The Michigan Department of Health and Human Services (MDHHS) extended the Behavioral Health Home (BHH) last week to other Michigan counties. The new counties are in the CMH partnership of Southeast Michigan and the Detroit Wayne Integrated Health Network Prepaid Inpatient Health Plans (PIHP)-region six and seven respectively.
BHH’s expansion will allow more Medicaid recipients to access coordinated services for serious behavioral health issues and aims to provide these services to people diagnosed with serious mental illness or severe emotional disorders.
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“The expansion of BHH will help address the complexity of physical and behavioral health conditions in Michigan and improve access to essential services,” said Elizabeth Hertel, Director of MDHHS. “For enrolled beneficiaries, the Health Home will function as the central point of contact to direct patient-centered care across the health care system.”
Coordination of care and consideration of the social determinants of health are key services that BHHs provide to Medicaid members. BHH has a variety of physical and behavioral health experts to meet these needs and connect members to other providers to meet their specific circumstances.
Michigan has struggled to provide reliable access to behavioral and mental health services. According to a 2019 report, 51% of Medicaid members in the state with a diagnosed mental illness did not receive treatment in a given year. This led to the development of these houses to create a care coordination network for people in need of behavioral health care.
Prior to this expansion, the program was only available in three PIHP regions. The success of the BHHs in the three smaller regions (Regions One, Two and Eight) demonstrated to MDHHS the quality of the program. Lindsey Naeyaert, behavioral health innovation specialist at MDHHS, said the success has led to its expansion into the more densely populated areas of southeast Michigan.
“We didn’t want to include Wayne County in the first implementation of BHH because it’s so large,” Naeyaert said. “We wanted to make sure we got it right with the top three [regions] which we started with.
To codify the expansion, CMS approved an amendment to Michigan’s state plan, which must be amended each time the state wishes to expand Medicare or Medicaid services. Prior to the approval of the amendment, the Budget 2022 also allocated funds for this expansion.
Naeyaert said the two expanded regions began implementing BHH coordinated care services on May 1 and already have people registered. In Region 6, two counties are still working on enrolling new members, but she said the regions are “gone racing.”
Bob Sheehan, executive director of the Community Mental Health Association of Michigan, said mental health care providers use a manual for the implementation of BHH, which facilitates the implementation schedule and the efficiency of the service.
“So if I have schizophrenia and I also have diabetes, my primary care provider, my diabetes provider, my physiotherapist, my psychiatrist, and my case manager are all in sync. [and communicating]”, Sheehan said. “I think we will see an increased emphasis on primary care and physical health so that people who already have a mental health problem in treatment can now ensure that it there will be a safety net around them.”
BHH teams will communicate regularly with people entering their facilities to ensure they do not fall through the cracks. Naeyaert said staff try to contact those who use their services once a month.
Opioid Health Homes (OHH) should also receive an expansion, Naeyaert said. OHH extensions should be included in the Budget 2023which will trigger a proposal to CMS for an amendment to the State Plan.