It’s time for a permanent, sustainable funding model for CCBHCs

Every house needs a solid foundation, and Certified Community Behavioral Health Clinics (CCBHCs) are no different.

CCBHCs are a one-stop shop for all a person’s mental wellbeing needs, including recovery from addiction.

When you get a call from home asking you to pick up bread and milk, you know where you can go to get it. And chances are the store has a lot of other things that you might need as well. When it comes to needing care for a substance use or mental health problem, most people don’t know where to go, or what they will get if they arrive. But any individual can walk through the doors of a CCBHC and know they’ll have access to a full array of services and supports, integrated with primary care and coordinated with other social service providers.

CCBHCs are built on the common-sense idea that financing should support the most patient-centered and effective clinical model rather than constraining it.

The American Rescue Plan, President Biden’s $1.9 trillion relief package, includes $420 million to fund CCBHC expansion grants delivered through the Substance Abuse and Mental Health Services Administration (SAMHSA). This new funding comes on top of more than $1.3 billion for CCBHC expansion grants allocated since the beginning of 2020, and a historic three-year extension of the Medicaid demonstration that supports CCBHCs’ efforts in 10 states.

The federal government’s strong and growing commitment to CCBHCs is clear, based on their demonstrated success over the life of the program.

But the clock is ticking as more than 160 CCBHC grantees approach the end of their grants in 2022, with hundreds more set to lose funding when their grants expire in 2023. If these clinics lose their funding — and with it, their ability to function as CCBHCs — hundreds of communities across the U.S. will lose access to the comprehensive, integrated care they need and deserve.

It’s time to strengthen the foundation upon which CCBHCs are built and allow this innovative and effective program to expand to new states and communities. It’s time to move to a permanent, sustainable model that assures a future for every CCBHC in the nation, while opening the opportunities that come with CCBHC status to new cohorts of clinics.

The pathway to sustainability lies in establishing permanence for the CCBHC model as a state option in Medicaid. This is the only way to give CCBHCs – and the people who rely on them – certainty that federal funding will remain in place over the long term.

Momentum is building in this direction. In 2020, Congress expanded the Medicaid CCBHC demonstration to two new states. Three demonstration states have had CCBHC Medicaid State Plan Amendments approved to make their initiatives permanent, with more on the verge of following suit. And states can use Medicaid 1115 waivers to implement system changes that make the vision for CCBHCs a reality—as Texas has demonstrated by moving forward with CCBHC implementation independently from the federal demonstration.

But we can’t rely on demonstration extensions and waivers alone to achieve permanence for CCBHCs.

CCBHCs’ progress to date offers evidence of the demand for the services they provide. The clinics have dramatically increased access to mental health and addiction services. They have expanded states’ capacity to address the substance use and overdose crises. They have established innovative partnerships with law enforcement, schools and hospitals to improve care, reduce recidivism and prevent hospital readmissions.

CCBHCs are leading a bold shift to integrate physical and mental health care, address social determinants of health and provide 24/7 crisis care.

If we want to continue making progress, we need to ensure the pipeline of funding for CCBHCs remains as strong as the passion and conviction of those devoted to providing care.

So it’s imperative that we continue working with Congress on a long-term solution that not only provides permanent funding for existing CCBHCs, but also expands the program to additional states.

Provider, consumer and advocacy organizations across the field have been vocal in urging lawmakers to increase resources for CCBHCs. We must establish permanence for CCBHCs in state Medicaid programs. That means we need more states moving toward plan amendments and waivers to accomplish this, and federal enactment of a Medicaid CCBHC state option to ease their path.

We are grateful for the bipartisan support that has brought us this far. Together, we can ensure the program continues to grow and achieves the long-term sustainability it needs.

It’s time to bolster the foundation and begin building toward the opportunity for clinics in every community to become a CCBHC.