The work Jonathan Porteus does is changing.

“If you said to me 15 years ago, ‘What do you run?’ I would have said, ‘Oh, I run a behavioral health program. I run a federally qualified health center,’” says Porteus, CEO of WellSpace Health in Sacramento. “Now, if you say that, I say, ‘I run an FQHC and a CCBHC.’”

CCBHCs, or certified community behavioral health clinics, are distinct from federally qualified health centers, or FQHCs, once WellSpace’s bread and butter. The nonprofit, which serves low-income and destitute people, has grown rapidly due to Medicaid expansion initiated during Barack Obama’s presidency. But, as Porteus acknowledged for a February cover story (“The Crusading Doctor”), FQHCs alone aren’t his passion, with Porteus saying, “At the end of the day, it’s people who are most in distress who need us.”

The company has also hit some struggles in recent months, announcing layoffs for 135 employees earlier this year, according to the Sacramento Business Journal. Ben Avey, a WellSpace spokesman, says these layoffs were “across the board” and not confined to one area like FQHCs.

Now, WellSpace is strengthening its behavioral work, announcing on Oct. 9 that its CCBHC had received the Gold Seal of Approval from The Joint Commission. That nonprofit, which dates to 1951, is a global agency committed to improving health care, has accredited more than 23,000 health care programs or organizations nationally and began accrediting CCBHCs last year.

With WellSpace and Porteus in particular renowned among local leaders for behavioral work, doubling down on it could be both a strategic move for the company and a plus for the Sacramento region.

“I think it’s fantastic and well-deserved,” Sacramento County Supervisor Patrick Kennedy says of the accreditation. “We at the county know how important WellSpace is as a partner, but this just validates how good they are at what they do.”

What CCBHCs are

CCBHCs date to 2017 and provide substance use and mental health services to anyone who seeks it, according to the National Council for Mental Wellbeing.

Congresswoman Doris Matsui helped write legislation that established CCBHCs. In March, she praised President Joe Biden signing legislation establishing “a permanent definition of Certified Community Behavioral Health Clinic services under the Medicaid program,” according to a release at the time from Matsui’s office.

“When it comes to expanding access to comprehensive mental health care, CCBHCs have proven their ability to close the treatment gap and provide care when and where it’s needed most,” Matsui, who didn’t reply to an interview request, said in WellSpace’s release. “By volunteering to undergo the additional scrutiny of accreditation, WellSpace is going above and beyond to demonstrate their commitment to the CCBHC model and giving their patients the highest quality of care.”

WellSpace has had a CCBHC operating for two years at 1820 J St. in Sacramento, where it also has an FQHC, according to Avey. WellSpace is the first accredited CCBHC in Northern California and only the second in the state, according to an Oct. 9 release from WellSpace.

Previously, WellSpace was accredited for ambulatory care and behavioral health. To determine the new accreditation, Joint Commission reviewers made an unannounced visit to WellSpace in July and “evaluated compliance with 1,800 individual standards spanning all areas of care,” according to WellSpace’s release.

“This shows that not only the outcomes are good for WellSpace but also the procedures that they take and the policies that they have in place are also up to a gold standard,” Kennedy says.

How CCBHCs tie in with what WellSpace already does

While WellSpace to this point hasn’t been an accredited CCBHC, it’s done work that’s in the same vicinity, such as with its Crisis Receiving for Behavioral Health, or the “Crib” program at 7th and H streets in downtown Sacramento. WellSpace also has a philosophy that could be in keeping with the goal of CCBHCs to provide mental health or substance use services to anyone who needs them.

“They’ll see anybody who comes through the door, that’s first and foremost,” Kennedy says of WellSpace. “But they treat people with behavioral health as people who are suffering a medical condition and nothing more, nothing less. And they give them the best care possible.”

The nonprofit also operates a 988 crisis response line in much of the state.

In general, WellSpace has worked with a broad assortment of people in Sacramento County through its FQHCs, with more than 600,000 people receiving Medi-Cal services as of April 2023. “We do have more need in the region and particularly for the population that WellSpace serves and that’s the Medi-Cal population,” Kennedy says.

Sacramento County is also working with WellSpace to develop a 13-acre community wellness campus in south Sacramento that Avey says could eventually include a CCBHC and FQHC. In time, he says, the company would like to have a CCBHC at every one of its FQHCs.

To Porteus, there are two components to defining where WellSpace’s initial CCBHC is located: the actual physical location at 1820 J St.; and the broader shift in organizational mindset that comes with being a CCBHC.

For Porteus, the accreditation from The Joint Commission allows WellSpace to infuse its care delivery with the CCBHC principles, meaning the nonprofit has integrated substance use, mental health and behavioral health services into everything it does and then gone far beyond.

“That is an identity,” Porteus says. “That’s a way of thinking. It’s an identity, and it means you’ve got this level of integration, and you live by it.”

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