Working With a Designated Collaborating Organization (DCO)

CCBHCs can establish formal relationships with designated collaborating organizations (DCOs) to provide certain services.

Program Requirements: Scope of Services

The certified community behavioral health clinic (CCBHC) criteria require that CCBHCs provide a range of services, either directly or by establishing a formal relationship with other providers. These other providers are known as designated collaborating organizations (DCOs).

Certain services can only be provided by the CCBHC directly. These services include:

  • Comprehensive behavioral health screening, assessment, and diagnosis, including risk assessments
  • Person-centered and family-centered treatment planning
  • Comprehensive outpatient mental health and substance use disorder services

The CCBHC criteria also state that the CCBHC must directly provide crisis behavioral health services, “unless there is an existing state-sanctioned, certified or licensed system or network for [their provision] that dictates otherwise” and can act as a DCO. Other required services may be provided by a CCBHC directly, by a DCO, or by both.

Formal Relationship With the DCO

The formal relationship with a DCO is critical because the CCBHC is ultimately clinically responsible for all care provided, whether those services are directly provided by the CCBHC or provided by a DCO.

The CCBHC criteria define this formal relationship as “a contract, Memorandum of Agreement (MOA), Memorandum of Understanding (MOU), or such other formal arrangements describing the parties’ mutual expectations and establishing accountability for services to be provided and funding to be sought and utilized.”

Requirements From the Criteria

The Department of Health and Human Services (HHS) has developed criteria for CCBHC certification. Access the complete CCBHC certification criteria – 2016 (PDF | 755 KB).

The CCBHC criteria include several requirements pertaining to DCOs. These requirements should be considered as part of the formal relationship agreement.

General Requirements for DCOs

  • DCO-provided services must meet the requirements related to those services specified in the CCBHC criteria’s “Program Requirement 4: Scope of Services,” as well as any state-implemented requirements
  • DCO-provided services must be provided in a manner aligned with the requirements of Section 2402(a) of the Affordable Care Act (PL 111-148) (PDF | 2.4 MB), titled “Removal of Barriers to Providing Home and Community-Based Services.” Under this section, services must reflect person- and family-centered, recovery-oriented care; be respectful of the individual consumer’s needs, preferences, and values; and ensure consumer involvement and self-direction of services. Services for children and youth should be family-centered, youth-guided, and developmentally appropriate.
  • CCBHC consumers receiving services from a DCO must have access to the CCBHC’s existing grievance procedures.

DCO Staffing and Training

  • DCO staff providing services to CCBHC consumers must be appropriately licensed, certified, registered, or credentialed
  • The CCBHC training plan must address training for DCO staff providing services to CCBHC consumers

Care Coordination

Data Collection and Reporting

Some of the CCBHC’s data and quality reporting measures might require access to data from DCOs. The CCBHC is responsible for arranging access to such data as legally permissible upon creation of the relationship with DCOs. The CCBHC must also ensure adequate consent, as appropriate, and obtain releases of information for each affected consumer.

Last Updated: 03/16/2023