Navigating the Community Mental Health System

Introduction

Community Mental Health, or CMH, provides a comprehensive range of services and supports to children, adolescents, and adults. Community Mental Health supports individuals with mental illnesses, developmental disabilities, and substance use and exists in all 83 counties.  24-hour emergency and crisis response services are included. CMH manages mental health benefits for persons enrolled in the Medicaid, MIChild, and Adult Benefit Waiver programs, as well as substance abuse coordinating agencies. (CMHA, 2019). Even if you are otherwise insured, you may still be eligible for CMH services through medicaid application.

Planning to apply for CMH services

A.  You must already have Medicaid before scheduling a meeting to apply for CMH services.

Apply for Medicaid at: https://newmibridges.michigan.gov/s/isd-landing-page?language=en_US

B.  Make sure you meet criteria for services.

Diagnostic Criteria
According to MCL 330.1100A, a “Developmental disability” means either of the following:

(a) individual older than 5 years of age, a severe, chronic condition that meets all of the following requirements:

1. attributable to a mental or physical impairment or combination of mental and physical impairments
2. manifested before the individual is 22 years old
3. likely to continue indefinitely
4. reflects the individual’s need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other lifelong services, individually planned and coordinated

(b) If applied to a minor from birth to 5 years of age, a substantial developmental delay or a specific congenital or acquired condition with a high probability of resulting in developmental disability as defined in subdivision (a) if services are not provided.

There must be substantial functional limitations in 3 or more of the following areas of major life activities to qualify for services through CMH:

  (A) Self-care

  (B) Receptive and expressive language

  (C) Learning

  (D) Mobility

  (E) Self-direction

  (F) Capacity for independent living

  (G) Economic self-sufficiency

Remember

1. Provide claims, with specific documentation, outlining the areas of functioning that are impacted most. 
2. This application process can be done individually, with a family member or friend, an advocate, or a paid attorney or professional support.
3. Filing under “disability” ensures more services than “healthy MI” Medicaid.

C. Gather documentation to prove disability status.

1. If the individual applying has a comorbid mental health condition, we recommend filing as a developmental disability as it provides appropriate services.
2. The more documentation about the history of impairment, the stronger your case will be!
3. Include notes from previous psychiatrists, doctors, evaluations, treatment notes, IEP, school reports, and attendance records. This involves a lot of time, but makes a big difference in supporting your case when applying for CMH services.
4. Questions to ask about the individual include, “What does their day typically look like? What are the hardest challenges that they face? What does their most difficult day look like? What amount of support is needed daily and what limitations do they face? How would they function if their support system was out of town for a week or month?” and use documentation to highlight these challenges and needs. The days that are most difficult are the ones that should be highlighted for CMH.

 D. Call CMH access line to set up an initial intake appointment to request services. 

1. CMH access line: Ann Arbor 734-544-305.
2. Find your local CMH access number on CMH’s web site: https://www.washtenaw.org/839/Community-Mental-Health
3. Initial intake appointments are usually 60-90 minutes and are in an interview format.  Clients can bring advocates, parents, significant others, partners, or anyone who is close to them who can help them advocate for themselves and speak to their disability.  
4. After the initial intake appointment, CMH must legally let you know if you have been approved to receive services within 7 days.

E. What can I do if the applicant is denied benefits?

            You have 30 days to appeal.

            You must prove a developmental disability. You can do this by:

1. Requesting a second opinion meeting (same as initial appointment but done with another intake specialist)
2. If denied after a second opinion appointment, appeal through CMH (included in the paperwork sent by CMH with initial denial of services) 
3. Finally, a hearing may occur if necessary

What comes next if my child is approved for CMH services?

1. Request an independent facilitator – CMH will assign your child a Supports Coordinator.  You have the option to request an independent facilitator, (a professional outside of CMH) to help determine your child’s plan of service or who will partner with the coordinator that CMH assigns.  
2. IPOS (Individual Plan of Service)/PCP (Person Centered Plan) – the individual will work with their supports coordinator to identify their goals, hopes, interests,  and preferences for their life. 
3. You can learn more about Person-Centered Planning here: https://www.michigan.gov/documents/mdch/How_Person-Centered_Planning_Works_for_You_367101_7.pdf

Resources

1. ACA-  (Washtenaw Association for Community Advocacy) located at the NEW Center- Provides advocacy and assistance with attaining CMH eligibility.
   1100 North Main Street, Suite 205, Ann Arbor, MI 48104
   Phone: 734.662.1256, Fax: 734.662.2699, E-mail: info@washtenawaca.org
2. Child Find– mandate that requires anyone with or suspected of developmental delay to receive support at school. For more information, please visit: https://www.understood.org/en/school-learning/your-childs-rights/basics-about-childs-rights/child-find-what-it-is-and-how-it-works
3. MRS- (Michigan Rehabilitation Services), provides solutions for businesses & individuals with disabilities, soft skills training. Ann Arbor District Office – provides services in Livingston and Washtenaw counties, located at 3810 Packard Road, Suite 170, Ann Arbor, MI 48108. Phone: 734-677-1125 or 877-901-9195 (Toll Free)
   
4. Center for Independent Living- provides testing, work capabilities. Phone:734 971-0277 Email: info@aacil.org
   
5. Peer Mentoring- program through CMH, provides peer advocacy/support. Contact your Case Manager / Supports Coordinator to find a Peer Mentor.

References

Ann Arbor Center for Independent Living. https://www.annarborcil.org/ 

Bilder, S., & Mechanic, D. (2003). Navigating the disability process: persons with mental
disorders applying for and receiving disability benefits. The Milbank quarterly, 81(1),
75–106. doi:10.1111/1468-0009.00039

CEICH, (2018). Peer mentoring. Retrieved from https://www.ceicmh.org/peer-mentoring.  

CMHA, Community Mental Health Association of Michigan, (2019). Retrieved from
https://cmham.org/about/about-cmham/

Determination of Eligibility for Michigan Mandatory Special Education for Infants and Toddlers,
Birth to Age Three Early Childhood Developmental Delay Guidance. (20160. Retrieved
from http://eotta.ccresa.org/Files/Uploads/New/188/ECDD_MMSE_Guidance.pdf

Holman, Kathy, (ACA). In person communication. (August 2019).

Lee, A. M. I. (2019). Child Find: What it is and How it Works.  Retrieved from
https://www.understood.org/en/school-learning/your-childs-rights/basics-about-childs-rights/child-find-what-it-is-and-how-it-works

MRS, Michigan Rehabilitative Services, ( 2019). Retrieved from
https://www.michigan.gov/mdhhs/0,5885,7-339-73971_25392_40237_40244_40913_41068-145433–,00.html

SocialSecurity.gov (2019).

WACA, Washtenaw Association for Community Advocacy, (2019).  Retrieved from  
https://www.washtenawaca.org/