Certified Community Behavioral Health Clinics (CCBHCs)

A Certified Community Behavioral Health Clinic model is designed to ensure access to coordinated comprehensive behavioral health care. CCBHCs are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, place of residence, or age - including developmentally appropriate care for children and youth.

CCBHCs must meet standards for the range of services they provide and they are required to get people into care quickly. An important feature of the CCBHC model is that it requires crisis services that are available 24 hours a day, 7 days a week. CCBHCs are required to provide a comprehensive array of behavioral health services so that people who need care don't have to piece together the behavioral health support they need across multiple providers. In addition, CCBHCs must provide care coordination to help people navigate behavioral health care, physical health care, social services, and the other systems they are involved in.

CCBHCs can be supported through the Section 223 CCBHC Medicaid Demonstration, through SAMHSA administered CCBHC Expansion (CCBHC-E) Grants, or through independent state programs separate from the Section 223 CCBHC Medicaid Demonstration.

Criteria

In March 2023, SAMHSA released the updated criteria (PDF | 1.3 MB) for certifying community behavioral health clinics in compliance with the statutory requirements outlined under Section 223 of PAMA. Clinics and states are on different schedules to come into compliance with the updated criteria, with most being required to come into compliance by July 1, 2024. See this summary of changes (PDF | 273 KB) and the redline edits (DOC | 181 KB) from the existing criteria to the updated criteria and an implementation timeline for the different CCBHC programs and deadlines from coming into compliance with the updated criteria.

Until these deadlines, CCBHCs are responsible for meeting the previously existing criteria (PDF | 760 KB). These criteria, which establish a basic level of service at which a CCBHC should operate, fall into six key program areas:

1. Staffing – Staffing plan driven by local needs assessment, licensing, and training to support service delivery
2. Availability and Accessibility of Services – Standards for timely and meaningful access to services, outreach and engagement, 24/7 access to crisis services, treatment planning, and acceptance of all patients regardless of ability to pay or place of residence
3. Care Coordination – Care coordinate agreements across services and providers (e.g., Federally Qualified Health Centers, inpatient and acute care), defining accountable treatment team, health information technology, and care transitions
4. Scope of Services – Nine required services, as well as person-centered, family-centered, and recovery-oriented care
5. Quality and Other Reporting – Required quality measures, a plan for quality improvement, and tracking of other program requirements 
6. Organizational Authority and Governance – Consumer representation in governance, appropriate state accreditation

The updated criteria maintain this structure and also include the nine required services in the existing criteria listed below.

Required Services

CCBHCs are responsible for providing all nine services, which can be provided directly or through formal relationships with Designated Collaborating Organization (DCOs):

1. Crisis Services
2. Treatment Planning
3. Screening, Assessment, Diagnosis & Risk Assessment
4. Outpatient Mental Health & Substance Use Services
5. Targeted Case Management
6. Outpatient Primary Care Screening and Monitoring
7. Community-Based Mental Health Care for Veterans
8. Peer, Family Support & Counselor Services
9. Psychiatric Rehabilitation Services

Map of CCBHCs Across the United States (as of March 6, 2023)

Currently, there are over 500 CCBHCs operating across the country, as either CCBHC-E grantees, as clinics participating in their states’ Medicaid demonstration, or as a part of independent state CCBHC programs.

CCBHC-Expansion Grant Program Funding Announcements

• FY 2022 Cooperative Agreements for CCBHC Planning Grants
• FY 2022 CCBHC Planning, Development, and Implementation Grants
• FY 2022 CCBHC Improvement and Advancement Grants
• FY 2021 National Training and Technical Assistance Center for CCBHC Expansion Grants
• FY 2021 CCBHC Expansion Grants
• FY 2020 CCBHC Expansion Grants
• FY 2018 CCBHC Expansion Grants
• FY 2016 Planning Grants for CCBHCs

Resources

• CCBHC Demonstration Program: Report to Congress 2020
• CCBHC Demonstration Program: Report to Congress 2019
• CCBHC Demonstration Program: Report to Congress 2018
• Section 223 Demonstration Program for CCBHCs