Michigan's Community Mental Health System: Facts and Figures

Alan Bolter from The Community Mental Health Association of Michigan (CMHAM) gave a presentation on 11/15/18 at a Town Hall meeting of the Washtenaw Community Mental Health Association (more about that later). He distributed a flyer with basic information about the Michigan Community Mental Health system. It describes what CMH agencies do, how they are funded, and who they serve. The flyer does not appear to be available on the internet, but if it does become available, I will provide a link to the complete document.

These are excerpts from the flyer with a few modifications to make it easier to understand in the way I am presenting it here: 

How Community Mental Health agencies are funded

• $2.319 billion from “Medicaid Mental Health” 
• $299 million from “Healthy Michigan” [Michigan’s Medicaid expansion under Obamacare] 
• $175 million from “Substance Use Disorder” 
• $192 million from Autism funding 

These funds go to Prepaid Inpatient Health Plans (PIHPs), behavioral health managed care entities. These are the regional administrative agencies that distribute Medicaid funds to local CMH agencies.] PIHPs are responsible for oversight and compliance (Federal & State), Administration, and Utilization Management.

These funds are passed on along with $125 million from the State General Fund [GF] to Community Mental Health Centers and their provider network covering all 83 counties. CMHs are responsible for service provision, coordinating the local service network, and ensuring compliance (Federal & State).

Who Community Mental Health serves

• Children with Serious Emotional Disturbance [examples: Obsessive-Compulsive Disorder (OCD) or Attention Deficit Hyperactivity Disorder (ADHD)] 
• People with Substance Use Disorders [SUD] 
• People with Developmental/Intellectual Disabilities 
• Adults with Mental Illness 

Michigan is the only state that serves all 4 populations in a managed care setting.

How the Money is Spent

• 49% on People with Intellectual/Developmental Disabilities [45,000 people served] 
• 36% on Adults with Mental Illness [155,000 people served] 
• 9% on Children with Serious Emotional Disturbance [45,000 people served] 
• 6% on People with Substance Use Disorders [70,000 people served] 

Other pertinent information

The percentage of dollars spent on actual care in Michigan’s PIHP system has a statewide average of 6% spent on administrative Costs. This is a 94% “medical loss ratio”, an indication that Michigan Medicaid dollars are spent very efficiently for the actual care of the people served.

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Community Mental Health Association of Michigan (CMHAM) is a trade association representing the 46 Community Mental Health Boards, 10 Prepaid Inpatient Health Plans, and more than 90 provider organizations that deliver services to adults with Mental Illness, children and adolescents with emotional disturbances, persons with Intellectual/developmental disabilities, and those with substance use disorders in every community across the state.