Michigan hearings on Community Mental Health: House Appropriations Subcommittee on Health & Human Services

Michigan State Representative Mary Whiteford, Chair of the MI House Appropriations Subcommittee on Health and Human Services, has announced a series of hearings on Behavioral Health, Community Mental Health Redesign, and Behavioral Health Integration. These are scheduled for Wednesday mornings, from October 2, 2019 through November 6, 2019: 

10:30 A.M. - 12 P.M.

Room 352

House Appropriations
State Capitol Building

Note that two hearings to receive public input will be held on October 30 and November 6, 2019. Call Mary Whiteford's office at (517) 373-0836 or email MaryWhiteford@house.mi.gov for more information (how much time will you have to testify, what is the signup procedure to register, how will written testimony be handled, etc. ???).

To watch a video recording of the 10/2/19 hearing, go to Video Archives for the MI House of Representatives, scroll down to "Appropriations Health and Human Services - Wednesday, October 02, 2019" and click on "Play Video". Presumably future hearings will also appear here after they have been held.

Here is the full schedule:

House Appropriations Subcommittee on HHS

Wednesday, Oct. 2

History and Overview of Public Behavioral Health Financing in Michigan

Jeff Patton - Kalamazoo CMH CEO

Jim Haveman - Former Director of Dept. of Community Health

Wednesday, October 16

CMH Perspective Benefits and challenges of the CMH, PIHP system including House fiscal analysis of Michigan’s behavioral health carve out
Bob Sheehan/Alan Bolter - Community Mental Health Association of Michigan (CMHAM)

House Fiscal Agency


Wednesday, October 23 

The case for Behavioral Health Integration from the former Medicaid Director of Arizona 
Thomas Betlach - former Arizona Medicaid Director

Wednesday, October 30
Public Input

Wednesday, November 6
Public Input

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The Michigan Community Mental Health system serves people with developmental disabilities, mental illness, substance abuse disorders  and children with emotional disturbances. People with DD are a small proportion of the total population served, but DD services represent a proportionately larger part of the CMH budget. This is largely due to the need by many with DD for up to 24/7 home or residential care, the complications of complex medical and behavioral needs, and needed support for families. 

It is often the case, that people with developmental disabilities receive less attention than they should by state legislators, so make sure your voice is heard. 

Will Michigan legislators listen to constituents on mental health funding proposals?

Michigan Public Radio aired an interview on 6/7/2017 with Gail Marsh, the mother of an adult daughter with Down Syndrome, and Bob White, the father of two adult sons on the autism spectrum. Both parents have been involved in “Section 298” workgroups and affinity groups for more than a year. These groups were formed after the Governor’s budget proposed to shift mental health Medicaid funding from public Community Mental Health (CMH) agencies to private health plans that currently administer Medicaid medical health plans. They were a response to the strong opposition that met the Governor's proposal. 

People with developmental disabilities are one of the populations served by the mental health system in local Community Mental Health (CMH) agencies.

From the Michigan Radio website, "Parents 'afraid to die' because of fear mental health care system won’t take care of their children" by Stateside staff and Josh Hakala, 6/7/17:

“Tomorrow, state lawmakers are expected to release their final budget for fiscal year 2017-18 for the Department of Health and Human Services.

“That budget will reveal if Republicans have chosen to shift control of mental health funding – which amounts to nearly $2.5 billion in annual Medicaid payments – away from public mental health organizations, and transfer it to private insurers.
...
"Listen to the full interview … to hear more about their children and how they rely on mental health services as well as Marsh's examples of how privatizing ‘doesn't work’ and why White describes it as a form of ‘outsourcing.’"

Here is part of the interview with Gail Marsh on how the legislature has so far ignored much of the public input from the “Section 298 Initiative”. Start listening at about 12 minutes and 30 seconds into the interview. [Note that in this discussion, “integration” of care is about integrating funding for medical and behavioral health services under one administrative roof - the private Medicaid health plans.] The stakeholder workgroups and affinity groups overwhelmingly supported maintaining a public system to provide behavioral health services which include the social services and supports necessary to maintain people served in community settings.

Gail Marsh recently testified at a Michigan House appropriations subcommittee where she heard references to a State Senator’s comment that, “We’ve been dancing around the concept of integration for too long and the legislature needs to force things to happen.”

Here is her response in the interview:

“…I told them, the reason we’ve been dancing around total integration for so long is because it’s not what people want …The job they’ve been hired to do …is not to force unwanted things on their constituents, but to listen to the people who elected them. So, both the House and the Senate…have dismissed the recommendations of the workgroup and the stakeholder affinity groups, which were to maintain a public behavioral healthcare system.”

• Listen to the whole interview here.
• Link to  background information on “Section 298 Initiative” 
• Minding Michigan, is Stateside’s ongoing series about mental health issues is Michigan.
• So far, I have not seen news on whether the budget proposals for MI Health and Human Services have been acted on.

FYI: Background information on Michigan's infamous Section 298 regarding funding of CMH services

May 25, 2017

This is background information from the Michigan Department of Health and Human Services with links to reports and the text of the proposed FY18 budget. Opinions vary on the intent of the initiative and whether it will be a benefit to the people served:

Background on the Section 298 Initiative

The Section 298 Initiative is a statewide effort to improve the coordination of physical health services and behavioral health services. The initiative started with the publication of the 2017 executive budget, which sparked a statewide discussion on the best approach for coordinating physical health services and behavioral health services. In order to facilitate this discussion, the Lieutenant Governor called an initial meeting of stakeholders, which resulted in the formation of the original 298 Workgroup. This workgroup met five times from March 2016 to June 2016 and produced a final report. This final report included final language for Section 298, a set of “core values” for the initiative, and a set of “design elements” for future discussions.

The Michigan Legislature used the recommendations from the original 298 Workgroup to create a Section 298, which was approved as part of Public Act 268 of 2016. Under the new Section 298, the Michigan Legislature directs the Department to develop a set of recommendations “…Regarding the most effective financing model and policies for behavioral health services in order to improve the coordination of behavioral and physical health services for individuals with mental illnesses, intellectual and developmental disabilities, and substance use disorders.”

The Department convened a new 298 Facilitation Workgroup to assist with the development of the report. The Department and the 298 Facilitation Workgroup have also hosted a series of Affinity Group meetings across Michigan to inform the development of the recommendations. 1,113 Michiganders participated in this process during 45 separate meetings. The Affinity Group meetings included individuals, families, providers, payers and advocates. The Department and the 298 Facilitation Workgroup used the input from these discussions to inform the development of the recommendations.

The Department ultimately submitted two reports to the legislature. The first report was an interim report that was submitted on January 13, 2017. The interim report focused on recommendations for policy changes. The second report was a final report, which was submitted on March 15, 2017. The final report includes the initial policy recommendations and incorporates recommendations on financing models and benchmarks for implementation.

Michigan: Annual HCBS Waiver Conference

The Michigan Department of Health and Human Services (MDHHS) & The Michigan Association of CMH Boards (MACMHB) Present:

The Annual Home and Community Based Waiver Conference

November 15-16, 2016
Kellogg Hotel & Conference Center
55 South Harrison Road, East Lansing 48823

FEATURED PROGRAMS
Children’s Waiver Program (CWP)
Habilitation Supports Waiver (HSW)
Autism Applied Behavior Analysis (ABA) Benefit

Conference Objective: This conference will provide technical assistance and training on the implementation and maintenance of the Children’s Waiver Program (CWP) and the Habilitation Supports Waiver (HSW), clinical issues, and administrative functions relevant to these waivers. Additionally, this conference will provide training in ASD, evidence-based services, highlight programs across the state, and provide technical assistance on implementation of the Medicaid Autism ABA Benefit.

Who Should Attend: This conference contains content appropriate for case managers, supports coordinators, clinicians, behavior analysts, administrative staff, providers, autism coordinators, people receiving services and family members and social workers at all levels of practice (beginning, intermediate and/or advanced).

Special Rate: A special $20 conference rate will be offered for people receiving waiver services and their family members.

Conference Brochure & Registration Materials: There is a PDF to download the tentative agenda, registration form and scholarship information.

Click Here to Register

For complete information, see the MACMHB Website

Michigan : DHHS wants to hear from you about the services you need and want

This is a flyer from the Michigan Department of Health and Human Services:

TELL US WHAT YOU WANT!

The Michigan Department of Health and Human Services (MDHHS) is asking people with mental illness, emotional disorder, developmental or intellectual disability, or substance use disorder, and their family members, what supports and services they need/want!

This is a follow-up to the Lieutenant Governor’s workgroup on the 298 boilerplate that was in the Governor’s budget recommending privatizing behavioral health services. The boilerplate was changed, but MDHHS needs to write a report to Legislators about suggestions for improving the service system.

To collect information a survey was developed. MDHHS is hosting group meetings to ask people the survey questions. Meetings are scheduled for:

October 4, 2016
From 1-4 pm

October 5, 2016
From 6-9 pm

at 

The Hannah Center
819 Abbot Road
East Lansing, Michigan 48823
(517) 333-2580

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For those wanting to comment on a proposal but unable to attend the meeting can access a questionnaire… and then send (email or USPO) the completed questionnaire to:   MDHHS-298@michigan.gov

To obtain the Word version of the survey go to the Affinity Group webpage and scroll down to "Questions for eligible populations and families". You can then fill in the survey answers using the Word document and return it by email or regular mail.

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Background information: 

The 298 Initiative

[Section 298 was the notorious proposal inserted into the Governor's 2016 budget bill in March 2016. It had language in it that would have handed over Medicaid funding for behavioral health, including Community Mental Health funding for DD, to Medicaid Health Plans. This change to privatize the funding of services was placed in the budget bill without hearings or input from people affected by the proposal. It was withdrawn and the 298 Initiative was created to make recommendations to the Michigan legislature regarding funding and services for people with DD and other disabilities.]

"The Section 298 Initiative is a statewide effort to improve the coordination of physical health services and behavioral health services in Michigan. This initiative is based upon Section 298 in the Public Act 268 of 2016. Under Section 298, the Michigan Legislature directs the Michigan Department of Health and Human Services to develop a set of recommendations “regarding the most effective financing model and policies for behavioral health services in order to improve the coordination of behavioral and physical health services for individuals with mental illnesses, intellectual and developmental disabilities, and substance use disorders...”

Follow the links on the 298 Website for more information.