Accreditation – A Solid Foundation for a CCBHC

The Certified Community Behavioral Health Clinic (CCBHC) model has seen rapid uptake in the last decade because it improves the quality of life for individuals with behavioral health needs. It does this by improving community-based access to behavioral healthcare, regardless of an individual’s ability to pay, which is important. Studies have shown that, in the U.S., one in five adults have a mental illness, but fewer than half received treatment in the past year. In addition, individuals with behavioral health needs often have poor physical health outcomes due to a lack of physical health care access, so the CCBHC model integrates and coordinates physical health services for this population. In order to meet this mission, CCBHCs receive enhanced Medicaid funding that allows them to provide more services as well as services that are not always reimbursed, like community outreach and partnerships.

In 2002, eight community mental health clinics formed the first CCBHC pilot. The number of CCBHCs has now grown to over 400 operating in 40 states. More states are considering adopting this model now that the program has gone nationwide. “Certified Community Behavioral Health Clinics help connect Americans to easy-to-access, comprehensive mental health and substance use disorder treatment and supports in their own communities,” said Miriam E. Delphin-Rittmon, Ph.D., the U.S. Health and Human Services Assistant Secretary for Mental Health and Substance Use and the leader of SMAHSA.

But becoming a CCBHC can be complex. Agencies may need to expand services and hours, hire staff, and determine how and where to integrate physical health care into their operations so they have the capabilities they need to meet the qualifications. CCBHCs are nonprofit organizations or units of a local government behavioral health authority, including tribal government. They must directly provide (or contract with partner organizations to provide) nine types of services, with an emphasis on the provision of 24-hour crisis care and substance use disorder treatment, use of evidence-based practices, care coordination with local primary care and hospital partners, and integration with physical health care.

Some of the key expectations for certified community behavioral health clinics are closely aligned with the accreditation requirements of the national accrediting bodies. These include:

  • Advancing integration of behavioral and physical health care
  • Coordination of care, treatment and services through care coordination/case management
  • Delivering services based on individualized plan of care/treatment by well-trained, competent staff who match culturally/linguistically to the population(s) served
  • Providing patient-centered, trauma-informed, recovery-oriented best practices in their care, treatment and services
  • Enhancing quality to improve outcomes for individuals served
  • Collecting, reporting, and tracking data
  • Continuous quality improvement.

Because national accreditation requirements contain standards of care for addressing these same CCBHC criteria, achieving and maintaining accreditation with Accreditation Association for Ambulatory Health Care (AAAHC) CARF International (CARF), Council on Accreditation (COA), or the The Joint Commission can provide a solid foundation for a  behavioral health care clinic’s journey as a CCBHC. Through compliance with accreditation requirements, organizations will have a roadmap to follow for addressing many key CCBHC components. These areas are then assessed by surveyors/reviewers during on-site or virtual site visits, providing validation of good practices and potential feedback that can generate further enhancements.

Recognizing this solid foundation, SAMHSA encourages accreditation for a CCBHC by an appropriate, nationally recognized organization such as AAHC, CARF, COA, or The Joint Commission. SAMHSA’s intent for a CCBHC is to improve access to and quality of mental health and addiction care, treatment and services for all persons in need. This intent is reflected in the mission of each of the national accrediting bodies: AAAHC, CARF, COA, and The Joint Commission.

Accreditation Guru has experts who can provide consulting to assist organizations throughout the CCBHC accreditation/reaccreditation process. Recently, AG was proud to partner with BestSelf Behavioral Health, a CCBHC, in their achievement of accreditation through COA. BestSelf provides outpatient, integrated behavioral and physical health care using evidence-based practices. Its programs and services include education and vocational supports, mobile mental health and substance use disorder services, homeless outreach and housing, community and school-based programs, and coordination with law enforcement and medical, mental health and child protection professionals. “COA accreditation has allowed BestSelf to focus on quality and maintain best practices as well as operate our Opioid Treatment Program,” says Rebecca S. Steffen LCSW-R, Vice President of Quality Improvement & Accreditation.

We would love to discuss your clinic’s accreditation needs, click here to contact us.

  1. The National Council for Mental Wellbeing, CCBHC Success Center, 2021 Impact Report, https://www.thenationalcouncil.org/wp-content/uploads/2021/08/2021-CCBHC-Impact-Report.pdf?daf=375ateTbd56 (October, 2021)
  2. National Alliance on Mental Illness, Certified Community Behavioral Health Clinics, https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Certified-Community-Behavioral-Health-Clinics (October, 2021)
  3. The National Council for Mental Wellbeing, CCBHC Success Center CCBHC Overview, Success Center, CCBHC Overview, https://www.thenationalcouncil.org/ccbhc-success-center/ccbhcta-overview (October, 2021)
  4. Substance Abuse and Mental Health Services Administration, Criteria for the Demonstration Program to Improve Community Mental Health Centers and to Establish Certified Community Behavioral Health Clinics https://www.samhsa.gov/sites/default/files/programs_campaigns/ccbhc-criteria.pdf (October, 2021)

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Engaging and Evaluating for Board Effectiveness

Nonprofit leaders and board members often ask about ways to maximize and maintain board member engagement. Furthermore, they ask about how to evaluate the board’s ongoing effectiveness. While there are a number of areas that go into developing an engaged and effective board, some of the initial key steps are outlined here.

How Do We Maximize and Maintain Board Engagement?

Build Teamwork to Make the Dream Work

It starts with having the appropriate people in place; without this thoughtfully constructed team of individuals, it becomes impossible to achieve a group that is able to work together cohesively and strategically.

In addition, how many nonprofits have members who have been on the board together for years and have never really gotten to know one another? Imagine how much more effectively a group like this could have guided their organization toward its mission had they been governing as a team rather than as acquaintances coming together for meetings, or to merely fill a seat at the table.

To maintain an effective board, there must be an atmosphere of mutual trust and respect among the members and the agency’s executive leadership team. Board members who enjoy interactions with one another and the organization have a higher level of trust and respect that will likely lead to quality participation and regular meeting attendance.

Ensure Commitment to the Nonprofit’s Direction

One of a nonprofit’s most valuable assets is its board of directors. To create this value, a board must be diverse, dedicated, and eager to assist your agency in fulfilling its mission.

Board members should not only be committed to the agency’s mission, but they should also be willing to support the nonprofit’s needs and understand what is expected of them as an actively involved member.

Clearly Communicate Involvement Expectations

Aligning expectations on both sides ins critical. Leadership needs to clearly understand what each member can and is willing to provide in terms of skills, time, and financial support (this means both direct giving and/or helping to raise funds) and successfully match those to the needs of the nonprofit organization.

The appropriate level of board involvement will depend, in part, on the size of the organization and its stage of development. A newly formed nonprofit or grassroots advocacy group will often require an “all hands on deck” approach, whereas a more advanced organization may focus more on maximizing the board members’ network of contacts and fundraising efforts. In either case, the legal and fiduciary oversight responsibilities of the board of directors must be considered priority.

Hold Effective Meetings

Meetings should be a positive use of the board members’ time. Discussions should allow for open debate and questioning, and time should be spent on strategic goal advancement, while not be mired in minutia or the detailed operations of the organization. For example, if a board is reviewing, debating, and approving agency procedures, they are operating on a micro-management level. The board should remain focused only on policy approval and developing and fulfilling strategic goals. There should also be an agreed-upon decision-making process to keep meetings moving forward, ultimately resulting in more effective meetings.

Plan for and Respond to Challenges

Developing and maintaining an effective and unified board requires consistent effort and a desire from each member to keep the interests of the agency first and foremost. This can become exponentially more challenging when starting out with ineffective or frustrated board members. It is important to be on the lookout for warning signs of disengagement or disenchantment as well as any new power struggles. Plan ahead about how you may prevent and handle some of these challenges.

Nonprofits often struggle with how to appropriately dismiss board members from their responsibilities when this becomes the necessary course of action. However, it can be done with time, thoughtful planning, and action. To plan for these situations, there is an entire process that must be in place to identify and recruit diverse, committed, new members. (contact us for additional information).

How Do We Measure Our Effectiveness?

In today’s competitive philanthropic environment, it is essential to regularly measure the functionality and influence of your nonprofit board and determine practices and strategies that will strengthen its impact. Conducting a thoughtful board assessment is a solid place to begin.

The following questions may help to better inform a board assessment:

  • Does each member of your board feel engaged and involved in the oversight of your organization on a regular basis?
  • Is your board directly involved in setting fundraising goals, and are they actively involved in the fundraising process as required by your nonprofit?
  • What are your board’s three greatest strengths, and how have these contributed to the overall success of your nonprofit?
  • What are your board’s three most significant weaknesses, and how have these held your nonprofit from operating at its optimal level?
  • Does your board culture encourage and welcome open discussion of issues, even when members are not in agreement?
  • Is there a mutual level of respect among all board members?

Developing relationships, establishing expectations, heading off potential challenges, and assessing board effectiveness are just some of the activities that will help foster an engaged, cohesive board of directors who can effectively contribute to fulfilling your nonprofit organization’s mission. For information on any of these questions or other ways to take your board to the next level of engagement and effectiveness, please feel free to contact us.

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Educating Your Board of Directors

“Education is the most powerful weapon which you can use to change the world.” – Nelson Mandela.

Education forms the foundation from which most everything else is created, making it one of the wisest investments a nonprofit can expend its precious resources on. Taking the time to educate your board of directors is one way you can develop that foundation so they are best prepared to serve your organization and its clients.

Keep in mind that many nonprofits do not formally educate their board members. Often, a nonprofit will assume that if someone is professional or a leader in their industry that they also have the knowledge to be an effective member on the board. Ultimately, this assumption can lead to increased risk and liability for your organization.

If you’re not educating your board members, who is?

Some questions to reflect on when considering topics to educate your new board member (or existing members for that matter):

  • Does each of your board members clearly understand the organization’s mission, vision, services, and programs well enough to make meaningful contributions in a leadership capacity?
  • What do orientation materials for new members include, and how are they used for onboarding new people?
  • Does your organization have an inclusive, formal orientation procedure in place for all incoming board members?
  • How do you train your board members for ongoing success?

Here are some ideas to consider implementing as you think about educating your board:

  • Board members should be diverse enough to bring different skills to the table. That said, you may need to consider educating them on mission-specific areas of your nonprofit. For example, teach them about the foster care and adoption process, or about how your homeless shelter changes the lives of its clients for the better.
  • From day one, help board members understand their roles and responsibilities. Knowing what is expected of them will encourage the confidence they need to be the leaders that your agency – and your clients – are counting on.
  • Customize educational opportunities to fit the needs of your board. Applicable areas of concentration can include fundraising, financial literacy, governance, and strategic planning. More often than not, there are board members who do not understand how to read financial data reports and the elements contained within. Arming them with this knowledge will also give them insight on the importance of their fundraising efforts as well as strategic planning.

The more effectively you educate your board members (especially regarding the agency’s mission), the more they are able to share with others throughout the communities you serve. They can use their newfound knowledge to both inform and strengthen relationships on your organization’s behalf, both now and well into the future.

Next week: Now that you have your board and they’re well prepared, it’s time to ensure they are everything your organization needs. How to engage and evaluate for board effectiveness.

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.