The 2023 Omnibus Appropriations Bill (H.R. 4373) was signed into law by President Biden on December 29, 2022. This bill is important to behavioral health because it includes numerous mental health and substance use-related provisions.
As the CCBHC Program Manager for Qualifacts, I am particularly interested in the $385M dollars allocated for Certified Behavioral Health Clinics (CCBHCs) that will be available through grants from the Substance Abuse and Mental Health Services Administration (SAMHSA). This is in addition to the previously approved and expanded CCBHC demonstration program allocated through the Bipartisan Safer Communities Act.
These additional SAMHSA grants would result in more opportunities for Community Mental Health Clinics (CMHC) to adopt the CCBHC treatment model:
- For those CMHCs who were previously awarded a CCBHC expansion grant, an additional grant could mean a continuation of CCBHC services.
- For demonstration CCBHCs, and expansion grants, this could mean improvements and expansion of CCBHC services.
- These new grant funding opportunities come to us in addition to the funds allocated in the Bipartisan Safer Communities Act, which allows states to apply for planning grants to fund the development of a strategy for becoming a CCBHC Demonstration state.
The CCBHC treatment model has proven its effectiveness in better meeting the needs of individuals with behavioral health or SUD conditions as evidenced in the National Council for Mental Wellbeing’s recent 2022 CCBHC Impact Report. Some of the data included shows these successes:
- Expanding Access to Care: An estimated 2.1 million clients are served nationwide by all 450 CCBHCs and grantees nationwide as of August 2022.
- This estimated total represents an increase of 600,000 clients1 compared to the estimated total number of individuals served by all CCBHCs in 2021.
- Coordination and Integration with Primary Care: 81% of respondents report increasing the number of referrals to primary care since becoming a CCBHC.
- CCBHCs also engage in numerous activities to coordinate and integrate care, from electronic information sharing with care coordination partners (94% currently do this or plan to) to co-locating physical health services on site (88% currently do this or plan to) and more.
- Managing Crisis Services and Supports Available to All: Either directly or through referral, 98% of respondents offer access to 24/7 crisis lines, 97% offer access to mobile crisis response, and 94% offer access to crisis stabilization services.
- Improving Collaboration with Criminal Justice Agencies: The vast majority of CCBHCs and grantees (96%) are actively engaged in one or more innovative activities in partnership with criminal justice agencies, such as providing services in partnership with courts (86%), training law enforcement officers in Mental Health First Aid or other awareness training (65%) or providing re-entry support to individuals returning to the community from incarceration (64%).
- Addressing Health Disparities: Since becoming a CCBHC, 100% report taking steps to improve access to care, reduce health disparities among, and serve people of color or other historically marginalized populations; at the top of the list is staff training on culturally sensitive/competent care (94%).
- Nearly three in five (58%) are currently engaged, or plan to engage, in work related to affordable housing by providing services at a site that provides affordable or supportive housing.
One of the impacts of the CCBHC treatment model not measured in the National Council for Mental Wellbeing’s 2022 CCBHC Impact Report is the increase in staff job satisfaction. The professionals I partner with share with me their satisfaction with this treatment model because of its alignment with the mission of the agency, and their personal satisfaction with tracking their organizational performance trends on the quality outcome measures. Successful trends in outcome measures equates to a high and increasing quality of services to the people the CCBHC serves, which is of critical importance. Clinical Quality Measures (CQM) Solution Dashboards from Qualifacts enable both supervisors and individual providers to see progress on each of the CCBHC behavioral health outcome measures, giving them specific insights into what is working and where more attention is needed.
In addition to additional funding for SAMHSA CCBHC grants, the National Council for Mental Wellbeing lists these dollar amounts allocated by the 2023 Omnibus Appropriations Bill for behavioral health priorities:
- Substance Use Services: $4.2 billion (increase of $203 million) to combat the opioid epidemic. Funds are targeted toward improving treatment and prevention and workforce needs.
- Mental Health Block Grant: $1.01 billion (increase of $150 million).
- National Institute of Mental Health (NIMH): $2.34 billion (increase of $120.9 million) for NIMH, including targeted funding for research on social media’s impact on mental health.
- School-based Grants: $111 million for school-based mental health grants at the Department of Education.
- Project AWARE: $140 million (increase of $20 million) for increasing awareness of mental health issues among youth, including training.
- Mobile Crisis: $20 million (increase of $10 million) to help communities create mobile behavioral health crisis response teams.
- Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program: $40 million toward educating and training SUD professionals.
- Parity: Authorizes $10 million for grants to states to support parity enforcement.
I am fortunate to be able to work closely with CCBHCs across the county, and I am grateful to learn of their successes firsthand. Some of my favorite anecdotes are those that include diversion strategies from the criminal justice system and the emergency department. I work with CCBHCs who travel out to the community with first responders for drug overdose calls. CCBHC providers on the scene make an early connection with an individual, and when starting treatment at that moment is not accepted, peer specialists and counselors build and maintain an ongoing relationship that can lead to CCBHC enrollment when the individual is ready.
Justice system diversion strategies among the CCBHCs I work with intervene in the community upon first contact. Working with the courts and the jail through SAMHSA’s “Sequential Intercept Model,” our CCBHCs are having remarkable success in getting people with BH and SUD issues into treatment instead of being incarcerated.
As both the right technology solution and partner to organizations offering services under the SAMHSA CCBHC grants and state CCBHC certification programs, Qualifacts welcomes the continued bipartisan support of the CCBHC treatment model and looks forward to the growth of federally designated CCBHC Demonstration states starting in July 2024.
Please check back to stay current with all news regarding CCBHC. To talk about anything CCBHC, please feel free to email Mary Givens at mary.givens@qualifacts.com. You can view all the CCBHC blogs and recorded webinars at CCBHC CENTRAL.
