Michigan 1915C SED Waiver

Michigan Presenters Sheri Falvay, Director of Mental Health Services to Children and Families  Connie Conklin, Director of Programs/Services for Children with a Serious Emotional Disturbance  Debbie Milhouse-Slaine, Director, Children's Home and Community Based Waivers 

Our SED Waiver (SEDW) Model  We wanted to maximize our existing structure (Community Mental Health Agencies, wraparound projects as well as system partners)  Michigan choose wraparound as the way to organize services and supports for the waiver as a required service  Wraparound provided the planning model to ensure youth and family voice to support needs driven plans versus service coordination

Rationale of SEDW Services  The SEDW services were chosen through a collaborative process with the CMHSPs and their system partners  It was important that these services matched the needs of the children and their families that were going to be served through the waiver  We wanted to ensure they allowed for creativity, flexibility and expanded beyond the traditional service array  After two years of implementing the waiver and doing site visits with CMHSP staff, administration and youth and families, we added additional waiver services based on their input and feedback (Parent to parent support and recreational therapy)

Structure that supports the SEDW  The SEDW is a separate Medicaid waiver from Michigan’s Capitated Managed care waiver  The SEDW is billed fee for service  The rates for the SEDW were established based on historical cost data of participating sites for similar services  The match requirement is the responsibility of the participating CMHSP/Local community  Many of the local communities have secured the local match requirement from other systems (Juvenile Court, Child Welfare)

Structure to supports the SEDW  There was extensive training offered to sites on administrative rules, Medicaid regulations, application process, billing, training requirements for staff, service array, program evaluation, etc  Wraparound requires that each county have a community team that oversees wraparound  The SEDW also requires that the community team acts as the gatekeeper for the waiver at the local level  The review referrals, plans, budgets and outcomes for all children/families on the SEDW

Service Capacity  Many of our SEDW services were developed and part of our CMHSP system  Expansion of core services (wraparound, home- based) needed to expand to support the SEDW  Other services (CLS, respite) were also expanded based on the needs of the children/families  The implementation of the waiver and the limited number of slots per county made it easier to plan for service expansion/capacity  Some services needed to be developed (Therapeutic foster care model)

Service Capacity  Some services were new and needed further explanation (Therapeutic overnight camps, transitional services, family training)  Some CMHSP needed to expand their provider network to meet demands/needs  CMHSP needed to ensure their contract providers met the provider qualifications to provide that service