We are united in a vision for bold, person-centric reform of Michigan’s Behavioral Health System.

The Michigan Department of Health and Human Services (MDHHS) recently announced an initiative to strengthen behavioral healthcare access, quality and choices for the approximately 300,000 individuals it serves.

On behalf of three nonprofit, direct-care provider organizations, we stand united in advocating for a reformed behavioral health system—one that is person-centered, efficient, effective, transparent, and accountable: a system free of conflicts of interest, designed to maximize resources for the people it serves.

While well-intended, Michigan’s Medicaid behavioral health system—in place since 1998—is outdated, underfunded, fragmented, and burdened by excessive administrative layers.

• • The system separates physical and behavioral health, making navigation difficult for individuals and creating bureaucratic barriers for providers.

• • The structure diverts critical resources and funds away from direct care, instead consuming them at the Prepaid Inpatient Health Plans (PIHPs) and Community Mental Health Authorities (CMHAs) levels.

• • There is no single point of accountability for whole-person health, nor incentives for investments that promote long-term well-being.

The most critical transformation needed in Michigan’s behavioral health system is empowering the people we serve with true choice and fully integrated care.

Michigan must move toward a stronger, more person-centered system that expands consumer choice by ensuring individuals can select from a fully funded, high-quality provider network. It should also strengthen specialized residential services, allowing people to thrive in community-based settings rather than face institutionalization. By reducing administrative waste, the system can direct more funding toward essential, direct-care services.

However, some CMHAs significantly underfund specialized residential services, arguing that personal care and community living supports should not cover essential wraparound services that help the people we serve live their best life possible. This short-sighted approach threatens the availability of residential options, increasing the risk of institutionalization rather than supporting people in their communities. To ensure individuals receive the care they need, funding must be appropriately allocated. This includes more support to direct care and less funding to administration, to sustain and expand high-quality, community-based residential services.

While the MDHHS’s recent survey is an important step in gathering feedback, we invite MDHHS leadership to visit our organizations firsthand—to see the growth, innovation, and direct-care solutions already making a difference in people’s lives.

This initiative should be a defining moment for Michigan—one that transforms the future of behavioral healthcare by ensuring more resources reach the people who need them most. Together, we advocate for a system that empowers the people we collectively serve—the more than 300,000 Michiganders with intellectual and developmental disabilities, serious mental illness, substance use disorders and other behavioral health needs—with the freedom to choose their service provider from a fully funded provider network. By adopting a statewide model that allows for continued coverage, transparency, and reimbursement based on the quality of outcomes from the care provided rather than the quantity of services provided, our state can build a system that provides seamless, high-quality care for those with behavioral health needs in Michigan.