The certified community behavioral health clinic (CCBHC) program is under threat.

A menacing line in a draft budget document from the U.S. Health and Human Services Department that leaked last week slates CCBHCs under “Other Eliminations” within a long list of other “AHA Mental Health Eliminations.” However, the document did not state what exactly the HHS and The White House plan to eliminate regarding CCBHCs. They have also not clarified what they propose to do with CCBHCs in public statements or following repeated requests for comment by Behavioral Health Business.

Several subject matter experts have described to BHB their interpretations of what such a proposal in a president’s pitch to Congress would apply to and what it could mean for CCBHCs. 

The consensus is that the White House may seek to eliminate hundreds of millions of dollars set aside for competitive planning and assistance grants for states and behavioral health organizations that want to establish a CCBHC. However, given the lack of clarity, many expressed a mix of worry and nonchalance about the document.

In 2021, the Bipartisan Safer Communities Act passed several mental health-related funding efforts into law, including expanded funds for CCBHCs. Later that year, Congress cleared $315 million for the Substance Abuse and Mental Health Services Administration (SAMHSA) for the CCBHC Expansion Grant Program.

“These grants support providers to meet the CCBHC criteria and establish CCBHC programs, improve and enhance existing CCBHC programs, and provide support for uncompensated care,” the SAMHSA website states. 

Industry insiders told BHB this $315 million program could be at risk because it is most within the administration’s power to eliminate. The CCBHC program itself and its funding mechanisms are much more insulated within the Medicaid program, both through waivers and state plan amendments. Eliminating grant funding would make it much more difficult for behavioral health providers to join the CCBHC program, potentially limiting its growth.

“It would absolutely make it that much harder to expand,” Joe Dan Beavers, CEO and president of Bowling Green, Kentucky-based LifeSkills, Inc., told BHB. “I guess the states would have to find funding in their own budgets for these kinds of things. If a state hasn’t already started this process, I think this makes it really, really hard for them to adopt the CCBHC model.”

Beavers, who leads a nonprofit behavioral health organization with 26 locations, also said that it is time, capital and technically intensive to establish clinics that meet CCBHC requirements. LifeSkills operates a CCBHC in Warren County, Kentucky.

While he has similarly heard from his contacts in the industry that these potential cuts would apply to discrete grant funding, the lack of clarity from the administration leads him to worry about a wider impact to the CCBHC program.

“I hope it’s nothing, actually; I hope that all the funding for CCBHC stays … We heard that given the magnitude of budget reductions that they’re looking to make, it’d be hard not to impact some of these programs,” Beavers said. “I wish I had better clarification. It’s those kinds of things that keep me up at night.”

On April 5, the U.S. Senate approved its version of budgetary outlines for federal spending limits. It clashes with what the U.S. House of Representatives passed. Now, lawmakers in both houses are to hash out the difference between the two plans via a process called budget reconciliation. 

The two different plans give the various congressional committees that oversee specific slices of the government conflicting directions on what direction funding levels will go. In the House budget outline, the committee that oversees health care programming is slated to cut spending by $880 billion over 10 annual budgets. The Senate plan calls for just $1 billion in cuts for the same period.

Nearly all of the federal funding overseen by that House committee is tied to Medicaid — a jointly administered state-federal health plan for vulnerable populations — and Medicare — a federal health plan for the elderly and those with certain terminal conditions. Analysis of the more dramatic cuts proposed by the House finds that nearly all, 93%, of the funding and spending unrelated to Medicare applies to Medicaid. President Donald Trump and other Republicans have publicly promised not to cut Medicare, Medicaid and Social Security funding. 

CCBHCs in practice 

The number of CCBHCs has grown swiftly in recent years. The National Council for Mental Wellbeing, an industry trade group for CCBHCs and similar organizations, states there are over 500 CCBHCs in the U.S. that serve about 3 million people a year.

CCBHCs integrate several services related to behavioral health in one location and get prospective payments via Medicaid to be able to do so. CCBHCs are required to offer nine integrated services. Some include outpatient services for mental health and substance use disorder, crisis services and psychiatric rehabilitation. 

“CCBHC at the core, to me, is the ideal reverse integration, where we take the concept of a community behavioral health center and we embed primary care and other services into that,” Stacy DiStefano, CEO of Consulting or Human Services, previously said in March during a panel chat at BHB’s event VALUE 2025.

The integration of several services and a unique-to-behavioral-health funding model make CCBHCs a standout example of several long-sought innovations in the industry. The model also requires strict data collection and reporting as well as care quality metrics.

“The dirty little secret in behavioral health is that all of our outcomes are terrible,” CJ Davis, CEO of the multi-state nonprofit health care provider Brightli, said during the VALUE panel. “The measurement of it is horrible, and it’s all dependent upon how passionate organizations are to get them better. So what happened with CCBHC is that it required us to — from a back-end perspective of data — to think and approach care way differently.”

When asked about the overall regulatory uncertainty under a new Congress and administration, each panelist expressed their hope but also their expectation that bipartisan interest in public mental health programs would prevent dramatic reductions.

“When you think about the CCBHC model and the data and the outcomes that have shown since 2017, even the most conservative critic cannot argue with the data and the outcomes,” DiStefano said, noting the Trump administration’s pretense for many cuts are related to fraud and waste. “There is proof in the pudding on this model, and so it’s not something you can point to, regardless of your political leaning, and say this doesn’t work.”