Mental health and addiction treatment services have long been underfunded and fragmented in the United States, leaving millions without adequate care. Certified Community Behavioral Health Centers represent a promising model designed to bridge these gaps by offering comprehensive, coordinated behavioral health services tailored to the needs of vulnerable populations. Now, proposed legislation in Congress seeks to make Certified Community Behavioral Health Centers a permanent feature of Medicaid, expanding access and ensuring long-term sustainability of this innovative care approach.
What Are Certified Community Behavioral Health Centers?
Certified Community Behavioral Health Centers are nonprofit organizations that deliver a full spectrum of outpatient mental health and addiction treatment services, along with critical social supports. Unlike traditional behavioral health providers, CCBHCs must meet strict criteria set by the federal government around care quality, staffing, and service integration. This model is built to offer holistic, patient-centered care — addressing not only behavioral health but also related social determinants that impact well-being.
Since their launch in 2017, Certified Community Behavioral Health Centers have been available only through a time-limited demonstration program authorized by the Centers for Medicare & Medicaid Services (CMS). This program uses a prospective payment system designed to provide financial stability to providers while encouraging efficiency and quality outcomes. Over 500 CCBHCs now operate nationwide, serving individuals facing mental illness, substance use disorders, and related challenges.
The Current Status: A Temporary Demonstration Program
Despite their growing popularity and demonstrated effectiveness, CCBHCs remain tied to a temporary federal demonstration waiver program. This means states participating in the program can offer CCBHC services, but only on a trial basis. Once the demonstration period ends, the program sunsets, and these centers lose the ability to bill Medicaid under this model.
The Bipartisan Safer Communities Act, passed in 2022, included funding provisions supporting Certified Community Behavioral Health Centers as part of a broader response to enhance behavioral health infrastructure after the tragic mass shooting in Uvalde, Texas. However, the legislation also established a timeline that could lead to the end of the demonstration program unless further congressional action is taken.
Without a permanent authorization, many CCBHCs risk losing critical funding and the ability to continue offering integrated services, potentially disrupting care for some of the nation’s most vulnerable populations.
Introducing H.R. 7545: A Path to Permanency for Certified Community Behavioral Health Centers
To address this uncertainty, Rep. Doris Matsui (D-California) introduced H.R. 7545, the “CCBHC Expansion Act,” with bipartisan support from Rep. Larry Buschon (R-Indiana). This bill would allow states to incorporate Certified Community Behavioral Health Centers into their Medicaid state plans as a permanent service option, no longer limited to demonstration status.
Under the bill, state Medicaid programs would have the option to include Certified Community Behavioral Health Centers as a covered service, enabling broader and more stable access to these centers nationwide. This would mean that states no longer have to wait for special waivers or demonstration approvals and could offer CCBHC services as part of their core Medicaid benefits.
According to Chuck Ingoglia, president and CEO of the National Council for Mental Wellbeing, “This bill would not only allow people living in a CCBHC demonstration state to continue to access care from a Certified Community Behavioral Health Center post-demonstration, but also enable other states to more swiftly take action to expand access to CCBHCs statewide.”
Currently, the bill is under consideration by the House Committee on Energy and Commerce, where it will be evaluated before moving forward in the legislative process.
Why Permanency Matters: The Medicaid Landscape and Behavioral Health Care
Medicaid is the nation’s largest payer for behavioral health services, covering millions of people with mental health and substance use disorders. However, Medicaid programs vary widely by state, with some services mandated as core benefits and others optional. States decide which optional services to include based on factors like funding availability and local priorities, striking agreements with CMS to receive matching federal funds.
Certified Community Behavioral Health Centers offer states a compelling value-based care model. They provide stable, predictable funding through a prospective payment system, which supports better financial planning and resource allocation. In return, these centers are held accountable for meeting high standards in service quality, staffing, and care coordination.
The nine core services CCBHCss must provide—either directly or through partnerships—include:
- 24/7 crisis services
- Outpatient mental health treatment
- Outpatient addiction treatment
- Personal and family treatment planning
- Community-based care for veterans
- Peer support and counseling
- Case management
- Primary care screening and monitoring
- Psychiatric rehabilitation
- Screening and risk assessment
This comprehensive array of services ensures individuals receive integrated care that addresses the full spectrum of their behavioral health needs in one place, reducing fragmentation and improving outcomes.
The Growing Popularity and Impact of Certified Community Behavioral Health Centers
Since their inception, CCBHCs have been praised by state leaders, providers, and behavioral health advocates for their ability to improve access and quality of care, especially for underserved and high-risk populations. More than 500 centers now operate across multiple states, showing that the model can scale and deliver meaningful results.
Certified Community Behavioral Health Centers also contribute to reducing emergency room visits, hospitalizations, and incarceration among people with behavioral health conditions by providing timely, community-based support. This helps ease the burden on the broader health care system while improving patients’ quality of life.
Federal Efforts to Enhance Behavioral Health Access
The establishment and expansion of Certified Community Behavioral Health Centers align with broader federal priorities to strengthen behavioral health infrastructure. The Bipartisan Safer Communities Act, in addition to funding CCBHCs, includes several other initiatives aimed at addressing the nation’s behavioral health crisis. The CMS Innovation in Behavioral Health Model is another recent federal effort seeking to test new ways to improve care delivery and integration.
Permanent inclusion of CCBHCs in Medicaid would complement these efforts by institutionalizing a proven, patient-centered care model that responds to the complex needs of people with mental health and substance use disorders.
What’s Next?
If Congress passes H.R. 7545, it could mark a significant step forward in expanding access to behavioral health services for Medicaid beneficiaries across the country. States would gain a powerful tool to improve care coordination, enhance outcomes, and better support vulnerable communities.
For individuals and families affected by mental health or addiction challenges, making CCBHCs a permanent Medicaid option means more reliable, accessible care that meets their comprehensive needs. For providers, it means financial stability and the ability to focus on delivering high-quality care rather than navigating short-term funding uncertainties.
As the bill moves through the legislative process, behavioral health advocates and stakeholders will be watching closely, hopeful that this legislation will become law and pave the way for stronger, more inclusive behavioral health care nationwide.
Conclusion
Certified Community Behavioral Health Centers represent a transformative approach to behavioral health care, emphasizing coordination, quality, and accessibility. The proposed H.R. 7545 legislation seeks to embed this model permanently within Medicaid, expanding its reach and impact. With mental health and addiction challenges rising nationwide, making CCBHCs a core Medicaid benefit is a critical opportunity to improve lives and strengthen communities.
