April 2018 update to section 298 initiative

The Section 298 Initiative

Implementation of the Pilots

On March 9, 2018, MDHHS announced the pilot sites for the Section 298 Initiative as follows:

1. Pilot #1: Muskegon County CMH (dba HealthWest) and West Michigan Community Mental Health

2. Pilot #2: Genesee Health System

3. Pilot #3: Saginaw County Community Mental Health Authority ·

On April 6, 2018, MDHHS will host a summit of the pilot participants to discuss the next steps for implementing the pilots.

Implementation of the Demonstration Project

MDHHS received a draft proposal from the Total Health Collaborative (TTHC) in Kent County. MDHHS has provided TTHC with a formal set of comments on the draft proposal. TTHC will be submitting a detailed project plan to MDHHS within the next few weeks. Implementation of the Policy Recommendations. MDHHS has reviewed and analyzed all of recommendations from the final report of the 298 Facilitation Workgroup. MDHHS is preparing to publish a progress report on implementing the workgroup recommendations.

Twenty-five % of the Medicaid population is not enrolled in a Medicaid Health Plan (MHP) for management of their physical health services. However, the Prepaid Inpatient Health Plans (PIHP) manages the specialty behavioral health benefits for this sub-population. Given that this group is not enrolled in a MHP, it is not possible to integrate the behavioral health and physical health benefits through the MHP for the purposes of the pilots. MDHHS has been evaluating options to manage the specialty behavioral health benefits for the unenrolled population during the pilots, and MDHHS anticipates publishing a concept paper on this issue in late April

Evaluation of the Pilots and Demonstration Project

The University of Michigan (UM) evaluation team has been working on identifying performance metrics for the evaluation of the pilots and demonstration project. MDHHS and UM are also reviewing current reporting requirements for the Prepaid Inpatient Health Plans, Medicaid Health Plans, and Community Mental Health Service Programs to identify how information from these current reports can be used during the evaluation process. MDHHS and UM are beginning the process of soliciting input on the performance metrics from representatives of the current system and external technical experts. Stakeholder Engagement. MDHHS will be providing the following updates this week: o No presentations are scheduled for this week

The Section 298 Initiative is a statewide effort to improve the coordination of physical health services and behavioral health services in Michigan. This initiative is based upon Section 298 in the Public Act 268 of 2016. Under Section 298, the Michigan Legislature directs the Michigan Department of Health and Human Services to develop a set of recommendations “regarding the most effective financing model and policies for behavioral health services in order to improve the coordination of behavioral and physical health services for individuals with mental illnesses, intellectual and developmental disabilities, and substance use disorders.” MDHHS submitted a final report with recommendations for the Michigan Legislature on March 15, 2017. The Michigan legislature approved a revised version of Section 298 as part of Public Act 107 of 2017. Under the revised Section 298, the Michigan legislature directed the department to develop and implement up to three pilots and one demonstration model to test the integration of physical health and behavioral health services.

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