Kristie R. Schmiege, MPH, President Michigan Association of Substance       Abuse Coordinating Agencies
   Substance Abuse Coordinating Agencies    (CAs) were created in Article 6, Public Act    368 of 1978, the Public Health...
3
   Comprehensive Planning for SA    Treatment, Rehabilitation (Recovery) &    Prevention Services:    ◦ Needs Assessment ...
 Review and Comment on Applications  for Licenses Provide Technical Assistance Collect/Transfer Data & Financial Info ...
   Local Advisory Council - Purpose:    ◦ Consult – Responsive to Community’s      Needs    ◦ Comment on Licenses    ◦ Co...
   Community Collaboratives (MPCBs)   Recovery Advocates, Persons in Recovery   Drug and Sobriety Courts   Community C...
 $75,358,174 – Fed. Block Grant + State * $34,236,115 – Medicaid (goes to PIHPs,  separate pe/pm) $4,565,329 – Adult Be...
   Administer Public Funds for SA Services to    eligible individuals:    ◦ Medicaid/ABW/MiChild    ◦ Federal SA Treatmen...
* Riverhaven - 800.448.5498                  * Detroit Health Dept. - 800.467.2452* Genesee Co. CMH - 877.346.3648        ...
   Strategic Prevention Framework – Prevention    Prepared Communities – Tobacco Compliance   Full Continuum of Treatmen...
   Refer to Existing SUD Provider Networks   Co-located Services -> Integrated Services   Health Centers can apply for ...
Please feel free to contact me:          Kristie Schmiege, MPHDirector of Prevention & Health PromotionGenesee County Comm...
Michigan Association of                              COMMUNITY MENTAL HEALTH                                              ...
Mental Health and Developmental                  Disabilities System - Structure          46 Community Mental Health Servi...
Michigan Association of                                                                                        Community M...
What is a CMHSP?              Formed under Act 258 of the Public Acts of 1974 as amended              (the Mental Health C...
Who Receives Services            For persons without Medicaid coverage, the Mental Health            Code establishes serv...
How Do People Access Services?            All CMHs have centralized access systems and a 24 hour            emergency serv...
How Are Services Funded?              State provides an annual General Fund appropriation              No General Fund inc...
Michigan Association of                                                                                        Community M...
How Does a PIHP Work?              Medicaid Prepaid Inpatient Health Plans (PIHPs) –              Eighteen (18) PIHPs mana...
How Does a PIHP Work?              PIHP (Prepaid Inpatient Health Plan) is a federal CMS              designation.        ...
How Does a PIHP Work?              Like HMOs, PIHPs can contract with providers, perform gate              keeping and aut...
Who Receives Services                For persons with Medicaid, access to mental health                services is an enti...
Questions ?            Michigan Association of Community Mental Health Boards            426 S. Walnut St, Lansing, MI 489...
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An Overview - Michigan's Publicly Funded Mental Health, Substance Abuse, and Developmental Disabilities System

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During this webinar you will get an overview of Michigan’s publicly funded mental health, substance abuse, and developmental disabilities system. This will include the management and delivery structure of Community Mental Health Service Providers (CMHSPs), Prepaid Inpatient Health Plans (PIHPs), and substance abuse Coordinating Agencies (CAs), as well as primary funding sources and priority service populations.

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An Overview - Michigan's Publicly Funded Mental Health, Substance Abuse, and Developmental Disabilities System

  1. 1. Kristie R. Schmiege, MPH, President Michigan Association of Substance Abuse Coordinating Agencies
  2. 2.  Substance Abuse Coordinating Agencies (CAs) were created in Article 6, Public Act 368 of 1978, the Public Health Code Designation of CAs Currently - 16 ◦ Local Public Health - 3 ◦ Community Mental Health Board - 8 ◦ Public or Private Nonprofit Agency – 5Bills passed last week in state legislativecommittee to change the designation toPIHPs, additional votes to come… 2
  3. 3. 3
  4. 4.  Comprehensive Planning for SA Treatment, Rehabilitation (Recovery) & Prevention Services: ◦ Needs Assessment ◦ Resource Identification ◦ Priority Setting ◦ Service Gap Identification ◦ Action Planning ◦ Evaluation Criteria Setting 4
  5. 5.  Review and Comment on Applications for Licenses Provide Technical Assistance Collect/Transfer Data & Financial Info Submit an Annual Budget Request Make (Sub)Contacts Necessary to the Performance of the CA’s Functions ◦ Must not Provide Direct Services Annually Evaluate and Assess Services ◦ Contract Monitoring 5
  6. 6.  Local Advisory Council - Purpose: ◦ Consult – Responsive to Community’s Needs ◦ Comment on Licenses ◦ Comment on Annual Action Plan ◦ Comment on Services ◦ Forum to Discuss SA Services and Problems in the Region Wide Array of Community Stakeholders 6
  7. 7.  Community Collaboratives (MPCBs) Recovery Advocates, Persons in Recovery Drug and Sobriety Courts Community Corrections Parole and Prison Re-entry Law Enforcement School Districts Department of Human Services Other Human Service Agencies Etc., etc. 7
  8. 8.  $75,358,174 – Fed. Block Grant + State * $34,236,115 – Medicaid (goes to PIHPs, separate pe/pm) $4,565,329 – Adult Benefit Waiver $44,057 – MIChild $18,492,219 – PA 2 (goes to Counties) $4,745,746 – Other $137,441,640 – TOTAL* 20% Earmark for Prevention 8
  9. 9.  Administer Public Funds for SA Services to eligible individuals: ◦ Medicaid/ABW/MiChild ◦ Federal SA Treatment & Prevention Block Grant – uninsured and “under” - insured ◦ PA2/Convention Facilities (liquor tax) Priority Populations–Pregnant Intravenous Drug Users, Pregnant, IVDU Assure Publicly Funded Services are Available Throughout the Fiscal Year Access Management System 9
  10. 10. * Riverhaven - 800.448.5498 * Detroit Health Dept. - 800.467.2452* Genesee Co. CMH - 877.346.3648 * Macomb – 877.484.8884* Kalamazoo CMH & SA Services - 888.373.6200 ◦ Venture/Calhoun – 877.252.0916* Lakeshore – 800.981.2481 Muskegon ◦ Benton Harbor – 800.926.8389* Midsouth – 888.230.7629 * Network 180 – 800.749.7720* Northern Michigan – 800.686.0749 * Pathways – 800.305.6564* Oakland Co. H. Div. – 888.350.0900 X 85200* Saginaw Co. H. Dept. – 1.855.277.8277 * St. Clair Co. CMH – 888.225.4447* Southeast Mich. Com. Al. – 800.686.6543* Washtenaw Com. H. Org. – 800.440.7548* Western UP – Medicaid clients – see Pathways – 800.305.6564 ◦ Baraga, Houghton, Keweenaw -888.482.4097 ◦ Dickinson & Iron – 888.779.0095 ◦ Gogebic & Ontonagon – 888.482-4097  (See map of regions & CA names on slide #3) 10
  11. 11.  Strategic Prevention Framework – Prevention Prepared Communities – Tobacco Compliance Full Continuum of Treatment Services ◦ Outpatient including Medication Assisted ◦ Residential Including Recovery Housing>Detox ◦ Women’s Specialty ◦ Focus – Co-occurring Competency (MH & SUD) Recovery Oriented System of Care Peer Coaches – Health Navigators Integration with Physical Health Care 11
  12. 12.  Refer to Existing SUD Provider Networks Co-located Services -> Integrated Services Health Centers can apply for a license to become a substance service provider ◦ Must meet requirements including SUD accreditation ◦ Submit Application to: ◦ Michigan Dept. of Licensing and Regulatory Affairs (LARA)  (517) 241-1970  http://www.michigan.gov/lara 12
  13. 13. Please feel free to contact me: Kristie Schmiege, MPHDirector of Prevention & Health PromotionGenesee County Community Mental Health 420 W. Fifth Ave. Flint, Michigan 48503 kschmiege@gencmh.org (810) 496-5541 13
  14. 14. Michigan Association of COMMUNITY MENTAL HEALTH Boards Overview: Michigan’s Publicly Funded, Community Based Behavioral Health & Developmental Disabilities System MPCA Webinar – 2/21/12MACMHB ~ www.macmhb.org ~ 517-374-6848 14
  15. 15. Mental Health and Developmental Disabilities System - Structure 46 Community Mental Health Services Programs (CMHSP) 18 Prepaid Inpatient Health Plans (PIHPs) All of the PIHPs are also CMHSPs Need to have at least 20,000 Medicaid beneficiaries in a PIHP 8 PIHPs are stand alone CMHSP; 10 are affiliations, with 2 to up to 5 CMHSPsMACMHB ~ www.macmhb.org ~ 517-374-6848 15
  16. 16. Michigan Association of Community Mental Health Boards Keweenaw Affiliation Map Copper Country Ontonagon Houghton Baraga Pathways Gogebic Gogebic Marquette Luce Alger Chippewa Hiawatha Iron Northpointe Mackinac SchoolcraftCMHSP AFFILIATIONS Dickinson Delta NORTHCARE Menominee Emmet Cheboygan Presque Isle North Country Charlevoix Northeast NORTHERN AFFILIATION Michigan Antrim Ostego Montmorency Alpena Leelanau NORTHWEST CMH AFFILIATION Manistee- Benzie Grand Traverse Kalkaska Crawford Oscoda Alcona Benzie Northern Lakes CMH Au Sable Valley ACCESS ALLIANCE OF MICHIGAN Manistee Missaukee Wexford Roscommon Ogemaw Iosco West Arenac THUMB MENTAL HEALTH ALLIANCE Michigan CMH for Central Bay- Mason Lake Osceola Clare Gladwin Arenac Huron Michigan Huron Ne wa Bay AFFILIATION OF MID-MICHIGAN yg o Oceana Mecosta Isabella Midland Tuscola Sanilac M Montcalm Saginaw us Newaygo Gratiot ke Tuscola go SOUTHWEST MICHIGAN AFFILIATION Ge Sanilac n Gratiot Saginaw Muskegon Montcalm ne Lapeer Kent se Sh St. Clair e ia ha m n- Ottawa Ionia wa Lapeer St. Clair I n g -E a to ss ee VENTURE BEHAVIORAL HEALTH M ac Shiawassee Genesee Ottawa Kent Ionia Clinton n Li Oakland om b nto vi ng Allegan Barry st o Macomb Cli n CMH PARTNERSHIP OF Allegan Barry Eaton Ingham Livingston Oakland Va W Detroit/ SOUTHEAST MICHIGAN n a sh Ka Bu Summit t en Wayne la m re aw n az Pointe oo LAKESHORE BEHAVIORAL Van Buren Kalamazoo Calhoun Jackson Washtenaw Washtenaw Wayne en HEALTH ALLIANCE Br St an Lenawee Monroe r ri .J Cass ch os Be ep h Berrien Cass St. Joseph Branch Monroe Hillsdale Lenawee UNAFFILIATED OVER 20,000 Updated November 4, 2010 16
  17. 17. What is a CMHSP? Formed under Act 258 of the Public Acts of 1974 as amended (the Mental Health Code). 12 member boards appointed by County Commissions. At least one-third of the CMH Board must be consumers or family members. One half must be primary consumers. Subject to FOIA and Open Meetings Act. Counties must contribute a financial match. CMHSP may be organized as an agency, organization or authority.MACMHB ~ www.macmhb.org ~ 517-374-6848 17
  18. 18. Who Receives Services For persons without Medicaid coverage, the Mental Health Code establishes service priorities for CMHSPs as to who receives services: 1. Persons in emergent / crisis situations 2. Persons with more severe forms of serious mental illness (SMI), serious emotional disturbance (SED), and developmental disability (DD), and substance use disorders 3. Persons with less severe or mild/moderate conditions, and the general community including prevention.MACMHB ~ www.macmhb.org ~ 517-374-6848 18
  19. 19. How Do People Access Services? All CMHs have centralized access systems and a 24 hour emergency service. • For non emergency referrals, a brief telephone screening will result a scheduled assessment for ongoing service. In emergent situations the person must be served within 3 hours. • Persons with Medicaid are entitled to service. Persons without Medicaid are served based on the severity of their illness.MACMHB ~ www.macmhb.org ~ 517-374-6848 19
  20. 20. How Are Services Funded? State provides an annual General Fund appropriation No General Fund increases in past 12 years Periodic redirection to match Federal funds (Adult Benefit Waiver) Significant reductions over past 5 years - 20% CMHs impacted disproportionally based on funding factors – effort to reduce funding per capita disparities – per capita range ($12.04 to $59.02)MACMHB ~ www.macmhb.org ~ 517-374-6848 20
  21. 21. Michigan Association of Community Mental Health Boards Keweenaw Affiliation Map Copper Country Ontonagon Houghton Baraga Pathways Gogebic Gogebic Marquette Luce Alger Chippewa Hiawatha Iron Northpointe Mackinac SchoolcraftCMHSP AFFILIATIONS Dickinson Delta NORTHCARE Menominee Emmet Cheboygan Presque Isle North Country Charlevoix Northeast NORTHERN AFFILIATION Michigan Antrim Ostego Montmorency Alpena Leelanau NORTHWEST CMH AFFILIATION Manistee- Benzie Grand Traverse Kalkaska Crawford Oscoda Alcona Benzie Northern Lakes CMH Au Sable Valley ACCESS ALLIANCE OF MICHIGAN Manistee Missaukee Wexford Roscommon Ogemaw Iosco West Arenac THUMB MENTAL HEALTH ALLIANCE Michigan CMH for Central Bay- Mason Lake Osceola Clare Gladwin Arenac Huron Michigan Huron Ne wa Bay AFFILIATION OF MID-MICHIGAN yg o Oceana Mecosta Isabella Midland Tuscola Sanilac M Montcalm Saginaw us Newaygo Gratiot ke Tuscola go SOUTHWEST MICHIGAN AFFILIATION G Sanilac n Gratiot Saginaw Muskegon Montcalm en Lapeer Kent es Sh ee St. Clair ia ha m n- Ottawa Ionia wa Lapeer St. Clair I n g -E a to ss ee VENTURE BEHAVIORAL HEALTH M ac Shiawassee Genesee Ottawa Kent Ionia Clinton n Oakland om b nto Li vi Allegan Barry ng Macomb Cli st o CMH PARTNERSHIP OF n Oakland Allegan Barry Eaton Ingham Livingston Va W Detroit/ SOUTHEAST MICHIGAN n a sh Ka Bu Summit t en Wayne la m re aw n az Pointe oo LAKESHORE BEHAVIORAL Van Buren Kalamazoo Calhoun Jackson Washtenaw Washtenaw Wayne en HEALTH ALLIANCE Br St an Lenawee Monroe r ri .J Cass ch os Be ep h Berrien Cass St. Joseph Branch Monroe Hillsdale Lenawee UNAFFILIATED OVER 20,000 Updated November 4, 2010 21
  22. 22. How Does a PIHP Work? Medicaid Prepaid Inpatient Health Plans (PIHPs) – Eighteen (18) PIHPs manage the services and supports for persons enrolled in the Medicaid, MIChild and Adult Benefit Waiver programs. These affiliations were created in order to realize administrative efficiencies in managing services and to provide a sufficiently large base of Medicaid enrollees to manage the risk-based, capitated funding system used to finance the system of care for Medicaid beneficiaries.MACMHB ~ www.macmhb.org ~ 517-374-6848 22
  23. 23. How Does a PIHP Work? PIHP (Prepaid Inpatient Health Plan) is a federal CMS designation. Medicaid health plans are responsible for a 20 visit per year benefit for persons with moderate psychiatric disabilities. PIHPs are responsible for management of all specialty BH/DD services to everyone enrolled in Medicaid. This is referred to as a “carve out” of specialty services.MACMHB ~ www.macmhb.org ~ 517-374-6848 23
  24. 24. How Does a PIHP Work? Like HMOs, PIHPs can contract with providers, perform gate keeping and authorization, monitor service outcomes and standards of care. Like HMOs, PIHPs must manage with the capped pool of funds that are paid each month based on the number of Medicaid eligibles in the PIHP area. When eligibles go up or down, funding corresponds. The # of people seeking service does not necessarily correspond & therefore managing the utilization of services is critical.MACMHB ~ www.macmhb.org ~ 517-374-6848 24
  25. 25. Who Receives Services For persons with Medicaid, access to mental health services is an entitlement. Based on a clinical assessment, people must be enrolled in appropriate services. • People have a choice of provider. • People denied service may have a second opinion. • People may file appeals at the local & state level. • People are not charged for servicesMACMHB ~ www.macmhb.org ~ 517-374-6848 25
  26. 26. Questions ? Michigan Association of Community Mental Health Boards 426 S. Walnut St, Lansing, MI 48933 (517) 374-6848 Michael Vizena Alan Bolter Executive Director Associate Director mvizena@macmhb.org abolter@macmhb.orgMACMHB ~ www.macmhb.org ~ 517-374-6848 26

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