The PIHPs lobbying organization offers their latest “alternative plan” by repackaging the current system, while providers and the state push forward with a redesign focused on accountability, transparency, and getting funds into care. There are some new places opening in Michigan and fresh leadership Up North, while the state focuses on passing their budget. Pull Up Your Chair & Let’s Start the Conversation.

Rearranging the Deck Chairs and Why Michigan Can’t Afford to Reskin Behavioral Health

Last week, the Community Mental Health Association of Michigan (CMHAM) unveiled the third leg of its $400,000 strategy against the state’s behavioral health rebid. The plan follows a lawsuit and a media campaign and now puts forward what CMHAM calls an “alternative system design.” On the surface, it reads like reform: new governance boards, promises of transparency, bold talk of redesign. But when you peel back the language, what’s left is the same structure we have today—dressed up to look like change.

The PIHP lobby’s “third leg” is less about co-designing transformation and more about stalling the state’s efforts. It is a placeholder model meant to block procurement, preserve PIHP power, and keep control in the hands of those who built and benefited from the current structure. Their proposal:

In short, CMHAM’s plan isn’t reform, it’s a defense of the status quo. It does nothing to remove barriers, resolve conflicts, or deliver the accountability legislators and MDHHS have demanded.

The system Michigan has relied on for decades is riddled with obstacles. Ten PIHPs and 46 CMHs each run their own contracts, audits, and rules. Dollars get tied up in reserves and administration while people wait for care. Families don’t need another round of promises; they need barriers removed. The state’s rebid does just that: fewer layers, standardized assessments, public transparency, and an end to PIHPs acting as both funder and referee.

CMHAM’s maneuvering extends beyond its “alternative plan.” PIHPs are now approaching county governments to create interlocal agreements that would form “public Medicaid behavioral health plans.” These agreements are an attempt to lock in the very structure the state has deemed broken. They are designed to bypass procurement, preserve PIHPs’ dual role, and undermine the legislature’s authority.

This isn’t about who owns the system—it’s about how funds are managed. The state’s redesign makes PIHPs funders only, subject to FOIA, Open Meetings, and uniform standards. Interlocal agreements, by contrast, keep PIHPs as funder, referee, and sometimes provider—an accountability loophole that no other Medicaid structure would allow. Counties and families deserve transparency, not backroom agreements that protect administrative fiefdoms.

MDHHS holds the Medicaid contract, and CMS provides the approval. Counties and PIHPs cannot unilaterally redefine the system. Interlocal agreements may be legal under the Mental Health Code, but they cannot override state procurement or federal waiver requirements. Medicaid belongs to the people of Michigan—not to ten regional PIHPs. Only the state can redesign it, and only with legislative oversight. MDHHS should make clear that interlocal agreements will not influence eligibility to bid or be recognized in the rebid process.

MDHHS holds the Medicaid contract and CMS approval. Counties and PIHPs don’t have the authority to redefine the system unilaterally. Interlocal agreements may be legal under the Mental Health Code, but they can’t override state procurement or federal waiver requirements. Medicaid belongs to the people of Michigan, not to 10 regional PIHPs. Only the state can redesign it, and only with legislative oversight. interlocal agreements are a defensive maneuver to protect bureaucracy, not as reform. TheMDHHS to issue guidance or a bulletin making clear that interlocal agreements won’t affect eligibility to bid or be recognized in the rebid process.

Michigan now faces a choice. We can embrace a real redesign that removes barriers and delivers trust, or we can accept a recycled version of the status quo that leaves families stuck in the same maze. Change doesn’t come from rearranging the deck chairs. It comes from removing the obstacles that keep people waiting for care. Legislators should stand with families and providers in moving forward—not with bureaucracies fighting to preserve themselves.

Read further,

MDHHS study finds harm reduction efforts make significant impacts
on overdose deaths, hospitalizations, cases of hepatitis C  

A new study from the Department of Health and Human Services shows that harm reduction efforts—once dismissed as fringe, even indulgent—are reshaping the state’s public health landscape. Naloxone kits, syringe service programs, and community-based agencies are no longer symbolic gestures but the bedrock of a statewide infrastructure that has cut overdose deaths, reduced emergency room visits, and slowed the spread of hepatitis C. The data, though clinical, points to a profound truth: lives that would have been abruptly ended in the shadows of addiction are, in growing numbers, being saved.

Since 2018, Michigan has built a lattice of thirty-seven harm reduction agencies with more than a hundred sites, distributing over a million naloxone kits and quietly changing the trajectory of families across the state. The numbers are startling: more than 550 lives saved in 2024 alone; thirteen thousand hospitalizations avoided in the past six years; more than four thousand hepatitis C cases prevented. These are not abstractions but the measurable residue of a shift in philosophy—from punishment and neglect toward prevention and care. The modeling suggests that every incremental investment in harm reduction yields not just returns in public health, but dividends in trust: between neighbors, between agencies, between the state and its citizens.

That these outcomes are being financed in part by settlement dollars from the same companies that fueled the epidemic adds an uneasy symmetry. Michigan will receive nearly $1.6 billion from distributors and manufacturers by 2040, and the state has chosen to direct much of it into a future that does not accept death as an inevitability of drug use. In a political climate where harm reduction is still debated, the findings are quietly radical: the epidemic bends not only to treatment and abstinence, but to the distribution of tools that keep people alive long enough to choose recovery. The state’s wager is that harm reduction is not a detour from healing—it is the path itself. See study and analysis and MDHHS News Release.

State Legislative Update

Michigan House Passes Bill Tying Mental Health Treatment to Competency Before Charges Are Dropped

Michigan lawmakers approved HB 4596, which delays the statutory 15-month timeline for dropping charges against defendants deemed incompetent to stand trial until after they receive mental health treatment. Supporters say the measure ensures justice for victims by making it more likely defendants can be restored to competency and face trial, while opponents argue it extends charges unfairly and risks punishing people who have not been convicted. The bill passed 64–36, with bipartisan opposition and support. Source MIRS.

CCBHCs Still 'Under Threat' Despite Some Federal Support - Behavioral Health Business, Behavioral Health Business

Licensure support sessions from Wayne State University, WSU

McDaniel Apartments at Andy’s Place II opens in Jackson, RE Journals

New Leaders Named for GT County Health Department, Northern Lakes CMH, (Lynda Zeller, new CEO), The Ticker

Oakland 360 Care Center Opens in Pontiac, Oakland County Times

ICYMI

Trump linked autism to childhood vaccine use and the taking of popular pain medication Tylenol by women when pregnant, elevating claims not backed by scientific evidence. On the Reuters World News podcastUS Healthcare and Pharma Editor Caroline Humer explains what Trump's warnings about Tylenol and autism are based on.

Fox Host Apologizes for Suggesting Lethal Injections for Mentally Ill Homeless People, The New York Times

Rural health clinics are closing after Trump’s ‘One Big Beautiful Bill,’ raising the legislation’s political risks (CNN)

Mindful Philanthropy released its latest report, Measuring Success in Mental Health Philanthropy, the capstone of our Mental Health at the Center series. This report anchors the field on a common set of goal metrics, a north star for measuring impact, driving accountability, and aligning investments toward lasting change.

The Quiet Crisis: Untreated Mental Illness and Violenc, Psychology Today

After Suicide Attempt, Michigan Family Battles Insurance Denial for Son’s Residential Mental Health Treatment, Bethel Advocate