Report: 3 Million People Now Served by Innovative Model of Care

WASHINGTON, DC (June 4, 2024) — Certified Community Behavioral Health Clinics (CCBHCs) are providing an estimated 3 million people with mental health and substance use treatment and care, with 79% of clinics serving more people after becoming a CCBHC, according to the 2024 CCBHC Impact Report, released today.

Through their documented ability to improve access to lifesaving substance use treatment, recovery supports, crisis services, integrated care and other services, CCBHCs are eliminating barriers to access for people in hundreds of communities, according to the new report, which is based on survey responses from more than 300 clinics. The National Council for Mental Wellbeing produced the study.

“This new report provides a clear signal that we must build upon previous bipartisan congressional action and expand access to CCBHCs nationwide,” National Council President and CEO Chuck Ingoglia said. “Further establishing the model in federal law — and the innovative payment system that gives clinics flexibility to tailor care to their communities — will improve access to lifesaving care.”

The report found that CCBHCs:

• Are helping a growing number of people: 79% of clinics report serving more people since becoming a CCBHC. Increases are particularly pronounced among CCBHCs whose states have adopted the model through Medicaid, with the number of people served by Medicaid-funded CCBHCs increasing 33%.
• Expand access to substance use care: 87% of CCBHCs report offering one or more forms of medication-assisted treatment (MAT) for opioid use disorder (OUD), compared to only 64% of substance use treatment facilities nationwide.
  • Provide overdose prevention and support: 60% have already implemented the new Substance Abuse and Mental Health Services Administration (SAMHSA) CCBHC certification requirement that individuals and/or families have access to naloxone for overdose reversal, ahead of the July 2024 deadline; 56% provide support following a nonfatal overdose after an individual is medically stable.
• Meet children, youth and families where they are: 83% of CCBHCs provided services on-site in one or more schools, childcare or other youth-serving settings.
  • 68% of Medicaid CCBHCs and established grantees reported the number of children/youth they serve has increased, and 24% of these indicated the increase was substantial.
• Support crisis care: More than 80% of CCBHCs are working in partnership with 988 Suicide & Crisis Lifeline call centers.
  • 29% of clinics have added mobile crisis response, greatly expanding access for underserved communities, particularly in rural areas.
• Work with law enforcement and correctional facilities: 98% of CCBHCs are actively engaged in partnership with criminal justice agencies to improve interactions with people who have mental health needs.
  • 85% have partnerships with courts, and 63% are increasing outreach to people with criminal justice involvement.
• Address health disparities and social determinants of health: CCBHCs have engaged in targeted access expansions to address health disparities, including 75% reporting increased outreach for individuals in historically underserved communities.
• Create jobs: Medicaid CCBHCs and established grantees hired 11,292 new positions, a median of 15 new positions per clinic.
  • Hiring was greatest among Medicaid CCBHCs, which reported a median of 22 new positions per clinic. Licensed clinicians, peer support specialists, care coordinators and nurses were among the most commonly hired staff.
  • 67% of Medicaid CCBHCs and established grantees hired staff with a substance use focus.

In May, legislation was introduced to codify CCBHCs in Medicaid and establish a CCBHC definition in Medicare.

What is the Ensuring Excellence in Mental Health Act?

Reps. Doris Matsui (D-Calif.), Larry Bucshon (R-Ind.), Marc Molinaro (R-N.Y.), Angie Craig (D-Minn.) and Paul Tonko (D-N.Y.) introduced the bipartisan Ensuring Excellence in Mental Health Act (H.R.8543) in the House of Representatives on May 23. Introduction in the House followed the Senate introduction of S.2993 by Sens. Debbie Stabenow (D-Mich.) and John Cornyn (R-Texas) in September 2023. The legislation would:

• Permanently authorize a Medicaid payment system for the CCBHC model.
• Establish a definition of services and prospective payment system for CCBHCs under Medicare, ensuring that CCBHCs can also provide behavioral health care for older adults.
• Establish a new certification and accreditation process for CCBHCs and a technical assistance program at the U.S. Department of Health and Human Services (HHS) to encourage program integrity and quality of care.
• Authorize expansion grants for certified or potential CCBHCs to expand clinics’ ability to provide comprehensive care.
• Authorize a new data infrastructure system for CCBHC data reporting.

Recently, the Consolidated Appropriations Act, 2024 (H.R.4366), codified a permanent CCBHC option for states without the CCBHC payment mechanism under the Medicaid program. Further action is needed to cement the payment structure within Medicaid and establish CCBHCs in Medicare so everyone in need of mental health or substance use care can access it through a CCBHC.

“The Ensuring Excellence in Mental Health Act would establish CCBHCs under the Medicare program, allowing comparable Medicare status and designated payment as other safety net health care providers,” Ingoglia said. “In real terms, that means more people — including children and historically underserved populations — will receive the care they need.”

CCBHCs are clinics, either certified by their states as CCBHCs or recipients of a federal CCBHC grant, that receive flexible funding to expand the scope of mental health and substance use services in their community. They serve anyone who walks through the door, regardless of ability to pay. CCBHCs were originally implemented at 66 clinics in eight states through a Medicaid demonstration that began in 2017. Today, there are 495 CCBHCs in 46 states, the District of Columbia and Puerto Rico.

Learn more about CCBHCs here.