Community Mental Health
Centers: Closing Gaps in
Care
Community mental health centers provide mental health care for individuals with complex needs and often limited resources. For these individuals, co-occurring physical issues can be common and deadly – partially explaining the massive gap in life expectancy compared to the general population. Policy can drive better integration of primary care services into mental health settings and ensure that individuals who need specialty mental health services receive whole-person, comprehensive, and coordinated care.
Having to navigate multiple types of specialty care in different settings with different treatment regimens can be a challenge, especially when individuals are already facing pressing mental health difficulties and other stressful circumstances.
Financing
Segregated financing often makes it difficult for specialty mental health settings to offer integrated, onsite primary care. And while Congress has initiated some innovative financing opportunities, community mental health centers have not been meaningfully included in most payment reform efforts.
- The federal government should expand the Certified Community Behavioral Health Centers (CCBHC) initiative to provide a more flexible and comprehensive financing to mental health centers so that they have the resources they need to provide integrated care for all who could benefit while assuring quality and accountability for integrated care.
- The federal government should encourage better inclusion of community mental health centers in alternative payment models, such as Accountable Care Organizations (ACO). Community mental health centers could take on accountability for the population of people that would benefit from having their care coordinated from a specialty mental health setting.
Data Integration
Specialty mental health hasn’t been included in most health information technology initiatives, making it difficult for them to provide integrated care and participate in different kinds of payment reform. Current regulations on data sharing create barriers for sharing some kinds of information, which make integration all the more challenging.
- The federal government should amend the HITECH Act to extend financial incentives to mental health clinicians for using electronic health records. Mental health and addiction clinicians are not included as clinicians eligible for the Act’s assistance.1
- The federal government should align 42 CFR part 2 with HIPAA, as a regulatory barrier, for purposes of treatment, payment, and health care operations so that Substance Use Disorder (SUD) information can be incorporated into health records while protecting privacy and individuals with mental health conditions can receive more integrated care
- The federal government should extend Medicaid and Medicare electronic health record (EHR) Incentive program eligibility to include all mental health professionals providing care at psychiatric hospitals, mental health treatment facilities, and SUD treatment facilities. Only psychiatrists are currently eligible for this program, hindering the use of electronic health records among other mental health clinicians.