Senators Rally Behind Bills to Expand, Extend CCBHC Medicaid Demonstration

More than 80 Certified Community Behavioral Health Clinic (CCBHC) advocates convened on Capitol Hill Wednesday to urge Congress to extend and expand the CCBHC Medicaid demonstration program.

Specifically, they’re asking lawmakers to support the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767), which would expand the pilot by two years and add 11 new states to the program. Currently, the demonstration is set to expire May 22.

Sen. Debbie Stabenow (D-Mich.) and Sen. Roy Blunt (R-Mo.) led the event, along with the National Council for Behavioral Health. Dozens of CCBHCs leaders and workers from across the country flew in to show their support.

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Advocates made their case from both a humanitarian and financial perspective, sharing stories about the impact of CCBHCs in a press conference to kick off the event.

“Our work … saves lives,” Stacy Cary, a patient turned certified recovery specialist at Centerstone in Bloomington, Indiana, said. “So the question is, why would we allow funding for such an important program to expire?”

Centerstone is the largest community behavioral health provider in the country, with more than 220 locations and two full-scale addiction recovery centers across five states. The organization helped Cary get herself recover from substance use disorder (SUD) after she sought help five years ago.

“I urge Congress to demonstrate that you have the compassion for this country’s most vulnerable people — people like me — who rely on CCBHCs for life saving care so they can overcome substance use disorder, overcome mental illness and overcome barriers.”

The CCBHC Medicaid demonstration was first established back in 2014.

The program allows participating CCBHCs to receive higher Medicaid reimbursements for providing a comprehensive range of around-the-clock behavioral health services to the under- and uninsured. Those elevated reimbursement rates allow clinics to pay more competitive wages, provide more expansive services and help more people, while also collaborating with law enforcement, hospitals and schools.

In turn, CCBHCs save money by keeping behavioral health patients out of emergency departments or jails, where they aren’t always able to get the care they need.

“Certainly, without any question, for the better part of 50 years, the emergency room and law enforcement personnel have been the mental health delivery system for the country,” Blunt said. “Nobody benefits from that.”

CCBHC clients report a 61% reduction in hospitalization and 62% reduction in emergency department visits, according to a recent report from the National Council. They also help reduce the burden on law enforcement, Kelly Rowe, who heads up the Lubbock County Sheriff’s Department in Texas, said during the press conference.

“One individual that came through [our system], he spent 755 jail days with us,” he said. “During that time he was a high-end consumer of both medical and mental health services, including multiple long-term stays in the hospital. Ultimately, he was deemed incompetent to stand trial, and he was sent to a state home.”

That one patient cost taxpayers $750,000, Rowe said, using the astronomical figure to highlight the cost-saving potential CCBHCs have.

“What the CCBHC provides us and provides the states [is] the funding to be able to put together the programs that allow [mental health services to happen] where they need to happen, which is in the outpatient care model, not within the systems.”

Eight states were chosen to participate in the original CCBHC Medicaid demonstration: Minnesota, Missouri, Nevada, New Jersey, New York, Oklahoma, Oregon and Pennsylvania. In those states, there are 66 CCBHCs in the demonstration.

Providers in other states who were excluded from the demonstration may apply for SAMHSA grants, but the difference is funding is capped and runs out, usually after two years. Spencer, Iowa-based Seasons Center for Behavioral Health was awarded one of those grants last year, giving them four million dollars in federal funding over two years to become a CCBHC.

“I’ve been here 30 years as a social worker,” President and CEO Kim Scorza said during the press conference. “This is the best funding we’ve ever received in northwest Iowa.”

If the Excellence in Mental Health and Addiction Treatment Expansion Act passes, another 11 states would be added to the Medicaid demonstration.

“Why wouldn’t we want to expand this to communities across our country?” Stabenow said. “We all benefit by that when someone gets the treatment [and] the medications that they need. We benefit by having them able to fully be a part of the community.

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