CCBHC Funding Helps Behavioral Health Combat Workforce Shortages

Nearly three years into the Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration and about a year and a half into the first round of CCBHC expansion grant program, behavioral health stakeholders continue to advocate for the wider roll out of the CCBHC model. And in January, the industry recorded a win on that front.

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced $200 million worth of CCBHC expansion grants available to providers nationwide, rather than just in a handful of states, as was previously the case.

While the news means that nearly 100 new community-based behavioral health providers could enter the program, many providers have expressed doubt regarding their readiness. Namely, they’ve cited concerns they won’t be able to hire enough staff to meet the needs and requirements of being a CCBHC.

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However, those worries could be for not: The CCBHC model has been shown to boost providers’ staffing levels, helping to combat the workforce shortages rocking the behavioral health industry at large.

“We have a third of clinics significantly increasing their hiring and recruitment,” said Rebecca Farley David, vice president of policy and advocacy at the National Council for Behavioral Health, a trade organization representing more than 3,300 behavioral health providers. “We have seen them using the CCBHC funding to implement initiatives that have resulted in greater staff satisfaction and retention.”

David explained the phenomenon during a recent National Council webinar hosted in partnership with Relias, a provider of healthcare talent and performance solutions.

In the first year of the CCBHC Medicaid demonstration, which included eight states, 66 participating clinics added about 3,000 new positions, according to estimates from the National Council, which David shared during the presentation. That’s an average of more than 90 new employees per CCBHC.

“We had some clinics that actually doubled their workforce,” David said. “Part of the reason they were able to do this is because the funding that comes with CCBHC status allowed organizations to offer more competitive salaries, which allowed them to court and hire more highly qualified candidates.”

Generally, CCBHCs receive additional funding in return for providing 24/7 crisis care and other integrated behavioral health services in community settings. CCBHCs must provide nine types of required services in total.

Currently there are more than 100 CCBHCs in more than 20 states, according to the National Council. That includes grant recipients, as well as 66 CCBHCs in the eight states selected for the original Medicaid demonstration program.

For providers in the original demonstration, which has been extended through May 22, that money comes from Medicaid in the form of increased reimbursement. For CCBHCs in the expansion grant program, the funding comes from SAMHSA in the form of grants.

Most current CCBHCs are eligible for the new SAMHSA expansion grants — but so are community-based behavioral health providers not currently in the program. Such organizations just have to meet the CCBHC certification criteria within four months of being awarded funding.

Grant applications will be due March 10, with SAMHSA expecting to award 98 recipients up to $2,000,000 per year over the course of the two-year grant.

While the National Council lauded SAMHSA for increasing and expanding CCBHC grant program, the organization continues to try to move the needle on the CCBHC Medicaid demonstration, as well.

“Grantees … only received $4 million over the course of two years for their activities,” David explained. “Demonstration participants … receive a Medicaid cost-related payment for their services, so by expanding the Medicaid demonstration, it allows us the opportunity to bring more clinics into that payment structure that provides you with that cost-related Medicaid reimbursement rate.”

Currently, there’s bipartisan, bicameral support for legislation that would extend and expand the demonstration by two years and into 11 new states, David explained during the webinar. However, such legislation has not yet been passed.

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