Article Spotlight

Certified community behavioral health centers (CCBHCs) were established under section 223 of the Protecting Access to Medicare Act (PAMA) of 2014. CCBHCs had the goal of expanding access to care for people with behavioral health needs “regardless of ability to pay and place of residence” (1, 2). PAMA, as well as subsequent legislation authorizing additional grants to CCBHCs, emphasized expanding services for serious mental illness, substance use disorders, co-occurring illnesses, and serious emotional disorders in children. The federal government has made CCBHCs a central component of the strategy to expand access to and quality of behavioral health services. It has done so by spending

CCBHCs had the goal of expanding access to care for people with behavioral health needs “regardless of ability to pay and place of residence”

$1.7 billion in grants to establish and expand CCBHCs since 2016, in addition to funding many CCBHCs through Medicaid (3). The recent Bipartisan Safer Communities Act (BPSCA) of 2022 directed an estimated $8.5 billion over 10 years to expand the section 223 demonstration program into a national initiative (4).

This evaluation is focused on the initial demonstration sites and offers a useful profile of the activities and indicators of quality of care offered by the original cohort of CCBHCs.

To date, the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services has systematically evaluated the program (5). This evaluation is focused on the initial demonstration sites and offers a useful profile of the activities and indicators of quality of care offered by the original cohort of CCBHCs. However, it does not gauge performance relative to any benchmarks such as community mental health centers or other community-based mental health programs (6). Furthermore, it does not indicate whether CCBHCs are meeting other performance requirements, particularly whether they serve counties that have high need for care and low economic resources.

In this study, we considered the geographic distribution of CCBHCs relative to indicators of rates of mental illness and the economic resources of communities across the United States. We examined this distribution in light of the rules governing the various approaches to funding CCBHCs and the programmaticrequirements for certification of CCBHCs. We conclude by proposing some modifications to policies for establishing CCBHCs to meet the goal of expanding access to care for people with behavioral health needs “regardless of ability to pay and place of residence.”