The Michigan Department of Health and Human Services (DHHS) hopes to expand the number of certified community behavioral health clinics (CCBHCs) in the state. DHHS staff met last week with lawmakers to discuss CCBHC expansion and related fiscal year 2025 budget requests during a House Appropriations Subcommittee on Health and Human Services meeting.
Amy Epkey, senior deputy director of DHHS’ Financial Operations Administration, said 22 percent of Michigan adults have been diagnosed with a behavioral health disorder.
“We really want to focus on prevention and early intervention,” Epkey said. “That is why, in this budget, you’ll see so many investments around community-based services. Our goal is to make sure we’re providing prevention and intervention early to minimize the need for inpatient care throughout our behavioral health system.”
Meghan Groen, senior deputy director of DHHS’ Behavioral and Physical Health and Aging Services Administration, noted that the state currently has 10 Medicaid prepaid inpatient health plans (PIHPs). PIHPs manage specialty mental health and substance use disorder treatment benefits. The state also has 46 community mental health services programs, which coordinate mental health services in Michigan.
“CCBHCs represent a new frontier that expands the traditional landscape to include individuals with mild/moderate mental health needs,” Groen said. “This allows providers to meet people where they are, develop person-centered (plans), and partner with community-based organizations.”
Approximately 290,000 Medicaid beneficiaries received specialty behavioral health services through DHHS’ 10 contracted PIHPs in fiscal year 2023, Groen said.
“This includes nearly 70,000 children at a time when rates of depression, anxiety, and suicidal ideation have increased over recent years. CCBHCs are unique in that they are required to serve anyone who walks through the door, regardless of their diagnosis and insurance status.”
— Groen
Eight states implemented the CCBHC Demonstration model in 2017. The model saw promising early evaluation results, and the Coronavirus Aid, Relief, and Economic Security Act passed in 2020, which authorized Michigan and Kentucky to join the demonstration.
Michigan’s CCBHC demonstration launched on Oct. 1, 2021, with 13 sites. It expanded its demonstration project in 2023 by adding 17 sites. The state now has 30 sites, making it the second-largest CCBHC demonstration in the country, Groen said.
“The fiscal year 2025 (budget) recommendation includes funding to support the further expansion of CCBHC sites in Michigan, focusing on community mental health agencies and organizations with federal grant funding supporting CCBHC implementation and advancement,” she said. “The initial CCBHC demonstration alone saw a decrease in the number of people experiencing homelessness, a decrease in time spent in correctional facilities, and fewer emergency room visits for behavioral health.”
Michigan does not currently have any CCBHCs north of Lake County. Rep. Phil Green (R-Millington) asked if the requested budget funds were going to be used to add CCBHC sites or for individuals visiting current sites, and if any sites were planned for the northern part of the state.
“We’re looking to add sites to the demonstration project. If additional individuals come to those sites, that is a wonderful thing, and we can build into that structure. Any community health association would be eligible, as well as some SAMHSA (Substance Abuse and Mental Health Services Administration) demonstration sites. Many of those are up north. They will need to meet federal criteria and apply. MDHHS meets regularly with providers and community mental health organizations across the state, and is committed to working with our partners up north, if they would like to apply.”
— Groen
Several SAMHSA grants are available to organizations that want to join the demonstration, Groen said. DHHS has not specified the number of CCBHCs it wants to add in the state.
“There is not a set number in the budget of how many, but we have some experience with bringing sites on, and what that may take,” Groen said. “That could be anywhere around a dozen additional sites.”
Groen also discussed Michigan’s new psychiatric residential treatment facilities (PRTFs). PRTFs offer voluntary placement for Medicaid-eligible youths who are ready to be discharged from a state psychiatric hospital system to the community. Youths are assessed prior to discharge on their need for intensive community-based residential treatment services prior to their transition.
“PTRFs are community-based facilities that provide care for youth ready to be discharged from a psychiatric hospital, who aren’t quite ready to be at home full-time,” Groen said. “We have a similar program for adults (intensive community transition services or ICTS). As we’re seeing people discharged from a PRTF or ICTS, we are able to see them go back home or (into) communities, and have the support they need to be successful and, hopefully, stay out of an inpatient setting.”
Readers interested in learning more about CCBHCs and their impact on mental health can register to attend our 2024 Michigan State of Reform Health Policy Conference, which will be held on April 4 at The Lansing Center. A “CCBHCs, Integration, & Other Opportunities to Improve Behavioral Health” panel will be held at 10:45 a.m.