Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Pennsylvania

09/10/2019

State Population
(in millions)
DY1--Total to Receive CCBHC Services
(all pay sources)
DY1--Projected CCBHC Consumers
who are Medicaid Recipients*
12.81 24,800 17,800
Number as of
March 2018
Population Density of
Clinic Service Area
Organizational
Structure
Number of CCBHCs
also Certified as...
Number
of DCOs
in State
CCBHCs Service
Locations
Urban Urban/
Rural
Rural/
Frontier
Government
Run
Non-Profit
Organizations
FQHCs Health
Homes
7 7 4 3 0 0 7 0 0 8
State Impact Measures
  • Provide the most complete scope of services to individuals eligible for medical assistance under the state Medicaid program.
  • Improve availability of, access to, and participation in services to individuals eligible for medical assistance under the state Medicaid program.
  • Demonstrate the potential to expand available mental health services in a demonstration area and increase the quality of such services without increasing net federal spending.
* This estimate may include dual-eligible Medicaid and Medicare recipients.
State map of Pennsylvania.

State Entity Responsible for Monitoring Compliance

Pennsylvania Department of Human Services' Office of Mental Health and Substance Abuse Services (OMHSAS)

Monitoring Instrument

SAMHSA Certification Guide, modified for the state certification process.

Method and Frequency of Monitoring

  • OMHSAS conducts an annual on-site review ateach clinic to determine that the clinic continues to meet CCBHC criteria.

  • The Finance Department monitors quarterly financial reports from the managed care plans, as well as all available encounter data.

  • In the first 6 months of demonstration program implementation, monitoring focused on the ability of the clinics to submit required data elements, including:

    • Weekly submissions of patients' and families' experience of care reports by each CCBHC.

    • Monthly data submission into the quality dashboard.

    • Accuracy of claims submission.

  • Interim cost reports were required for the first 6 months of the demonstration program (July-December 2017).

  • A report of activity from the FFS program was requested.

Additional Safeguards

  • All CCBHCs must maintain valid licensing for the services provided under the demonstration program. These licensing processes occur annually to comply with current Pennsylvania regulations.

  • Discussions occur with individual clinics regarding their data, as well as with all clinics regarding the overall results of the various evaluation findings.

  • After the completion of the first year of the demonstration program, a critical review will explore the results of all the quality metrics being collected, including the six which can result in a QBP.