New Community Behavioral Health Centers Target Gaps in Care

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BOSTON (State House News Service) - The state plans to open 25 community behavioral health centers early next year as Massachusetts residents continue to struggle with increased mental health challenges exacerbated by the COVID-19 pandemic.

Beginning in January 2023, the new designated community behavioral health centers, or CBHCs, will offer 24/7 crisis intervention and urgent visits, as well as routine appointments for mental health conditions and substance use disorders to all Massachusetts residents, regardless of ability to pay.

Both in person and via telehealth, patients will be able to access same-day evaluation and treatment, clinical services, peer support services and crisis stabilization beds.

The CBHCs are a cornerstone of Gov. Charlie Baker and Lt. Gov. Karyn Polito's "Roadmap for Behavioral Health Reform." Launched in 2021, the administration describes the initiative as a "multi-year blueprint" for "expanded access to treatment, more effective treatment and improved health equity."

Another piece of the "roadmap" is ensuring that a mental health provider is only a call away in an emergency. A state-run behavioral help hotline goes live in early January, which will offer a single point of contact for Massachusetts residents to receive real-time support, clinical assessment and connection to mental health evaluation and treatment regardless of a person's insurance status or ability to pay.

The state contracted with Mass Behavioral Health Partnership to run the hotline, according to Health and Human Services Secretary Marylou Sudders. It will offer help in more than 200 languages.

"The effects of this pandemic on our community will be with us for years to come and warrants our strong recommitment to comprehensive behavioral health care. We must lean in, embrace and support individuals and their families struggling and not let stigma hold us back," Sudders said Thursday at a ribbon-cutting ceremony at one of the new CBHCs, North Suffolk Mental Health Association in East Boston.

Massachusetts was ranked second among U.S. states for access to mental health care in 2022 by Mental Health America. Though there is an existing system for treatment and crisis care, the CBHCs will help close the gap, Sudders said at a health plan conference in November.

"They can provide an immediate, in-person clinical assessment and short-term treatment to help stabilize the situation," she said. "This is not going to replace existing relationships, it is for those individuals who do not have an existing relationship."

Additionally, the centers will create more options when mental health issues are on the rise.

The reported rate of poor mental health among survey respondents of Massachusetts' COVID Community Impact Survey is three times as high as the reported rate in 2019, with one-third of adults surveyed saying they are experiencing poor mental health.

The survey, last updated in November, also found that people experiencing poor mental health were two to three times more likely to experience barriers to accessing care as those not grappling with poor mental health.

At Thursday's ribbon cutting, North Suffolk Mental Health Association CEO Damien Cabezas said it was important for people facing mental health challenges to have a place to turn to other than the emergency department.

Many patients experiencing mental health crises languish boarding in emergency departments for hours or days while awaiting placement to a designated mental health bed, slowing their access to necessary care and straining providers.

"I want to thank Gov. Baker and his administration, including Secretary Sudders, the Legislature, and many of you here today for recognizing the need to look beyond inpatient hospital beds as the one solution for those seeking behavioral health treatment and psychiatric care," he said.

Sudders said at the November health plan conference that she was impressed with how the new CBHCs were able to navigate recent workforce shortages in health care.

"When you invest funds up front, I've been really impressed with how the 25 community behavioral health centers are able to recruit," she said.

The CBHCs are funded with a combination of state budget appropriations, MassHealth and an assessment on commercial payers, according to a Health and Human Services spokesperson. The fiscal year 2023 budget included funding for the centers and language to create the payer assessment.

The state is investing more than $200 million to roll out the implementation of CBHCs, through $19 million in start-up funding in preparation for the centers' launch and $130 million annually in increased funding and bundled MassHealth rates for outpatient, urgent and crisis services provided to MassHealth members, the spokesperson said. Around $75 million will go toward 24/7 community and mobile crisis intervention.

There is also enhanced funding to support CBHC staff, and the centers are also considered "priority providers" for direct state workforce investments, such as the $130 million Baker announced last month to go toward primary care and behavioral health loan repayment.

The East Boston-based CHBC will serve residents of Chelsea, Revere, East Boston, Winthrop and Charlestown, but the centers will be spread across the state.

The state so far has announced opening four centers to service central Massachusetts, three for the northeast area of the state, five in metro Boston, four in western Massachusetts, and five covering the southeast area, including the Cape and islands.

They are just one part of "a much larger series of initiatives," Baker said Thursday, including the 24/7 hotline and policies included in the expansive mental health care bill enacted this summer.

The new law Baker signed in August seeks to rein in the emergency department boarding crisis, eliminates a prior authorization requirement for mental health acute treatment, and requires commercial insurers to cover emergency service programs.

Still, with mental health laws under his belt and funding for substance abuse disorder quintupled during his tenure as governor, Baker said Thursday that there is more work to do when Gov.-elect Maura Healey takes his spot in the corner office.

"My recommendation to the next administration would be, this is -- this was always an issue," he said. "Even in a state like Massachusetts, which does well relative to others across the country, it was exacerbated by the pandemic, it's been exacerbated by social media, and I really do believe this is a place and a space where we're going to continue to need to make investments."

Written by Sam Drysdale/SHNS

WBZ's Carl Stevens (@CarlWBZ) reports

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