October 4, 2023
Last week, Senators Debbie Stabenow (D-Mich.) and John Cornyn (R-Texas) introduced the Ensuring Excellence in Mental Health Act.
The legislation would amend the Social Security Act and the Public Health Service Act to permanently authorize Certified Community Behavioral Health Clinics (CCBHCs).
· The Ensuring Excellence in Mental Health Act (S.2993) would establish a federal definition of CCBHCs into law and create the infrastructure needed to achieve the long-term vision of the model.
· The bill’s introduction demonstrates the continued bipartisan support to address the mental health and substance use crises in our nation by expanding access to high-quality care.
Background:
While the CCBHC demonstration was expanded in 2022 through the Bipartisan Safer Communities Act to include 10 new states every two years, the model needs permamanent sustainability past the end of the demo period. The bill defines CCBHCs, their full scope of services as outlined in the Substance Abuse and Mental Health Services Administration (SAMHSA) criteria and their payment methodology. It also creates ongoing technical assistance infrastructure to enhance and improve existing CCBHCs and state-based implementation of the CCBHC model. And, it authorizes development, improvement and enhancement grants to support activities like strengthening the CCBHC workforce, building capacity for evidence-based practices and improving partnerships with law enforcement, schools and housing sectors locally.
According to the National Council the bill would:
- Create CCBHC as a Medicaid Option service. States could submit a SPA to CMS seeking approval to develop Medicaid CCBHC services.
- Establish a PPS rate for Medicare, using a methodology that is in some ways similar to what is used for FQHCs.
- Would specifically authorize the CCBHC Expansion Grant Program. This formalization could increase the likelihood of future rounds of funding.
- Authorizes SAMHSA to review and approve accreditation processes so that SAMHSA could use accreditation in the CCBHC Expansion Grants process, and states would have the option to use the SAMHSA approved accreditation process in their own CCBHC certifications.
The Downside
CCBHC Demo services receive an enhanced FMAP rate. From what we can see and at the present time, the bill does NOT include direct language that requires continuation of the eFMAP and without it, NYS could realize a significant fiscal (cost) associated with continued operation of demo services. This could present serious barriers to further expansion of the CCBHC Demo Program here in New York. I’m going to speak to the National Council about this as soon as possible to make sure I am correct about this wrinkle and if so, how we can ensure continued progress here in New York.
Finally, here’s a note that just arrived (10/4) from the National Council:
At the links below please find the National Council’s “CCBHCs: A Vision for the Future of Community Behavioral Health Care,” paper which outlines a national vision for excellence in community mental health and substance use care and describes how clinics can leverage their CCBHC status to transform the experience of accessing care. as well as a press release on the paper. You can also find the full paper at this link: https://www.thenationalcouncil.org/wp-content/uploads/2023/10/CCBHCs-A-Vision-for-the-Future-of-Behavioral-Health-Care.pdf
We are releasing this paper later today. We encourage you to share this with your members and to disseminate it broadly and widely.