A decade after the establishment of the Certified Community Behavioral Health Clinic (CCBHC) model, more than 60 percent of the U.S. population now has access to such facilities and the mental health and substance use disorder treatment services they provide. This is revealed in a new study led by the National Academy of Sciences. Researcher at New York University School of Global Public Health. In addition, these clinics expand the availability of crisis mental health services such as mobile crisis response teams and stabilization.
Certified community behavioral health clinics are the cornerstone of a bipartisan strategy to increase access to and improve the quality of behavioral health care in the United States. ”
Amanda Mauri, assistant professor/faculty at New York University School of Global Public Health and lead author of two new studies on CCBHC
A new approach to community-based behavioral health care
CCBHCs meet federal standards for the provision of outpatient mental health and substance use care, including emergency services, regardless of a patient’s ability to pay. The federal government established standards for the CCBHC model in 2014, and the first CCBHC opened in October 2016. Clinics that become CCBHCs are typically community mental health centers that provided outpatient behavioral health care before becoming a CCBHC, but other types of facilities may as well. Hospitals and federally qualified health centers also have the CCBHC designation.
“The creation of the CCBHC marks the first major change in federal involvement in community behavioral health care since the 1980s, when Congress converted the National Community Mental Health Center Program into a block grant,” Mauri said. said. “Given this important policy change, whether and how CCBHC will change community behavioral health care, particularly for those who are uninsured, underinsured, or on Medicaid. It is essential to evaluate
Over the past decade, federal funding for CCBHCs has increased. For example, the bipartisan Safe Communities Act of 2022 funnels $8.5 billion to CCBHCs over 10 years. A clinic can be designated as a CCBHC through two initiatives. One is the Medicaid program, which makes bundled payments to clinics on a daily or monthly basis, and the other is the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Expanded Grant Program.
Despite significant investment in CCBHCs, there is little research regarding the location of these clinics, the services they provide, and contact information. To address this gap, Mauri and colleagues created a dataset of CCBHCs and began exploring their scope and services.
Extensive range of CCBHC
In a study published Oct. 4 in JAMA Health Forum, researchers found that CCBHC has an extensive network and that since the first clinic opened in 2016, U.S. found that the proportion of counties and people has increased significantly.
As of June 2024, 39.43 percent of counties are served by CCBHCs (22.85 percent of counties served by Medicaid CCBHCs and 22.85 percent of counties served by SAMHSA-funded expanded CCBHCs). 25.37%, some offering both services). More than half of CCBHCs serve multiple counties. Additionally, the majority of the U.S. population (62.26 percent) has access to mental health care through local CCBHCs (26.63 percent in Medicaid CCBHCs, 53.93 percent in expanded CCBHCs, and some receiving both services).
The researchers found geographic differences in the location of CCBHCs, but noted that these differences were not necessarily along partisan lines. For example, Texas was an early adopter of CCBHCs and established statewide access through its Medicaid program. In contrast, North Dakota, South Dakota, Delaware, and South Carolina had no CCBHCs as of June.
“This is one of the few policy areas with bipartisan support. Republican- and Democratic-controlled states alike have launched CCBHC efforts, and under the Obama, Trump, and Biden administrations, they have invested heavily in the program. We are seeing investments being made,” Mauri said.
Increase in crisis response services
CCBHCs must provide three primary types of behavioral health crisis care: 24/7 telephone lines, mobile crisis response, and crisis stabilization. The need for crisis services has increased since the launch of the Suicide and Crisis Lifeline’s new national number, 988, in 2022.
To better understand the crisis services provided, Mauri and colleagues analyzed national survey data from the National Council on Mental Health Services on CCBHCs, as well as demographic and socio-economic data for the regions they serve. I did. Their findings were published last month in the journal Psychiatric Services.
This study found that practices that receive CCBHC Medicaid bundled payments are much more likely to add new crisis services when they become a CCBHC than practices that do not receive these Medicaid payments. I understand.
“This suggests that CCBHC Medicaid bundled payments are important and may be an effective tool to increase the availability of resource-intensive crisis care, such as mobile crisis response services and crisis stabilization services. “We are doing so,” Mauri said.
The researchers also found that CCBHCs with higher staffing levels relative to the population they serve were more likely to provide crisis services directly rather than contracting with third-party providers.
In addition to Mauri, study authors in the JAMA Health Forum include Nuannuan Xiang of Columbia University’s Mailman School of Public Health, Daniel Adams of the University of Missouri-Columbia, and Jonathan Pirtle of New York University’s School of Global Public Health. It is. Additional study authors of the Mental Health Services article include Saba Rouhani and Jonathan Pirtle of New York University’s School of Global Public Health; This study was funded in part by the National Institute of Mental Health (R01 MH121649).
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Reference magazines:
Mauri, A.I., et al. (2024). Percentage of U.S. counties and population served by accredited community behavioral health clinics. JAMA Health Forum. doi.org/10.1001/jamahealthforum.2024.3001.
