Legislative Analysis
Phone: (517) 373-8080
CERTIFIED COMMUNITY BEHAVIORAL
http://www.house.mi.gov/hfa
HEALTH CLINICS
Analysis available at
House Bill 5371 (H-3) as referred from subcommittee http://www.legislature.mi.gov
Sponsor: Rep. Felicia Brabec
House Bill 5372 (H-1) as referred from subcommittee
Sponsor: Rep. Phil Green
Committee: Health Policy
Complete to 11-12-24
SUMMARY:
The bills would add provisions to the Social Welfare Act related to certified community
behavioral health clinics (CCBHCs). Neither bill can take effect unless both bills are enacted.
Certified community behavioral health clinic would mean an entity that has been
certified by the Department of Health and Human Services (DHHS) in accordance with
federal criteria and the federal Protecting Access to Medicare Act of 2014, Public Law
113-93, 1 or an appropriate change or waiver to the Medicaid state plan.
House Bill 5371 would require DHHS to develop, in accordance with federal law and
regulations, a prospective payment system under the medical assistance program for funding
all of the following:
• A CCBHC.
• A community mental health service program (CMHSP), nonprofit organization, or
private organization that provides mental health services that is certified by DHHS as
a CCBHC, is licensed by DHHS, and adheres to all federal CCBHC requirements.
• A mental health provider who is certified by DHHS as a CCBHC and who adheres to
all federal CCBHC requirements.
Prospective payment system would mean a payment methodology that funds, in
advance, a CCBHC for the anticipated costs of carrying out the direct and indirect
clinical and administrative activities required of CCBHCs.
The payment system would have to fully comply with all federal payment methodologies.
DHHS would have to apply for any necessary waivers and approvals from the federal Centers
for Medicare and Medicaid Services. The system would have to be implemented (subject to
approval) before October 1, 2027.
DHHS would have to develop and issue rules to implement the bill, including at least rules that
do the following:
• Ensure continuing compliance with DHHS licensing and certification requirements.
1
https://www.govinfo.gov/content/pkg/PLAW-113publ93/pdf/PLAW-113publ93.pdf
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 • Prohibit retaliation against a mental health provider described above by a CMHSP
described above and establish procedures for investigating and adjudicating claims of
retaliation.
• Clearly define retaliatory actions and ensure fair enforcement as described below.
• Ensure equal payment to applicable persons under the prospective payment system
developed as described above.
• Outline the process for dispute resolution, including at least the appointment of an
independent adjudicator, timeline for filing of disputes, and standards for selecting and
compensating an independent adjudicator.
DHHS also would have to establish and enforce penalties for a violation of the rules, including
at least imposition of fines, suspension of contracts, or loss of certification as a CCBHC.
Proposed MCL 400.109o
House Bill 5372 would do all of the following:
• Prohibit the state government from implementing a policy that contradicts or interferes
with the implementation of federal definitions or requirements for a CCBHC.
• Require the state government to develop a process of determination for additional
CCBHC sites in specific geographic regions that must comply with federal CCBHC
requirements, to address service area overlap.
• Require the state government to continue to participate with the federal government to
implement CCBHCs. The bill states, “To opt out of participation, there must be a vote
of the legislature.”
Proposed MCL 400.109p
BACKGROUND:
As described by the Congressional Research Service: 2
CCBHCs are community-based outpatient facilities operated by nonprofit,
governmental, or tribal entities that offer a comprehensive range of behavioral health
services. Federal criteria related to access and quality of mental health care are used to
certify outpatient behavioral health clinics that meet these standards. The criteria
require CCBHCs to provide specified services, such as risk assessment, outpatient
mental health and substance use treatment, case management, psychiatric rehabilitation
services, peer and family supports, 24-hour crisis management, primary care screening,
and care coordination (among others), on site or through partnerships with other health
and social service providers. CCBHCs must provide services to individuals with mental
health and substance use disorders seeking care regardless of ability to pay or place of
2
https://crsreports.congress.gov/product/pdf/IF/IF12494
From the Council of State Governments: https://csgjusticecenter.org/wp-content/uploads/2023/06/Certified-
Community-Behavioral-Health-Clinics-Can-Address-Mental-Health-and-Substance-Use-Needs-Across-the-
Criminal-Justice-System-Intercepts-1.pdf
From the National Center for State Courts: https://www.ncsc.org/__data/assets/pdf_file/0019/71380/CCBHCs.pdf
Michigan’s demonstration program: https://www.michigan.gov/mdhhs/keep-mi-healthy/mentalhealth/ccbhc
House Fiscal Agency HBs 5371 (H-3) and 5372 (H-1) as referred to Health Policy Page 2 of 3
 residence. CCBHCs can serve patients covered by Medicare, Medicaid, and private
health insurance, as well as those who are uninsured. CCBHCs may receive state funds
or funding from other federal discretionary grant programs.
FISCAL IMPACT:
The state is currently participating in a federal demonstration program to provide Medicaid
reimbursements for enrolled CCBHC sites through September 30, 2027. The FY 2024-25
DHHS appropriations for supplemental CCBHC costs total $525.9 million Gross ($128.4
million GF/GP), which, according to DHHS, will support 33 CCBHCs located in 30 counties
and an additional three locations within those 30 counties starting January 1, 2025.
Since FY 2021-22, the program has expanded based on available appropriations. House Bill
5371 would instead allow DHHS to expand the number of CCBHC sites if DHHS decides to
certify mental health organizations and providers as CCBHCs if the mental health
organizations and providers adheres to all federal CCBHC requirements. It is unknown how
many additional CCBHC sites would enroll, but each additional CCBHC costs, on average,
approximately $14.5 million Gross ($3.5 million GF/GP).
Additionally, once the current federal demonstration program ends, states can decide to
continue the CCBHC program, but at a lower federal reimbursement rate. Under House Bill
5372, that continued participation would be required. The lower federal reimbursement rate,
based on the FY 2024-25 FMAP rates, would cost the state approximately $90.0 million
annually.
A number of CCBHCs are community mental health services programs (CMHSPs), so a local
CMHSP could receive additional Medicaid reimbursements for providing CCBHC services.
Legislative Analyst: Rick Yuille
Fiscal Analyst: Kevin Koorstra
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
House Fiscal Agency HBs 5371 (H-3) and 5372 (H-1) as referred to Health Policy Page 3 of 3


Statutes affected:
Substitute (H-3): 400.1, 400.119
Substitute (H-5): 400.1, 400.119
House Introduced Bill: 400.1, 400.119
As Passed by the House: 400.1, 400.119