Provider Updates on Community Mental Health
November 13, 2023
Legislators are taking a long vacation, putting parity on hold.
Both chambers passed resolutions this past Thursday, setting Nov. 14 as its “sine die” session, in which the Legislature adjourns without date, meaning that, barring an unexpected special session called by the Governor, lawmakers won’t return until Jan. 10. Even then it will be for a ceremonial event with no formal votes likely until May 2024. Before the legislature left, they failed to take action on HB 4707, the Mental Health Parity legislation. Read - A federal law demands mental health care parity. Why don't kids in Michigan get it? Detroit Free Press.
Telehealth Moving Forward
Before it adjourned last week, Michigan's House passed legislation ensuring telemedicine services are covered by health insurers, Medicaid, and Healthy Michigan at the same rates as in-person visits. This move aims to address doctor shortages and increase care access, especially in mental health and substance abuse. The COVID-19 pandemic demonstrated telemedicine's effectiveness, leading to a push to make temporary equal payment rates permanent. While receiving support from medical associations, the bill faced opposition from Blue Cross Blue Shield and concerns over potential oversight issues and cost increases from some conservative lawmakers. The Blues are also planning to launch their own telemedicine product and see these bills as a threat. State law temporarily allowed telemedicine coverage to be paid for at the same rate as in-person visits. HB 4213, HB 4579, HB 4580, and HB 4131 make this permanent. However, there is some confusion over an existing state law that requires payment for Medicaid services. As these bills move to the Senate, we will work to seek further clarification as to what the law is and what needs to happen to ensure the state is enforcing them. ****The State is proposing changes to a Medicaid policy on telehealth. You can find that policy and where to provide the state comments in another story below****
CCBHC Expansion
Senate Finance Committee Passes Stabenow Legislation to Expand Mental Health Services and Workforce
The Senate Finance Committee has approved legislation introduced by Senator Stabenow to bolster mental health services, addressing a crucial need for more professionals in the field. Stabenow's bill, part of a larger bipartisan effort, seeks to widen the scope of behavioral health care and enhance the support system for social workers and mental health providers. Key measures include extending Medicare incentives to attract professionals to underserved areas, mandating Medicaid to help states improve their mental health workforce, and ensuring social workers can fully serve Medicare beneficiaries. Additionally, the legislation solidifies the role of Certified Community Behavioral Health Clinics in Medicaid, sustaining their transformational community care model. This legislative effort builds on Stabenow's ongoing commitment to mental health, following last year’s initiative that significantly funded mental health and addiction services across the United States. Source: Stabenow News Release. Find additional testimony from the hearing during the Senate Finance Committee meeting.
RFP Announced
MDHHS Releases Comprehensive Health Care Program RFP
The Michigan Department of Health and Human Services (MDHHS) recently released a request for proposals (RFP) for a new Comprehensive Health Care Program (CHCP) contract for the state’s Medicaid health plans. The CHCP managed care program covers approximately 2.2 million Michiganders receiving coverage through Medicaid and the Healthy Michigan Plan and is worth $15 billion. MDHHS Director Elizabeth Hertel discussed the impact of the CHCP. "Through this rebid process, MDHHS will select Medicaid health plan contractors with the experiences, capabilities, and commitment to deliver an equitable, coordinated, and person-centered system of care that will ultimately provide Michigan residents with a healthier future."
The CHCP rebid is part of MIHealthyLife, an initiative MDHHS launched in 2022 to strengthen Medicaid services through new Medicaid health plan contracts. MIHealthyLife is an initiative that brings MDHHS and its partners—including health plans, providers, and communities—together to create a more equitable, coordinated, and person-centered system of care. MDHHS received input from nearly 10,000 enrollees, family members, healthcare providers, and health plans to strengthen Medicaid managed care contracts when the CHCP was initially launched.
Medicaid managed care organizations (MCOs) serve ten regions, and MCOs will bid on one or more regions. Each region requires at least two plans except Region One, a rural area that includes the state’s Upper Peninsula, where members are enrolled in a single plan. RFP proposals are due on Jan. 16th, 2024, and implementation is anticipated to begin on Oct. 1st, 2024. Contracts will run through Sept. 30th, 2029, with three one-year optional periods.
Conflict-Free Access and Planning (CFA&P)
MDHHS Survey on CF&P
MDHHS is gathering feedback about the potential impacts of Conflict-Free Access and Planning (CFA&P) implementation as required by the 2014 HCBS Final Rule and several other federal regulations. These federal rules require that providers responsible for assessments and planning CANNOT provide direct services. MDHHS wants to understand how this rule implementation will impact providers in Michigan, such as your organization. MDHHS has heard from various stakeholders, including CMHs, PIHPs, and beneficiaries. The survey below is being distributed to gather feedback from providers. Your feedback will be compiled and provided to MDHHS to inform CFA&P implementation. For more information about CFA&P and to complete the survey, please visit https://www.surveymonkey.com/r/CFAPFeedback. The survey will be open for responses until 5 pm Monday, 11/20/2023. Please enter your organization's response by that time. If you have any questions about how to complete this survey or if you have additional feedback, please email mdhhs-conflictfreeaccess@michigan.gov.
TELHEALTH. Comments Needed
Public Comment Review of Proposed Medicaid Policy
Below, find the proposed Medicaid policy changes ((Project #2345-Telemedicine) for your public comment review. The proposed policy discusses telemedicine authorized provider updates. Comments on this proposed policy are due December 13, 2023, and should be emailed to Laura Kilfoyle at KilfoyleL@michigan.gov.
SUD Transportation Awards Given
MDHHS awards $2.7 million to expand transportation services for substance use disorder treatment and recovery
In a significant move to combat overdose fatalities, the Michigan Department of Health and Human Services (MDHHS) has allocated $2.7 million across 17 grants aimed at bolstering transportation for those in need of substance use disorder treatment and recovery services. Recognizing transportation as a critical barrier, especially in rural and underserved areas, MDHHS is channeling opioid settlement funds to diminish this obstacle. MDHHS Director Elizabeth Hertel emphasized that the initiative will alleviate individual hurdles in treatment and recovery, thereby facilitating equitable access to a comprehensive care continuum. The funding will enable agencies to enhance transportation capacity, offering gas cards, bus passes, and taxi/rideshare vouchers, ensuring patients reach necessary appointments and support services.
Awardees:
Blue Water Recovery & Outreach Center (St. Clair County) – $194,338
CARE of Southeast Michigan (Macomb County) – $18,455
Community Mental Health Services of Muskegon County (Muskegon County) – $199,659
CRC Recovery (Kent and Washtenaw Counties) – $139,525
Grand Traverse Band of Ottawa and Chippewa Indians (Leelanau County) – $101,437
Great Lakes Recovery Centers (Marquette County) – $200,000
Home of New Vision (Jackson County) – $200,000
List Psychological Services (Sanilac County) – $200,000
Live Rite Structured Recovery Corp (Macomb County) – $200,000
Mid-Michigan Recovery Services (Ingham County) – $150,059
Our Hope Association (Kent County) – $200,000
Quality Behavioral Health (Wayne County) – $200,000
Sacred Heart (Berrien, Mackinac, and Macomb Counties) – $156,931
Saginaw Chippewa Indian Tribe of Michigan (Isabella County) – $194,776
Serenity House of Flint (Genesee County) – $200,000
WAI-IAM (Ingham County) – $120,371
Wedgwood Christian Services (Kent County) – $112,211
The award period begins Nov 1, 2023, and ends Sept. 30, 2024. Additional information regarding proposed programming under Michigan’s Opioid Healing and Recovery Fund is provided on the opioids settlement website.
Grant Announced.
$100,000 MolinaCares Grant Powers U-M Health Equity Challenge
The University of Michigan School of Public Health is set to spearhead the Michigan Health Equity Challenge, thanks to a $100,000 grant from The MolinaCares Accord in collaboration with Molina Healthcare of Michigan. This challenge encourages graduate students to design and implement innovative, community-driven solutions to address the state’s health disparities. Ten finalists will partner with local organizations, supported by stipends and mentorship, to bring their ideas to life. The best projects, determined by an independent committee, will receive additional funding for real-world application, aiming to make a tangible difference in health equity across Michigan communities. For further details or participation inquiries, visit mihealthequitychallenge.org.
MDHHS Reports.
MDHHS issues update on the work of Michigan’s Behavioral Health and Opioid Health Homes
Michigan’s Behavioral Health Homes (BHH) and Opioid Health Homes (OHH) have been doing cutting-edge work for nearly a decade. MDHHS recently summarized the work and outcomes of Michigan’s BHH and OHH systems. That summary is contained in the slides found here. Source CMHAM.
White House Mobilizes on Opioid Crisis.
Biden Administration Seeks $1.55 Billion Boost to Combat Overdose Crisis
The White House's Office of National Drug Control Policy Director, Dr. Rahul Gupta, emphasized the urgency for Congress to act on President Biden's request for additional funding to combat the U.S. overdose epidemic. The Biden-Harris Administration is seeking $1.55 billion to expand the State Opioid Response grant program, which has already provided treatment for over 1.2 million people and distributed millions of overdose reversal kits. This funding aims to bolster addiction treatment, overdose prevention, and recovery support nationwide. Additionally, President Biden is requesting over $1.2 billion to enhance drug trafficking enforcement, including measures to curb the flow of fentanyl. Addressing the overdose epidemic is a key pillar of President Biden's Unity Agenda, marking it as a bipartisan priority and a top concern for the Administration. Source: The White House. Want to learn more about POTUS’ key priorities and how The White House is asking Congress to Deliver Critical Resources to Address the Nation’s Overdose Epidemic? Visit The White House.
Children’s Behavioral Health.
Collaborating to Improve Children’s Behavioral Health
Investments in children's behavioral health are crucial for fostering resilience and well-being, with Medicaid serving as a key platform for enhancing services for over 40% of U.S. children. Health Management Associates (HMA), in partnership with the National Association of State Mental Health Program Directors, has produced briefs highlighting the need for coordinated services and cross-system reforms to address children's mental health. These reforms advocate for integrated financing, improved care coordination, and upstream prevention efforts, emphasizing socio-emotional well-being as essential to childhood development. HMA and partners, including federal agencies, are convening state agencies to promote collective approaches to child-centered care and develop more efficient systems of care for behavioral health needs. Upcoming events and webinars will continue the dialogue, offering insights and strategies to improve children's behavioral health services. Find links to those briefs and additional resources here.
K.B. settlement update.
In Michigan, however, we hear rumors within the MDHHS that something is happening with the settlement of the K.B. lawsuit. Here is an article from 2021 about the settlement. We will continue to monitor the settlement.
Supporting Teenagers Today.
These Teens Got Therapy. Then They Got Worse. See story in The Atlantic.
Other Voices.
60 Years Post Landmark Act, New 90-90-90 Mental Health Goals Set, a Chicago Sun-Times Editorial
The Community Mental Health Act of 1963, signed by President Kennedy, transformed the mental health system by promoting community-based care. Celebrating its 60th anniversary, mental health advocates, including Patrick J. Kennedy, have set ambitious 90-90-90 goals for screening, treatment, and management of mental health and substance use disorders by 2033. Illinois has made strides in mental health care with initiatives like the 988 crisis line, "living rooms" for crisis intervention, and expanded insurance coverage for mental health services. Despite progress, disparities and access barriers persist, requiring continued advocacy for funding and policy improvements to fulfill the Act's promises. The editorial emphasizes prioritizing mental health and building a more equitable system to ensure comprehensive care. Find the editorial here.
What else am I reading?
Decriminalizing Drugs in Oregon.
Oregon Decriminalized Hard Drugs. It Isn’t Working. The Wall Street Journal.*
Meth over Opioids
A Monster: Super Meth and the Crisis Beyond Opioids. Read the story in The New York Times.*
*Paywall