Services for Adults
This section explains some of the services available to adults from CMHCM. Please contact the office in your county to start the application process.
Before services can be started, you will take part in an assessment to find out if you are eligible for services and what services will best meet your needs. During this planning process, you will be helped to figure out the medically necessary services, as well as amount, scope, and duration of those services. You will also be able to choose who provides your supports and services. You will receive an individual plan of service that provides all of this information.
Services CMHCM Provides
NOTE: Services in red are evidenced-based practices.
Access/Referral provides people with information and referral about community resources. Access assists with service determination and eligibility and may screen and triage routine and urgent situations. All eligible persons will be linked to appropriate resources and those not eligible will be connected to community resources.
Assertive Community Treatment (ACT) provides intensive and basic services and supports essential for people with serious mental illness to maintain independence in the community. An ACT team will provide mental health therapy and help with medications. The team may also help access community resources and supports needed to maintain wellness and participate in social, educational, and vocational activities.
ACT consumer criteria—one of the following:
- Serious mental illness (SMI) with difficulty managing medications
- SMI with a co-occurring substance disorder
- SMI who exhibit socially disruptive behaviors at high risk for jail or prison, or those who have been incarcerated
- Frequent psychiatric hospitalizations
- SMI and serious medical conditions
Anger Management is a weekly cognitive behavior therapy group service focused on reducing anger and enhancing self-control and is offered in many of our counties.
Assessment includes a comprehensive psychiatric evaluation, psychological testing, substance abuse screening, or other assessments, except for physical health, conducted by a qualified mental health practitioner to determine person’s level of functioning and mental health treatment needs.
*Assistive Technology includes adaptive devices and supplies that are not covered under the Medicaid Health Plan or by other community resources. These devices help individuals to better take care of themselves or to better interact in the places where they live, work and play.
Behavior Treatment Review is a review that occurs if a person’s illness or disability involves behaviors that they or others who work with them want to change. Their individual plan of service may include a plan that talks about the behavior. This plan is often called a “positive behavior supports plan.” The positive behavior supports plan is developed during person-centered planning and then is approved and reviewed regularly by a team of specialists to make sure that it is effective and dignified and continues to meet the person’s needs.
Brief Strategic Family Therapy (BSFT) is a short-term, family-based, therapeutic intervention that targets children and adolescents aged six to 17 years. BSFT was designed and empirically validated to eliminate/significantly reduce conduct problems, drug use and associated acting-out behaviors and their corresponding emotional problems. By utilizing BSFT change interventions, dysfunctional family interactions are reversed, families are strengthened and the psychosocial problems of the children are significantly improved. BSFT is delivered in weekly, one to one-and-a-half hour sessions. The key approaches included in the treatment are (1) focus on improving parent-child interactions; (2) parent training; (3) developing conflict resolution, parenting, and communication skills; and (4) family therapy. This therapy is available in all six counties.
Clubhouse Programs are programs where members (adult consumers with a mental illness) and staff work side-by-side to operate the clubhouse and to encourage participation in the greater community. Clubhouse programs focus on fostering recovery, competency and social supports, as well as vocational skills and opportunities. Programs such as this are available in several of our communities.
Cognitive Behavior Therapy (CBT) is a therapeutic approach to helping resolve emotional and behavioral disturbance by looking at how the consumer’s thoughts and beliefs impact the way they feel and behave. According to this model, the best way to change dysfunctional emotions and behaviors is to modify inaccurate and dysfunctional thinking. There are a number of thought distortions and irrational beliefs that humans are drawn toward, but are not helpful. For instance, a person might use “all-or-nothing thinking” and view things as either all good or all bad—if their performance falls short of perfect, they see themselves as a total failure. Another example is “overgeneralization,” where you see a single negative event as a never-ending pattern and may view a situation in terms of “never” going right or “always” going wrong. The goal is to help the consumer recognize and change negative thoughts and maladaptive beliefs that lead to distressing emotions and/or ineffective ways of coping. In realizing these mistaken beliefs, a person’s mood and subsequent behaviors improve as a result. CBT is brief/time-limited and present-centered, focused on current concerns.
Community Inclusion and Participation is a part of the person-centered planning process that assists individuals to use community services and to participate in community activities.
Community Inpatient Services are hospital services used to stabilize a mental health condition in the event of a significant change in symptoms of in a mental health emergency. Community hospital services are provided in licensed psychiatric hospitals and in licensed psychiatric units of general hospitals.
Community Living Supports (CLS) are activities provided by paid staff that help adults with either serious mental illness or developmental disabilities live independently and participate actively in the community. Community Living Supports may also help families who have children with special needs (such as developmental disabilities or serious emotional disturbance).
Crisis Interventions are unscheduled individual or group services aimed at reducing or eliminating the impact of unexpected events on mental health and well-being.
Crisis Residential Services are short-term alternatives to inpatient hospitalization provided in a special licensed residential setting with on-site nursing consultation for psychiatric stability.
Dialectic Behavioral Therapy (DBT) for adults and adolescents is a treatment approach that focuses on skill enhancement to improve emotional regulation. This treatment approach is best utilized for people with Borderline Personality Disorder.
Dual Recovery Resource Group (DRRG) is a peer operated support group for people with co-occurring mental illness or substance use disorders.
Entitlement Specialist assists people, as needed, to apply for entitlements, including social security paperwork, DHHS forms, and Medicaid applications.
*Environmental Modifications are physical changes to a person’s home, car or work environment that are of direct medical or remedial benefit to the person. Modifications ensure access, protect health and safety, or enable greater independence for a person with physical disabilities. Note that other sources of funding must be explored first, before using Medicaid funds, for environmental modifications.
Family Psychoeducation (FPE) is a specific method of working in partnership with consumers and families in a long-term treatment model to help them develop coping skills to deal more effectively with a serious mental illness. Families participate in multi-family groups for problem-solving, or as an individual family in single-family FPE. Family is defined as any support person in the consumer’s life.
Family Skills Training is education and training for families who live with and/or care for a family member who is eligible for specialty services or the Children’s Waiver Program.
Fiscal Intermediary Services help individuals manage their service and supports budget and pay providers if they are using a “self-determination” approach.
Habilitation Supports Waiver (HSW)/Children’s Waiver Program (CWP) are available to Medicaid enrolled individuals with a developmental disability meeting program requirements. These waivers provide services/supports to individuals in community settings that help them avoid having to go to an institution. In order to receive these services, people with developmental disabilities need to be enrolled in either of these “waivers.” The availability of these waivers is limited. People enrolled in the waivers have access to other services listed as well as those listed below:
- The following are available to both programs Habilitation Supports Waiver & Children’s Waiver Program:
· Community Living Supports facilitate an individual’s independence, productivity, and promote inclusion and participation.
· Family Training includes training and counseling services for families.
· Respite Care to provide the primary unpaid caregiver a break.
· The following are available to those enrolled in the Habilitation Supports Waiver program:
· Enhanced Medical Equipment and Supplies* enable the person to increase his abilities to perform activities of daily living; or to perceive, control, or communicate with the environment. These supplies, controls or appliances are not available under regular Medicaid coverage or through other insurances.
· Enhanced Pharmacy* includes specific physician ordered, nonprescription “medicine chest” items.
· Environmental Modifications* provide physical adaptations to the home and/or workplace that are necessary to ensure the health, safety, and welfare of the person or enable him to function with greater independence.
· Goods and Services are available to those utilizing self determination to increase independence, facilitate productivity, or promote community inclusion and substitute for human assistance.
- Out-of-Home Non-Vocational Supports and Services is assistance to gain, retain or improve in self-help, socialization or adaptive skills.
- Personal Emergency Response Systems help a person maintain independence and safety in their own home or in a community setting. These are devices that are used to call for help in an emergency.
- Prevocational Services include supports, services and training to prepare a person for paid employment in integrated, community settings. .
- Private Duty Nursing is individualized nursing service provided in the home, for those who require more individual and continuous care than periodic or intermittent nursing. (Nursing assessment required and approval from MDCH.)
- Supports Coordination - See supports coordination service listing.
- Supported Employment include support services enable the person to work in community-based, integrated settings.
- The following are available to those enrolled in the Children’s Waiver Program:
- Specialty Services are music, recreation, art, or massage therapies that may be provided to help reduce or manage the symptoms of a child’s mental health condition or developmental disability. Specialty services might also include specialized child and family training, coaching, staff supervision, or monitoring of program goals.
- Environmental Accessibility Adaptations* include physical adaptations to the home to ensure the health, welfare and safety of the child, or enable him to function with greater independence.
- Specialized Medical Equipment and Supplies* include durable medical equipment, environmental safety and control devices, adaptive toys, activities of daily living aids, and allergy control supplies to enable the child to increase his abilities to perform activities of daily living or control or communicate with the environment.
- Non-Family Training is customized training for the paid, in-home support staff who provide care for a child enrolled in the waiver.
Health Services include assessment, treatment and professional monitoring of health conditions that are related to or impacted by a person’s mental health condition. A person’s primary doctor will treat any other health conditions they may have.
Home-Based Services for Children and Families are provided in the family home or in another community setting. Services are designed individually for each family and can include things like mental health therapy, crisis intervention, infant mental health, service coordination, or other supports to the family. A highly intensive treatment program where at least 4 hours per month are spent working with the consumer and/or family in their home or community. Consumer criteria vary based on age ranges of birth to age 3, ages 4 through 6, and 7 through 17.
Housing and Homelessness Assistance is assistance with short-term, transitional or one-time-only expenses in an individual’s own home that his/her resources and other community resources could not cover. Eligibility requires Michigan State Housing Development Authority (MSHDA) denial and an ability to eventually cover ongoing housing expenses through another funding source.
Independent Case Management is offered as an option for individuals to utilize non-CMHCM staff through the use of contractual coordinators and case managers. Services provided include case monitoring, linking and coordinating services. (See Supports Coordinator/Case Management.)
Integrated Dually Diagnosed Treatment (IDDT) is an evidence-based treatment approach that helps people recover by offering treatments that combine or integrate mental health and substance abuse interventions at the level of the clinical encounter. This means the same clinicians or teams of clinicians, working in one setting, provide appropriate mental health and substance abuse interventions in an integrated fashion. For the individual with a co-occurring disorder, the services appear seamless, with a consistent approach, philosophy, and set of recommendations that supports recovery.
Intermediate Care Facility for Persons with Mental Retardation (ICF/MR) is a facility that provides 24-hour intensive supervision, health and rehabilitative services, and basic needs to persons with developmental disabilities. The State of Michigan has one ICF/MR called The Caro Center.
Jail Diversion is a voluntary program for individuals with a serious mental illness and sometimes a co-occurring substance disorder or developmental disability, which seeks to avoid or reduce time spent in jail on current charges. The program also assists people to obtain community based treatment and support services. The services may be either pre-booking or post-booking for individuals who are alleged to have committed misdemeanors or certain non-violent felonies.
Medication Administration is when a doctor, nurse or other licensed medical provider gives an injection, oral medication or topical medication.
Medication Review is the evaluation and monitoring of medicines used to treat a person’s mental health condition, their effects, and the need to continuing or changing their medicines.
Mental Health Therapy and Counseling for Adults, Children and Families includes therapy or counseling designed to help improve functioning and relationships with other people.
Mentor Services are provided to adolescents with a serious mental illness and sometimes a co-occurring substance disorder or developmental disability who are returning from a residential setting of at-risk out-of-home placement. As a member of a treatment team, mentors teach and model skills necessary for the adolescent to maintain residency in the community, such as decision-marking, problem-solving and assertiveness. Mentors also seek to promote the individuals self-esteem and self-confidence. Services are provided through the mentor participating with the adolescent in daily school, home, social, and recreational activities.
Michigan Prisoner Re-Entry Program is an initiative to assist in transitioning prisoners back into their communities. For CMH, it means helping individuals deal with the impact of their mental illness or developmental disability that is interfering with their becoming productive members of the community.
Motivational Interviewing (MI) is a way of being with people. As a therapeutic model, it focuses on helping people make changes in their life through an understanding of human nature. This is accomplished through collaboration, which honors the client’s perspective and skills. In addition, MI seeks to draw the reasons and motivation for change from the consumer’s own perceptions, values and goals. Also, the therapist respects and affirms the client’s right and ability to make his or her own choice.
MI is a powerful tool for therapists as it can help with a wide range of issues, including substance abuse, various addictions, anxiety disorders, depressive disorders, suicidality, eating disorders, medication adherence, and other psychological problems. It addresses ambivalence about change, resistance to change, how to increase confidence in consumers’ ability to change, strengthening commitment to change, and developing a change plan and following it through.
Multisystemic Therapy (MST)® offers an evidenced-based intensive family and community based treatment to address serious anti-social behavior in adolescents. The program specifically serves those youth referred by the local family court to address issues that may contribute to delinquency and other serious struggles with a youth’s family, peers, school, and local community. This therapy incorporates cognitive behavioral approaches, parenting training, family therapy, and pharmacological intervention. Youth improvement is gained by engaging all family members in a non-blaming strength-based approach. The therapist carries a lower case load (five families) and works with families for three to four months to reduce rates of youth truancy, crime, recidivates, re-arrest, and out-of-home placements while improving overall family functioning. This therapy is currently available in one county.
Multisystemic Therapy® for Youth with Problem Sexual Behaviors (MST-PSB) is a clinical adaption of MST that has been specifically designed and developed to treat youth (and their families) for problematic sexual behavior. The MST-PSB model is an EBP developed to address the multiple determinants underlying problematic juvenile sexual behavior. MST-PSB is delivered in the community (youth’s home, foster home, school, and neighborhoods) to ensure ecological validity and treatment generalization, occurs intensively (often three or more sessions a week), incorporates researched treatment interventions, and places a high premium on approaching youth/families as unity. Ensuring youth, victim and community safety is a paramount mission of the model. Extensive assessment and planning underlie the individualized safety plan for each youth and family. Treatment commonly incorporates intensive family therapy, parent training, cognitive-behavioral therapy, skills building, school and other community system interventions, and clarification work. The length of the treatment is 5-7 months and the case load of a MST-PSB therapist is typically four families.
Nursing Home Mental Health Assessment and Monitoring (OBRA) includes a review of a nursing home resident’s need for and response to mental health treatment, along with consultations with nursing home staff.
The Nurturing Parent Program (NPP) address primary, secondary, and tertiary prevention, addressing parenting needs from prenatal stages to parenting teenagers, and programs for teen parents. NPP Constructs which are: Inappropriate Parental Expectations, Lack of an Empathic Awareness of Children’s Needs, Strong Belief in the Use of Corporal Punishment, Parent-Child Role Reversal, and Oppressing Children’s Power and Independence. The NPP is designed as a home-based visiting model in addition to families attending skill-based groups. The 16-week program consists of 16 2 ½ hour group sessions and seven home visits. The group sessions involve parent activities, family activities, educational videos, handouts, homework sheets, and meals for the families to promote a nurturing environment. The skills group will initially begin each week with only the parents, with their children participating in the later part of the skills group.
*Occupational Therapy includes the evaluation by an occupational therapist of an individual’s ability to do things in order to take care of themselves every day, and treatment to help increase these abilities. The need for this service must be directly related to the developmental disability or mental illness.
On-Call 24-Hour Crisis Services are available to everyone by phone and when needed in person. This often involves a crisis telephone response, but if additional intervention is needed, this may result in a face-to-face evaluation for inpatient hospitalization.
Outpatient Therapy is used to improve a consumer’s level of functioning through evidence-based mode of therapy including family, group and individual.
Outpatient (Local) is short-term, acute care inpatient psychiatric hospitalization for the purposes of stabilizing an individual with a mental illness or a developmental disability and presenting as a danger to self or others. All consumers utilizing this resource must be pre-screened for appropriateness of admission.
Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for oppositional defiant young children (ages 3-7) in which parents learn the skills of child-directed interaction (CDI) in the first phase of treatment. This phase teaches parents to build warm and responsive relationships with their children. In the second phase, parent-directed interaction (PDI), parents are taught to monitor and apply consequences consistently to change their children’s negative behaviors. While parents interact with their child in the playroom, therapists provide live coaching to parents through a bug-on-the-ear device to help parents apply skills they are learning right in session. This allows parents to get immediate feedback about what they can do in response to their child’s behavior. Progress is monitored every session with trouble-shooting provided to parents. Each phase of treatment usually takes between 5-10 weeks.
Parent Management Training—Oregon (PMTO) is an evidence-based practice that teaches effective parenting practices to caregivers who have a child and/or adolescent who exhibit anti-social, aggressive and other externalizing behavior problems. Sessions with caregivers focus on active teaching of five core components including skills encouragement, limit setting, problem-solving, monitoring, and positive involvement.
Parent-to-Parent Support is a peer-delivered family support intervention for parents of children within the Community Mental Health system to enhance parenting skills, knowledge and engagement. The Parent Support Partner is the parent or primary caregiver of a child with emotional, behavioral and/or mental health challenges who serves as an example and mentor to other parents and is included in the service planning, implementing, and transition process, as delineated in the Person Centered Plan.
Partial Hospital Services include psychiatric, psychological, social, occupational, nursing, music therapy, and therapeutic recreational services in a hospital setting, under a doctor’s supervision. Partial hospital services are provided during the day; participants go home at night.
Peer-Delivered and Peer Specialist Services are activities designed to help persons with serious mental illness in their individual recovery journey and are provided by individuals who are in recovery from serious mental illness.
Person-Centered Planning is a process for planning and supporting the individual receiving services that builds upon the individual’s capacity to promote community life and that honors the individual’s preferences, choices and abilities. The person-centered planning process involves familiar, friends and professionals, as the individual desires.
Personal Care in Specialized Residential Settings assists an adult with a mental illness or developmental disability with activities of daily living, self-care and basic needs, while they are living in a specialized residential setting in the community.
Personal Emergency Response System provides a more independent, less invasive, support system for people, insuring safety, privacy and consistency in people’s homes. Individuals are provided assistance with medications, primary needs and emergency transportation, as needed and approved.
*Physical Therapy includes the evaluation by a physical therapist of a person’s physical abilities (such as the ways they move, use their arms or hands, or hold their body) and treatments to help improve their physical abilities. The need for this service must be directly related to the developmental disability or mental illness.
Prevention Service Models such as Applied Suicide Intervention Skills Training (ASIST), Services to Deaf and Hard-of-Hearing, Outreach, and Yellow Ribbon (suicide prevention), use both individual and group interventions designed to reduce the likelihood that individuals will experience serious mental health conditions.
Psychiatric Services include full assessments and medication management. These services are most often offered in conjunction with other agency services.
Psychological Testing services are offered when appropriate as a part of the comprehensive array of services available to assist individuals to meet their full potential.
Respite Care Services provide short-term relief to the unpaid primary caregivers of people eligible for specialty services. Respite provides temporary alterative care, either in the family home or in another community setting chosen by the family.
Serious Emotional Disturbance (SED) Waiver is for children with a serious emotional disturbance currently at risk of placement in a state psychiatric institution. Children must have a CAFAS score of 90 or greater if they are 12 years or younger, or have a CAFAS score of 120 or greater if 13 or older. All children in the waiver program must be involved in wraparound services and the Wraparound Community Team oversees the plan of service. There is an array of services by the SED waiver, which is intended to be creative and flexible to meet the child and family needs. Blended funding with Department of Human Services (DHS), courts, etc., and accessing the state Child Care Fund.
Skill-Building Assistance includes supports, services and training to help a person participate actively at school, work, volunteer, or community settings; or to learn social skills they may need to support themselves or to get around in the community.
Smoking Cessation courses are available to consumers and staff in each office. Stopping smoking can be tough, but smokers don’t have to quit alone. The Health Living Program, and Stop Smoking by the American Lung Association, are two of the well-known programs that are being offered by trained staff. The programs provide solid information about nicotine addiction and on what it takes to prepare to quit. Participants learn valuable information on skills and techniques that will help in becoming a non-smoker. The homework assignments reinforce the lessons and help with the commitment. Staff provide additional support through nicotine replacement products and auricular acupuncture.
State Inpatient (ICF/MR) represents the most restrictive intervention for individuals with mental health or a developmental disability. This is utilized when an individual is no longer deemed safe in a community setting as they have been found to be an imminent danger to themselves or others.
Substance Abuse Treatment Services (See IDDT)
Supports Coordination/Targeted Case Management is a service that provides a staff person, supports coordinator or case manager who works directly with the consumer of mental health services. His or her role is to listen to a person’s goals and to help find the services and providers inside and outside the local community mental health services program that will help achieve the goals. This staff person also helps write an individual plan of service, makes sure the services are delivered, and may also connect a person to resources in the community for employment, community living, education, public benefits, and recreational activities.
Supported/Integrated Employment Services provide initial and ongoing supports; services and training, usually provided at the job site, to help adults who are eligible for mental health services find and keep paid employment in the community.
Therapeutic Foster Care (TFC) is an evidenced-based practice delivered in a licensed setting. It provides an intensive therapeutic living environment for a child with a behavior disorder. Important components of TFC include: intensive parental supervision, positive adult-youth relationship, reduced contact with other children with behavior disorders, and family behavior management skills. TFC seeks to change the negative trajectory of a child’s behavior by improving social adjustment, family adjustment and peer group relationships. TFC attempts to decrease negative behavior and increase appropriate behavior and build pro-social skills.
Transportation may be provided to and from a person’s home in order for them to take part in a non-medical Medicaid-covered service.
Trauma-Focused Cognitive Behavior Treatment (TF-CBT) is an evidenced-based practice that helps address the biopsychosocial needs of children with Post Traumatic Stress Disorder (PTSD) or other problems related to traumatic life experiences, and their parents or primary caregivers. TF-CBT is a model of psychotherapy that combines trauma-sensitive interventions with cognitive behavioral therapy. Children and parents are provided knowledge and skills related to processing the trauma; managing distressing thoughts, feelings and behaviors; and enhancing safety, parenting skills and family communication.
Trauma Recovery Empowerment Model (TREM) utilizes individual and group therapy to learn more effective strategies to deal with issues related to trauma. There are adaptations for Post Traumatic Stress Disorder, anxiety, depression, parents, males (known as M-TREM), domestic violence, as well as for teens. The program duration varies at approximately 20-25 weeks.
Wellness Recovery Action Plan (WRAP) is a system for monitoring, reducing and eliminating uncomfortable or dangerous physical symptoms and emotional feelings. The program gives people proven tools that they can use to design their own recovery plan and regain control of their lives. The materials work wells for individuals or groups.
Wraparound Services for Children and Adolescents with serious emotional disturbance and their families that include treatment and supports necessary to maintain the child in the family home.
*In addition to meeting medically necessary criteria, services marked with an asterisk (*) require a doctor’s prescription.
Services for Habilitation Supports Waiver Participants
Some Medicaid beneficiaries are eligible for special services that help them avoid having to go to an institution for people with developmental disabilities or nursing home. These special services are included in the Habilitation Supports Waiver. In order to receive these services, people with developmental disabilities need to be enrolled in either of these waivers. The availability of these waivers is very limited. People enrolled in the waivers have access to the services listed above as well as those listed here:
Out-of-home Non-Vocational Supports and Services is assistance to gain, retain, or improve in self-help, socialization, or adaptive skills.
Personal Emergency Response System (PERS) is a 24/7 monitoring system used to maintain a person’s independence and safety. Consumers can use the system for security, support, or emergencies. Two monitoring levels are available: one for minimal assistance and another for more urgent needs. Staff can also assist with medications, transportation, and well/safety checks. When activated, the monitor automatically calls a CMHCM center where a Community Support Technician assists.
Prevocational Services include supports, services, and training to prepare a person for paid employment or community volunteer work.
Private Duty Nursing is individualized nursing service provided in the home, as necessary, to meet specialized health needs.
You need to know that not all people who come to us are eligible and not all services are available to everyone we serve.