Excellence in Mental Health Act Moves Forward

The Excellence in Mental Health Act (also referred to as the Certified Community Behavioral Health Clinic Prospective Payment System Demonstration Program), which Senator Roy Blunt helped to introduce, allows states to seek award of a demonstration program for the development of Certified Community Behavioral Health Clinics (CCBHCs) and a Medicaid Prospective Payment System (PPS) for reimbursement of services.

Missouri was one of 24 states that received a planning grant to develop the application for the demonstration program grant.  The planning grant award was for $982,373.  Eight states will be selected for the demonstration program.

CCBHCs will provide services to individuals with serious mental illness and substance use disorders.  CCBHCs will provide integrated, comprehensive care using Evidenced-Based Practices (EBPs).

The PPS, which will include Quality Bonus Payments, will promote and incentivize efficient and effective care while controlling over utilization of services.

The planning grant will enable Missouri to:

  • Develop standards to certify clinics as CCBHCs
  • Develop a Medicaid PPS
    • The PPS Demonstration will shift Medicaid reimbursement for community behavioral health services from a fee-for-service model to a cost-based reimbursement model that promotes more cost effective quality care.
  • Prepare the application for a two-year demonstration program which begins in early 2017

The demonstration program will enable Missouri to:

  • Enhance integration and coordination of behavioral health and physical health services
  • Promote the use of evidence-based and promising practices that support recovery
  • Use a prospective payment system for the delivery of care
  • Receive for two years an enhanced Medicaid match

The application for the demonstration program is due October 2016, with eight states awarded the grant by the end of 2016.  No funding is awarded with the demonstration program apart from the enhanced Medicaid match.

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