent clients from making an appointment to keep them engaged in services as they continue their journey to recovery.
The Path Forward
Washington’s next opportunity to unlock federal funding for statewide CCBHC adoption is in 2025, when our state can apply for a federal CCBHC planning grant.
Fourfront Contributor is ready to lend the expertise we’ve built serving communities across Washington to help our application be successful, and take a critical step in building the behavioral health system our state deserves.
