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Certified Community Behavioral Health Clinic (CCBHC)

Certified Community Behavioral Health Clinics, commonly referred to as CCBHCs, are a new provider type in Medicaid being offered across Oklahoma. CCBHCs are replacing the old Community Mental Health Center (CMHC) model.

CCBHCs are designed to provide a comprehensive range of mental health and substance use disorder services to vulnerable individuals. In return, CCBHCs receive an enhanced Medicaid reimbursement rate based on their costs of services to meet the needs of these populations.

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 high quality care and improved outcomes.

Certified Community Behavioral Health Clinic

CCBHCs are a new provider type in Medicaid. They are designed to provide a comprehensive range of mental health and substance use disorder services to vulnerable individuals. In return, CCBHCs receive an enhanced Medicaid reimbursement rate based on their costs of services to meet the needs of these populations.

Insufficient funding has long posed a barrier to increasing Americans' access to behavioral health care. The CCBHC model address financing shortfalls by paying clinics a Medicaid rate inclusive of their costs of expanding service lines and serving new consumers.

Increased access to services, innovative relationships with law enforcement, reduction in crisis hospitalizations, enhanced crisis services and increased use of evidenced-based practices.

CCBHCs...

  1. Provide easy access to integrated services for all individuals regardless of pay sources or ability to pay.
  2. Provide a full array of mental health and substance use disorder services available in every certified location and provide or coordinate with primary care services.
  3. Provide quality-driven services as demonstrated through data reports and outcomes reports generated by ODMHSAS or its contractors.
  4. Provide enhanced integration and coordination of mental health and substance use disorder services and supports for people across their lifespans.

  •  More than 600 new staff added to system
  • Expanded service hours
  • Staff match clients served
  • Increased community partnerships
  • iPad program
  • Team-based care

Access to Care

- CCBHC: Required to serve everyone, significant increase in staff

- CMHC: Low reimbursement rate, workforce shortages

Evidence-Based Practices

- CCBHC: Required evidence-based practices listed, rate supports implementation

- CMHC: No requirements, dependent upon grant funding to support

Crisis Services

- CCBHC: Required to provide 24/7 crisis care, including mobile crisis teams

- CMHC: Referrals to crisis centers, not consistent across the state

Medication Assisted Treatment (MAT)

- CCBHC: Reimbursement rate supports it, increase in services

- CMHC: Difficulty hiring and retaining prescribers, low reimbursement

Quality Measures

- CCBHC: Additional standardized measures across providers and nationally

- CMHC: Inconsistent measures nationally, Oklahoma has standardized ETPS measures

  1. Nine (9) types of services
  2. Provision of 24-hour crisis care
  3. Evidence-based practices
  4. Care coordination with local primary care and hospital partners
  5. Integration with physical health care

  • Care coordination
  • Outreach
  • Crisis services
  • Targeted case management
  • Comprehensive integrated care planning
  • PCP screening and monitoring
  • Psychiatric rehabilitation
  • Integrated care and health promotion
  • Outpatient mental health and substance use services
  • Housing and employment services
  • Peer and family support services
  • Screening, assessment and diagnosis
  • Veterans services

Services

CCBHCs provide a comprehensive collection of services needed to create access, stabilize people in crisis and provide the necessary treatment for those with the most serious, complex mental illnesses and substance use disorders. CCBHCs integrate additional services to ensure an approach to health care that emphasizes recovery, wellness, trauma-informed care and physical-behavioral health integration. Comprehensive care includes, but is not limited to, the following required services:

  1. Crisis Services
  2. Screening, Assessment and Diagnosis
  3. Physical Healthcare Screening and Monitoring
  4. Comprehensive Integrated Care Planning
  5. Mental Health and Substance Use Outpatient Services
  6. Targeted Case Management
  7. Psychiatric Rehabilitation
  8. Peer & Family Support Services
  9. Veterans Services

 

Required Activities:

  1. Care Coordination
  2. Outreach
  3. Integrated Care
  4. Health Promotion
  5. Housing & Employment

Prospective Payment System (PPS)

The State uses a Prospective Payment System (PPS) for services delivered by a CCBHC. PPS is a cost-based, per clinic monthly rate that applies uniformly to all CCBHC services rendered by a certified clinic. CCBHC payment is based on an individual clinic’s expected cost of care. The PPS is paid when a CCBHC delivers at least one (1) CCBHC covered service, and when a valid individual procedure code is reported for the calendar month.

Rate Updates 

Provider specific monthly rates will be updated annually by the Medicare Economic Index to reflect changes due to inflation. ODMHSAS will review cost reports bi-annually to determine rate adequacy.

Providers


Contact the CCBHC Team

Malissa McEntire

Manager of Integrated Care