Provider Updates on Mental Health and SUD Services in Michigan
November 20, 2023
Enhancing Health Equity and Diminishing Health Disparities
MDHHS to Launch Innovative SDOH Hub Pilots in Michigan
The Michigan Department of Health and Human Services (MDHHS) recently announced the launch of five Social Determinants of Health (SDOH) Hub pilots, set to commence in January 2024. These hubs are a part of the 2022-2024 MDHHS SDOH Strategy, aptly titled "Michigan’s Roadmap to Healthy Communities." The initiative seeks participants from across the state to join the SDOH Hub Advisory Council, aiming to synergize state and local resources for a heightened impact in communities.
The SDOH hubs represent a collaborative effort, uniting community members, healthcare and social care professionals, social workers, housing providers, government partners, and business leaders. This coalition strives to address various non-medical factors that significantly influence health outcomes, such as food and housing access, transportation, and other social drivers. By fostering a shared mission, these hubs encourage local entities to work towards a unified goal collaboratively - reducing health disparities based on the specific needs of their communities. MDHHS Director Elizabeth Hertel emphasizes incorporating community feedback and experiences to enhance health equity and diminish health disparities. The first cohort of SDOH Hub pilot projects will be discussed at the second annual SDOH Virtual Summit from January 23 – 25, 2024. This event, marking the launch of phase III of the Roadmap initiatives, will showcase various community approaches to addressing SDOH and advancing health equity in Michigan. Community residents and partners are encouraged to attend the SDOH Summit to gain insights into the social factors impacting health and the efforts underway to support Michigan communities.
For more information on the SDOH Hubs and to apply for a position on the SDOH Hub Advisory Council, interested parties are encouraged to visit the MDHHS website. Queries regarding the SDOH Hub pilots can be directed to MDHHS-SDOH-PolicyandPlanning@michigan.gov.
CCBHC
CCBHC Definition Added During Senate Mark-up of Better Mental Health Care, Lower-Cost Drugs, and Extenders Act
On November 8, the Senate Finance Committee held a markup of the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. Sen. Debbie Stabenow (D-MI) proposed an amendment to define Certified Community Behavioral Health Clinics (CCBHCs) in the statute. The amendment would add a definition for CCBHCs within the Medicaid program, including the nine essential CCBHC services, based on provisions within the Ensuring Excellence in Mental Health Act (S.2993). The committee chair adopted these changes in the mark-up, and the committee voted unanimously to advance the amended version of the package. To read more, click here. Source: National Council for Mental Wellbeing
Telehealth
Senate Finance Committee Holds Hearing on Telehealth Flexibilities
On November 14, the Senate Finance Subcommittee on Health Care convened a hearing titled “Ensuring Medicare Beneficiary Access: A Path to Telehealth Permanency.” Members of the subcommittee and witnesses discussed making the telehealth flexibilities established during the COVID-19 Public Health Emergency (PHE) permanent. The committee explored a wide array of subjects, ranging from remote prescribing of controlled substances to the utilization of telehealth for mitigating the healthcare workforce shortage. Witnesses emphasized preserving coverage of audio-only visits and allowing controlled substances that are not Schedule II to be prescribed during telehealth visits. Members also noted the lack of access to mental health and substance use disorder services in the United States and discussed how telehealth can improve access to care. Source: National Council for Mental Wellbeing
Workforce Shortage
As Bridge Michigan has noted throughout the year, Michigan is battling a severe shortage of key players in the healthcare field, from medical assistants to case managers, primary care doctors, nurses, and resident care aides. But nowhere is that shortage more persistent or difficult to fill than with child and adolescent psychiatrists. Health reporter Robin Erb notes that the state would need more than 200 more specialists to bring us up to recommended standards, a gap that’s become even more urgent to fill amid a surge in anxiety and depression among young people. See the story in Bridge Magazine.
Home-Based Care
The Home and Community-Based Services (HCBS) Relief Act (S. 3118) proposes additional two-year funding for states to enhance Medicaid HCBS, which provides essential support to people with disabilities, enabling them to live in their homes and communities. The support includes assistance with employment, mobility, personal care, and medication management. The urgency of this support is highlighted by the fact that over 650,000 people are currently on waiting lists for these services. The stagnant Medicaid payments have also resulted in underpaid direct care workers, with unpaid family caregivers often compensating for the service gaps. The HCBS Relief Act aims to address these issues by increasing the federal Medicaid match (FMAP) by 10 points for two years, facilitating improved pay for direct care workers, offering benefits like paid leave, covering transportation expenses, supporting family caregivers, and funding the recruitment and training of more direct care workers. To support this legislation to aid people with disabilities and their families, you can send a letter to the Congressional Delegation from The Arc’’s website.
Rep. Thompson Calls for House Hearings on Detroit Area Mental Health Facilities
State Representative Jamie Thompson (R-Brownstown) has requested the House Behavioral Health Subcommittee, chaired by Felicia Brabec (D-Ann Arbor), to hold a hearing regarding failures in the state juvenile mental health system, particularly affecting families in greater Detroit. Thompson highlighted concerns at the Walter Reuther Psychiatric Hospital, where children are housed in an adult facility, and the Hawthorn Center in Novi, which has faced requests for an audit and lawsuits over an unannounced shooter drill. Thompson raised issues such as communication barriers, health concerns, inconsistent education, and limited recreational opportunities in these facilities. She emphasized the need for accountability and remedies for these issues. The request for the hearing, supported by mental health advocacy groups and co-signed by Representatives Kathy Schmaltz (R-Jackson) and Alicia St. Germaine (R-Harrison Township), aims to address these challenges urgently. Source MIRS
SUD Updates
Biden-Xi Agreement Targets Fentanyl Precursors in China Amid U.S. Overdose Crisis
President Joe Biden and Chinese leader Xi Jinping reached an agreement last week to combat the production and export of fentanyl precursors from China, a significant move considering the escalating fentanyl-related deaths in the U.S. This agreement focuses on restricting the manufacturing and export of these chemicals from China to Mexico, a major source of fentanyl in the U.S.
In 2021, nearly 107,000 Americans died from drug overdoses, with three-quarters involving opioids, primarily synthetic opioids like fentanyl, as reported by the CDC. The U.S. overdose death rate involving fentanyl has more than tripled from 2016 to 2021.
The effectiveness of this agreement hinges on China's law enforcement actions and sustained commitment. Experts caution that the impact may be limited and dependent on geopolitical factors, noting that previous cooperation on fentanyl was affected by broader tensions between the U.S. and China. The deal, while a step forward in disrupting drug trafficking, is not expected to resolve the fentanyl crisis in the U.S. completely.
Interested in monitoring how Michigan is spending its Opioid Settlement funds, here is the MDHHS website to view.
What else am I reading?
Behavioral Health Regulatory Outlook: Fight Over Parity, Changes to Telehealth Spill into 2024
U.S. Senator Debbie Stabenow and community mental health, Second Wave Media
The new campaign aims to address rising overdose deaths in communities of color.
Cities know the way police respond to mental crisis calls needs to change. But how?
MDHHS officials recently provided testimony in Lansing, updating the legislature on their activities around the end of the public health emergency (PHE). The slides from that testimony can be found here. Source CMHAM.
MI Certified Community Behavioral Health Clinic (CCBHC) Handbook (Oct 2023)
Rosalynn Carter, former first lady and tireless humanitarian who advocated for mental health issues, dies at 96
Former First Lady Rosalynn Carter has been a driving force in mental health throughout her public service career. According to this story on NPR,
In the White House, Carter's top priority was mental health. It was a passion she developed years earlier when she was campaigning across Georgia and heard from people who had family members struggling with mental health. At the time, there were few community-based mental health services in Georgia, especially for children, and Carter became concerned by the deficiencies in state resources, which included hospitals and institutions that were known for mistreating patients. As first lady of Georgia, Carter encouraged her husband to establish a governor's commission on mental health, which outlined an influential plan to shift treatment from large institutions to community centers. Carter was also an early advocate for reducing the stigma around mental illness and, in speeches, often framed mental health care as "a basic human right." In 1980, President Carter signed the Mental Health Systems Act, which provided grants for community mental health clinics, one of many achievements credited, at least in part, to his wife's advocacy in the U.S. and globally.