In advocacy the message matters. What you say and how you support it is critical to advancing your agenda. In a traditional campaign, we hear the same message over and over again. We have to do the same in advocating for policies on behalf of community-based providers. Below we share the messages that will stick. Pull Up Your Chair & Let’s Start the Conversation.
Making Michigan’s Behavioral Health System Stronger
Issues around affordability are dominating the mid-term elections. And for any candidate dominating in the polls, it seems that they are constantly sticking to their talking points. Those that veer off, get distracted or caught off guard, loose site of their key message and loose support. While the candidates may give the same speech and tell the same stories across the state, many people are hearing it for the first time.
For over 15 years, community-based behavioral health providers have been trying to raise the same issues without any resolution: workforce shortages, funding not making its way into the communities it is intended for, a patchwork of rules interpreted differently in each region, and a system built on conflicts, where the same entity that pays for care also competes to deliver it.
As these issues persist, someone who needs care, can’t get it. Without a workforce, there is no one to answer the phone and guide people through the system of care. When funding doesn’t reach the community, providers cut programs or close, and care stops. When the rules change in every region, care does not follow the person. And when the entity that pays for care also competes to deliver it, it decides who gets certified and what rates get paid. This all impacts who can access care.
Successful campaigns win on discipline. They lead with people, not process. They use facts to support their agenda and work to draw a clear contrast and stay on their own agenda instead of arguing someone else’s. And everyone on the campaign says the same thing, the same way, every time. That is how a message breaks through.
The Stump Speech for Behavioral Health Providers
Let’s make Michigan’s behavioral health system stronger.
This is about people accessing care. Not about who runs the system.
Right now, 1.76 million Michiganders live with mental illness. 638,000 live with a substance use disorder. Most don’t get treated. 38 percent of people with mental illness go without care. 80 percent of people with a substance use disorder go without care. And Michigan ranks 47th in the nation for psychiatric beds.
Left untreated these issues don’t disappear. They show up in overcrowded emergency rooms. It shows up in a county jail. It shows up as a missed shift, an eviction, or a person sleeping in their car.
Part of the problem is how the system was built. With ten prepaid inpatient health plans (PIHPs), forty-six community mental health service programs (CMHSPs), each have their own rules, their own audits, and their own contracts. A credential or audit earned in one region doesn’t count in the next. A rate approved in one region isn’t honored in the next. That’s not local control. That’s a patchwork that prevents people from accessing care.
Michigan's behavioral health system was built in pieces. Different rules in different regions. Different rates for the same service. Funding, oversight, and care tangled together in ways that slow people down at the moment they need help.
There is a way to make Michigan’s community mental health system stronger. The path forward is convergence. Bring the pieces together around the person seeking care. One set of standards in every county. Rates that hold for the full year so providers can plan accordingly. Clear lines between who pays for care, who provides it, and who checks the work.
The Path Forward
First, focus on care over control. Separate who pays for care from who delivers it. And publish the rates, the overhead, and where every dollar goes so providers can have the data to help them make informed decisions.
Second, create one statewide standard. One set of rules for credentialing, audits, and rates. A family in Ironwood should follow the same rules as a family in Inkster.
Third, create a stable provider network. When a provider is forced to close because the rates they are asked to charge are not enough to pay for the care they give, access stops. A person shouldn’t lose their counselor because a rate got cut mid-year. No provider should operate with so much uncertainty.
Fourth, let every Michigander have access to care. Expand Certified Community Behavioral Health Clinics (CCBHCs) so more people get in the door. Keep substance use disorder (SUD) treatment available where people already go for it and pay for SUD services at the same rates and under the same rules as mental health.
Every Michigander deserves quality care, when and where they need it. Regardless of zip code.
This is about people, not politics. In Michigan’s behavioral health system, we need:
Access. Stability. Continuity. Accountability. Efficiency.
The Vision: A stable, accountable system. Access driven by need — not by structure, not by control.
The one liner: This is about people accessing care, not about who runs the system.
The one number: 80 percent of Michiganders with a substance use disorder go without care.
The problem: Ten PIHPs, 46 CMHSPs, different rules in every region.
The fix: Care over control, one standard statewide, a stable network, access regardless of zip code.
Direct Care Wages, Minimum Wage, H.R. 1, and Rates
The state mandated a wage, and it has the potential to force providers to stop providing services
Fair pay for direct care workers seems reasonable. So does adjusting the minimum wage. Yet a wage mandate only works if the money to pay it reaches the providers who employ those workers. Since January 1, 2026, providers have been required to pay direct care workers at least $17.13 an hour. Some PIHPs and CMHSPs are passing funding along to their providers to address the increate in wages. However, others are keeping the funding or passing through too little to cover the costs, leaving providers without the resources to pay for the direct care wages.
Actuaries set rates based on the minimum wage plus a universal add-on, and do not account for overtime or travel. There is no standard process for Milliman to set rates that reflect the new wage. Workforce shortages force providers to keep paying overtime and incentives just to cover shifts. CMHA, for its part, points to declining Medicaid enrollment and increasing deficits as the reason some CMHSPs are cutting rates. It has proposed eliminating the universal add-on or moving to a directed payment for direct care wages, similar to how hospital and autism rates are paid.
The pressure is about to get worse. On January 1, 2027, Michigan’s minimum wage rises from $13.73 to $15.00 an hour, and it will be adjusted for inflation every year after that. Today’s $17.13 direct care wage is the current minimum wage plus the $3.40 add-on. If that formula holds, the direct care wage rises to $18.40, and unless rates follow, the gap between what providers must pay and what they are reimbursed gets wider.
The Legislature also needs to take a hard look at the rates providers are paid. Those rates have not kept up with the direct care wage mandate, the minimum wage increases, or the other costs that come with delivering care, including benefits, overtime, travel, and the incentives it takes to fill shifts. Rates should be adjusted every time a wage mandate changes, set through a clear and consistent process, and held for the full year so providers can plan and keep their staff. Funding intended for rate increases should be required to reach providers, with a public accounting of where it went. Without that, providers are left making difficult decisions about where to prioritize care, and those decisions fall on the people they serve.
HR1 adds another layer. The expected loss of Healthy Michigan Plan enrollees will shrink the dollars flowing into the system at the same moment providers are being asked to pay more. Many providers will also have to hire additional staff just to handle the new requirements under HR1, with no additional funding to cover them. All of it leads to the same place: providers footing the bill and making difficult choices that affect access to care. Without action in FY 2027 to send any relief to providers, they may be forced to cut services, limit capacity, close programs, and in some cases close entirely. When that happens, people will lose access to care. Providers should not have to choose between complying with a state mandate and keeping their doors open.
Overall, the funding passed by the legislature, intended for the people providing care is not, making its way into the communities it was meant for. The same entities that received the money decided how much of it to pass along, with no requirement to show where it went. That is why full transparency on rates, overhead, and where every dollar goes is so important to have oversight on. It is why we need one standard statewide, so a rate approved in one region is honored in the next. And it is why a stable provider network matters. When a provider closes, care stops.
The Campaign
Where Mental Health and SUD Fit in Medicare for All
Medicare for All would replace private insurance, Medicaid, and the ACA marketplaces with a single government health plan for every U.S. resident. Mental health and substance use treatment are written in as covered benefits, alongside hospital care, prescription drugs, and home- and community-based long-term care. There would be no deductibles or copays for covered services, with prescription drugs the only exception. Earlier versions of the Medicare for All legislation also covered services from licensed marriage and family therapists and licensed mental health counselors, along with transportation to care for people with disabilities, older adults, and people with low incomes.
For providers, behavioral health and SUD treatment would be guaranteed benefits for everyone, and cost would no longer keep people from walking in the door. The risks are just as real however. The bill would end Medicaid payments for services once the new program begins, and Michigan’s public behavioral health system runs on Medicaid. Nothing in the variations of Medicare for All explains how PIHPs, CMHSPs, or the specialty services provided today would fit into a single federal plan, or what rates would look like. A transition that large would test a provider network that is already stretched. Public opinion is also soft: a KFF poll found 66 percent support a single national plan, but support drops when people hear it could mean delays in care or higher taxes. Coverage for everyone is a promise; access depends on whether there is still a provider there to keep it.
Dive Deeper, see Medicare for All’ Is Back. Now Comes the Hard Part, KFF Health News
Whitmer Signs Law Letting Limited License Psychologists Practice Without Supervision
Gov. Gretchen Whitmer signed SB 413, which allows Michigan’s limited license psychologists to practice without ongoing supervision, MIRS reports. The bill, sponsored by Sen. Paul Wojno (D-Warren), also lifts advertising restrictions on these master’s-level clinicians, though they must still limit their work to services they are qualified for by education, training or experience. For community-based providers that struggle to fill clinical roles, the law lets experienced LLPs on staff work independently without tying up a supervising clinician’s time. New licensing standards begin 12 months after the law takes effect and require two years of supervised postgraduate experience: 3,000 hours for master’s degrees earned before Aug. 31, 2027, and 4,000 hours for degrees earned on or after that date. Leaders should review their LLP staffing and supervision structures now and identify any staff in supervised training who may fall under the transition provisions.
Sobriety Court Graduates Reoffend at Less Than Half the Rate of Non-Participants
Michigan sobriety court graduates had a 10% rate of new drug or alcohol convictions within five years, compared with 21% for a comparison group that did not participate, according to the Michigan Supreme Court’s fiscal year 2025 report. The state’s 115 adult drug treatment courts pair substance use treatment with drug testing, probation supervision and regular check-ins with judges, and participants who complete the program can earn a reduced sentence or charge. Ingham County District Court in Mason held its 69th graduation this week, bringing its total to 898 graduates since 2004, with peer resource coaches, therapy facilitators, probation officers and family members speaking on behalf of the seven new graduates. Judges say referrals come from court cases, arresting officers and even defendants’ families, and Gladwin and Clare County Judge Joshua Farrell said these are programs people deserve to know about. Providers should connect with the specialty court coordinators in their counties to strengthen referral and treatment partnerships and make sure courts know what services they offer.
MDHHS Updates
State and local officials commemorate completion of new $383 million Southeast Michigan Psychiatric Hospital
State and local officials gathered last week for an open house commemorating the completion of the new 264-bed Southeast Michigan Psychiatric Hospital and the state’s continued focus on improving access to behavioral health care for Michigan families.
Slated to begin accepting patients this fall, the new hospital will offer care for up to 192 adults and 72 youth, increasing the state’s capacity by 54 beds. The facility is being made possible due to $383.4 million in budget investments by Gov. Gretchen Whitmer and the legislature.
Access to reliable, affordable behavioral health care is critical to the health and well-being of Michigan residents and communities. Throughout my time as Governor, I have been committed to expanding access to care across the state. The new Southeast Michigan Psychiatric Hospital increases patient care capacity and creates an additional 150 professional health care jobs. It will offer a healing environment where patients can receive treatment with dignity and hope.
While the new psychiatric complex will serve all ages, the hospital features distinct facilities with separate living and programmatic spaces for children and adults. There are 198 single-bed suites with private bathrooms and 33 double rooms. A fully equipped studio apartment also offers the opportunity for independence training for adult patients. The hospital’s interior design features a Michigan wildflower theme and includes flowers indigenous to the state throughout the building, bringing Michigan’s natural beauty indoors to help create a calm, healing environment.
The more than 400,000-square-foot facility features a gymnasium, art rooms and sensory spaces to support holistic care and 12 secure outdoor courtyards for recreational space. Modernized spaces for staff for treatment consultations, meetings and breakrooms are also featured in the new hospital, along with building access controls and video surveillance for enhanced patient safety.
The complex includes shared administration and food service, allowing for budget savings, along with building management systems and a geothermal HVAC system designed to significantly enhance energy efficiency and long-term sustainability. Powered by 352 geothermal wells, this modern infrastructure is expected to reduce heating and cooling costs by approximately 40% compared to traditional HVAC systems, an estimated savings of about $168,000 a year.
The new facility continues efforts to ensure access to behavioral health care for Michigan families when they need it, where they need it and at the level of care they need.
It will replace Hawthorn Center, which opened in 1965 and was demolished to make way for the new hospital, and Walter Reuther Psychiatric Hospital, which opened in 1979, and is slated to close after the new facility opens and patients are relocated.
The State of Michigan currently operates four inpatient hospitals that serve nearly 600 patients. Caro Psychiatric Hospital and Kalamazoo Psychiatric Hospital serve adult patients and the Southeast Michigan Psychiatric Hospital serves both adults and youth in separate areas of the facility. The Center for Forensic Psychiatry provides diagnostic services to the criminal justice system and psychiatric treatment for criminal defendants adjudicated incompetent to stand trial or acquitted by not guilty by reason of insanity.
Michigan's state hospitals are accredited by the Joint Commission and authorized by the Centers for Medicare & Medicaid Services, and are committed to providing evidence-supported, person-centered inpatient care to individuals in an environment that values compassion, collaboration and community reintegration.
Slated to begin accepting patients this fall, the Southeast Michigan Psychiatric Hospital will offer care for up to 192 adults and 72 youth, increasing the state’s capacity by 54 beds. The facility is being made possible due to $383.4 million in budget investments by Gov. Gretchen Whitmer and the legislature.
MDHHS seeks applicants for Michigan Opioid Treatment Access Scholarship Program
The Michigan Opioid Treatment Access Scholarship Program aims to increase the number of qualified substance use disorder (SUD) professionals. It provides educational scholarships to students who are participating in a degree program that will lead to a career dedicated to providing opioid treatment services. It continues MDHHS’ commitment to addressing SUD workforce shortages and improving access to services through stipends, scholarships and loan forgiveness. Since 2019, MDHHS has provided $4.9 million to 262 students and providers.
Applicants must be enrolled in an accredited program within the United States and sign a personal service agreement with MDHHS to participate in the scholarship program. Participants will take part in surveys and engage in program evaluation activities. A commitment to seek employment providing opioid treatment services in Michigan for a minimum of two years after graduation is also required. Applicants must complete an online application and submit financial aid information and other necessary supporting documentation by Monday, Nov. 9. Applicants will receive an email notification of their acceptance status within 12 weeks of the application deadline. For more information and to apply, visit the Michigan Opioid Treatment Access Scholarship Program website or email MIOTA-SP staff at [email protected].
From the PIHPs/CMHSPs
Treatment and Reentry Partners Support Secure Care for Kent, Secure Care for Kent
Johnston retires, Garthe leads Centra Wellness Network, Benzie County Record Patriot
Relationships with law enforcement and community organizations central to rural mental health services, Second Wave
Take Time for You Fall Lunch and Learn Series, Alpena News
CCBHC
Expansions
Marshfield Clinic earns $580K grant to address mental health, Sanford Health News
Michigan set to open new $383 million psychiatric hospital in Northville , Michigan Advance (See MDHHS story above)
Investigations
Oakland County man indicted in $4.75M Medicare fraud scheme at Detroit adult daycare, Oakland Confidential
Gov. Whitmer And President Grasso: Evidence Too Serious For Silence—Michigan Must Investigate Cassandra Fameux Case, Black Star News
Theater Review
Detroit ʼ67 tackles grief, love, and legacy in a Black family, Chicago Reader
Midterm Elections
Jackson state rep faces school board president in District 46 Michigan House race, Wolverine Confidential (MLIVE)
Michigan House Candidates Outline Priorities for Local Districts, The Sun Times News (Washtenaw County)
ICYMI
Houston, Detroit and Miami-Dade Among Eight Communities Sharing $96 Million to Bring Addiction Care to Homeless Residents, Medical Daily
Can “Poetry Saves Lives?” Festival shares how poetry benefits mental health, Rapid Growth (this is part of a paid placement by the CMHA)
Shared by Bridge Magazine
‘300 patients on our wait list’: That’s what Dr. George Mellos, a psychiatrist and superintendent of Michigan’s state hospitals, told me about the demand for long-term psychiatric care. “We don't want people in state hospitals,” he said, preferring expanding assertive community treatment and wraparound services for patients. “It's a direction we need to go.” (Cleveland Clinic)
Gov. Gretchen Whitmer signs bipartisan bills to: prohibit use of restraints when transporting youth to residential treatment, except in emergencies, and increase awareness of risks of tobacco, cannabis use by youth, (GOPMI, Bridge Magazine)
Michigan foster kids struggle under system that gives ‘nothing’ after aging out (Bridge) and How the system failed us: Former foster youth tell their stories (Michigan Public)
Is This a Healthcare Economy? KFF Health News
H.R. 1
Workforce
Other events
If you are a nonprofit behavioral health provider in Michigan, and not a member of the MI Care Council, MI Behavioral Health & Wellness Collaborative, or the Michigan Association of Substance Addiction Providers, or just interested in collaboration, please contact [email protected], for more information on the value of membership. If you know of someone who might find this content, please share this link to the newsletter.