2023 West Virginia Code
Chapter 9. Human Services
Article 5. Miscellaneous Provisions
§9-5-30. Certified Community Behavioral Health Clinics
(a) The Bureau for Medical Services shall develop, seek approval of, and implement a Medicaid state plan amendment as necessary and appropriate to effectuate a system of certified community behavioral health clinics (CCBHCs).
(b) The Bureau for Medical Services, in partnership with the Department of Health and Human Resources Bureau for Behavioral Health, shall establish a state certification system for CCBHCs in accordance with the following requirements:
(1) To the fullest extent practicable, the CCBHC system shall be consistent with the demonstration program established by Section 223 of the Protecting Access to Medicare Act of 2014 (P.L. 113-93, 42 U.S.C. 1396a note), as amended.
(2) Standards and methodologies for a prospective payment system shall be established to reimburse each CCBHC under the state Medicaid program on a predetermined, fixed amount per day for covered services rendered to each Medicaid beneficiary.
(3) A quality incentive payment system shall be established for those CCBHCs which achieve specific thresholds on performance metrics identified by the Bureau for Medical Services. Such quality incentive payments shall be in addition to the bundled prospective daily rate.
(4) The prospective payment rate for each CCBHC shall be adjusted tri-annually by the Medicare Economic Index as defined in Section 223 of Protecting Access to Medicare Act of 2014. In addition, the prospective payment rate shall allow for modifications based upon a change in scope for an individual CCBHC. Rate adjustments can be made upon request by the provider.
(5) Criteria shall be established to certify a facility as a CCBHC which, at a minimum, shall require each CCBHC to offer directly, or indirectly through formal referral relationships with other providers, the following services:
(A) Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization;
(B) Screening, assessment, and diagnosis, including risk assessment;
(C) Patient-centered treatment planning or similar processes, including risk assessment and crisis planning;
(D) Outpatient clinic primary care screening and monitoring of key health indicators and health risk;
(E) Targeted case management;
(F) Psychiatric rehabilitation services;
(G) Peer support and counselor services;
(H) Family support services; and
(I) Community-based mental health services, including mental health services for members of the armed forces and veterans.
(c) All nonprofit comprehensive community mental health centers, comprehensive intellectual disability facilities, as established by 27-2A-1 of this code, and all other providers set forth in the Medicaid state plan amendment shall be eligible to apply for certification as a CCBHC.
(d) The Bureau for Medical Services, in partnership with the Department of Health and Human Resources Bureau for Behavioral Health, shall establish any other procedures and standards as may be necessary for an eligible facility to apply for certification, become certified, and remain certified as a CCBHC, as set forth in the legislative rule developed pursuant to this section.
(e) The participation of any eligible facility in the CCBHC system shall be strictly voluntary. Nothing in this section shall require a facility that is eligible for certification as a CCBHC to apply for such certification.
