Only certain organizations are permitted to become CCBHCs, according to requirements from the statute that established the program.
For-Profit Clinics or Organizations
A private, for-profit clinic or organization cannot be a CCBHC, but it can enter into a formal agreement with a CCBHC and become a designated collaborating organization (DCO). For-profit clinics cannot become a CCBHC even if the local behavioral health authority or the Indian Health Service (IHS) pays for services received there.
The Department of Health and Human Services (HHS) has developed criteria for CCBHC certification. A nonprofit organization with multiple clinics can become a CCBHC as long as all its components satisfy the criteria. The parent organization cannot be a CCBHC if all its components do not satisfy the criteria.
One clinic in a larger nonprofit organization can be a CCBHC, and another part of the nonprofit organization can be a DCO, if the clinic meets the CCBHC certification criteria and the relationship between the clinic and the other component of the nonprofit meets the DCO requirements. For example, if a large nonprofit organization has only one clinic that is a CCBHC, but the nonprofit also operates a state-sanctioned, certified, or licensed behavioral health crisis system, the crisis system may be a DCO for the CCBHC if the requirements of that relationship are satisfied.
A state-operated clinic can be a CCBHC because it is considered part of a local government behavioral health authority. However, a locality, county, region, or state must maintain authority to oversee mental health and/or substance use services at the local level and use the clinic to provide those services. A clinic that is owned and operated by a local behavioral health authority also can be a CCBHC if it meets the criteria for certification.
Tribal Health Organizations
A tribal health organization, clinic, or health center can be a CCBHC as long as it meets the criteria and is operated under authority of the IHS, an Indian tribe, or tribal organization pursuant to a contract, grant, cooperative agreement, or compact with IHS under the Indian Self-Determination Act (PL 93-638). A clinic that is funded as an Urban Indian Health Center through a grant from IHS can be a CCBHC if it meets the criteria for certification. A clinic funded as an Urban Indian Health Center also can be a DCO that works with a CCBHC if the requirements of a CCBHC-DCO relationship are satisfied.
Section 223 of the Protecting Access to Medicare Act (PAMA) (PL 113-93) requires that a CCBHC be one of the following entities:
- A nonprofit organization
- Part of a local government behavioral health authority
- An entity operated under authority of the IHS, an Indian tribe, or tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the IHS pursuant to the Indian Self-Determination Act.
- An entity that is an urban Indian organization pursuant to a grant or contract with the IHS under Title V of the Indian Health Care Improvement Act (PL 94-437).