In January 2021, Community Mental Health Ottawa County (CMHOC) applied for the Certified Community Behavioral Health Center (CCBHC) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Federal Government for the purpose of providing coordinated comprehensive behavioral health care to anyone in need.
Although it sounds like a CCBHC is a facility, like a doctor’s office, where people can go to get services, this is not the case. A CCBHC is a network of approved providers, and care is coordinated through the county. Since CCBHC’s must accept all people, regardless of residency or ability to pay, it appears, creating a CCBHC is a way to transform our county health care system to be more collectivist.
The idea of the grant was to provide money for Ottawa County to establish and operate a CCBHC. This involved both treating patients and ensuring the CCBHC met federal guidelines for certification. According to the grant application project summary, “CCBHC expansion will improve and expand coordination of care and whole person wellness for individuals in Ottawa County who are living with or at risk of developing severe mental illness, severe emotional disorders, and/or substance use disorders.”
The $3.8 million CCBHC grant began August 30, 2021, with an expiration date set for August 29, 2023. According to the grant application and progress reports obtained via FOIA, it seems the majority of the money was spent on data collection, staff training, hiring additional staff for the purposes of data entry and coordinating services, and community outreach. With a focus on data collection and community outreach, it appears very few community members benefited, aside from county employees and partnering organizations.
When a CCBHC is established, the services provided are shown in the graphic below.
These services greatly overlap with current services provided by CMHOC, which is the largest provider of services for people with severe mental illness, severe emotional illness, and substance use disorder in Ottawa County.
Crisis mental health services
Screening, assessment, and diagnosis
Patient-centered treatment
Outpatient mental health and substance use services
Outpatient clinic primary care screening and monitoring of key health indicators and risk
Targeted case management
Psychiatric rehabilitation services
Peer support, counselor services, and family support
Intensive community-based mental health care
Criteria for certification is defined in the CCBHC Certification Criteria document. Some certification requirements include:
Staff training in areas such as trauma informed care and cultural competence
Electronic record keeping and coordination with other systems
Data collection, reporting and tracking
Involving a significant number of people with lived experience in governance
Establishing mobile crisis teams
According to the certification criteria, “CCBHCs across the country are transforming systems by providing comprehensive, coordinated, trauma-informed, and recovery-oriented care for mental health and substance use conditions.” After beginning the CCBHC program the certification criteria was later updated. The updates were based on “listening sessions where the public, people with lived experience of mental health and substance use conditions, and CCBHC stakeholders provided input.” Some of the updates included changing words:
“detoxification” to “medical withdrawal management”
“client” to “person or people receiving services”
“psychiatric crisis” to “behavioral health crisis”
Another requirement change was specifying the community needs assessment be completed by CCBHC. In addition, requirements were added for improving health equity as shown in the text below.
It appears CMHOC already successfully provides nearly identical services to consumers as a CCBHC and it doesn’t appear that becoming a “certified” CCBHC offers Ottawa County residents and tax payers any advantages. It is redundant. Ottawa County already has a mental health millage that is supposed to cover the costs of services for uninsured and underinsured people. Establishing a CCBHC will add more layers of bureaucracy to behavioral and mental health care. It will ensure equity of outcomes, not equal opportunity. It will facilitate government data collection of residents which could later be used for intrusive purposes. It could be used to implement more socialist policies upon the population and enable the government to further encroach on the rights of the people. Is this really beneficial for the citizens of Ottawa County?
The next two articles on this topic will explore the CCBHC grant application and progress reports.