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Mental Health Framework

Mental Health Framework

What is the Michigan Medicaid “Mental Health Framework”?

The Michigan Department of Health and Human Services (MDHHS) is shifting to a more person-centered approach to serving Michiganders with mental health needs. As part of MIHealthyLife, an initiative that began in 2022 to strengthen the Comprehensive Health Care Program (CHCP), MDHHS is partnering with Medicaid Health Plans (MHPs), Prepaid Inpatient Health Plans (PIHPs), and providers to improve access to and coordination of mental health care across the Medicaid program.

Under the Mental Health Framework, an enrollee’s level of mental health need, as determined through a State-identified standardized assessment tool, will more clearly determine which payer—the enrollee’s MHP or PIHP—is responsible for their mental health coverage and care. Also, MHPs will begin covering some additional mental health services for enrollees with lower levels of mental health need, so MHPs are accountable for more of these enrollees’ continuum of care. Beginning in October 2026:

  • MHPs will cover most mental health services for CHCP enrollees with lower levels of mental health need, and
  • PIHPs will cover all mental health services for CHCP enrollees with higher levels of mental health need.

Referrals for mental health care, including those across MHP and PIHP systems, will be standardized to facilitate enrollee access to needed care. 

 

What Does this Mean for Mental Health Providers?

Beginning in October 2025, all qualified mental health providers participating in Michigan’s Medicaid program and contracted with an MHP and/or PIHP will need to incorporate into their practice:

  • Use of standardized tools for assessing the level of mental health need of CHCP enrollees seeking mental health The State’s designated assessment tools are the Michigan Child and Adolescent Needs and Strengths (MichiCANS) Screener for children and youth (under 21) and the Level of Care Utilization System (LOCUS) for adults (21 and older). MDHHS will provide more information and access to trainings on these tools in the coming months. This is only a requirement for CHCP enrollees (enrolled in a Medicaid Health Plan). Information regarding the assessment frequency requirement, billing, and instructions for accessing the tools will be included in an upcoming policy guide. MDHHS understands that not all providers will be fully trained by October 1, 2025, and anticipates that it will take time -- over the course of the next fiscal year -- for all eligible providers to be fully trained. Training status over the next year will not impact a provider's ability to provide and be reimbursed for other mental health services rendered.
  • Adoption of a standardized referral process for mental health services, including use of a new referral platform accessible Community Mental Health Services Programs (CMHSPs), MHPs and PIHPs. Mental health care providers and primary care providers will be included in this referral process during FY2026, but have no changes as of 10/1/25. See below for more details related to the referrals policy.

Beginning in October 2026, MHPs will begin covering additional mental health services—including inpatient psychiatric care, crisis residential services, partial hospitalization services, and targeted case management—for enrollees with lower levels of mental health need. Providers of these services should prepare to contract with MHPs, as well as PIHPs, for coverage effective October 1, 2026. In the coming months, MDHHS will provide more detailed guidance to facilitate these efforts.

MDHHS encourages all mental health providers to send any questions or comments to MDHHS-MentalHlthFramework@michigan.gov.

 

Standardized Assessments

Standardized assessment training will be free for providers and eligible for CME/CEU credit (details vary between each training).

  • LOCUS:
    • The LOCUS Training will be an online, self-paced training. Once available, there will be a link provided here on the webpage, as well as communication sent out. If you are provider that is in need of LOCUS training, please fill out this form.
  • MichiCANS:
    • Please utilize these instructions to register for the MichiCANS training. Providers must complete the TCOM Training prior to taking the Overview Training.

 

Referrals

What is the Standardized Mental Health Referrals Policy?

One of the forthcoming policy changes effective October 2025 is a standardized process for making referrals for mental health care across Medicaid Health Plan (MHP) and Prepaid Inpatient Health Plan (PIHP) delivery systems. This policy is being designed to improve enrollee experience during referrals and strengthen accountability for ensuring referrals are completed in a timely manner.MHPs, PIHPs, CMHSPs, will be required to use a standardized process for making referrals for mental health care, with implementation phased in during the course of fiscal year (FY) 2026.

The Mental Health Framework referrals policy includes the following components:

  • Use of a standardized referral form and process with consistent information and format;
  • Use of a CareConnect360 (CC360) referrals module to make referrals and enable information sharing and tracking referral status across MHPs, PIHPs, and CMHSPs.
  • MHPs proactively monitoring mental health referrals for all of their enrollees based on information in the CC360 referrals module, and conducting outreach to enrollees, providers, and/or the PIHP as needed to support referral completion and access to care.

What is the timing for participation in the Standardized Referral Process?

Key Message: If you are a mental health provider contracted with a Medicaid Health Plan (MHP) and are not a Community Mental Health Services Program (CMHSP) provider, you will not be expected to participate in the standardized mental health referrals process beginning in October 2025. Any changes that impact providers during FY26 will be communicated in advance of those changes. 

MHPs, PIHPs, and CMHSPs can access the CC360 module access beginning in October 2025 and are required to participate in the initial launch of the new standardized mental health referral process and provide feedback on the process and tools to support refinement.

Training and other support will be available from MDHHS will be available as MHPs, PIHPs, and CMHSPs utilize the referrals process and use of the CC360 module. 

 

Webinars and Meetings:

 

Documents

Comparison Rates for the Standardized Assessments
Frequently Asked Questions