1. Certified Community Behavioral Health Clinics

3. Certified Community Behavioral Health Clinics (CCBHC)
March 2014 Congress passed the Protecting Access to Medicare Act (H.R. 4302)
Included Excellence in Mental Health Act – an eight state demonstration project and the single largest investment in community behavioral health in more than 50 years (approximately $1.1Billion)

4. Certified Community Behavioral Health Clinics (CCBHC)
What does the act accomplish?
Gave behavioral health clinics a federal definition with defined quality standards and reimbursement that reflects cost of care
Created criteria for Certified Community Behavioral Health Clinics (CCBHCs)
Provides $25,000,000 in planning grants for states to develop applications for 2-year demonstration pilot

5. Certified Community Behavioral Health Clinics (CCBHC)
Texas House Bill 1, 84th Regular Session, Article II, HHSC:
Rider 79. Excellence in Mental Health. Out of funds appropriated above, the Health and Human Services Commission shall develop and submit an application to Centers for Medicare and Medicaid Services for an Excellence in Mental Health planning grant as authorized in the Protecting Access to Medicare Act (H.R. 4302). It is the intent of the Legislature that applying for the grant and participation in a pilot will be cost neutral to the state and that the principles of the grant are consistent with Commission’s value based payment strategies.

6. Certified Community Behavioral Health Clinics (CCBHC): Planning Grant
Phase I: One-Year Planning Grants
Texas was one of 24 states awarded a planning grant ($982,373)
Program proposal for Demonstration Grant due to SAMHSA by October 23, 2016

7. Certified Community Behavioral Health Clinics (CCBHC): Planning Grant
Two Key Planning Grant Activities:
CCBHC Readiness and Certification
Development of a Prospective Payment System (PPS) for Medicaid Clients

8. Certified Community Behavioral Health Clinics (CCBHC): Planning Grant
Texas will focus on four key populations who would benefit from CCBHC model:
Children/youth with mental health issues
Children/youth with substance use disorders
Adults with mental health issues
Adults with substance use disorders

9. Certified Community Behavioral Health Clinics (CCBHC): Planning Grant Activities
Certification of Clinics:
Must offer services to all clients – regardless of payer or age
Must be not-for-profit, local mental health authorities or Indian Health Service
Minimum of 2 clinics must be selected in Texas (at least 1 rural and 1 urban)
Control group must be identified
Must participate in data collection up to 3 years post demonstration

10. Certified Community Behavioral Health Clinics (CCBHC): Required Services
CCBHC must directly provide the following:
Crisis Mental health services including 24-hour mobile crisis teams, emergency crisis intervention and crisis stabilization
Screening, assessment and diagnosis including risk management
Patient-centered treatment planning
Outpatient mental health and substance use services

11. Certified Community Behavioral Health Clinics (CCBHC): Required Services
CCBHC must provide either directly or through Designated Collaborating Organization(DCO) the following:
Primary Care Screening & Monitoring
Targeted Case Management
Psychiatric Rehabilitation Services
Peer support, counseling services, and family support services
Services for members of the armed services and veterans
Connections with other providers and systems

12. Certified Community Behavioral Health Clinics (CCBHC): Why Required Services Defined
Comprehensive array necessary to create access, stabilize people in crisis, and provide the necessary treatment for those with the most serious, complex mental illnesses and addictions.
Approach to health care that emphasizes recovery, wellness, trauma-informed care, and physical-behavioral health integration.

13. Certified Community Behavioral Health Clinics (CCBHC): Prospective Payment System (PPS)
Certification of Clinics:
Monthly payment rate – to be adopted by partnering MCOs
Payment for different populations
Service bundles will build off Texas Resiliency and Recovery model
Outlier payments may be required
Quality bonus payment is required – upside bonus

14. Certified Community Behavioral Health Clinics (CCBHC): Prospective Payment System (PPS)
Certification of Clinics:
Service are reimbursed to Texas at enhanced (CHIP) FMAP during the demonstrations phase
Regular FMAP %
Enhanced FMAP %
Provides a waiver for Medicaid state plan authority to implement payment and services expansion

15. Certified Community Behavioral Health Clinics (CCBHC): Center Required Reporting Measures
Measure or Other Reporting Requirement
National Quality Forum Measure (# if endorsed)
Number/Percent of clients requesting services who were determined to need routine care
N/A
Number/percent of new clients with initial evaluation provided within 10 business days, and mean number of days until initial evaluation for new clients
Mean number of days before the comprehensive person-centered and family centered diagnostic and treatment planning evaluation is performed for new clients
Number of Suicide Deaths by Patients Engaged in Behavioral Health (CCBHC) Treatment
Documentation of Current Medications in the Medical Records
0419
Patient experience of care survey
Family experience of care survey
Preventive Care and Screening:  Adult Body Mass (BMI) Screening and Follow-up
0421

16. Certified Community Behavioral Health Clinics (CCBHC): Center Required Reporting Measures
Measure or Other Reporting Requirement
National Quality Forum Measure (# if endorsed)
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)
0024
Controlling High Blood Pressure - Adult
0018
Preventive Care & Screening:  Tobacco Use:  Screening & Cessation Intervention
0028
Preventive Care and Screening:  Unhealthy Alcohol Use:  Screening and Brief Counseling
2152
Initiation and engagement of alcohol and other drug dependence treatment - Adult
0004
Child and adolescent major depressive disorder (MDD): Suicide Risk Assessment
1365
Adult major depressive disorder(MDD):  Suicide risk assessment
0104
Screening for Clinical Depression and Follow-Up Plan – Adult
0418
Depression Remission at 12 months
0710

17. Certified Community Behavioral Health Clinics (CCBHC): Potential Quality Bonus Measures
Measure or Other Reporting Requirement
National Quality Forum Measure (# if endorsed)
Follow-Up After Hospitalization for Mental Illness (Adult
NCQA/HEDIS
Follow-Up After Hospitalization for Mental Illness (child/adolescents)
Adherence to Antipsychotics for Individuals with Schizophrenia
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
Adult Major Depressive Disorder (MDD):  Suicide Risk Assessment
AMA-PCPI
Child and Adolescent Major Depressive Disorder (MDD):  Suicide Risk Assessment
Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication
Screening for Clinical Depression and Follow-Up Plan
CMS
Antidepressant Medication Management

18. Certified Community Behavioral Health Clinics (CCBHC): Demonstration Grant
Phase II: Selection of States
SAMHSA will select up to eight states to carry out their CCBHC projects
Demonstration project grants will fund the selected CCBHCs for at least two years
Demonstration would begin Early 2017

20. The Principles of CCBHC Apply to All of the Behavioral Health Industry