Mental Hygiene Law, sections 7.09, 7.15, 19.07(a), (c), (e), 19.09(b), 19.20, 19.21(b), (d), 19.40, 31.01, 31.04, 31.05, 31.06, 31.07, 31.09, 31.13, 31.16, 31.19, 31.27, 32.05(b), 32.07(a), 32.09(b), 32.21, 43.01, 43.02, 43.02(b), 36.04, 36.06; Social Services Law, sections 364, 364-a; Public Health Law, art. 29-G; CFR part 2, title 45

Certified Community Behavioral Health Centers (CCBHC)

Behavioral Health Services Advisory Council Summary-CCBHC

Subpart 600-1 Certified Community Behavioral Health Centers (CCBHC)

What is a CCBHC? CCBHCs provide comprehensive, coordinated mental health and substance use services for individuals across the lifespan. They increase access to high quality community mental health and substance use care, including crisis care, they provide integrated person- and family-centered services, driven by the needs and preferences of people receiving services and their families. They provide a range of evidence-based practices, services, and supports to meet the needs of their communities. And last, they provide services to anyone seeking help for a mental health or substance use condition, regardless of their diagnosis, place of residence or ability to pay.

600-1.1 Background and Intent. This section introduces the CCBHC and the purpose of this part-to establish standards for the certification, operation, and reimbursement of CCBHCs in New York after the end of the federal demonstration on 9/30/25. CCBHC certification is issued jointly by the Office of Mental Health (OMH) and the Office of Addiction and Support Services (OASAS) under Article 36 of the Mental Hygiene Law.

Currently there are 39 CCBHCs in NYS as a part of the demonstration, and while they have either an Article 31 or 32 license, they operate under the Substance Abuse and Mental Health Services Administration (SAMSHA) standards/criteria for CCBHCs. What this regulation does is take the SAMHSA criteria and put it into regulation so that these providers can continue to exist, provide services, and be reimbursed accordingly, all with oversight from both agencies.

600-1.2 Legal Base. This section specifies the provisions of statute (mainly Article 31, Article 32, and Article 36) that provide the OMH and OASAS with authority to oversee CCBHCs and jointly issue certification.

600-1.3 Applicability. This section specifies that these regulations apply to any provider of services who operate or propose to operate a CCBHC in NYS.

600-1.4 Definitions. This section contains all definitions applicable to this Subpart, including staffing.

600-1.5 Certification. This section outlines the requirements that CCBHCs need to meet for application and approval, in order to receive an operating certificate from the OMH and OASAS. CCBHCs are certified for up to three years before recertification is required. This section contains requirements for both main sites and satellite sites, as well as describes what is needed for the Community Needs Assessment. Last, this section also outlines the process for denial of an application, or a decision to suspend, revoke or limit CCBHC operating certificates by the OMH and OASAS.

600-1.6 Inspection. The offices have responsibility of ongoing inspection of all CCBHCs to ensure compliance with Federal and State rules and regulations. This section describes the how inspections shall be conducted by the OMH and OASAS.

600-1.7 Organization and Administration. This section contains the requirements for the governing body of each CCBHC, which has responsibility for the operation of the program. This section outlines requirements for the composition of the governing board, the responsibilities and duties of the board, as well as policies and procedures.

600-1.8 Services. This section contains the requirements for the services that each CCBHC must provide. There 9 required CCBHC services:

(1) Screening, assessment and diagnosis;

(2) Person-centered and family-centered treatment planning;

(3) Outpatient mental health and substance use services;

(4) Crisis behavioral health services;

(5) Outpatient primary care screening and monitoring;

(6) Targeted case management;

(7) Psychiatric rehabilitation services;

(8) Peer and family supports; and

(9) Intensive community-based outpatient behavioral health care for members of the U.S. Armed Forces and veterans.

The first three services must be provided directly by the CCBHC, but the remaining six may be delivered directly by the CCBHC or by a Designated Collaborating Organization (DCO).

600-1.9 Medication for Addiction Treatment (MAT) for Substance Use Disorder (SUD). This section contains the requirements for CCBHCs to provide MAT, and mainly specifies that they must comply with all state and federal rules for the provision of MAT. All CCBHCs must have the capacity to prescribe medication for addiction treatment.

600-1.10 Staffing. This section contains the minimum staffing requirements for CCBHCs, which are required to continuously have adequate and appropriate staff to carry out the objectives and services offered by a CCBHC. Includes requirements for staffing including Chief Executive Officer, Medical Director, CASACs and Peers. This section includes training requirements as well.

600-1.11 Case Records. This section contains the requirements for case records for each person admitted to a CCBHC. This section also includes requirements for Health Information Systems.

600-1.12 Premises. This section contains the minimum requirements for CCBHC premises, ensuring that they maintain premises adequate and appropriate for the safe operation of a CCBHC. Providers must also possess a certificate of occupancy.

600-1.13 Approval for the use of Telehealth. This section describes how CCBHCs may obtain approval for the use of telehealth. A CCBHC must apply to the OMH and OASAS and submit their policies and procedures and an attestation to provide telehealth that meets the minimum requirements in this section including confidentiality, availability of in person services, how to address emergency situations, and compliance with State and Federal privacy rules.

600-1.14 Medical Assistance Billing Standards. This section contains the minimum requirements for CCBHC reimbursement.

600-1.15 Medical Assistance Certified Community Behavioral Health Center Program Reimbursement System. This section requires providers to produce and submit cost reports for the program.

600-1.16 Quality Based Bonus Payments. This section details the eligibility for providers to participate in the Quality Bonus Payments program which is based on achieving specific thresholds on State-mandated performance measures each year.

600-1.17 Application and Approval Process for CCBHC Established Under Federal Demonstration. This section provides for a designation status for each CCBHC previously established under the Federal CCBHC demonstration to continue operating temporarily. This designation expires, unless extended, and CCBHCs must ultimately apply for certification under this Part to become fully certified.

1. Statutory Authority:

(a) Section 7.09 of the Mental Hygiene Law (MHL) grants the commissioner of the Office of Mental Health (OMH) the power and responsibility to adopt regulations that are necessary and proper to implement matters under their jurisdiction.

(b) Section 7.15 of the MHL charges the commissioner of OMH with the responsibility for planning, promoting, establishing, developing, coordinating, evaluating and conducting programs and services of prevention, diagnosis examination, care treatment, rehabilitation, training, and research for the benefit of persons with mental illness. Such law further authorizes the commissioner to take all actions that are necessary, desirable, or proper to carry out the statutory purposes and objectives of the OMH, including undertaking activities in cooperation and in agreement with other offices within the Department of Mental Hygiene, as well as with other departments or agencies of State government.

(c) Section 31.04 of the MHL authorizes the commissioner of OMH to set standards of quality and adequacy of facilities, equipment, personnel, services, records and programs for the rendition of services for adults diagnosed with mental illness and of children or youth diagnosed with serious emotional disturbance, pursuant to an operating certificate.

(d) Sections 31.05, 31.07, 31.09, 31.13, 31.19, and 31.27 of the MHL authorize the commissioner of OMH or their representatives to examine and inspect CCBHCs to determine their suitability and proper operation.

(e) Section 31.06 of the MHL requires every holder of an operating certificate to develop and implement policies and training programs regarding child abuse.

(f) Section 31.16 of the MHL authorizes the commissioner of OMH to suspend, revoke, or limit any operating certificate, under certain circumstances.

(g) Sections 43.01 and 43.02 authorize the commissioner of the OMH to establish fees and rates for department services and services provided by facilities licensed by the OMH, subject to the approval of the director of the Division of Budget.

(h) Section 43.02(b) of the MHL authorizes the commissioner of the OMH to request from operators of facilities licensed by the OMH such financial, statistical, and program information as the commissioner may determine to be necessary.

(i) Sections 364 and 364-a of the Social Services Law charges OMH with the responsibility to establish and maintain standards for medical care, and services and facilities in accordance with cooperative arrangements with the Department of Health.

(j) Article 29-G of the Public Health Law authorizes the provision of and reimbursement for health care services provided via telehealth.

(k) Section 19.07(a) of the MHL charges the Office of Addiction Services and Supports (OASAS) with assuring the development of comprehensive plans, programs and services for research, prevention, care, treatment, rehabilitation, education and training related to substance use disorder and compulsive gambling.

(l) Section 19.07(c) of the MHL charges the commissioner of OASAS with the responsibility to ensure that persons who have a substance use disorder and their families are provided with care and treatment that is effective and of high quality.

(m) Section 19.07(e) of the MHL authorizes the commissioner of OASAS to adopt standards including necessary rules and regulations pertaining to substance use disorder treatment services.

(n) Section 19.09(b) of the MHL authorizes the commissioner of OASAS to adopt regulations necessary and proper to implement any matter under their jurisdiction.

(o) Section 19.20 of the MHL requires review of criminal history information concerning certain prospective employees and volunteers (includes staff and volunteers who will have direct, unsupervised contact with clients) of providers of services certified, operated or otherwise authorized by OASAS.

(p) Section 19.20-a of the MHL authorizes OASAS to receive criminal history information from the Division of Criminal Justice Services related to persons seeking to be credentialed or applicants for an operating certificate issued by OASAS that will have regular and substantial unsupervised or unrestricted contact with patients/clients.

(q) Section 19.21(b) of the MHL requires the commissioner of OASAS to establish and enforce regulations concerning the licensing, certification, and inspection of substance use disorder treatment services.

(r) Section 19.21(d) of the MHL requires OASAS to establish reasonable performance standards for providers of services certified by OASAS.

(s) Section 19.40 of the MHL authorizes the commissioner of OASAS to issue operating certificates for the provision of substance use disorder treatment services.

(t) Section 22.11 of the MHL authorizes treatment for minors for substance use disorder without consent from parents of guardians.

(u) Section 32.01 of the MHL authorizes the commissioner of OASAS to adopt any regulation reasonably necessary to implement and effectively exercise the powers and perform the duties conferred by Article 32 of the MHL.

(v) Section 32.05(b) of the MHL provides that a controlled substance designated by the commissioner of the Department of Health as appropriate for such use, may be used by a physician to treat a chemically dependent individual pursuant to 32.09(b) of the MHL.

(w) Section 32.07(a) of the MHL authorizes the commissioner of OASAS to adopt regulations to effectuate the provisions and purposes of Article 32 of the MHL.

(x) Section 32.09(b) of the MHL provides that the commissioner of OASAS may, once a controlled substance is approved by the commissioner of the Department of Health as appropriate for such use, authorize the use of such controlled substance in treating a chemically dependent individual.

(y) Section 32.21 of the MHL provides the commissioner of OASAS with the authority to suspend, revoke, or limit operating certificates and impose fines.

(z) Part 2 of Title 45 of the Code of Federal Regulation (CFR) relates to the confidentiality of substance use treatment records.

(aa) Section 36.04 of the MHL authorizes the commissioners of OMH and OASAS to jointly certify community behavioral health centers, subject to the availability of State and federal funding.

(bb) Section 36.06 of the MHL provides authority for the shared criminal history information review and suitability determination for prospective employees and volunteers, providers, operators and individuals seeking to be credentialed for entities that are licensed, certified, or otherwise authorized by OASAS and OMH.

2. Legislative Objectives:

CCBHCs were originally established under New York States CCBHC demonstration, pursuant to section 223 of the Protecting Access to Medicare Act (P.L. 113-93), as amended. Providers authorized to participate in this demonstration operate integrated mental health and substance use disorder programs pursuant to the federal demonstration requirements, the Substance Abuse and Mental Health Services Administration (SAMHSA) criteria, and integrated care regulations promulgated by the commissioners of OMH and OASAS. Over the course of the demonstration, there have been 39 CCBHCs established across the State, however, the federal demonstration ends on September 30th, 2025.

Article 36 of the MHL provides OMH and OASAS the authority to establish a joint regulation and certification process for CCBHCs. New Subpart 600-1is the integrated regulation developed by both OMH and OASAS to provide for certification of the existing 39 CCBHCs, pursuant to this statutory provision.

New Subpart 600-1 implements the legislature’s intent to (1) provide a framework for State certification for CCBHCs at the end of the federal demonstration, (2) ensure continuity of operations for providers currently approved under the federal demonstration, (3) maintain access to integrated behavioral health services across the State, and align the State certification requirements with the SAMHSA criteria.

3. Needs and Benefits:

Due to the end of the federal CCBHC demonstration, OMH and OASAS have determined that there must be an oversight mechanism in place so that the currently existing CCBHCs can continue to operate in an efficient manner and allow providers to continue billing Medicaid. New Subpart 600-1 is substantially based on the SAMSHA CCBHC criteria, which is what the current CCBHCs are following.

New Subpart 600-1, pursuant to Article 36, provides for a joint certification process, inspection procedures, standards for organization and administration of CCBHCs, description of the services offered by CCBHCs, standards for Medication for Addiction Treatment, staffing requirements, requirements for case records, requirements for premises, approval for the use of telehealth, billing standards, reimbursement standards, and standards for quality bonus payments. OMH and OASAS are jointly developing both an application and guidance document that will be ready for the providers as soon as possible. The regulation will also contain a provision allowing for the immediate “designation” of all CCBHCs currently operating under the federal demonstration to continue operating in order to prevent treatment and services disruption and provide for a seamless transition for these providers.

4. Costs:

Costs for providers should be minimal, as the current standard is for CCBHCs to be in compliance with the SAMSHA criteria. New Subpart 600-1 is substantially in compliance with the SAMSHA criteria, however, it may require providers to incur minimal costs to ensure that staff training, reporting, and overall governance are in compliance with Subpart 600-1. These costs would vary by provider size and existing compliance with the SAMHSA criteria.

Costs to the State are minimal; OMH and OASAS will use existing inspection, oversight, and certification systems that are currently in place.

There are no anticipated costs to local governments.

5. Paperwork:

Providers must submit a certification application to OMH and OASAS as appropriate, supporting documentation demonstrating compliance with new Subpart 600-1, and provide ongoing quality assurance. Documentation requirements are consistent with the existing federal demonstration reporting as well as Medicaid billing procedures.

6. Local Government Mandates:

There are no new local government mandates.

7. Duplication:

This regulation does not duplicate any existing efforts after the September 30th 2025 ending of the federal CCBHC demonstration. The new regulation implements Article 36 of the MHL, which authorizes the commissioners of OMH and OASAS to jointly certify CCBHCs. Overall, Subpart 600-1 consolidates the federal demonstration authority into a State-administered, jointly certified program.

8. Alternatives:

The alternative to promulgating this new regulation would be to simply let the federal demonstration end and have no joint oversight mechanism for the existing 39 CCBHCs. This would result in a loss of the CCBHC designation for those providers operating under the federal demonstration, and a potential disruption of services. The approach taken by OMH and OASAS ensures integrated behavioral health services, continuity for existing providers, and adherence to federal quality standards.

9. Federal Standards:

This regulation does not conflict with federal standards. The federal demonstration ends on September 30th 2025 and this new regulation replaces the certification criteria and oversight mechanism that the federal demonstration provided. Subpart 600-1 aligns with the SAMHSA CCBHC criteria for certification.

10. Compliance Schedule:

This rule will become effective upon publication of the Notice of Adoption in the State Register.

The Office of Addiction Services and Supports (OASAS) and the Office of Mental Health (OMH) have determined that the rule will not impose any adverse economic impact or reporting, recordkeeping or other compliance requirements on small businesses or local governments because the new Subpart only provides for continued oversight of CCBHCs in New York after the ending of the federal demonstration period. The regulation is substantially based on the federal Substance Abuse and Mental Health Services Administration (SAMHSA) criteria (what the CCBHCs are currently following).

The Office of Addiction Services and Supports (OASAS) and the Office of Mental Health (OMH) have determined that new Subpart 600-1 will not impose any adverse impact on rural areas or reporting, recordkeeping or other compliance requirements on public or private entities in rural areas, because the new regulation only allows for the continued existence of Certified Community Behavioral Health Centers (CCBHCs) in New York State after the ending of the federal demonstration period on September 30th 2025. The regulation provides for State level certification of the CCBHCs, and an immediate designation to continue the proper billing mechanism.

The new Subpart 600-1, while it substantially follows the CCBHC Substance Abuse and Mental Health Services Administration (SAMHSA) criteria, will require all CCBHCs to submit a certification application. The application has been designed to lessen the burden on all CCBHCs applying for certification so as to ease the transition from the federal demonstration to the new certification. The regulation also provides for an immediate provisional designation once the regulation is adopted as a final rule, and providers do not have any paperwork on their end. Once the rule is adopted as a permanent rulemaking, the providers who apply for certification within 90 days may have their provisional designation extended as necessary until their application is acted upon, again, to ease the burden on the providers.

The Office of Addiction Services and Supports (OASAS) and the Office of Mental Health (OMH) have determined that new Subpart 600-1 will have no adverse impact on jobs in New York State and therefore will not be submitting a Job Impact Statement for this rulemaking. New Subpart 600-1 implements Article 36 of the Mental Hygiene Law as it relates to the certification of Certified Community Behavioral Health Clinics (CCBHCs) in New York and provides an oversight mechanism at the end of the federal demonstration period for the 39 CCBHCs that currently exist in New York. As this regulation is substantially based on the Substance Abuse and Mental Health Services Administration (SAMHSA) CCBHC criteria (which is what the current CCBHCs are operating under) the regulation intends to preserve the current state of CCBHCs. No change in jobs is anticipated, and if anything, the regulation prevents a disruption in the operation of the current CCBHCs. A disruption such as lack of oversight and ability to bill could have a negative impact on jobs, which will be prevented by the certification and temporary designation mechanism in this new regulation when the rule becomes effective. Until that time, CCBHCs will be expected to continue operation pursuant to their Article 31 or Article 32 license and pursuant to the SAMHSA criteria.