CCBHC vs. DCO: Expert guidance through the transition
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the US Department of Health and Human Services (HHS) that focuses on advancing national behavioral health. In 2015, they set forth Section 223 Demonstration Program for Certified Community Behavioral Health Clinics of the Protecting Access to Medicare Act (PAMA) to help states establish certified community behavioral health clinics (CCBHCs).
The program appealingly creates new revenue streams, but for SAMHSA to certify your clinic as a CCBHC that can take advantage of these opportunities, you must adhere to strict service requirements. Only about 15% of the market is even eligible. Groups that do not provide the required nine core services have the option to become a designated collaborating organization (DCO). A DCO renders specialized service(s) on behalf of a CCBHC.
To qualify as a CCBHC per SAMHSA, the core services you must provide are:
- Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention, and crisis stabilization
- Mental health screening, assessment, and diagnosis
- Patient-centered mental health treatment planning
- Outpatient mental health and substance use disorder services
- Primary care general wellness screening and monitoring*
- Targeted mental health case management*
- Psychiatric rehabilitation services*
- Peer and family support services*
- Mental health services for members of the armed services and veterans*
CCBHCs in every state must provide these services regardless of whether they are independently covered under the Medicaid state plan.
* Services that may be provided via a contracted DCO