Communications Director, Connecticut Hospital Association
110 Barnes Road, Wallingford, CT
rall@chime.org, 203-265-7611
CT Post – Wednesday, January 29, 2025
By Cris Villalonga-Vivoni
Funding certified community behavioral health clinics has been a “patchwork” approach for years, not only across the country but within Connecticut itself, providers said.
However, a federal planning grant from the Biden-Harris administration recently awarded to Connecticut, 13 other states and Washington D.C. aims to develop a statewide payment model to expand services at certified community behavioral health clinics, which have effectively proven to be successful in increasing access to care.
Certified community behavioral health clinics, more commonly known as CCBHCs, are 24/7 mental health and substance use providers that offer timely outpatient care and access to many other support and rehabilitation services to anyone in crisis, regardless of their ability to pay, location or age.
“The CCBHC movement… may finally be able to accomplish equitable access for everyone to the behavioral health services they need, which has never existed in this country,” said Heather Gates, president and CEO of the Community Health Resource, Inc., a nonprofit behavioral healthcare provider and one of the designated CCBHC in the state.
The grant is welcome news as funding for mental health and substance use disorder health and support services has varied widely across the country, Gates said.
She said each state has a different model, creating a “patchwork of funding”. At the same time, providers are still trying to serve communities with the most significant mental health needs.
More than 500 CCBHCs operate in 46 states. Still, most of these clinics are time-limited grants, said Brett Beckerson, senior director of public policy and advocacy at the National Council for Mental Wellbeing, a nonprofit that promotes mental health and substance use policy.
Services offered by CCBCHs are funded through a federal grant or are state-certified within Medicaid and must meet specific standards, nine services and several community partnerships to keep their certification, according to the National Council. As a result, these clinics are typically reimbursed at higher rates than other mental health clinics, depending on the funding model, so they can tailor their care to the community’s needs.
When a state establishes the model, it converts clinics to CCBHC. Beckerson said clinics can add multiple services, staff, and partnerships while meeting the federal and state criteria. To ensure the clinics are sustained, states need to plan and apply for funding through a demonstration, which the new grant makes the state eligible.
The first demonstrations started in 2014 to prove that if behavioral health services were adequately funded, it would increase access to care for the communities they work with. Gates said the demonstrations were wildly successful, which led to further legislation.
CBHCs serve an estimated 3 million people nationally, according to the council’s impact report. Most of them work with criminal justice agencies, are present in schools and have increased their outreach to historically underserved or underrepresented communities.
The various demonstration grants also helped create 11,292 new staff positions nationally, with licensed clinicians, peer support specialists, care coordinators and nurses being the most common, the council reported.
“Bit by bit, across the country, it began to take hold, and states realized that it was an effective way to improve their behavioral health systems,” Gates said.
Gates said Community Health Resource, Inc. was awarded the first grant to meet the CCBHC requirements after applying for the 2017 funding round. They are one of seven in Connecticut.
She said the grant allowed Community Health Resource Inc. to move the crisis teams to a 24/7 rotation through federal funds, embed clinicians in local police departments, screen for primary health conditions and add peer support and engagement specialists.
As a result, Community Health Resource, Inc. helped more than 30,000 individuals with a variety of mental health and substance use disorder services during the five-year CCBHC grant demonstration. Gates said staff helped 5,300 people in crisis services and performed 31,000 screenings and risk assessments.
With the arrival of the COVID-19 pandemic, Gates said the need for behavioral health services went up dramatically and has since stayed at very high levels everywhere, including Connecticut.
The most recent planning grant lasts for a year, and funding was provided by U.S. Sen. Chris Murphy’s Bipartisan Safer Communities Act of 2022. It also authorized adding up to 10 states to the demonstration every two years. The funds will help the selected states develop the certification process and prospective payment systems and prep the application for the U.S. Substance Abuse and Mental Health Services Administration.
Connecticut was among the 14 states selected this this cycle. In 2026, 10 of those 14 states will be selected to participate in the four-year Medicaid demonstration program and receive the enhanced reimbursement, according to the press release announcing the grant.
“We’ve seen the success of statewide models to support CCBHCs, and I’m thrilled that thanks to the Bipartisan Safer Communities Act, Connecticut has a chance to build out its own,” Murphy said. “This first grant is just the beginning, and I’ll keep fighting to make sure our state is part of the Medicaid demonstration and receives more funding to make it a success.”
The enhanced reimbursement under Medicaid and the prospective payment system would ultimately better compensate health clinics than in the past, said Gian-Carl Casa, president & CEO of the Connecticut Community Nonprofit Alliance, a statewide association of community nonprofits.
Casa said the state is looking to implement an administrative program and workforce development plan to see if more provider agencies can become CCBHCs nationwide to expand the existing system further. He hopes the planning grant will lead to a robust system of these clinics and that the clinics will continue to develop partnerships with the community to meet the needs of the people.
“Without money, they can’t hire people. Without people, they can’t open programs and without the programs, they cannot provide services. There’s no access,” Casa said. “Funding and access are tied very directly.”