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HHS Taps Eight States for Behavioral Health Demonstration Project

December 28, 2016
by Heather Landi
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The U.S. Department of Health and Human Services (HHS) last week announced the selection of eight states for participation in a two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program designed to improve behavioral health services in various communities.

According to HHS, the demonstration project is part of a comprehensive effort to integrate behavioral health with physical health care, increase consistent use of evidence-based practices, and improve access to high quality care for people with mental and substance use disorders.

“These states and their community clinics have done an incredible job in paving the way for the demonstration program,” Kana Enomoto, deputy assistant secretary for mental health and substance use, said in a statement. “We look forward to demonstrating that by balancing incentives and accountability, an enhanced level of accessible, comprehensive, and quality care can be provided to all Americans.”

The eight states HHS selected for this demonstration program include Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon, and Pennsylvania.

“The demonstration program will improve access to behavioral health services for Medicaid and the Children’s Health Insurance Program Services (CHIP) beneficiaries, and will help individuals with mental and substance use disorders obtain the health care they need to maintain their health and well-being,” Vikki Wachino, deputy administrator of the Centers for Medicare & Medicaid Services (CMS), and director of the Center for Medicaid and the Children’s Health Insurance Program Services (CHIP).

In 2015, HHS awarded planning grants to 24 states to support certification of community behavioral health clinics, solicit input from stakeholders, establish prospective payment systems for demonstration reimbursable services, and prepare an application to participate in the demonstration program. At the end of the planning grant year, 19 states submitted applications to participate in the demonstration program. The applications were reviewed by subject matter experts from the Substance Abuse and Mental Health Services Administration, CMS, and Office of the Assistant Secretary of Planning and Evaluation for strengths and weaknesses. A key consideration in their selection was that participating states represented a diverse selection of geographic areas, including rural and underserved areas.

Under the program, selected states will be reimbursed through Medicaid for behavioral health treatment, services, and supports to Medicaid-eligible beneficiaries using an approved prospective payment system. To qualify for certification, CCBHCs provide core services across the lifespan, utilize evidence-based practices and health information technology, report on quality measures, and coordinate care with primary care providers and hospitals in the community. Populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long term and serious substance use disorders, as well as others with mental illness and substance use disorders.

The selected states’ demonstration programs will be evaluated based on data from 21 quality measures collected through sources such as program records, Medicaid claims, managed care encounter data, and clinic cost reports. Qualitative data also will be obtained from interviews with state officials and clinic staff. HHS will report on the access, quality and financial performance of the demonstration programs annually beginning December 2017, using data from the evaluation.

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