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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[1] 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.
  • Adoption of a standardized referral process for mental health services, including use of a new referral platform accessible to mental health providers, primary care providers, Community Mental Health Services Programs (CMHSPs), MHPs and PIHPs.

 

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.

 

Training for 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.
  • MichiCANS: Please utilize these instructions to register for the MichiCANS training. Providers must complete the TCOM Training prior to taking the Overview Training.

 

Webinars and Meetings:

The feedback process related to the Mental Health Framework MichiCANS Screener and LOCUS All Provider Draft Rate Meeting is now closed. Feedback received during the will be reviewed and considered.