Managing Your CCBHC Transformation | Stage 2 Funding and Launch

Written by Mary Givens, CCBHC Program Manager

Five Stages of the CCBHC EXPERIENCE| Stage 2 Funding and Launch 

This stage is primarily about procuring the finances to start up your CCBHC. There are several streams of funding available, depending on federal and state actions. Once funding is procured, the next step will be to launch your CCBHC.  

Let’s look at the set of tasks and deliverables Qualifacts recommends that you execute during Stage 2 Funding and Launch.   

Procuring the Funds: Whether your agency will apply for a SAMHSA (Substance Abuse and Mental Health Services Administration) CCBHC expansion grant, additional SAMHSA funding, new SAMHSA funding, or state funding if your state is under a CCBHC demonstration grant, be prepared for an arduous application process. 

I recommend you have the managing member of your CCBHC group lead the completion of your application, to assign tasks and manage the timeline for the completion of the components. Your application will need to include these deliverables, some of which are complex and time-consuming to complete:  

• Community Needs Assessment 
• Demographics of your service area  
• Project Abstract or Summary  
• Budget and Budget Justification 
• Site location addresses and descriptions  
• Organizational Chart 
• Job Descriptions 
• Bios of key staff 
• CCBHC Criteria Compliance checklist (Readiness Assessment) 
• Current level of criteria Compliance and Dates for meeting any unmet criteria 
• List of Designated Collaboration Organizations (DCOs) and Memos of Understanding (MOU) or Memo of Agreement (MOA) 

Timelines and project plans are critical for the application process and beyond. For the SAMHSA CCBHC grants, you will have just four months from receiving the funding to when you are required to start delivering your newly launched CCBHC programs and services. As part of the application process and then once a year thereafter, you will need to complete a Community Needs Assessment and submit a budget.  

Evaluate DCO Benefits and Risks: As you review the criteria for the types of services the CCBHC includes, you will decide whether to expand to provide missing required services directly OR if you will opt to use a Designated Collaborating Organization (DCO).  

Certain CBHC services can only be provided by the CCBHC itself: you must continue to offer them or expand to provide them: 

• Comprehensive behavioral health screening, assessment, and diagnosis, including risk assessments 
• Person-centered and family-centered treatment planning 
• Comprehensive outpatient mental health and substance use disorder services 

DCO Risk Evaluation the CCBHC has the option of using DCOs to provide any of the remaining services; be sure your management team fully understands the risks inherent with those partnerships. 

•  Your CCBHC will be fully responsible for the delivery and quality of DCO services.  
• Close oversight of DCO partners can be challenging and will require a commitment of time and resources.  
• One downside of DCO partnerships that our CCBHCs have shared is that while they are responsible for the contracted DCO services, they reap none of the revenue and face new and significant ongoing expenses to monitor the quality of those services.
• Positive reasons to use a DCO are that the partner organization may have a level of experience and expertise in delivering a specific type of service (i.e., MAT or Primary Care) that the CCBHC does not. Creating a partnership with the DCO for the delivery of this service avoids any startup costs, hiring of new credential types, and ramp-up time which can be beneficial to the CCBHC.  

DCO MOA and MOU | If you decide to use a DCO (s) you will need to have a formal “Memo or Understanding” (MOU) and “Memo of Agreement” (MOA) between you and the DCO entity. This second stage of the CCBHC experience is the right time to identify the DCO, develop that partnership, and execute the MOU and MOA.  

To my knowledge, the key difference Between a Memo of Agreement (MOA) and a Memorandum of Understanding (MoU) Is that the former agreement is a document in which two or more parties agree to work together for a common objective, whereas the Memorandum of Understanding (MoU) describes in writing the terms of an agreement. You will need both, but you should consult your legal representative on this point.  

Develop a CCBHC Launch project Plan: I strongly suggest you develop and adhere to a formal project plan for the many moving and integrating components of care that will need to be built and tracked. Having a documented plan with goals, milestones, and timelines will really help your agency stay on track for this important transition.

The plan does not have to be complicated, and spreadsheets are a convenient and accessible tool for building and managing it. Here are the types of data you will want to include in your plan: 

• Name of Task, with a brief description 
• Who is responsible for the task? If it is more than one person, describe the delegated relationships and teams. 
• Start date 
• Target completion date  
• Status 
• Actual Completion Date 
• Notes or Comments 

You will find it to be extremely helpful to designate one member on the CCBHC team as the “Project Manager.” This person ensures that the project plan is reviewed during every meeting, and updates it accordingly. This is not a full-time position, but it is a key responsibility; we have seen it added to the scope of duties of the person who carries the CCBHC Director title. The team as a group is responsible for holding each other accountable to the timelines.  

Develop a CCBHC Marketing Plan: Getting the word out to your referral sources and the community about your commitment to move to the CCBHC treatment model is an important part of your readiness plan and your ultimate success. You want to ensure your referral sources know about any new services you will be providing, new hours you will be open, and new populations you will be serving. To do this effectively, your marketing plan should include a list of referral sources and contacts to communicate with one on one:

• Hospitals 
• Other providers 
• Payers 
• List of Alumni and current clients to communicate with 
• A template for an email and “snail mail” letter content, with content customized by audience 
• A series of press releases marking your milestones 
• Letter to Board and other agency members (donors) and stakeholders 

The template communication should include:

• A brief description of the CCBHC treatment model and why it is different and better for the people you serve 
• Any new hours of locations for intakes since you will be increasing your access to care 
• Any new services you will be providing 
• Any new populations you will begin to serve (military/veterans, SUD?) 

Develop a CCBHC Communication Plan: The communication plan is the content that supports the marketing plan; the two are complementary. The framework for both should be built early in your process; the details can be filled in as you go.   

The communication plan is a vehicle for sharing your objectives for moving to the CCBHC treatment model, and the benefits it will bring to stakeholders. It will include an explanation of why your organization is taking on this strategic change, why the change is so important to the organization as well as the people and the communities you serve, and what your strategy is for managing the change. 

The communication plan gives you the opportunity to share with all the stakeholders how moving to the CCBHC treatment model further supports your mission.  

Some of the stakeholders to consider are the Board of Directors and all of the staff within the agency. The message may be different for each different audience. For the Board, for example, it will be important to share that you have done your due diligence including cost analysis and a proposed budget. For the staff, specifically the providers, it might include an explanation of how this change will impact workflows and information about your training plan. Your communication plan should include the following: 

• Intended Audience (s) 
• Purpose of communication 
• Person responsible 
• Target date to send communication 
• Actual date 
• Notes/comments 

Completing each of these activities listed above launches your CCBHC from an idea to reality.  

Deciding whether to contract with DCOs or to expand your programs and services to meet CCBHC requirements and service gaps is a significant marker on your CCBHC path. If you elect to start with DCOs to meet timelines, you always have the option of changing your organizational structure later to provide services yourselves; that is a viable option.  

The task of developing the Project Plan, the Marketing Plan, and the Communication Plan are all important processes you will want to execute to ensure there is structure around the many activities it takes to launch the CCBHC. Once these activities are off the ground, your CCBHC can take off!  

In the next installment in this series, we will focus on the Certification (or self-attestation) of your CCBHC and the all-important data collection.   

Mary Givens, MRA
CCBHC Program Manager
Qualifacts  

Mary Givens has been with Qualifacts for 13 years. She has a Masters in Rehabilitation Administration from the University of San Francisco. Before coming to Qualifacts, Mary was the CEO of a non-profit organization that served IDD, she was the Director of Client Services and a Director of Supported Employment for people with SPMI. Since coming to Qualifacts, she has been a Project Manager for Implementation and a Program Manager of Meaningful Use, and is currently the CCBHC Program Manager.

It was clear early on that the customization and behavioral health-specific capabilities would ease the concerns held by the organization at the beginning of their search.

“From the beginning, we’ve been able to customize everything,” Simons said. “While the printout view may look different, InSync has allowed us to translate all the information regarding treatment and assessment plans without issue, as we would have before when using paper.”