The two-year Certified Community Behavioral Health Clinics (CCBHC) demonstration program—starting on Oct. 1—has been operational for around four months and is finding continued success and promise.
Jon Villasurda, state assistant administrator in the Behavioral Health and Developmental Disabilities Administration at the Michigan Department of Health and Human Services (MDHHS), says over 13,000 people are currently receiving primary care and behavioral health services through the thirteen funded clinics.
However, up to 300,000 Michiganders—within the counties with a CCBHC site—are eligible for these services. Villasurda expects the number for those receiving services to “grow sizably,” in the near future.
Eight other states are conducting CCBHC demonstrations across the country in an effort to increase access to high quality and integrated physical and behavioral health care for persons in need, regardless of their ability to pay or insurance coverage.
Villasurda says this demonstration was greatly needed due to the growing number of mental and behavioral health issues that continue to go untreated. In a 2019 study he cited from Altarum, it showed almost 50% of the Medicaid population and 65% of the uninsured population went untreated for a diagnosed mental illness in the state.
Within the last four months, the 13 CCBHC demonstration sites have been using a scientific method approach—of testing hypotheses and gathering data driven outcomes—and “working out the kinks” in operating under the federal guidelines of the demonstration program.
These guidelines include providing 24-hour mobile crisis teams and mental health services to cover crisis stabilization for patients. They also include giving holistic screenings for physical and behavioral health, targeted case management, and outpatient services on primary and behavioral health care.
Villasurda says the CCBHCs—in partnership with MDHHS—are also working to promote the care provided at these clinics through public outreach campaigns in areas with an accessible CCBHC. However, due to the continued strain on health care workforce capacity in Michigan, the sites and MDHHS will be cautious on their outreach campaign in an attempt to not overload the clinics.
“[The workforce issues] have prompted caution from the sites and they have asked us to taper the outreach overtime and gradually implement it. This is so there is not a peak in demand when they might not have the supply in order to meet that demand. We don’t want to be in a position where we are overpromising or overextending at a time when the health care industry is the most overextended it ever been in my lifetime.”
Of the thirteen CCBHCs, most have been long-standing providers within their community and have built trust among the people within that community. Due to this, changes in operation of these CCBHCs are mainly around integrating the physical and behavioral health care delivery. Villasurda says some have already been integrated for years before the demonstration.
These sites also place importance on access to care, case management, and follow-up appointments with patients once they have been treated in their facility.
“If you can’t be served right then and there, the care coordination and care management you receive will make sure you have facilitated access to care, with proper follow-up,” Villasurda says. “One of the great things about the demo is that it [sets aside] payment for that service to people don’t get ‘lost in the sauce.’”
Villasurda highlights the support this demonstration has in Michigan amongst MDHHS and care providers of all silos in the state.
“What we have seen is just a tremendous amount of buy-in from all the players and a commitment to implement everything that we have put forth in our CCBHC certification.”