The Vermont Department of Mental Health made good on a promise to replace the term “Certified Community Behavioral Health Clinic” this spring.

DMH had inherited the nomenclature from a federal program at the Substance Abuse and Mental Health Services Administration. SAMHSA’s model – which aims to offer “comprehensive, coordinated, trauma-informed, and recovery-oriented care for mental health and substance use conditions” – will guide expansion plans at Vermont’s community mental health centers, but while preserving the abbreviation “CCBHC,” they will call themselves “Certified Community-Based Integrated Health Centers” instead.

Counterpoint has long opposed the use of “behavioral health” as a synonym for “mental health” on the basis that it implicitly characterizes mental health struggles in terms of bad behavior, in which suffering becomes a potentially blameworthy disruption or impoliteness. Last year, Vermont became one of 15 states to win a $1 million federal grant to develop a network of CCBHCs, but DMH pledged to develop a different name for them.

In the meantime, however, planning began under the original nomenclature. Five of the ten nonprofit agencies that deliver mental health services on behalf of the state won grants of their own to start the process of becoming CCBHCs.

Soon, the term started to migrate beyond the closed doors of policymakers. The Clara Martin Center achieved compliance with SAMHSA’s standards first and began to advertise itself on its website as a Certified Community Behavioral Health Clinic in prominent text.

DMH revealed its reworking of the initialism in a May 6 press release publicizing an extension of its aforementioned planning grant, which will give officials an additional year to develop a certification program for CCBHCs. The press release declared that “the term ‘behavioral health’ does not align with DMH values.” “Certified Community-Based Integrated Health Center,” on the other hand, “reflects ongoing integration efforts across the state.”

Last year, DMH convened a CCBHC Steering Committee composed of mental health providers, advocates, and peers. During two polls, members voted to turn “CCBHC” into “Certified Community-Based Health Center.”

DMH chose “Certified Community-Based Integrated Health Center” instead, telling the committee that the addition of “Integrated” would help avoid confusion with Federally Qualified Health Centers. Some members argued that the CCBHCs would not, in fact, offer integrated healthcare.

CCBHCs do not provide primary care services, but either directly or through a “designated collaborating organization,” they must administer “outpatient primary care screening and monitoring of key health indicators,” such as weight and tobacco use. Vermont’s community mental health centers expect to hire additional nurses as they become CCBHCs.

In January, Vermont’s Mental Health Integration Council endorsed the development of CCBHCs. Its final report to the legislature highlighted their promise to establish “a standard definition for care coordination across primary care and mental health,” but the recommendation was not unanimous, as some members worried that CCBHCs “may further separate people with mental health needs from physical health care,” according to the document.

SAMHSA first developed the criteria for CCBHCs in 2015. Howard Center, Northeast Kingdom Human Services, Health Care and Rehabilitation Services of Southeastern Vermont, and Rutland Mental Health Services have begun work toward compliance. Certified entities can access enhanced Medicaid reimbursement rates.

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