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Industry History

Below is a list of how the community mental health industry has changed over time, including important legislation and how CHFF responded

Legislation
Industry Impact
CHFF's Response

1980 and before
 

Willowbrook Consent Decree

Other Federal Legislation (1) 

  • ​Developmental Disabilities Assistance and Bill of Rights Act 1975; Education for All Handicapped Children Act of 1975; Civil Rights of Institutionalized Persons Act of 1980

Deinstitutionalize Treatment Settings

Capital for facility acquisition

1990 - 2000

American Disabilities Act

 

Olmstead Decision 

Deinstitutionalize Treatment Settings

Capital for facility acquisition 

2000 - 2010

Mental Health Parity Act

Integrate Delivery Settings  

Consolidation 

Technology 

Capital for facilities and technology

2010 - 2020

Affordable Care Act

Integrate Delivery Settings

Consolidation

Technology

Growth in Demand

Capital for facilities and technology

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Financial sustainability assistance

2020+

Affordable Care Act

Integrate Delivery Settings

Consolidation

Technology

Growth in Demand

Financial sustainability assistance

CHFF was formed in 1991 to assist in the deinstitutionalization of large psychiatric institutions by providing capital to behavioral healthcare organizations to acquire community-based facilities.  At the time, banks were reluctant lenders to this new type of organization and CHFF provided much needed capital. 

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Deinstitutionalization and demand for capital financing continued to grow throughout the 1990s supported by the American Disabilities Act and the Olmstead Supreme Court Decision.  CHFF provided debt financing for the acquisition and renovation of community-based facilities.

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The Mental Health Parity Act and the Affordable Care Act provided new opportunities and challenges for community-based behavioral health care organizations. 

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The growth and maturation of CBHOs coincided with the challenge of adopting new technologies for electronic health records and digital clinical and payment systems.  These technologies required investment in computer software and hardware and once again CHFF assisted with capital to meet these needs.

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CBHOs are challenged again to continue their integration with the larger health care system and meet new demands for growth while providing value. Capital is more available for the growth of nonprofit and for-profit providers with debt and equity.  Long-term sustainability requires using this capital most efficiently and choosing organic growth or consolidation to achieve it.  

To help address this next generation of challenges, CHFF developed Destination, which provides an interactive financial analysis and planning application based on decades of experience in the evolution of CBHOs. 

CHFF in the industry, a brief history

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