Michigan has been picked to partake in a federal pilot program that funds mental health and addiction services in community health clinics — an approach that’s helped to keep those needing treatment out of jails, hospitals and off the streets.
The pilot is tied to legislation enacted in 2014 from Sens. Debbie Stabenow, D-Lansing, and Roy Blunt, R-Missouri, to offer reimbursement for community-based mental health treatment.
The program established new federal criteria for participating clinics to meet quality standards and offer a broad range of services, including 24-hour crisis psychiatric care, counseling and integrated help to treat substance abuse, and physical and mental health issues.
Stabenow said the funding of community mental health and addiction services should not happen through grants that “start and stop,” rather than as part of the health care system.
“You would never say to someone who needed heart surgery, ‘We’d love to help you, but the grant ran out.’ And that’s what happens to someone with a mental illness or substance abuse every day,” Stabenow said in an interview.
The senator noted the the last piece of legislation that President John F. Kennedy signed his before his assassination in 1963 was the Community Mental Health Act. That was based on the idea to provide mental health services in the community, rather than housing people in institutions.
“That has never happened. My goal has been to make that a reality,” Stabenow said.
Michigan was not selected for the initial round of eight states for the pilot project in 2016 but has now been selected, along with Kentucky, for an expansion authorized under the federal coronavirus relief or CARES Act.
Twelve centers included in Michigan’s proposal will be part of the demonstration, Stabenow said, and receive funding for two years through Medicaid, the government health program for mostly low-income individuals.
A study by the U.S. Department of Health and Human Services using data from the first eight states in project found a 60% reduction in number of people taken to jails and a 40% reduction in homelessness, Stabenow said.
“Because police had a place and mental health or substance abuse professionals they could work with or take them to a 24-hour psychiatric facility or get them other services they need,” she said.
Blunt and Stabenow also set up start-up grants for communities outside of the eight demonstration states where health centers across the country can apply for funding if they meet the quality standards. The start-up grants have brought about $88 million into Michigan in recent years, she said.
“I see this as a movement. Not just a bill or demonstration project. My goal is to treat community and mental health addiction services the same way we treat community physical services in terms of infrastructure and funding,” she said.
The model is a “game changer” for the public mental health system, said Robert Sheehan, CEO of the Community Mental Health Association of Michigan.
“This returns the system to a community-based system,” Sheehan said. “One of the requirements is that the (clinic) will take all coverage. Any citizen who needs mental health care — regardless of Medicaid coverage or insurance coverage — will get that coverage.”
The timing is ideal for the expansion of Certified Community Behavioral Health Clinics because of the increase in depression and anxiety tied to widespread psychological trauma and economic hardship caused by the coronavirus pandemic, he said.
“This won’t happen tomorrow. It will take months for Michigan to get fully engaged, but at least it raises the floor for really sound services for Michigan,” Sheehan said.
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