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HHS Taps 8 States for Behavioral Healthcare Integration Demo

Eight states will further the integration of physical and behavioral healthcare by participating in a new HHS care coordination demonstration project.

By Jennifer Bresnick

- Continuing its push to improve the overall health of vulnerable populations by integrating physical and behavioral healthcare, HHS has announced that eight states will participate in its newest care coordination effort.

Medicaid behavioral healthcare integration

The two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program, a follow-up to a 2015 planning effort, will help Medicaid community providers increase access to quality behavioral and mental health services, develop and leverage evidence-based best practices, and work more closely with partners across the care continuum.

“The demonstration program will improve access to behavioral health services for Medicaid and 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,” said Vikki Wachino, Deputy Administrator of the Centers for Medicare & Medicaid Services, and Director of the Center for Medicaid and the Children’s Health Insurance Program Services. 

Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon, and Pennsylvania were among the 24 states participating in a Substance Abuse and Mental Health Services Administration (SAMHSA) initiative started last year, which aimed to create the administrative infrastructure required to support the current demonstration project.

During the planning year, states worked to certify community behavioral health clinics, architect payment structures for the next phase of the demonstration project, and collected stakeholder feedback about the challenges and opportunities of expanding care integration.

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Out of the 24 initial participants, nineteen applied for the new demonstration project, and eight emerged as grantees.

“These states and their community clinics have done an incredible job in paving the way for the demonstration program,” said Kana Enomoto, Deputy Assistant Secretary for Mental Health and Substance Use. “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 certified clinics will receive reimbursement through Medicaid under the system developed during the planning period.  Using quality metrics collected through provider reporting on program records, claims, encounter data, and clinic cost reports, HHS will assess the providers’ performance while serving adult and pediatric patients with serious mental illnesses and long-term behavioral healthcare needs.

"This grant is one of the most significant investments in community behavioral health in decades and has the potential to transform the way these services are delivered in the commonwealth," said Pennsylvania’s Department of Human Services (DHS) Secretary Ted Dallas.

"We are committed to providing Pennsylvanians with access to high-quality services in their communities and look forward to improving the way individuals with mental health and substance abuse disorders receive help."

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Ten Pennsylvania locations across the region will begin implementing the program in July of 2017.

In Nevada, four behavioral healthcare providers will engage in the demonstration project, according to the Nevada Appeal.

“Our community clinics have done an incredible job in paving the way for the demonstration program,” Dr. Stephanie Woodard, senior adviser on Behavioral Health for the Nevada Department of HHS, Division of Public and Behavioral Health Bureau of Behavioral Health, Prevention, and Wellness, said to the outlet.

“The services include 24-hour mobile crisis and crisis services, outpatient mental health and substance use treatment, case management, recovery supports, services for Veterans and their families,” she added.  “Through the collaborative efforts of state and local agencies working together, Nevada has an opportunity to implement system-wide changes for Medicaid and Nevada Check Up beneficiaries and help individuals with mental and substance abuse disorders obtain the health care they need.”

While the program providers for a great deal of flexibility for individual care sites, CCBHC providers must exhibit competency in care coordination services, health IT use for quality reporting, and cultural sensitivity for veterans and active military and patients with limited English proficiency.

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Senator Ron Wyden (D-OR) praised the program for opening up new healthcare opportunities for his state’s residents.

“This program will help rural and urban Oregonians receive quality treatment that’s proven effective for mental health and substance use disorders,” said Wyden, the ranking member of the Senate Finance Committee. “All of Oregon can look forward to seeing real gains from this comprehensive approach that blends behavioral health care with physical health care.”

Congressman Frank Pallone of New Jersey expressed similar hopes that a coordinated approach to mental and physical healthcare could improve overall wellness for Medicaid patients.

“Improving the quality and scope of healthcare is critical to ensuring that individuals and families struggling with mental illness or substance use disorders get the tools they need to meet those challenges,” he said.  “I am excited about the prospects of this demonstration project, and I hope it will improve health outcomes across New Jersey.”

The CCBHC demonstration is authorized under Section 223 of the Protecting Access to Medicare Act of 2014, and represents a collaborative partnership between several divisions of HHS, including SAMHSA, CMS, and and the Office of the Assistant Secretary of Planning and Evaluation (ASPE).

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