At the 2023 Minnesota State of Reform Health Policy Conference, two leaders of certified community behavioral health clinics (CCBHCs) provided updates on the effectiveness of the CCBHC program.
In 2014, Congress passed the Excellence in Mental Health Act, which created the CCBHC model. The Substance Abuse and Mental Health Services Administration (SAMHSA) piloted the program across the nation. Minnesota was one of eight states selected, with six Minnesota agencies having been early adopters of the program, including Northern Pines Mental Health Center. The agencies operated the CCBHC pilot from 2017-2019. In 2019, the legislature approved a state plan amendment to add CCBHCs to Medicaid benefits in Minnesota.
Laura Vaughn, executive director of Northern Pines, noted the dedication of CCBHC staff and the impact of federal public health emergency funding.
“The federal pandemic relief funds were absolutely key to us being able to survive that time. We did a freeze on our wages … once that came back through, we were able to … be whole and look at raises and things like that. Our folks hung in there,” Vaughn said.
Ashley Kjos, chief executive officer of Woodland Centers, said CCBHCs require 24/7 mobile crisis coverage, and how a crisis could mean differing things; it could be a suicidal crisis or a crisis of a child not wanting to go to school, for example. Kjos said individuals can call Woodland Centers, where they offer to meet individuals in their homes or in the community.
Care following the first point of contact starts with evaluations and assessments, including what providers at CCBHCs can improve in the short-term, like developing a safety plan. Both Woodland and Northern Pines have residential crisis programs. Woodland Center generally offers a stay of three to five days, while also having a youth center.
Last May, Northern Pines opened a mental health urgent care center.
“It’s a clinic that is open 10am until 7pm, seven days a week,” Vaughn said. “It is run within our mobile crisis outreach program.”
The stationary urgent care center served 200 individuals within the first four months of operation. Vaughn noted a large portion of individuals were self-referred, and offered services ranging from treatment plans, to stabilization services, and psychiatry appointments. Northern Pines’ opened this facility because their partnering hospitals are not in a solid standing to assist and treat patients experiencing mental health crises.
“Our hospitals are not equipped to handle mental health,” Vaughn said. “In one of our hospitals, it is a bare room with a mattress on the floor … it’s such an egregious response to [someone] in crisis.”
Kjos said federal and SAMHSA partners are uplifting the CCBHC model as a solution to better respond to the crisis system, while creating stabilization and incorporating funding into the existing crisis system. CCBHC facilities in Minnesota do not have a cap or limit on how many times individuals can utilize services, but Vaughn said commercial insurance doesn’t pay for crisis services at all.
Kjos noted how Woodland started their urgent care program with a soft launch in 2022, and opened to the public at the start of last year. She believes it’s a great model and is thankful to have the infrastructure to do so.
“For us, it’s almost rebranding our mobile crisis team,” Kjos said.
Kjos acknowledged how the COVID-19 pandemic interrupted the momentum of the program regarding next phase activities. She said Congress introduced a new bill 2021, Excellence in Mental Health and Addiction Treatment Act, which has yet to move forward after being introduced in the Senate. Congress is also taking next steps with the Ensuring Excellence in Mental Health Act, which seeks to make CCBHCs a permanent Medicaid and Medicare option, and solidifies funding streams that were offered during the CCBHC demonstration period.