By: Warren Bates, CEO at Mend
Certified Community Behavioral Health Clinics (CCBHCs) have become essential lifelines in the nation’s efforts to expand access to comprehensive mental health and substance use care. These organizations operate at the intersection of healthcare and social services, delivering everything from 24/7 crisis care to outpatient therapy, care coordination, and even primary care screenings.
But as critical as CCBHCs have become, they are also vulnerable. A rising tide of economic pressures threatens their ability to sustain services. Despite being heralded as a successful model with strong outcomes, many clinics are finding that maintaining operations under unpredictable funding models is becoming increasingly difficult.
The recent developments in Oklahoma, where Grand Mental Health—one of the largest and most impactful CCBHCs in the state—faced termination of its CCBHC status and contracts, illustrate just how precarious the situation has become.
The CCBHC Model: A Transformational Yet Fragile System
Since launching in 2016, CCBHCs have grown significantly in number and impact. By June 2024, an estimated 3 million Americans were receiving care through this model. Clinics that transition to CCBHC status typically report a 25% increase in the number of patients they can serve.
The model’s impact goes far beyond volume. Individuals receiving care through CCBHCs experience a 72% reduction in hospitalizations, a 40.7% reduction in homelessness, and a 60.3% drop in time spent in jail.2,3 In the context of a national mental health and addiction crisis, these outcomes represent meaningful strides toward community stability.
Additionally, CCBHCs have taken the lead in implementing evidence-based practices. Eighty percent offer some form of Medication-Assisted Treatment (MAT), far outpacing the national average of 64% among substance use treatment facilities. And nearly a third now offer mobile crisis services, which have become especially critical in rural and underserved communities.
This transformation has also spurred job creation. Clinics have hired more than 11,000 new staff nationwide, helping to alleviate shortages in the behavioral health workforce.
Despite these gains, the CCBHC model is still dependent on complex, often inconsistent funding streams. Many clinics rely on a mix of federal grants, state contracts, and Medicaid reimbursements, all of which can shift dramatically due to policy changes or economic pressures.
Adding to the financial strain, Medicaid reimbursements often don’t reflect how care is actually delivered. Cornerstone services of the CCHBC model like care coordination, outreach, and peer support are frequently non-billable under traditional Medicaid fee-for-service structures.
Clinics may dedicate hours to stabilizing a high-risk patient, only to receive payment for a single 15-minute visit. This disconnect forces organizations to subsidize critical components of care with limited unrestricted funding, a challenge that compounds quickly when reimbursement rates remain stagnant or outdated.
Oklahoma’s Funding Freeze: A Tipping Point
Oklahoma has historically relied heavily on SAMHSA funding to support its behavioral health infrastructure. In the past five years alone, the state has received nearly $750 million in federal support. These funds have supported mental health services for hundreds of thousands of children, tribal nations, and rural populations across the state.
But a recently reportedbudget shortfall at the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) triggered a chain reaction. State officials implemented a freeze on additional CCBHC funding.
Patients of Grand Mental Health will be among the most affected. Although communications are ongoing and they are hopeful for a resolution, Grand Mental Health received notice that its contracts and CCBHC status would be terminated, effective May 10, 2025.
The immediate implications are severe: the potential loss of Tulsa’s Urgent Recovery Center and the state’s largest residential addiction recovery program, both of which are run by Grand. Over 53,000 individuals who have received care from Grand Mental Health could lose access to care. And yet, Grand has remained committed to continuity, communicating that services will continue as normal while leadership seeks resolution.
This situation has rippled across the CCBHC community. What happened in Oklahoma could happen anywhere. The freeze illustrates the fragility of a system that, while successful on paper, is dependent on political and fiscal stability that can change overnight.
The Bigger Picture: Economic Vulnerability Across the U.S.
Grand Mental Health’s experience is not isolated. Clinics nationwide are navigating a tightening financial environment marked by increased oversight, evolving payment models, and growing demand. With SAMHSA’s own future in question and many states moving toward prospective payment systems, CCBHCs face the dual challenge of justifying their funding and improving their margins.
Some level of financial accountability is appropriate and necessary. But without reliable and flexible infrastructure, even the most impactful clinics may struggle to keep up with the new reporting demands, let alone withstand sudden funding disruptions.
Strengthening Financial Foundations Through Innovation
To weather this uncertainty, CCBHCs need more than resilience. They need better systems for proving their value, streamlining operations, and securing sustainable revenue. That’s where technology plays a pivotal role.
For example, platforms that enable Measurement-Based Care (MBC) are becoming essential. Tools that collect, analyze, and report patient-reported outcomes help clinics meet quality benchmarks, tell their impact story to funders, and strengthen their eligibility for ongoing certification.
Likewise, automation in billing and payment collection can significantly reduce administrative overhead while improving cash flow. As staffing shortages persist and payer scrutiny increases, solutions that free up staff to focus on care delivery will only grow more critical.
Technology is not a silver bullet. But when used strategically, it can serve as the operational backbone that allows CCBHCs to remain mission-focused while navigating a volatile financial landscape.
Practical Strategies for Financial Resilience
In addition to adopting the right tools, CCBHCs can pursue a range of strategies to improve their financial sustainability:
- Diversify funding sources through private grants, insurance partnerships, and philanthropic investments.
- Strengthen revenue cycle management by staying current on billing codes and proactively addressing claim denials.
- Adopt value-based care models that reward outcomes instead of volume.
- Develop strategic community partnerships to support joint programs and shared resources.
Invest in workforce retention and training to minimize costly turnover and ensure quality care. - Track performance data rigorously to meet evolving oversight requirements and justify continued funding.
- Engage in policy advocacy to ensure the CCBHC model remains supported at both federal and state levels.
These strategies, while not simple, reflect the kind of proactive planning that will be necessary to protect the gains CCBHCs have made over the past decade.
CCBHCs Are Worth Protecting.
The case in Oklahoma is a wake up call for anyone invested in the future of behavioral healthcare, where even large-scale clinics can face destabilization due to financial and political shifts.
As we look ahead, the mission is clear: protect the progress CCBHCs have made, shore up their financial foundations, and equip them with the tools and strategies they need to thrive.
Organizations like Mend are proud to stand alongside CCBHCs in this effort. We exist to help clinics not only survive moments of uncertainty, but emerge stronger, more efficient, more impactful, and more connected to the communities they serve.
