Skip to main content

Oregon State Flag An official website of the State of Oregon »

Oregon Health Authority

Certified Community Behavioral Health Clinics Frequently Asked Questions

​While a FQHC may apply to become a CCBHC, there are a number of factors providers may want to consider before moving forward.​​

​Oregon will consider certifying more than one CCBHC in a geographic region.  However, the need for more than one CCBHC (especially if there is any overlap in populations served) must be clearly indicated in the needs assessment.  Referencing criteria 1.a.2, SAMHSA has clearly indicated a CCBHC’s staff needs to be appropriate in size and compensation for the population to be served by the CCBHC.​

​OHA recommends multiple applicants in one geographic area coordinate their needs assessment activities to ensure that, collectively, their staffing plan will align with need.​

​The needs assessment template for applicants has been posted on the main page of the website, under Certification Resources. We are actively working on developing additional resources for CCBHC applicants to use during their preparation for the needs assessment, which is due to OHA on August 1, 2016. The state's needs assessment will rely on information gathered from a number of sources, including the CCBHC application materials.​

​The rate methodology selected is PPS-1.​

​A combination of learning collaboratives and intensive design sessions were held in January, April, and May. Oregon is working with a consulting team to identify applicants’ technical assistance needs and is developing a plan for technical assistance (inclusive of regional learning collaboratives) for CCBHC applicants.​

​CCBHCs will need to collect data and information to report on the Oregon CCBHC Standards, Federal Quality Measures, and CCBHC Measures required by SAMHSA.  Page 53 of the SAMHSA criteria document addresses Program Requirement 5: Quality and Other Reporting. Additional information is available on the SAMHSA website.​

​CCBHCs will be permitted to use the CMHP crisis system as a DCO. Any of the requirements that are not met by the CMHP crisis system will need to be provided directly by the CCBHC or negotiate with the CMHP crisis system to add those requirements.​

​The CCBHC bills for all demonstration services provided to CCBHC consumers, including DCO services.​

​Yes.​

​To be a DCO, the organization must have a formal arrangement with the CCBHC (contract, MOU, MOA, or another formal arrangement). The CCBHC assumes clinical responsibility for DCO services provided to CCBHC consumers.​

​No. While some states participating in planning grant activities are requesting preliminary cost reports along with application materials, Oregon is not requiring submission of cost reports at this time. Cost report resources are available under the PPS section on the website and we strongly encourage you to access these resources as you begin to develop your cost reports.​

​We know SAMHSA is interested in prioritizing the needs of individuals with SMI/SED. To become certified as a CCBHC in Oregon, an organization will need to demonstrate the capacity to serve all populations with behavioral health disorders – mild/moderate/serious/severe, children/adolescents/transition age/adults, active duty military and veterans, and all cultures and ethnic groups in your service delivery area.​

"The CCBHC ensures children receive age appropriate screening and preventive interventions including, where appropriate, assessment of learning disabilities, and older adults receive age appropriate screening and preventive interventions. Prevention is a key component of primary care services provided by the CCBHC” – (CCBHC Criteria, 4.G, page 45)

“…primary care screening and monitoring of key health indicators and health risk pursuant to criteria 4.G, either: (a) an assessment of need for a physical exam or further evaluation by appropriate health care professionals, including consumer’s primary care provider (with appropriate referral and follow-up), or (b) a basic physical assessment as required by criteria 4.G” - (CCBHC Criteria, 4.d.5, page 40)​

​

​Yes, CCBHC demonstration services need to be billed through the CCBHC at their PPS rate.​

​No. However, the CCBHC opportunity is reserved for non-profit or governmental entities. Rural health clinics, being for profit, are not eligible for the CCBHC demonstration.​

​The CCBHC will bill for the service provided by the DCO APCM provider. The state will take steps to avoid duplication of payment whether the arrangement between the state and DCO is a fee-for-service agreement or capitated agreement; however this policy has not been developed at this time.​

​

After receiving questions regarding the guidance on Ambulatory and Medical Detoxification, SAMHSA released the following:

“…[W]e found an omission in the answer around Ambulatory and Medical Detoxification. The response should have included the wording in red below. This issue has to do with the statutory prohibition of payment for inpatient care, residential treatment and other non-ambulatory services. Since 3.2 WM and 3.7 WM are services that can be provided through residential or inpatient care, the response was amended to include referral agencies.”

SAMHSA Clarification:

Ambulatory and Medical Detoxification (criteria 4.c.1): The revised American Society of Addiction Medicine (ASAM) (link is external) criteria list five levels of Withdrawal Management for Adults. It is a requirement that the CCBHC will have the first four available and accessible levels as part of their crisis services. These services need to be readily available and accessible to people experiencing a crisis at the time of the crisis. The four levels include:

  • 1-WM: Mild withdrawal with daily or less than daily outpatient supervision; likely to complete withdrawal management and to continue treatment or recovery. The CCBHC must directly provide 1-WM.
  • 2-WM: Moderate withdrawal with all-day withdrawal management support and supervision; at night, has supportive family or living situation, likely to complete withdrawal management. The CCBHC is encouraged to directly provide 2-WM. While the CCBHC must have the 2-WM level of ambulatory withdrawal management available and accessible to eligible consumers, it is not a requirement that this service be provided directly, although it is encouraged.
  • 3.2-WM: Moderate withdrawal, but needs 24-hour support to complete withdrawal management and increase likelihood of continuing treatment or recovery. May be provided directly either by the CCBHC or through a DCO relationship or by referral.
  • 3.7-WM: Severe withdrawal and needs 24-hour nursing care and physician visits as necessary; unlikely to complete withdrawal management without medical, or nursing monitoring. May be provided directly either by the CCBHC or through a DCO relationship or by referral.​

​ The state is not requiring a standardized assessment and treatment tools. We will only use the SAMHSA assessment and treatment planning criteria which include: a holistic assessment encompassing all areas of the consumers life and a treatment plan that is consumer centered, recovery oriented and based on the expressed needs and goals of the consumer.

​Not all rural health clinics can be a CCBHC. Section 6.a.1 of the CCBHC Criteria states that the CCBHC must be either a non-profit organization, part of a local government behavioral health authority, operated under the authority of the Indian Health Service, an Indian tribe, or tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursuant to the Indian Self-Determination Act, or is an urban Indian organization pursuant to a grant or contract with the Indian Health Service under Title V of the Indian Health Care Improvement Act. If the rural health clinic meets one of these criteria, all CCBHC demonstration services provided to Medicaid recipients will be billed at the CCBHC PPS rate (and through the CCBHC wraparound process). Primary care screening and monitoring is considered a CCBHC demonstration service, and costs for the provision of these screening and monitoring services for CCBHC patients should be factored into the CCBHC PPS rate. The CCBHC PPS rate will be calculated exclusively from the existing RHC PPS rate.​

Our site reviewers are interested in meeting with what the site considers the treatment team and those who regularly attend treatment team meeting. We would be interested in meeting all staff in the most efficient and least intrusive appropriate forum.​