The Michigan Department of Health and Human Services (MDHHS) expanded the Behavioral Health Home (BHH) initiative last week to more counties in Michigan. The new counties lie within the CMH Partnership of Southeast Michigan and Detroit Wayne Integrated Health Network Prepaid Inpatient Health Plans (PIHPs)—region six and seven respectively.
The expansion of BHHs will give more Medicaid beneficiaries access to coordinated services for serious behavioral health concerns, and are meant to provide these services for those diagnosed with a serious mental illness or serious emotional disturbance.
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“The expansion of the BHH will help address the complexity of physical and behavioral health conditions in Michigan and improve access to essential services,” said Elizabeth Hertel, Director of MDHHS. “For enrolled beneficiaries, the Health Home will function as the central point of contact for directing patient-centered care across the broader health care system.”
Care coordination and addressing the social determinants of health are the main services BHHs offer Medicaid members. BHHs have a variety of physical and behavioral health experts to address these needs and connect members to other providers to address their specific circumstance.
Michigan has struggled to offer reliable access to behavioral and mental health services. According to a 2019 report, 51% of Medicaid members in the state with a diagnosed mental illness did not receive treatment in a given year. This led to the development of these homes to create a care coordination network for those in need of behavioral health care.
Before this expansion, the program was available in only three PIHP regions. The success of BHHs in the three smaller regions—regions one, two, and eight—showed MDHHS the quality of the program. Lindsey Naeyaert, Behavioral Health Innovation Specialist at MDHHS, said the success led to its expansion into the more densely populated areas of Southeast Michigan.
“We didn’t want to include Wayne County in the first implementation of BHH because it is so large,” Naeyaert said. “We wanted to make sure we got it right with the first three [regions] that we started with.”
To codify the expansion, CMS approved an amendment to Michigan’s State Plan, which needs to be amended anytime the state wants to extend Medicare or Medicaid services. Before the amendment was approved, the FY 2022 budget allocated funds for this expansion as well.
Naeyaert said both expanded regions started implementing care coordinated BHH services on May 1st and already have people enrolled. In region 6, two counties are still working on enrolling new members, but she said the regions are “off to the races.”
Bob Sheehan, Executive Director of the Community Mental Health Association of Michigan, said mental health providers are using a handbook for BHH implementation, which facilitates the timeline of implementation and the effectiveness of the service.
“So if I have schizophrenia and I also have diabetes, my primary care provider, diabetes provider, my physical therapist, psychiatrist, and case manager are all in sync [and communicating],” Sheehan said. “I think we will see a strengthened primary care and physical health focus so that people who already have a mental health condition being treated can now ensure that there will be a safety net around them.”
The teams at BHHs will make regular contact with the folks that enter their facilities to make sure they do not fall through the cracks. Naeyaert said the staff try to make contact once a month with those who use their services.
Opioid Health Homes (OHH) are also planned to receive an expansion, Naeyaert said. OHH expansions are expected to be included in the FY 2023 budget, which will trigger a proposal to CMS for a State Plan amendment.