Certified Community Behavioral Health Clinics (CCBHC) | Department of Health Care Policy and Financing

Colorado CCBHC Planning Grant Application Submitted

On September 11, 2024, the Department of Health Care Policy & Financing (HCPF), in partnership with the Behavioral Health Administration (BHA), submitted an application to the Substance Abuse and Mental Health Service Administration (SAMHSA) for the 2024 Certified Community Behavioral Health Clinic (CCBHC) Planning Grant. If awarded, the CCBHC Planning Grant will provide federal funds to support Colorado in developing a model that will benefit communities and people around the state in need of behavioral health services and will strengthen the provider network. The grant will also support Colorado in preparing an application to participate in a four-year CCBHC Demonstration program. Grants are anticipated to be awarded in December. Colorado’s CCBHC Planning Grant Application Narrative can be found here.

HCPF and BHA would like to extend gratitude to all stakeholders who informed the application and continue to be engaged in creating the best system of care for Colorado. 30 letters of support and/or commitment for the CCBHC Planning Grant were submitted by providers, community advocates, managed care entities, and partner agencies. A listing of supporters is available for review here. HCPF hosted a CCBHC Stakeholder Forum twice a month since July 21, 2024, and met with each of the seven current CCBHC Expansion sites in Colorado. Stakeholder meetings will continue throughout October and November and will be updated based on need once the grant recipients are announced.

Please sign-up to attend future CCBHC Stakeholder Forums.

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 also 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.

External Training Information and Resources

CCBHCs and Colorado

Learn more about the CCBHC Forum

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.