Mental health community program works, study says

Expanding an integrated care system helped patients. Now it should become permanent, advocates say
Credit: (Rudy and Peter Skitterians from Pixabay)
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Advocates for people with serious mental illness and drug addictions have hailed a federally funded program that, when started in 2017, made New Jersey one of just eight states to offer a unique model of coordinated community-based care.

Now, four years in, a new report by a national nonprofit shows the initiative — known by the clunky acronym CCBHC, for Certified Community Behavioral Health Clinics — has allowed outpatient providers to expand programs and benefited clients in a variety of ways.

In New Jersey, there was nearly a two-fold increase in the number of patients at these community clinics getting follow-up mental health care and those getting gold-standard addiction treatment, and most now get screenings for other conditions, like diabetes or tobacco use, and case management services, according to a paper released last week by the National Council for Mental Wellbeing. Wait times for services at the clinics, which now benefit some 20,000 New Jerseyans, are far below the national average.

“CCBHCs in New Jersey are making a difference and saving lives,” said Debra Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies, which represents community-based providers. “They have lowered costs, improved outcomes, and contributed to building critical substance use and mental healthcare system capacity in our communities. The need is more urgent than ever,” Wentz said, noting the more than 2,800 lives lost to overdose deaths in 2020 alone in New Jersey.

But the pilot program — which is funded on two-year cycles through a mix of grants from the federal Substance Abuse and Mental Health Services Administration and expanded Medicaid reimbursements — has yet to be made permanent. The initiative, which has grown to involve 10 states, was most recently extended through September 2023.

Ongoing funding needed

Wentz urged New Jersey’s congressional delegation to support ongoing funding for the program, now accessible at dozens of sites here, to ensure it can continue. There has been a documented rise in the need for both inpatient and outpatient mental health services — for children and adults — under the COVID-19 pandemic, which has led to unprecedented levels of grief, economic loss and isolation, and treatment providers are already stretched thin.

Community-based providers have fought for years for increased funding. Those designated CCBHCs in 2017 have since received millions in grant funds, enabling them to invest in staff, training, new technology and tracking metrics. A change to the Medicaid program allows these sites to get paid for services that were previously not eligible for reimbursements, like transportation or employment assistance for clients or coordinating their care with other providers.

The National Council report said state officials noted that this funding was instrumental in the program’s success. “In New York, the CCBHC demonstration has proven to be an effective approach in the delivery of a comprehensive model of care that when properly resourced has the potential to deliver outstanding outcomes,” Donald Zalucki, director of program and policy development for the New York State Office of Mental Health, said in the paper.

Both Pennsylvania and New York were also among the eight original states to participate in the community clinic program. New York saw participation in the program rise 21% in the first year alone, according to the report, a 54% decline in inpatient admissions and a 46% drop in emergency room use among participants. Costs in several categories fell significantly as a result. Pennsylvania doubled the number of community-clinic clients who were receiving depression screenings and follow-up care.

In New Jersey, CCBHCs noted a slight decline in hospital readmissions among the program’s clients, while case management services among this group tripled between the first and second year, the report notes. Better screening helped identify more cases of diabetes, obesity, depression and other conditions, leading to a significant increase in behavioral health diagnoses among this group — a critical step to help them access more effective care.

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