an overview - michigan's publicly funded mental health, substance abuse, and developmental...
TRANSCRIPT
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 – 5
Bills passed last week in state legislative committee to change the designation to PIHPs, additional votes to come…
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Comprehensive Planning for SA Treatment, Rehabilitation (Recovery) & Prevention Services:◦ Needs Assessment◦ Resource Identification◦ Priority Setting◦ Service Gap Identification ◦ Action Planning◦ Evaluation Criteria Setting
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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
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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
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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.
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$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
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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
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* 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)
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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
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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
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Please feel free to contact me:
Kristie Schmiege, MPHDirector of Prevention & Health PromotionGenesee County Community Mental Health
420 W. Fifth Ave.Flint, Michigan 48503
[email protected](810) 496-5541
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Michigan Association of
COMMUNITY MENTAL HEALTH
Boards
Overview:
Michigan’s Publicly Funded,
Community Based Behavioral Health
& Developmental Disabilities System
MPCA Webinar – 2/21/12
14MACMHB ~ www.macmhb.org ~ 517-374-6848
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 CMHSPs
MACMHB ~ www.macmhb.org ~ 517-374-6848 15
Mental Health and Developmental
Disabilities System - Structure
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Ontonagon
Gogebic
Houghton
Iron
Baraga
Keweenaw
Marquette
Dickinson
Alger
Delta
Schoolcraft
Luce
Chippewa
Mackinac
Emmet
Cheboygan Presque Isle
Charlevoix
Leelanau
Antrim Ostego Montmorency Alpena
Benzie Grand Traverse Kalkaska Crawford Oscoda Alcona
ManisteeWexford Missaukee Roscommon Ogemaw Iosco
Mason Lake Osceola Clare Gladwin
Arenac
Bay
Oceana
Newaygo
Mecosta Isabella Midland
Muskegon
Ottawa Kent
Montcalm
Ionia
Gratiot
Clinton
Saginaw
Shiawassee
Huron
Tuscola
Sanilac
Lapeer
Genesee
St. Clair
Macomb
OaklandLivingstonInghamEatonAllegan Barry
Van Buren Kalamazoo Calhoun Jackson
Berrien Cass St. Joseph Branch
HillsdaleLenawee
Washtenaw Wayne
Monroe
MenomineeNORTHCARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
AFFILIATION OF MID-MICHIGAN
SOUTHWEST MICHIGAN AFFILIATION
VENTURE BEHAVIORAL HEALTH
THUMB MENTAL HEALTH ALLIANCE
CMH PARTNERSHIP OF
SOUTHEAST MICHIGAN
ACCESS ALLIANCE OF MICHIGAN
UNAFFILIATED OVER 20,000
LAKESHORE BEHAVIORAL
HEALTH ALLIANCE
Washtenaw
Ber
rien
Cass
Van Buren
Kalam
azoo
St. Joseph
Summit
Pointe
BranchLenawee Monroe
Washtenaw
Detroit/
Wayne
Maco
mb
Oakland
St. Clair
LapeerG
enesee
Shiawassee
LivingstonC
lin
ton
-Eat
on-
Ingh
am
Ionia
Barry
SanilacTuscola
SaginawGratiot
Montcalm
Allegan
Ottawa
Kent
Muskegon
Newaygo
CMH for Central
Michigan
Bay-
Arenac Huron
Au Sable ValleyNorthern Lakes CMH
Northeast
Michigan
North Country
Manistee-
Benzie
Hiawatha
Pathways
Northpointe
Copper Country
Gogebic
West
Michigan
Michigan Association ofCommunity Mental Health Boards
Affiliation Map
Updated November 4, 2010
CMHSP AFFILIATIONS
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
What is a CMHSP?
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
Who Receives 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
How Do People Access Services?
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
How Are Services Funded?
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Ontonagon
Gogebic
Houghton
Iron
Baraga
Keweenaw
Marquette
Dickinson
Alger
Delta
Schoolcraft
Luce
Chippewa
Mackinac
Emmet
Cheboygan Presque Isle
Charlevoix
Leelanau
Antrim Ostego Montmorency Alpena
Benzie Grand Traverse Kalkaska Crawford Oscoda Alcona
ManisteeWexford Missaukee Roscommon Ogemaw Iosco
Mason Lake Osceola Clare Gladwin
Arenac
Bay
Oceana
Newaygo
Mecosta Isabella Midland
Muskegon
Ottawa Kent
Montcalm
Ionia
Gratiot
Clinton
Saginaw
Shiawassee
Huron
Tuscola
Sanilac
Lapeer
Genesee
St. Clair
Macomb
OaklandLivingstonInghamEatonAllegan Barry
Van Buren Kalamazoo Calhoun Jackson
Berrien Cass St. Joseph Branch
HillsdaleLenawee
Washtenaw Wayne
Monroe
MenomineeNORTHCARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
AFFILIATION OF MID-MICHIGAN
SOUTHWEST MICHIGAN AFFILIATION
VENTURE BEHAVIORAL HEALTH
THUMB MENTAL HEALTH ALLIANCE
CMH PARTNERSHIP OF
SOUTHEAST MICHIGAN
ACCESS ALLIANCE OF MICHIGAN
UNAFFILIATED OVER 20,000
LAKESHORE BEHAVIORAL
HEALTH ALLIANCE
Washtenaw
Ber
rien
Cass
Van Buren
Kalam
azoo
St. Joseph
Summit
Pointe
BranchLenawee Monroe
Washtenaw
Detroit/
Wayne
Maco
mb
Oakland
St. Clair
LapeerG
enesee
Shiawassee
LivingstonC
lin
ton
-Eato
n-
Ingh
am
Ionia
Barry
SanilacTuscola
SaginawGratiot
Montcalm
Allegan
Ottawa
Kent
Muskegon
Newaygo
CMH for Central
Michigan
Bay-
Arenac Huron
Au Sable ValleyNorthern Lakes CMH
Northeast
Michigan
North Country
Manistee-
Benzie
Hiawatha
Pathways
Northpointe
Copper Country
Gogebic
West
Michigan
Michigan Association ofCommunity Mental Health Boards
Affiliation Map
Updated November 4, 2010
CMHSP AFFILIATIONS
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
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
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
How Does a PIHP Work?
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 services
MACMHB ~ www.macmhb.org ~ 517-374-6848 25
Who Receives Services
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
[email protected] [email protected]
MACMHB ~ www.macmhb.org ~ 517-374-6848 26
Questions ?