4C Health reports sharply increased services after joining CCBHC pilot; will not bill county mental‑health levy for 2025–28

Carrie Cadwell, chief executive officer of 4C Health, told the Pulaski County Board of Commissioners that the community mental health center has expanded services in the county after joining a federally approved, state‑run Certified Community Behavioral Health Center (CCBHC) pilot on Jan. 1.

Cadwell said 4C Health provided more than 29,000 services to Pulaski County programs in the last fiscal year — a 67% increase over the year prior — and served 473 Pulaski County residents during the July 1–June 30 fiscal year. The agency recorded 241 admissions in the county during the year, about 49% of them first‑time admissions, Cadwell said. She gave a payer‑mix breakdown for Pulaski County clients as 64% Medicaid (or HIP), 15% Medicare, 14% commercial insurance and 7% self‑pay.

Cadwell and Nicole Hajadre, 4C Health chief clinical officer, described services now available locally: outpatient therapy for behavioral health and substance use; psychiatric medication management; school‑based, home‑based and community services; mobile crisis response; an assertive community treatment (ACT) team offering 24/7 supports for people with serious mental illness; peer recovery services; and psychiatric urgent care (located in Peru, which Pulaski County residents can access). Hajadre said the mobile crisis team, now in its fifth year, has handled just under 1,000 calls since inception and averaged roughly 30 deployments per month in 2025; more than half of deployments are stabilized in the community.

Cadwell said participation in the CCBHC pilot changed the center’s reimbursement model and enabled hiring and service expansion, including a nurse practitioner specializing in medication‑assisted treatment for substance use, enrollment of 18 people in the new ACT team, same‑day access at the county office and a planned community navigator position funded by the pilot model. Cadwell said 4C Health purchased the Curtis Building in Pulaski County to establish a permanent local clinic location and expects to open it within about a month.

On funding, Cadwell told commissioners that because the CCBHC pilot changes how the center receives federal/state matching funds for Medicaid, 4C Health will not invoice or request the county mental‑health levy amounts budgeted for calendar years 2025–2028. She estimated counties covered about $125,000 per year for Pulaski County under the old levy arrangement and said across the counties 4C serves the decision represents approximately $500,000 over four years that the counties will retain. Cadwell characterized the move as a gesture intended to ease county budget pressures during the pilot period; she said it does not change 4C Health’s service obligations to the county.

Commissioners asked clarifying questions about the 67% growth figure, which Cadwell said refers to the number of services delivered (the 29,000 figure) rather than the number of individual clients; resident counts rose modestly from about 460 to 473 Pulaski County residents in the year cited. Commissioners also asked whether navigation services would duplicate an existing county navigator; Cadwell said the CCBHC navigation role is a pilot requirement and must be available to people regardless of payer, and that 4C Health’s navigation would focus on meeting people where they are and connecting them to the right provider, whether 4C or another local provider.

Hajadre described jail programming that now includes two tracks — an education/outreach track and a clinical treatment track — with certified peers offering one‑on‑one support, trauma groups and intensive outpatient (IOP) substance‑use programming. For higher‑acuity patients, 4C Health provides no‑cost clinical assessments, psychiatric evaluations, medication management and individual therapy in coordination with jail medical staff, and tries to bridge services for 30–60 days after release.

The presentation included an anonymized success example of a person who entered family treatment court, completed treatment, obtained a GED and connected to employment and peer supports; Hajadre used the example to illustrate how coordinated services across courts, probation, child welfare and providers can affect outcomes.

No formal county action was recorded on 4C Health’s decision about the levy; commissioners received the report and asked for clarifications during the meeting.