§ 40.1-8.5-8. Certified community behavioral health clinics.
(a) The executive office of health and human services is authorized and directed to submit
to the Secretary of the United States Department of Health and Human Services a state
plan amendment for the purposes of establishing Certified Community Behavioral Health
Clinics in accordance with Section 223 of the federal Protecting Access to Medicare
Act of 2014.
(b) The executive office of health and human services shall amend its Title XIX state
plan pursuant to Title XIX [42 U.S.C. § 1396 et seq.] and Title XXI [42 U.S.C § 1397 et seq.] of the Social Security Act as necessary to cover all required services for
persons with mental health and substance use disorders at a certified community behavioral
health clinic through a monthly bundled payment methodology that is specific to each
organization's anticipated costs and inclusive of all required services within Section
223 of the federal Protecting Access to Medicare Act of 2014. Such certified community
behavioral health clinics shall adhere to the federal model, including payment structures
and rates.
(c) A certified community behavioral health clinic means any licensed behavioral health
organization that meets the federal certification criteria of Section 223 of the Protecting
Access to Medicare Act of 2014. The department of behavioral healthcare, developmental
disabilities and hospitals shall define additional criteria to certify the clinics
including, but not limited to, the provision of these services:
(1) Outpatient mental health and substance use services;
(2) Twenty-four (24) hour mobile crisis response and hotline services;
(3) Screening, assessment, and diagnosis, including risk assessments;
(4) Person-centered treatment planning;
(5) Primary care screening and monitoring of key indicators of health risks;
(6) Targeted case management;
(7) Psychiatric rehabilitation services;
(8) Peer support and family supports;
(9) Medication-assisted treatment;
(10) Assertive community treatment; and
(11) Community-based mental health care for military service members and veterans.
(d) Subject to the approval from the United States Department of Health and Human Services'
Centers for Medicare & Medicaid Services, the certified community behavioral health
clinic model pursuant to this chapter shall be established by February 1, 2024, and
include any enhanced Medicaid match for required services or populations served.
(e) By August 1, 2022, the executive office of health and human services will issue the
appropriate purchasing process and vehicle for organizations that want to participate
in the Certified Community Behavioral Health Clinic model program.
(f) The organizations will submit a detailed cost report developed by the department of
behavioral healthcare, developmental disabilities and hospitals with approval from
the executive office of health and human services, that includes the cost for the
organization to provide the required services.
(g) The department of behavioral healthcare, developmental disabilities and hospitals,
in coordination with the executive office of health and human services, will prepare
an analysis of proposals, determine how many behavioral health clinics can be certified
in FY 2024 and the costs for each one. Funding for the Certified Behavioral Health
Clinics will be included in the FY 2024 budget recommended by the Governor.
(h) The executive office of health and human services shall apply for the federal Certified
Community Behavioral Health Clinics Demonstration Program if another round of funding
becomes available.