Mental Illness Is A Community Disease

For those Pub patrons interested in being kept informed on happenings affecting the future of mental health policy in the US. the Substance Abuse and Mental Health Services Administration (SAMHSA) will be holding a public listening session next Wednesday, November 12^th, to solicit input and feedback on the establishment of criteria for  the Certified Community Behavioral Health Clinics (CCBHC) Demonstration Program, as outlined in Protecting Access to Medicare Act (P.L. 113-93, Section 223).

The demonstration program was originally introduced as the Excellence in Mental Health Act by Senators Stabenow (D-MI) and Blunt (R-MO) and U.S. Representatives Matsui (D-CA) and Lance (R-NJ) and is an effort to strengthen community mental health systems by establishing higher standards of care and better coordination and communication across individuals, organizations and agencies that provide assistance and care to individuals in their communities. 

Under provisions of the Act, which was an extender bill used to delay until March of next year pending cuts to Medicare, a maximum of eight states will be selected to participate in a two-year demonstration program whereby the federal government will pay a matching percentage to those states for providing medical assistance for mental health services equal to what Federally Qualified Health Centers (FQHCs) currently receive for primary care services. This is strictly an outpatient clinic initiative (i.e., no funding for inpatient care, boarding, residential treatment).

Example services to be provided by CCBHC’s under the demonstration program include 24-hour crisis management, screening assessments and diagnostic services, outpatient mental health and substance-abuse services, primary care screening and peer support and counseling. The HHS secretary is to determine criteria for a clinic to be certified by a state as a CCBHC no later than September of next year. Next week’s session will solicit input on criteria such as,

• staffing requirements: e.g., qualifications, areas of experience & expertise, licensing and credentialing, recruiting;
• availability, scope and accessibility of services: e.g., looking beyond crisis management, determining basis of financial responsibility, evidencing service and referral relationships;
• care coordination: e.g., relationships with other providers, integration into and with community services and agencies, enabling technical requirements;
• governance, accountability & reporting: e.g., organizational authority, measuring outcomes, evidential reporting.

The secretary is also directed to provide guidance for the establishment of a prospective payment system for this demonstration program, no later than Sept. 1, 2015.

As I have shared in this space numerous times before, mental and behavioral health services are underfunded and inadequately available to meet the growing needs across the country. We are learning more every day of the evidentiary benefits – to the individual and society – of taking a holistic approach to individual health and welfare. I am hoping to learn more next week whether and how this demonstration program might lead to addressing this critical concern – and I will report back what I learn.

Cheers,
  Sparky