Mental well-being is an important component to aging well. Yet our current mental health systems are stretched thin. Long wait times, fragmented care, and rising costs make it especially hard for marginalized groups like older adults, people with disabilities, and individuals facing economic hardship to get the help they need.

Certified community behavioral health clinics (CCBHCs) were created to help bridge the care gap and ensure that everyone can access the care they deserve. 

What are certified community behavioral health clinics? 

CCBHCs are community-based, federally supported clinics designed to improve access to mental health and substance use disorder treatment. They are funded by the Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA). They offer comprehensive behavioral health services to anyone who requests them regardless of ability to pay, geographic location, or age.

By integrating mental health, substance use treatment, and chronic physical health care, CCBHCs help people navigate a way forward.  

These clinics are redefining care for communities that have limited access to care by providing 24/7 crisis services, person-centered treatment, and intentional partnerships with schools, hospitals, law enforcement, and community organizations. 

CCBHC required services

Clinics must directly provide or establish partnerships to deliver the following services:  

1. Crisis Services to address urgent behavioral health concerns
2. Outpatient Mental Health and Substance Use Services 
3. Person- and Family-Centered Treatment Planning 
4. Community-Based Mental Health Care for Veterans 
5. Peer Family Support and Counselor Services 
6. Targeted Care Management 
7. Outpatient Primary Care Screening and Monitoring 
8. Psychiatric Rehabilitation Services 
9. Screening, Diagnosis, and Risk Assessment¹  

How are CCBHCs relevant to older adults and aging services?

CCBHCs are uniquely positioned to support the behavioral health needs of older and aging adults by addressing challenges like social isolation, cognitive decline, substance use, elder abuse, depression, and chronic disease issues. These chronic conditions, such as heart disease, diabetes, arthritis, hypertension, and chronic respiratory diseases, are prevalent among older adults and can significantly impact mental and emotional well-being.  

Chronic disease self-management and behavioral health often intersect, with chronic diseases contributing to the development or exacerbation of mental health conditions and vice versa. For instance, individuals with diabetes may experience depression or anxiety because of the burden of managing their condition, and individuals with hypertension may face stress that negatively impacts their overall mental health. Addressing both the physical and mental health needs of older adults is critical for improving their quality of life and health outcomes. 

Another area of focus is traumatic brain injuries (TBI), which are recognized as a critical health concern for older adults. TBI can have a significant impact on cognitive and emotional well-being. These injuries can lead to complications such as memory loss, difficulty concentrating, mood changes, and in some cases, a long-term decline in quality of life. CCBHCs can play an important role in screening for, diagnosing, and providing integrated care for TBI, helping individuals manage both the physical and mental health aspects of recovery. 

By partnering with senior centers, home care agencies, and geriatric behavioral health providers, CCBHCs can ensure continuity of care across health, housing, nutrition, and transportation. Through early identification of TBIs and appropriate care planning, CCBHCs help mitigate the effects of these injuries. 

Addressing barriers

Many older adults, especially those on fixed incomes, living in rural areas or other communities with limited care access, face economic barriers that restrict access to behavioral health services. CCBHCs help remove cost-related barriers by offering care regardless of ability to pay and by accepting a wide range of payment sources, including Medicaid and Medicare. Additionally, CCBHCs make care more accessible by being conveniently located in community spaces and coordinating transportation and housing services to meet people where they are. This helps reach older adults who face housing insecurity, mobility limitations, and/or food insecurity. 

Ensuring access to behavioral health for all

Traditional behavioral health systems have often struggled to adequately meet the needs of people with disabilities, including older adults experiencing cognitive impairments, physical limitations, sensory disabilities, or traumatic brain injuries. While CCBHCs are mandated to provide accessible services, more effort is still needed to ensure environments, communication methods, and service delivery models can be adapted to all people. This includes ensuring that screenings and treatment planning are disability-competent and respect autonomy and dignity. 

CCHBCs in action

Rhode Island was one of just 10 states chosen to join the latest cohort of the federal Certified Community Behavioral Health Clinic (CCBHC) demonstration program, with services officially launching in the state on Oct. 1, 2024. The program’s implementation has been a coordinated, interagency effort led by the RI Executive Office of Health and Human Services (EOHHS)/Medicaid, in partnership with the RI Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH), and the RI Department of Children, Youth and Families (DCYF). Rhode Island is actively strengthening its infrastructure to expand behavioral health services by partnering with local schools, community centers, faith-based organizations, libraries, senior centers, and more.

RIPIN, a 2022 ACL CDSME grantee, collaborates with the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals to address the behavioral health needs of Rhode Islanders of all ages. Together, they emphasize the essential role that CCBHCs play in delivering mental health support to the entire community, with a special focus on older adults and individuals with intellectual and developmental disabilities.

Resources for working with CCBHCs in your community

• SAMHSA’s Certified Community Behavioral Health Clinic (CCBHC) State Technical Assistance Center (CCBHC S-TAC) is a national technical assistance (TA) center dedicated to supporting states as they implement and advance the CCBHC model. CCBHC experts are ready to partner with you and your state to provide customized TA to support your state’s uptake of integrated care through the CCBHC model.
• The National Association of State Head Injury Administrators (NASHIA) provides information on national trends, best practices, and state contacts to federal agencies, state and national associations, and brain injury partners across the country. NASHIA recently developed a resource, Supporting People with Brain Injury through Certified Community Behavioral Health Clinics.

Sources

1. Substance Abuse and Mental Health Services Administration. CCBHC Certification Criteria. Found on the internet at https://www.samhsa.gov/communities/certified-community-behavioral-health-clinics/ccbhc-certification-criteria

This project was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100 percent funding by ACL/HHS.  The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS or the U.S. Government.