A Service User Informed Study of Certified Community Behavioral Health Center (CCBHC) Implementation and Impact in New York State

This is a service-user informed mixed-methods study of the implementation and impacts of the Certified Community Behavioral Health Clinic (CCBHC) program in New York State. CCBHCs are comprehensive outpatient behavioral health clinics that were originally authorized by Congress in 2014, through a federal

demonstration project. Since that time, the original program has been extended, and a new form of CCBHC, which includes the same mix of services but not the original program’s innovative payment model, has been introduced. The model is slated, through recent legislation, for national expansion. Yet, assessment of the

impacts of CCBHCs has been limited. Differences between the two models, the perception of the models by service users, and the impacts of the models on acute care utilization and quality of care are not well studied. No studies have compared effects of the two types of CCBHCs, which is critical for understanding the role of

the payment model and the potential impact of future payment reforms. No studies of CCBHCs have involved service users in the research team to ensure that service user perspectives are represented in all aspects of the research. New York State is an ideal setting in which to study CCBHCs because of the large number of

different types of CCBHCs and the unique institutional and data resources available in the state. The study has three components. First, the study will assess implementation of the CCBHC model through qualitative interviews with administrators, clinicians and peer support staff in the clinics, clinic surveys,

and administrative data related to staffing and salaries. This component of the study will provide rich description of how the clinics changed when they became CCBHCs, how they have maintained those changes over time, and how the two types of CCBHCs differ from each other. Information on implementation of the

models from this component will inform the design and content of the other two components. Second, we will investigate the perspectives of the people who receive services in CCBHCs on the impact that the model has had on them. This component will involve interviews with service users at a diverse set of CCBHCs as well as

site visits to a subset of clinics to conduct direct observations and hold in-person discussions with staff and service users. Third, the study will use Medicaid claims data to examine the impact that the CCBHCs have had on utilization of acute mental health services, such as visits to an emergency room for a mental health

problem, and quality of care, such as appropriate monitoring of metabolic indicators for patients on antipsychotic medications. The study will provide needed evidence on the diverse impacts of the CCBHC models on core outcomes along with rich contextual information to assist in interpreting the findings to inform further

implementation and modification of the program in NYS and other states.