As the idea of Certified Community Behavioral Healthcare Clinics (CCBHC) matures, we will see leading organizations moving toward this type of structure. This type of client-focused attention and coordination will improve the overall health of the Medicaid/Medicare population by integrating primary care, establishing evidence-based practices, and actively coordinating services outside of their four walls. The criteria for certification for Certified Community Behavioral Healthcare Clinics falls into six areas of focus:
Since a high percentage of recipients have a number of health issues, it’s important to move towards the next level of multidisciplinary teams. At the base of CCBHC, these teams will need to work together and coordinate service plans for better connections, improving outcomes. With the inclusion of family members, peer specialist, and staff at all levels of care, it will be vital that staff have a working electronic platform to communicate and review updates in real-time. This includes expanding direct client documentation into the health record, medications reminders & alerts, telehealth services, and a continual commitment of the team to stay connected. This will provide better focus on specific care plans, and more immediate actionable items increasing value.
Like everyone else, problems can happen at any time. Certified Community Behavioral Healthcare Clinics will begin to have 24/7 clinics and walk-in urgent care centers, like we’ve seen in physical health for the last twenty-five years. Staff that work for these organizations will expect to not only see a care plan, but also up-to-the-day/minute healthcare information, client assessments, if and when medications were been picked up, lab results, and be able to securely connect with team members by phone, telehealth, text or chart note. Updates to the record will be seamless for all members including outside referrals, insurance eligibility and treatment team metrics. Metrics include identifying urgent needs within ten days, or following up with all referrals to other providers.
With the passing of the Mental Health Parity and Addiction Equity Act insurance companies should treat all illnesses as, well… illnesses. If a client has congestive heart failure and also has bipolar disorder or a drug addiction, they will be offered the same level of services. Integrative care will become the norm and treatment silos will become a thing of the past. The use of structured data will provide the ability for better communication via continuity of care documents or secure texting to all team members including Designated Collaborating Agencies (DCO’s). As care becomes more and more decentralized, organizations such as Hospitals, Urgent Care Centers, Residential Crisis Centers, Detox Facilities, Homeless Shelters, Housing Agencies, and Employment Services will need to work together, all assuming risk for the client. There should be no gaps in any organization’s understanding of where the client is in their treatment process.
Comprehensive, continuous, connected person-centered plans will be pushed as the norm throughout organizations of care. At first this will be a daunting task for individuals and teams to be connected. As both staff-facing and client-facing applications, like specialized Fitbits or Wellframe, become more integrated into the technology platform, communication and connection will become easier. Organizations will be expected to provide a wide-range of services including mental health services, physical health, and community outreach services. Client screening, assessments, and planning processes will be validated and standardized so clinical staff across a city or across the country can speak the same language as far as client progress or regression. Universal “next steps” in the care giving process will begin to materialize for specific population types.
What comes in must go out. To provide this level of care and service coordination, it will require a lot of data to be captured, communicated, and transferred across all provider types and agencies. Staff will need to be able to “read the story” of an individual client, or a client population. All follow up activities and total cost of services will need to be easily accessible to providers and Medicaid enrollees. DCO’s will need to report outcome data, or log into a system and complete the documentation process. Other federal required data like MIPS and TEDS data will need to be gathered and reported as well. All organizations must continuously review the populations they service to improve service outcomes.
Organizations must be not-for-profit and include board and management input from the people they serve. The organizations need to be certified by state and local authorities. Additionally, they must be certified by national accreditation agencies like CARF, Joint Commission, and the Council on Accreditation (COA). Processes must be standardized at all organizational levels across town and across the country.
Undoubtedly, the marrying of process and technology will move us closer to the goal of deep population health. Community Mental Health Centers will branch out and connect with outside providers to meet clients “where they are” to provide care. As mental health providers move towards more outpatient urgent care, and meeting place care, they will need more extensive training and investment in technology to adhere to these requirements.
Medicaid dollars are reimbursed at just 61% of commercial plans, and under continuously stricter regulations that differ across states, the idea of CCBHCs will help the neediest populations receive better healthcare through expanded teams and communication.
We have a very long way to go to realize the goals of CCBHCs, and Streamline is committed to partner with all clients as they evolve.
Ted Wright joins Streamline with over twenty years of healthcare management experience. He has led both clinical and sales teams, and is completely focused on producing tangible results for the health and human services market. Prior to joining Streamline, Ted worked in numerous leadership roles including National Sales Director and Regional Vice President for some of the largest software vendors in the health and human services market. Ted has over fifteen years of experience in software, as well as an additional six years of experience in direct care management where he managed logistical coordination of rehabilitation services for multi-independence level, thirty-bed facility. Ted holds a Bachelor of Science in Psychology along with a Masters in Health Administration.