CCBHC Basics
This federally designated care model expands clinics beyond therapy alone to include screening, coordination, and whole-person care.
What is the CCBHC Model of Care?
A client’s care is supported by multiple disciplines working together rather than a single provider.
What is a team-based approach to care?
A clinician screens for alcohol use as part of routine care, regardless of the presenting concern.
What is the AUDIT-C?
This required CCBHC structure ensures client feedback informs clinic and program improvement efforts.
What is the Peer Advisory Board?
This SAMHSA-required dataset is collected from a 10% sample of clients.
What are the NOMs?
CCBHCs are built on this care philosophy, integrating behavioral health, physical health screening, and social supports.
What is whole-person care?
A client qualifies for care but is stuck navigating Medicaid rules, renewals, or coverage confusion.
What is Behavioral Healthcare Navigation?
This screener identifies needs like housing or food insecurity that directly affect treatment outcomes.
What is the SDOH screener?
A client asks how they can share feedback about their experience, and their clinician sends them this.
What is the Client Feedback Survey?
This role tracks data, reporting, and improvement so clinicians can focus on care.
Who is the program evaluator?
These required services are why CCBHC work spans therapy, coordination, screening, and follow-up.
What are the nine CCBHC core services?
A client wants support rooted in lived experience.
What is Peer Support?
After a positive alcohol screen, the clinician discusses risk and provides brief counseling and a referral to SUD services.
What is SBIRT?
This CCBHC requirement prohibits denying services based on a client’s financial situation.
What is access regardless of inability to pay?
SAMHSA requires CCBHCs to submit annual reports during this month every year.
What is December?
Before CCBHC, behavioral health was largely funded under this model, which focused on paying for visits rather than impact.
What is fee-for-service?
A client with depression and unmanaged diabetes needs medical screening and coordination with primary care alongside behavioral health treatment.
What is Nurse Care Coordination?
The Avatar action required for the brief intervention to be visible in CCBHC data.
What is selecting the “Counseling about Alcohol” clinical indicator checkbox?
Collecting, reviewing, and acting on client feedback reflects this ongoing improvement process.
What is continuous quality improvement?
During GY4, this requirement standardizes outcome data collection across CCBHCs nationally.
What is the CCBHC National Evaluation?
After requesting services, clients should not wait more than 10 days for this step under CCBHC standards.
What is an intake assessment?
This core service focuses on building daily living skills, social connections, and recovery beyond symptom reduction.
What is Psych Rehab (Pathways to Wellness)?
A client screens positive for housing or food insecurity and requires follow-up within this timeframe.
What is SDOH follow-up within 30 days?
This principle ensures client perspectives are treated as expertise, not just opinions.
What is client-centered treatment?
Instead of guessing what the community needs and resources are, CCBHCs are required to complete this assessment to guide planning and CQI.
What is a community needs assessment?