Certified Community Behavioral Health Clinics (CCBHC)

The CCBHC Model

In 2014, Congress passed the Protecting Access to Medicare Act (PAMA) which established the Certified Community Behavioral Health Clinics model also known as the CCBHC model. The goal of this legislation was to encourage states to individually seek out innovative & effective ways to deliver and reimburse for improved and expanded community based behavioral health care. More information about the history and background of the CCBHC model can be found at the Substance Abuse and Mental Health Services Administration’s (SAMHSA) CCBHC Website.

The CCBHC model requires:

• Crisis services to be available 24 hours a day, 7 days a week.
• Comprehensive behavioral health services so people don't have to piece together behavioral health support across multiple providers.
• Care coordination to be provided to help people navigate behavioral health care, physical health care, social services, and the other systems they are involved in.

Additional federal legislation has increased federal funding opportunities for both states and organizations to plan for and implement the CCBHC model into existing behavioral health systems in ways that allow providers to deliver care tailored to the unique needs of local communities.

States and organizations have the opportunity to stand-up the CCBHC model through one of three funding pathways:

• States may apply for a one year CCBHC Planning Grant prior to seeking a CCBHC Demonstration Grant. Additional information can be found on the Planning Grant and 223 CCBHC Demonstration Grant website. The CCBHC Planning Grant provides support for State agencies to: 
  • Stand-up state specific CCBHC certification standards and processes
  • Establish a prospective payment system (PPS)
  • Prepare an application for participation in the 4-year Demonstration program. 
• Organizations may apply for a SAMHSA Expansion Grant. For more information, provider organizations can visit the CCBHC Expansion Grants webpage.  
  • Individual organizations may apply for SAMHSA Expansion Grant funding regardless of state agency application or participation in the CCBHC Demonstration.  
• CCBHCs can be funded directly through state Medicaid programs without additional federal funding. 
  • In 2023, Nevada made the programs and policies established through a CCBHC Demonstration grant part of their state’s Medicaid State Plan.

What are Certified Community Behavioral Health Clinics?

Certified Community Behavioral Health Clinics (CCBHCs) are provider organizations designed to ensure access to coordinated, comprehensive behavioral health care. CCBHCs are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, insurance coverage, place of residence, or age including services for children & youth.

CCBHCs must meet quality standards set by SAMHSA as defined by the PAMA legislation which can be further defined by each state participating in the CCBHC Demonstration or adopting the CCBHC model into their Medicaid program. CCBHCs must improve access, availability and outcomes for the range of services they provide, must get people into care quickly, and must account for the unique needs of their community.

The 9 Required CCBHC Services

• Crisis Services
• Outpatient Mental Health and Substance Use Services
• Person- and Family-Centered Treatment Planning
• Community-Based Mental Health Care for Veterans
• Peer Family Support and Counselor Services
• Targeted Care Management
• Outpatient Primary Care Screening and Monitoring
• Psychiatric Rehabilitation Services
• Screening, Diagnosis and Risk Assessment

Priority Populations of Note

Priority Populations include the following groups who should be considered, among others, when CCBHCs complete community assessment work:

• Uninsured, underinsured, Medicaid-eligible, publicly insured, or whose income is below thresholds established by the Behavioral Health Administration (BHA). 
• Persons presenting with acute or chronic behavioral health needs, including but not limited to individuals who have been determined incompetent to stand trial, adults with serious mental illness, and children and youth with serious emotional disturbance 
• Regional or statewide underserved populations based on health equity data, including but not limited to: 
  • People experiencing or at risk of homelessness 
  • Children and youth at risk of out-of-home placement and their parents 
  • People involved with the criminal or juvenile justice system 
  • People of color 
  • American Indians 
  • Alaska Natives 
  • Veterans 
  • People who are pregnant 
  • People who are lesbian, gay, bisexual, transgender, or queer or questioning 
• Individuals with disabilities as defined by the federal “Americans with Disabilities Act of 1990” 
• Individuals with trauma 
• Individual living in rural areas 
• Adults with substance use disorder 
• Refugees/undocumented individuals

CCBHC Program Criteria

CCBHCs must meet the following program and operational criteria:

• Staffing – Staffing plan driven by local needs assessment, licensing, and training to support service delivery.
• Availability and Accessibility of Services – Standards for timely and meaningful access to services, outreach and engagement, 24/7 access to crisis services, treatment planning, and acceptance of all patients regardless of ability to pay or place of residence.
• Care Coordination – Care coordinate agreements across services and providers (e.g., Federally Qualified Health Centers, inpatient and acute care), defining accountable treatment team, health information technology, and care transitions.
• Scope of Services – Nine required services, as well as person-centered, family-centered, and recovery-oriented care.
• Quality and Other Reporting – Required quality measures, a plan for quality improvement, and tracking of other program requirements.
• Organizational Authority and Governance – Consumer representation in governance, appropriate state accreditation.

Details about these 6 program areas can be found on the CCBHC Certification Criteria webpage.

CCBHCs and Colorado

In 2016, Colorado was one of 24 states selected to participate in an initial Planning Grant program administered by SAMHSA. Following a year-long planning and building period, Colorado was not one of the 8 states selected to receive the first demonstration model funds. Although Colorado did not receive the additional support and funding that came from the CCBHC Demonstration Grant, state agencies, including the Department of Health Care Policy and Financing (HCPF) and Behavioral Health Administration (BHA), continue work independently to strengthen the statewide Safety Net Provider system with the goal of increasing and improving behavioral health treatment across the state. Safety Net Provider systems reforms to date  are detailed on the Behavioral Health Reform page.

Currently 7 organizations in Colorado are participating in the SAMHSA administered Expansion Grant program. Further exploration of how the CCBHC model could extend fundamental principles established in Colorado’s safety net system towards its goal of promoting comprehensive and accessible behavioral healthcare with sustainable funding practices is necessary. 

In 2023, Colorado applied again for a CCBHC Planning Grant. While Colorado scored well in the assessment process, the state was not selected. As HCPF prepares to complete another CCBHC Planning Grant application, partnering with other state agencies, managed care organizations, behavioral healthcare providers, and behavioral health advocates throughout the state in the coming months will be essential to develop the most compelling application possible. The Department is eager to review and revise previous work and incorporate feedback received as part of the process of identifying the next best steps for Health First Colorado members, providers, and all Coloradans.

CCBHC Stakeholder Forum

The Colorado Department of Healthcare Policy & Financing (HCPF), in collaboration with the Behavioral Health Administration (BHA), is launching a Certified Community Behavioral Healthcare Center (CCBHC) Stakeholder forum.

The purpose of the forum is to strengthen collaboration and partnership with behavioral health providers, care centers, and advocates from across Colorado as HCPF prepares to apply for an upcoming CCBHC Planning Grant. The forum will be a space for all stakeholders to provide updates, lessons learned, challenges, and ideas to inform Colorado’s CCBHC Planning Grant application and future CCBHC structure.

Upcoming CCBHC Forums

CCBHC Forums take place over Zoom on the fourth Wednesday of the month at 12:00 pm MST. Complete the sign-up form to register for one or all of the upcoming forums.

Provider Resources

Below please find provider resources, externally produced training and technical guides, and additional links to information about CCBHCs. 

Related Webpages:

• SAMHSA Certified Community Behavioral Health-Clinics

Related Public Training and Technical Assistance:

• SAMHSA Technical Assistance Resources
• SAMHSA CCBHC Certification Criteria
• CCBHC Prospective Payment System Guidance

Contact Us

We’re here to help! See the contact information below for specific needs or email HCPF Safety Net Forum - HCPF if you are not sure where to start.

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