MAC sets Dec. 11 webinar to update counties on state opioid efforts
Join MAC for a Dec. 11 webinar with the Michigan Department of Health and Human Services that will highlight how state opioid settlement funds are being prioritized to advance prevention, harm reduction treatment and recovery efforts across Michigan.
The webinar will run from 2:30 p.m. to 3:30 p.m. Eastern. Click here to register.
This session will discuss the latest data on opioid and substance use disorder, walk through the state’s current funding strategies, highlight opportunities for alignment with local priorities and outline the technical assistance and resources available to support local governments in decision-making.
Local governments will gain clarity on where the state is headed and what supports they can access to strengthen their own planning and implementation.
Direct questions about the webinar to MAC’s Amy Dolinky at dolinky@micounties.org.
MAC extends local control efforts on mental health oversight
In the spring, the Michigan Department of Health and Human Services proposed to solicit bids for the state’s Prepaid Inpatient Health Plan (PIHP) contracts. MAC joined with the Community Mental Health Association and other stakeholders in urging the department to reverse course. Opposition efforts included litigation in state courts.
In late September, however, it became clear the state was not to be dissuaded from its course. And a much-anticipated ruling from the Court of Claims did not block the state’s project prior to the bid submission deadline.
This left MAC to make tough choices quickly to continue our defense of local control by engaging in the RFP process we had opposed at the policy level.
Why did MAC bid on the MDHHS Specialty Behavioral Health Services RFP?
The answer is simple. Without knowing who was going to bid on the MDHHS RFP and who the department might select, MAC’s Board of Directors decided to submit a bid to offer a collaborative option based on local control and maintain as much of the current system as possible within the MDHHS RFP criteria. MAC still opposes the direction the department has taken in putting the system out to bid and has asked for the RFP to be pulled back.
MAC did this through the creation of the MAC Behavioral Health Network (MACBHN), a separate 501(c)(3) nonprofit whose board will meet the MDHHS RFP criteria and be made up of regional representatives, individuals with lived experience, including one family member of a child with lived experience, and at-large representatives from any Michigan county.
MAC’s statewide footprint — and direct connection to locally elected commissioners — gives MAC a unique ability to ensure that decisions about behavioral health services remain grounded in the needs of the people and counties they affect.
Through MAC’s bid, the system would:
- Maintain local control and accountability
- Promote and support behavioral health services statewide
- Improve access through collaboration across counties, local governments, and providers
- Develop programs that address mental health, substance use, and community wellness
- Provide training, education, and technical assistance
- Advocate for policies and system integration that strengthen behavioral health in Michigan
Michigan’s current PIHP system — built by community mental health service programs (CMHSPs) and Michigan counties — holds decades of knowledge and experience. MAC acknowledges that this expertise is vital and must not be lost.
Losing local financial control would be damaging, but losing institutional knowledge could be devastating for individuals who rely on care. For that reason, MAC intends to honor the intent of state statute (MCL 330.1204b(7)(b)) by ensuring that employees are transferred to the new entity with their rights and benefits protected for one year.
The goal of the MAC bid is not disruption or competition with the current system — but continuity to the extent possible in an environment where MDHHS is signaled change will occur. …
Podcast 83: Housing prices worsening homeless crisis in Michigan
A special episode of MAC’s Podcast 83 this week looks at a growing crisis in all corners of our state: homelessness.
“Since 2020, home prices, or rental prices, in Michigan have gone up over 25 percent since the pandemic,” said Nick Cook of the Michigan Coalition Against Homelessness (MCAH), “and this is leading to this exacerbated situation of homelessness. We’re starting to see more families, more seniors losing their housing access.”
“The Michigan Coalition Against Homelessness is a statewide nonprofit that provides supports to homeless service providers, counties, communities, anyone interested in addressing and preventing homelessness,” explained Sarah Rennie, Cook’s colleague. “We look at this as an affordable housing, and economic development, issue, and so we represent hundreds of folks across the state who have joined together to say hey, this is an issue for our communities.”
Homeless counts reached record levels in 2024, reports the National Alliance to End Homelessness in a report, adding, “More people experiencing homelessness in rural and suburban areas are unsheltered, in part due to federal cuts to rural housing programs and barriers to rural development. Still, most people experiencing homelessness live in urban areas in a handful of states due to the larger populations in these areas.”
Cook and Rennie explained that county leaders and others wishing to connect constituents to resources should engage with two resources:
“There is a structure in the state that there will be a housing assistance resource advocacy, specific nonprofit that’s designated to sort of be the hub to take in folks who have needs, and then refer them to the correct, place,” Rennie said. “So, you should find out who your HARA is, because they’ll be able to sort of direct folks exactly where they need to go.
“Together with the HARA is also part of a larger network called your Continuum of Care, and all those folks meet to see how they can best use resources and serve folks, and they meet weekly. … I would really recommend for the listeners here that you sit down with your local COC chair.”
“If you could talk to any county commissioner right now about the work that you guys are doing that maybe they don’t fully realize, what would you tell them?” asked the episode’s host, Jimmy Johnson of MAC.
“What I would like folks to know is there’s this weird stereotype that these are sort of dangerous people that are gonna get you in the streets … These are our neighbors, these are families, these are people who have served our country. And they are all one paycheck away from needing these support services, because this is an affordable housing issue. … We have more than 298,000 units missing of affordable housing … So, I would want folks to know that (the coalition) is here to support you; that criminalization doesn’t work; but that we can make a difference together.”
For more details, watch the full episode by clicking here or on the image above.
Cook can be reached at ncook@mihomeless.org, while Rennie can be reached at srennie@mihomeless.org.
CMS tightens Medicaid oversight, prompting local review needs
The Centers for Medicare and Medicaid Services (CMS) released new federal guidance last week that changes how states can use certain taxes to finance their Medicaid programs — an adjustment that may eventually influence state budgeting and the county-level services tied to it.
The guidance, issued under the Working Families Tax Cuts Act (Public Law 119-21), restricts states from creating or increasing “provider taxes” used to draw down enhanced federal Medicaid match dollars. CMS is also closing a long-standing financing loophole that allows some states to use these taxes to generate disproportionately high federal reimbursements. Nationally, the agency estimates these changes will save more than $200 billion over 10 years.
States will have staggered transition windows to unwind these practices. Taxes levied on Medicaid managed care organizations must comply by the end of each state’s FY 2026, while all other affected provider taxes must be phased in by FY 2028. CMS describes these steps as part of a broader effort to improve transparency and reinforce the federal-state partnership in funding Medicaid.
For Michigan, these changes could add pressure to the state budget over the coming years. If federal dollars tighten, state policymakers may need to adjust how they support core health and human services programs — several of which counties help deliver or rely on, including community mental health, public health operations, long-term care services, and indigent care. Counties may also encounter more detailed reporting or financial oversight requirements as the reforms take hold.
With these federal changes now in motion, it may be useful for counties to take stock of how Medicaid dollars intersect with local services. For most Michigan counties, the most common touchpoints include community mental health services (through CMHSPs and PIHP regions), public health departments, medical care facilities (county-owned medical care facilities), juvenile justice and child welfare programs supported through DHHS pass-throughs, local transportation for medical appointments (NEMT coordination) and indigent medical or jail-related behavioral health services. Many counties also have additional Medicaid-connected programs depending on local structure and partnerships, such as aging services, housing stabilization supports, crisis response teams, etc.
For more information on this issue, contact Jimmy Johnson at Johnson@micounties.org.
New tool aids counties on opioid spending
The Partnership to End Addiction has released a new tool, Guidance for Investing the Opioid Settlement Funds in Primary Prevention, to assist decision makers. The complete guide outlines what prevention is, the types of prevention efforts, why they are effective, which approaches to utilize, and provides practical examples. The document intends to help communities invest in prevention strategies that reduce current risks but also protect the next generation.
Additionally, a one-pager detailing green flags and red flags to look for when funding primary prevention activities. The document can be found here and outlines:
- Green Flags
- Evidence-based
- Address risk factors
- Engage families
- Address community needs
- Red Flags
- One-time events
- Guest speakers
- Standalone media campaigns
- Scare tactics
- Punitive practices
- Reliance on a single product
For more information, or to request technical assistance, contact Amy Dolinky at dolinky@micounties.org.
Staff picks
- Michigan Forecast: Blizzard warnings, damaging winds as powerful winter storm strikes (MLive)
- The most popular Thanksgiving sides by state — one favorite barely ranked (Mental Floss)
- Archaeologists found a 2,000-year-old garden beneath a church. It may be the site of Jesus’ tomb. (Popular Mechanics)
- Most modern dogs have wolf DNA from relatively recent interbreeding. Here’s which breeds are the most and least ‘wolfish.’ (Live Science)