It is in our right to speak up, speak out and create some “good trouble.” But too many providers are targeted for speaking up. For a system created to improve lives, too often people have issues accessing the system of care out of fear of retaliation for speaking up. It’s time to redesign the system. Pull Up Your Chair & Let’s Start the Conversation.
Retaliation
Retaliation in Michigan’s Behavioral health System is Real, but Unconstitutional
Community-based providers depend on public dollars, and that dependence makes speaking up feel risky. In Michigan, testifying in Lansing, talking to a reporter, or publicly questioning a funder puts contracts and referrals at risk. We have seen examples of the PIHPs and CMHSPs across the state eliminate contracts, cut of referrals, and reduce rates as a form of retaliation against providers.
But when your funder is a public body, including a PIHP or a CMHSP, the First Amendment limits what it can do in response. Retaliation against a provider for protected speech is not just bad practice. It is unconstitutional, and a recent federal court filing challenging a government ban on journalists at The White House, lays out the roadmap for making that case. (See Memo in Support of Preliminary Injunction in CNN, MS Now, Politico v Donald Trump)
The roadmap rests on three U.S. Supreme Court rulings.
In Houston Community College System v. Wilson (2022), the Court held that government officials may not take retaliatory action against people after the fact for protected speech.
In NRA v. Vullo (2024), the Court said officials may speak forcefully themselves but may not use state power to punish or suppress views they dislike.
In Counterman v. Colorado (2023), the Court recognized that retaliation produces self-censorship of speech the government could never ban outright.
For providers, the risk comes from system design. The same public entities that fund, audit, and credential providers also receive their criticism. A delayed payment, a sudden audit, a network exclusion, or a contract nonrenewal that follows public advocacy fits the pattern these cases address.
And when providers stay quiet to protect their contracts, legislators lose the information they need to fix the system.
What to do?
Keep a dated record of your public advocacy, including testimony, media interviews, coalition sign-ons, and public comments. Keep a parallel record of any adverse action from a public funder and the reason given in writing. If the timing lines up, take it to counsel before it becomes a dispute, and raise it through your association so no single provider carries the risk alone.
From the PIHPs/CMHSPs
CCBHC
The New Republic examined the national youth mental health crisis and highlighted Certified Community Behavioral Health Clinics (CCBHCs) as a bipartisan solution.
An Indiana clinic, 4C Health, is showing measurable improvements after 18 months operating as a CCBHC.
Oversight
Expansions
Michigan got $173M to transform rural health. Where is it going? , Associated Press
NSO Aims to Create a Park Near the Joe Louis Greenway to Support Detroiters Recovering from Substance Addiction, The Michigan Chronicle
SUD
County commissioners to review 2027 budget, opioid survey Tuesday, Ludington Daily News
Rural Health
Rural Health and Medicaid: Strategies to Expand Access and Strengthen Care
People living in rural communities face distinct barriers to care, including facility closures, workforce shortages, and long travel distances. At the same time, rural communities are developing innovative approaches to improve access and care delivery. New federal investments, including the Rural Health Transformation Program (RHTP), are providing additional resources for states to build on these efforts. The Center for Health Care Strategies (CHCS) is identifying promising strategies and examples from the field to help states and their partners use Medicaid to strengthen access to care, expand workforce capacity, and support sustainable health care delivery in rural and frontier communities.
For more, Upcoming Webinar | Strengthening Rural Behavioral Health Care Access Through a Community-Based Workforce;
October 13, 12:00 – 1:00 pm ET | This CHCS webinar will highlight how rural providers and health systems in Georgia, North Carolina, and Tennessee are using community-based workforce approaches to expand behavioral health care. Speakers will share insights on program design, recruitment, care team integration, sustainability, and implementation considerations. Learn more and register |
Rural communities across the country are expanding behavioral health care access through roles such as peer specialists and community health workers. Drawing on interviews with providers and community organizations in 10 states, this brief explores opportunities for extending care team capacity through a community-based workforce. A related profile describes how a peer-led community organization in rural Georgia provides recovery services while developing the local peer support workforce. Read the brief | Read the profile |
ICYMI
Mental Health First Aid is cited as a valuable resource in this coverage of the CDC’s Youth Risk Behavior Survey.
Detroit and Flint teens struggle with mental health – and worried adults around them feel ‘helpless’, Michigan Advance
The Campaign
Meet the candidates running for Michigan attorney general, The Eastern Echo
2 go head-to-head for Washtenaw County probate judge, Ann Arbor News
Meet the 2 candidates running to represent Grand Rapids’ 1st Ward, Grand Rapids Press
Gauss appointed to county commission vacancy, The Lenawee Voice
Detroit News endorsements for Wayne County state House races (See Stephen Boyle endorsement), Belleville News Democrat
Who is running for Port Huron school board? Meet the 4 candidates, The Times Herald
From the Department
MDHHS offers opportunity for collaboration to help strengthen juvenile justice residential treatment system
The Michigan Department of Health and Human Services (MDHHS) released a Request for Information(RFI) to collect input on solutions to help strengthen the state’s juvenile justice residential treatment continuum and shift how juvenile justice programs, policies and services are delivered statewide. Through an RFI, MDHHS is inviting vendors, service providers and subject matter experts to collaborate on improvement strategies that could help build on the department’s strategic planning, procurement and policy decisions related to Michigan’s juvenile justice residential treatment system. The RFI is grounded in comprehensive results from a juvenile justice needs assessment conducted by MDHHS, which included a statewide survey of court administrators and a series of stakeholder workgroup sessions facilitated by Public Consulting Group LLC. The assessment identified seven priority areas, including workforce recruitment and retention, specialized placement options for high-needs youth, expanded clinical services and greater access to services in rural and underserved areas of the state Responses to RFI 260000000016 must be submitted online through SIGMA, by 3 p.m., Friday, Oct. 9.
Medicaid Bulletin MMP 26-18 discusses Updates to Behavioral Health Treatment (BHT) Requirements for Autism Services and is issued on October 1, 2026. Final Bulletin MMP 26-18-BCCHPS.pdf
ICYMI
Medicaid
Nonprofits
Other newsletters to follow
Read their newsletter here and we wish Dean Kubiak well in her retirement and look forward to working with Dean Smith.
Events
Find their agenda here.
*Please send any upcoming events to [email protected]
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.