Hawaii is set to overhaul how it delivers mental health and substance use treatment, after being tapped for a ten-state federal Medicaid demonstration that could reshape care across the islands. Under the Certified Community Behavioral Health Clinic, or CCBHC, model, community clinics receive steadier Medicaid funding and a wider menu of services, which is intended to support 24/7 crisis response, outpatient care and long-term recovery support. State leaders say the shift should boost capacity in under-served neighborhoods and help stabilize services on neighbor islands that have long struggled to keep pace with need.
The U.S. Department of Health and Human Services named Hawaii as one of 10 states newly selected for the CCBHC Medicaid Demonstration Program, which is designed to expand access to comprehensive mental health and substance use disorder treatment through sustainable Medicaid financing, according to HHS. The federal announcement lists Alaska, Colorado, Hawaii, Louisiana, Maryland, Mississippi, Montana, North Dakota, Washington and West Virginia as the latest additions. HHS said participating CCBHCs are paid through a prospective payment system that is intended to match the projected cost of delivering the required scope of services.
Gov. Josh Green called the selection a nod to Hawaii’s recent investments in crisis centers, kauhale housing projects and tighter care coordination, as reported by Kauai Now. According to the local outlet, the state plans to roll out the Demonstration through a partnership between the Department of Health and the Department of Human Services’ Med-QUEST Division. Joseph Campos II, who leads the department, told Kauai Now that ensuring access to high-quality behavioral health services remains a central Med-QUEST priority.
What CCBHCs must provide
Federal rules require CCBHCs to deliver a wide range of services, including round-the-clock crisis care, timely outpatient mental health and substance use treatment, intensive case management, peer support and basic primary care screening, no matter a person’s ability to pay, according to CMS. The Demonstration also expects states to certify eligible clinics, track and report quality data and set up a prospective payment system so that Medicaid reimbursement is predictable instead of fluctuating with each visit.
Local timeline and impact
Hawaii has been working under a CCBHC planning grant since December 2024, with the planning period scheduled to end on June 30, 2026, local officials told Kauai Now. Two Adult Mental Health Division clinics on Maui, located in Kahului and Lahaina, are slated to seek full CCBHC certification by Jan. 1, 2027. Those facilities now serve more than 1,700 Maui residents and are expected to broaden and better coordinate services once the new model is in place. State leaders say the planning work is meant to lock in certification standards and payment policies so clinics are ready when the four-year Demonstration officially begins.
What comes next
HHS noted that the CCBHC framework has expanded rapidly since its 2017 debut and now includes more than 500 clinics operating in 46 states, the District of Columbia and Puerto Rico, according to the federal announcement. In the coming months, Hawaii officials and Med-QUEST will move to certify participating clinics, stand up the Medicaid prospective payment system and gradually bring sites into the Demonstration, state and federal officials said. If you or someone you know is in crisis, call or text 988 for immediate support.
