Department outlines conversion of human service centers to CCBHCs and seeks youth crisis pilot funding

Pam Segnus, executive director for Behavioral Health, and Tony (Antonio) Berning Seely, director of operational development and compliance, gave the committee an overview of the Department of Health and Human Services’ plan to convert state human service centers into state‑operated behavioral health clinics (CCBHCs) and outlined budget requests and operational needs.

The presentation and discussion

Segnus and Tony said the department has eight regional clinics and three satellite clinics offering integrated mental‑health and substance‑use outpatient care, crisis services, psychiatric and psychological evaluations, case management, rehabilitative services and peer supports. The department reported 10,382 adults served with 231,860 services and 2,380 youth served with 63,310 services during the last biennium.

Tony described the clinics’ role as a state safety net for people who lack access to community services. Clinic activities include 24‑hour crisis hotlines, mobile response teams, crisis residential beds where available, and regional drop‑in centers in some areas. He said the department has increased peer support positions and is developing formalized care‑coordination functions to help people navigate benefits, treatment and community services.

CCBHC timeline and scope

The department is participating in federal planning and pilot work for CCBHC certification. Tony said the official certification process will not be complete until 2026; the department has received a $1 million planning grant to prepare for implementation. The CCBHC scope includes screening and triage, outpatient mental‑health and substance‑use treatment, psychiatric rehabilitation, peer and family caregiver support, and coordination with primary care, veterans’ services and other partners.

Youth crisis stabilization pilot request

Tony highlighted a decision package requesting $6 million (split $3 million general fund, $3 million federal) to pilot youth crisis stabilization services. He told the committee that youth crisis calls are rising: in 2023 the department received more than 12,000 calls for ages birth‑17, with roughly 5,600 referred to human service centers for further crisis services. The department said youth crisis infrastructure is incomplete in North Dakota — partial hospitalization and youth crisis residential spaces are limited — and described the pilot as a way to provide short‑term crisis resolution, reduce out‑of‑home placements and limit juvenile‑justice involvement.

Budget lines, carryover and questions

Courtney Peterson (assistant CFO, Behavioral Health) and other finance staff explained requested carryovers: $6.4 million of SIF (CCBHC transition) funding designated to specific human service centers and $4.15 million repurposed from prior appropriations. During questioning committee members asked about a roughly $7 million discrepancy in what the department thought had been appropriated for 2023–25; the department said reconciliation found that funds it expected were not present in the final legislative appropriation and promised to work with fiscal staff and legislative counsel to identify the cause.

Regional capacity and gaps

Tony walked through crisis coverage differences by region: some regions lack a staffed crisis residential provider or drop‑in center due to workforce shortages; others have limited nighttime capacity because a single on‑call worker covers large geographic areas. The department said telehealth and partnerships (for example, integrated telehealth services inside county jails) help extend reach. Committee members asked for detail on jail telehealth locations and on interactions with telehealth provider Avel eCare; staff said the region slides would include those specifics.

Why it matters

Conversion to the CCBHC model changes the clinics’ operating expectations (expanded hours, integrated services and standardized quality measures) and could change funding needs and workforce arrangements. Lawmakers pressed the department on concrete timelines, workforce recruitment and the scope of new residential or inpatient needs. The $6 million youth crisis package and the earlier SIF transition funds together aim to reduce strain on emergency departments, avoid juvenile placements and provide a more consistent regional crisis continuum.

Ending

Segnus and Tony told the committee they will provide additional reconciliation on the $7 million appropriation discrepancy, more detail about regional crisis‑unit capacity, and clearer numbers on carryover and capital requests. The department said it expects official CCBHC certification activity to conclude in 2026 and plans to use the 2024–26 period to build capacity, partnerships and the operational framework required for certification.