AMOUNT OF FUNDING PAID TO PIHPs January 10, 2010

AMOUNT OF FUNDING PAID TO PIHPs
(FY2010 Appropriation Bill - Public Act 131 of 2009)
January 10, 2010
Section 418: On or before the tenth of each month, the department shall report to
the senate and house appropriations subcommittees on community health, the senate
and house fiscal agencies, and the state budget director on the amount of funding paid
to PIHPs to support the Medicaid managed mental health care program in the
preceding month. The information shall include the total paid to each PIHP, per capita
rate paid for each eligibility group for each PIHP, and number of cases in each eligibility
group for each PIHP, and year-to-date summary of eligibles and expenditures for the
Medicaid managed mental health care program.
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
This report is provided in compliance with the Michigan Department of Community Health Appropriations Act, Sec. 418 which states: "On or
before the tenth of each month, the department shall report to the senate and house appropriations subcommittees on community health,
the senate and house fiscal agencies, and the state budget director on the amount of funding paid to PIHPs to support the Medicaid
managed mental health care program in the preceding month. The information shall include the total paid to each PIHP, per capita rate paid
for each eligibility group for each PIHP, and number of cases in each eligibility group for each PIHP, and year-to-date summary of eligibles
and expenditures for the Medicaid managed mental health care program."
The Michigan Department of Community Health operates a Medicaid prepaid specialty services managed care program through a 1915(b)
managed care waiver. This waiver operates concurrently with a 1915(c) Habilitation Supports Waiver (HSW). All Medicaid specialty mental
health, developmental disability and substance abuse services are provided through this program. Michigan's 46 community mental health s
Inpatient Health Plans (PIHPs) as proposed by the state and approved by the Center for Medicare and Medicaid Services
(CMS). The waiver is required to be implemented through the PIHP structure.
Note 1: Throughout the year PIHP capitation payments include recoupments or other payment adjustments for deceased recoveries, HSW
non-service recoupments and HSW retroactive eligibility or other payments or recoveries. The payments listed in this report include
adjustments. Adjustment details amounts are not separately reported. Calculation examples are provided on the Per Capita Cap Rates Paid
tab, and in those instances where adjustments have been made, the results from applying the examples' calculation methodology will not
reconcile to the amounts shown as paid.
Note 2: MCHIP-Healthy Kids MEG is a subset of the TANF eligibility group that is paid at the same Per Capita Rate, and thus is not
separately reported.
Note 3: The FY2010-capYTD and FY2010-popYTD tabs include the months of October through the current pay period.
Note 4: PIHPs and Affiliates tab contains a full lists of PIHPs and CMHSPs
MEG Summary
Year-To-Date:
October 2009 through December 2009
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
Capitation Paid (including adjustments)
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
MH
12,277,086
16,836,794
8,347,522
15,630,353
73,482,340
18,095,403
12,199,785
6,158,914
30,272,801
18,928,043
13,453,702
7,115,516
8,252,646
40,580,942
7,870,913
14,275,548
11,921,593
13,524,949
$329,224,851
DAB
SA
148,104
180,263
112,863
184,838
2,297,500
430,714
180,562
87,253
455,760
330,646
119,071
130,808
111,263
407,484
204,781
242,975
94,511
206,789
$5,926,184
Combined
12,425,191
17,017,058
8,460,386
15,815,191
75,779,839
18,526,118
12,380,347
6,246,167
30,728,561
19,258,689
13,572,773
7,246,324
8,363,909
40,988,426
8,075,694
14,518,522
12,016,104
13,731,738
$335,151,036
TANF
120,282
188,279
83,392
157,284
885,913
189,086
136,713
70,030
208,711
197,821
85,551
92,595
88,039
214,344
81,113
151,865
98,657
178,995
3,228,670
DAB & TANF
167,759
261,642
120,391
214,701
1,253,722
260,575
183,809
97,115
285,764
272,357
127,826
132,186
123,158
307,645
118,763
207,056
130,154
251,078
4,515,701
MH
2,135,266
2,824,570
1,218,189
1,886,143
7,756,350
1,598,658
1,014,503
893,579
2,590,712
1,720,569
1,925,156
868,682
1,552,371
3,403,911
498,366
1,775,391
1,879,441
1,687,581
$37,229,438
Eligible Months Paid
DAB
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
47,477
73,363
36,999
57,417
367,809
71,489
47,096
27,085
77,053
74,536
42,275
39,591
35,119
93,301
37,650
55,191
31,497
72,083
1,287,031
HSW
1,075
1,049
1,574
1,959
3,374
1,083
683
763
1,279
490
1,046
1,231
504
2,250
337
1,323
829
947
21,796
TANF
SA
213,773
209,965
92,940
234,581
817,509
446,165
196,416
130,831
373,798
225,317
120,498
125,656
116,985
335,179
135,892
223,760
165,443
240,521
$4,405,230
Combined
2,349,039
3,034,535
1,311,128
2,120,725
8,573,859
2,044,823
1,210,919
1,024,410
2,964,510
1,945,886
2,045,654
994,338
1,669,356
3,739,089
634,258
1,999,151
2,044,884
1,928,102
$41,634,669
MH
14,412,352
19,661,365
9,565,711
17,516,496
81,238,690
19,694,061
13,214,288
7,052,493
32,863,513
20,648,612
15,378,858
7,984,198
9,805,017
43,984,853
8,369,279
16,050,939
13,801,034
15,212,530
$366,454,290
DAB & TANF
SA
361,878
390,229
205,803
419,420
3,115,009
876,880
376,978
218,084
829,558
555,963
239,568
256,463
228,248
742,663
340,673
466,735
259,955
447,309
$10,331,415
Combined
14,774,230
20,051,593
9,771,514
17,935,916
84,353,699
20,570,941
13,591,266
7,270,577
33,693,071
21,204,576
15,618,427
8,240,662
10,033,265
44,727,515
8,709,951
16,517,673
14,060,988
15,659,840
$376,785,705
HSW
4,757,893
5,247,168
5,928,721
7,951,063
17,539,577
4,092,469
3,339,451
1,798,040
4,600,737
1,910,413
5,340,365
6,501,631
2,321,338
11,518,358
1,910,998
4,873,447
4,436,135
4,245,874
$98,313,679
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
Monthly MEG Summary
Report Period: October 2009
Capitation Paid (including adjustments)
TOTAL
MH
4,042,980
5,505,138
2,742,566
5,103,468
24,138,470
5,950,065
3,996,035
2,033,196
9,864,766
6,209,169
4,428,794
2,333,306
2,712,575
13,273,766
2,595,630
4,684,390
3,928,305
4,440,512
$107,983,131
DAB
SA
48,785
58,947
37,084
60,347
754,354
141,588
59,116
28,805
148,558
108,460
39,185
42,870
36,571
133,128
67,514
79,715
31,131
67,897
$1,944,053
Combined
4,091,764
5,564,085
2,779,649
5,163,814
24,892,823
6,091,654
4,055,151
2,062,001
10,013,324
6,317,629
4,467,979
2,376,177
2,749,146
13,406,895
2,663,144
4,764,105
3,959,436
4,508,409
$109,927,185
TOTAL
DAB
15,621
24,010
12,147
18,760
120,756
23,491
15,409
8,947
25,082
24,443
13,911
12,994
11,539
30,562
12,405
18,118
10,382
23,694
422,271
TANF
39,522
61,827
27,399
51,240
290,678
62,046
45,064
22,991
67,821
64,956
28,001
30,247
28,973
69,599
26,575
49,867
32,430
59,111
1,058,347
DAB & TANF
55,143
85,837
39,546
70,000
411,434
85,537
60,473
31,938
92,903
89,399
41,912
43,241
40,512
100,161
38,980
67,985
42,812
82,805
1,480,618
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
MH
701,109
926,169
399,939
613,707
2,543,185
523,932
333,963
293,106
840,630
564,452
629,496
283,215
510,389
1,104,708
163,293
582,458
616,689
556,491
$12,186,930
Eligible Months Paid
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
HSW
354
348
527
652
1,130
351
227
254
426
164
344
408
163
751
108
440
275
313
7,235
TANF
SA
69,885
68,511
30,373
75,862
266,837
145,429
64,122
42,620
120,187
73,508
39,241
40,540
38,317
108,363
44,483
72,939
53,849
78,730
$1,433,795
Combined
770,994
994,680
430,312
689,569
2,810,022
669,361
398,084
335,725
960,817
637,960
668,737
323,754
548,705
1,213,071
207,775
655,397
670,538
635,221
$13,620,725
MH
4,744,088
6,431,307
3,142,505
5,717,175
26,681,655
6,473,998
4,329,998
2,326,302
10,705,396
6,773,621
5,058,289
2,616,521
3,222,963
14,378,474
2,758,923
5,266,848
4,544,994
4,997,003
$120,170,061
DAB & TANF
SA
118,670
127,458
67,457
136,209
1,021,191
287,017
123,237
71,424
268,745
181,969
78,426
83,410
74,888
241,491
111,997
152,654
84,980
146,627
$3,377,848
Combined
4,862,758
6,558,765
3,209,961
5,853,384
27,702,846
6,761,014
4,453,235
2,397,726
10,974,141
6,955,590
5,136,715
2,699,931
3,297,851
14,619,966
2,870,919
5,419,502
4,629,974
5,143,630
$123,547,909
HSW
1,577,885
1,722,966
1,961,321
2,639,221
5,821,545
1,335,355
1,103,723
586,035
1,528,458
631,713
1,745,693
2,146,626
753,077
3,845,400
613,504
1,629,827
1,472,491
1,383,505
$32,498,345
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
Monthly MEG Summary
Report Period: November 2009
Capitation Paid (including adjustments)
TOTAL
MH
4,109,343
5,653,535
2,799,157
5,244,301
24,605,553
6,053,763
4,090,039
2,056,164
10,158,807
6,344,501
4,514,135
2,384,239
2,772,726
13,589,143
2,638,920
4,788,985
3,985,350
4,528,215
$110,316,874
DAB
SA
49,544
60,525
37,841
62,005
769,397
144,057
60,542
29,104
152,986
110,820
39,953
43,832
37,401
136,494
68,709
81,505
31,587
69,212
$1,985,516
Combined
4,158,887
5,714,059
2,836,999
5,306,306
25,374,950
6,197,820
4,150,581
2,085,268
10,311,793
6,455,321
4,554,088
2,428,071
2,810,127
13,725,637
2,707,629
4,870,490
4,016,937
4,597,427
$112,302,390
TOTAL
DAB
15,903
24,635
12,408
19,264
123,155
23,926
15,809
9,049
25,853
24,975
14,183
13,265
11,787
31,250
12,623
18,503
10,533
24,128
431,249
TANF
40,364
63,392
27,926
52,864
296,772
63,472
45,726
23,511
70,062
66,430
28,778
31,089
29,671
71,961
27,216
50,877
33,023
60,025
1,083,159
DAB & TANF
56,267
88,027
40,334
72,128
419,927
87,398
61,535
32,560
95,915
91,405
42,961
44,354
41,458
103,211
39,839
69,380
43,556
84,153
1,514,408
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
MH
716,335
950,967
408,179
634,025
2,598,555
536,745
339,502
300,128
870,043
577,903
647,873
291,699
523,293
1,143,086
167,189
595,020
629,134
566,224
$12,495,898
Eligible Months Paid
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
HSW
368
349
519
649
1,120
372
229
254
426
162
352
409
174
745
117
445
278
316
7,284
TANF
SA
71,665
70,689
31,212
78,928
274,043
149,960
65,899
44,045
125,854
75,735
40,663
42,196
39,451
112,684
45,565
75,129
55,414
80,900
$1,480,035
Combined
788,000
1,021,656
439,391
712,953
2,872,598
686,705
405,401
344,172
995,897
653,638
688,536
333,895
562,745
1,255,770
212,754
670,149
684,548
647,125
$13,975,933
MH
4,825,678
6,604,502
3,207,336
5,878,325
27,204,108
6,590,507
4,429,541
2,356,292
11,028,849
6,922,404
5,162,007
2,675,937
3,296,019
14,732,229
2,806,109
5,384,005
4,614,484
5,094,439
$122,812,772
DAB & TANF
SA
121,209
131,214
69,054
140,934
1,043,441
294,017
126,441
73,149
278,840
186,555
80,616
86,029
76,853
249,178
114,274
156,634
87,001
150,112
$3,465,551
Combined
4,946,886
6,735,716
3,276,390
6,019,259
28,247,548
6,884,524
4,555,982
2,429,440
11,307,690
7,108,959
5,242,624
2,761,966
3,372,872
14,981,407
2,920,382
5,540,640
4,701,485
5,244,552
$126,278,323
HSW
1,598,271
1,759,767
1,986,317
2,654,648
5,868,321
1,377,674
1,125,450
608,134
1,534,625
639,350
1,797,864
2,175,945
778,035
3,833,352
646,061
1,633,557
1,493,386
1,418,020
$32,928,778
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
Monthly MEG Summary
Report Period: December 2009
Capitation Paid (including adjustments)
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
MH
4,124,764
5,678,121
2,805,799
5,282,585
24,738,317
6,091,575
4,113,711
2,069,554
10,249,228
6,374,373
4,510,774
2,397,971
2,767,346
13,718,033
2,636,363
4,802,172
4,007,938
4,556,222
$110,924,846
DAB
SA
49,776
60,792
37,938
62,486
773,749
145,069
60,905
29,344
154,216
111,365
39,932
44,105
37,290
137,862
68,558
81,755
31,794
69,680
$1,996,615
Combined
4,174,540
5,738,913
2,843,738
5,345,071
25,512,065
6,236,644
4,174,616
2,098,898
10,403,444
6,485,739
4,550,706
2,442,076
2,804,636
13,855,894
2,704,921
4,883,927
4,039,731
4,625,902
$112,921,461
TANF
40,396
63,060
28,067
53,180
298,463
63,568
45,923
23,528
70,828
66,435
28,772
31,259
29,395
72,784
27,322
51,121
33,204
59,859
1,087,164
DAB & TANF
56,349
87,778
40,511
72,573
422,361
87,640
61,801
32,617
96,946
91,553
42,953
44,591
41,188
104,273
39,944
69,691
43,786
84,120
1,520,675
MH
717,822
947,434
410,071
638,411
2,614,610
537,981
341,038
300,346
880,040
578,214
647,788
293,769
518,689
1,156,117
167,884
597,913
633,618
564,866
$12,546,611
Eligible Months Paid
DAB
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
15,953
24,718
12,444
19,393
123,898
24,072
15,878
9,089
26,118
25,118
14,181
13,332
11,793
31,489
12,622
18,570
10,582
24,261
433,511
HSW
353
352
528
658
1,124
360
227
255
427
164
350
414
167
754
112
438
276
318
7,277
TANF
SA
72,223
70,765
31,354
79,791
276,629
150,776
66,396
44,167
127,757
76,074
40,593
42,920
39,217
114,131
45,845
75,692
56,180
80,890
$1,491,400
Combined
790,045
1,018,199
441,426
718,202
2,891,239
688,758
407,434
344,513
1,007,796
654,288
688,381
336,689
557,906
1,270,248
213,729
673,604
689,798
645,757
$14,038,011
MH
4,842,586
6,625,556
3,215,871
5,920,996
27,352,927
6,629,557
4,454,749
2,369,900
11,129,267
6,952,587
5,158,562
2,691,740
3,286,035
14,874,149
2,804,248
5,400,085
4,641,556
5,121,088
$123,471,457
DAB & TANF
SA
121,999
131,556
69,292
142,277
1,050,378
295,846
127,300
73,511
281,973
187,440
80,526
87,024
76,507
251,993
114,402
157,446
87,974
150,570
$3,488,015
Combined
4,964,585
6,757,112
3,285,163
6,063,273
28,403,304
6,925,402
4,582,049
2,443,411
11,411,240
7,140,027
5,239,087
2,778,764
3,362,542
15,126,142
2,918,650
5,557,531
4,729,529
5,271,658
$126,959,472
HSW
1,581,737
1,764,435
1,981,083
2,657,194
5,849,711
1,379,441
1,110,278
603,871
1,537,654
639,350
1,796,808
2,179,061
790,227
3,839,605
651,433
1,610,063
1,470,257
1,444,349
$32,886,556
Specialty Services Waiver
State Plan (b) & Alternative (b)(3) Services Capitation Rates
Effective April 1, 2009
State of Michigan
Department of Community Health
Statewide Capitation Rates
For (b) and (b)(3) Capitation Rates:
Capitation Rate [a.k.a. "per capita rate paid for each eligibility group for each PIHP]" = Base Rate X AgeGender Factor X Geographic Factor
Service and Population
TANF Mental Health
DAB Mental Health
April 1, 2009 Rates
State Plan
1915(b)(3)
$9.87
$1.53
$135.96
$115.75
TANF Substance Abuse
DAB Substance Abuse
Service and Population
Mental Health - TANF
Male
Female
$0.90
$3.24
0 - 17
$0.41
$1.30
Total
$11.40
$251.71
$1.31
$4.54
SFY 2009 Age / Gender Factors
18 - 25
26 - 39
40 - 49
50 - 64
65+
1.0322
0.7172
1.1058
0.9930
1.2308
1.4869
1.4352
2.1682
0.9976
2.0001
0.0011
0.0011
Mental Health - DAB
Male
Female
0.4612
0.3208
1.0440
0.7947
2.0615
1.5486
2.0956
1.5495
1.5912
1.0973
0.4480
0.2467
Substance Abuse - TANF
Male
Female
0.3421
0.1742
2.0595
1.7588
3.7791
3.4471
4.7942
5.4737
5.0710
5.0160
0.0064
0.0064
Substance Abuse - DAB
Male
Female
0.3534
0.1808
1.1537
0.8368
1.3869
1.6105
2.3987
2.1509
2.2103
1.0049
0.1691
0.0223
State Fiscal Year 2009 Geographic Factors
PIHP Name
Access Alliance
CMH Affiliation of Mid-Michigan
CMH for Central Michigan
CMHSA Network of West Michigan
Detroit-Wayne
Genesee
Lakeshore Affiliation
Lifeways
Macomb
North Care
North Country
Northern Lakes
Oakland
Saginaw
Southeast Partnership
Southwest Alliance
Thumb Alliance
Venture
Mental Health
TANF
DAB
1.5591
0.9943
1.3178
0.9153
1.2725
0.8630
0.7747
0.9995
0.7557
0.7737
0.7295
0.9422
0.6600
1.0211
1.1320
0.8894
1.0770
1.6707
1.9805
1.3050
0.8272
0.7124
1.5547
0.9208
1.3910
1.8685
0.5339
0.7951
1.0561
1.0811
1.0233
1.0350
1.6740
1.4908
0.8326
0.7497
Substance Abuse
TANF
DAB
1.3159
0.6543
0.8342
0.5398
0.7852
0.6349
0.9311
0.9656
0.6545
1.3132
1.6109
1.2051
1.1690
0.8298
1.4672
0.6914
1.2820
1.4155
1.0725
0.6451
1.0329
0.7152
1.0220
0.6755
1.1890
1.0688
1.1929
1.1232
1.1517
0.7079
1.1619
0.9543
1.2622
0.6454
1.0266
0.6301
Example 1: Access Alliance DAB Male, age 55
Base
Age/Gender GeoFactor
MH St. Plan
$135.96
1.5912
0.9943
MH (b)(3)
$115.75
1.5912
0.9943
MH Total
$251.71
1.5912
0.9943
Example 2: Detroit Wayne TANF Female, age 42
Base
Age/Gender GeoFactor
MH St. Plan
$9.87
2.1682
0.7557
MH (b)(3)
$1.53
2.1682
0.7557
MH Total
$11.40
2.1682
0.7557
=
=
=
CapRate
$215.11
$183.13
$398.24
=
=
=
$16.17
$2.51
$18.68
Page 15 of 18
Specialty Services Waiver
State Plan (b) & Alternative (b)(3) Services Capitation Rates
Effective April 1, 2009
State of Michigan
Department of Community Health
Statewide Capitation Rates
To avoid problems with transmitting data in HIPAA compliant formats, all capitation rates are set to a minimum of $0.01.
State of Michigan
Specialty Sew ices Waiver
Waiver C Capitation Rates
Rates Effective April 1, 2009
Capitation Rate [a.k.a. "per capita rate paid for the Waiver C eligibility group for each PIHP]" = Base Rate + Age Additive + Residential Living
Arrangement Additive X Multiplicative Factor + Mt Pleasant Additive [for enrollees discharged from MPC on or after 10-1-07]
Note: Waiver C rates are calculated based on County of Residence and Paid to County of Financial Responsibility
Rate Development Base:
Additive Parameter - Age
Age 18 and Younger
April 1, 2009
Rates
$4,601.04
($942.29)
Additive Parameter - Residential Status
Supported Independence Program
Private Residence with Spouse or Non-Family
Specialized Residential Home
Private Residence with Family or Foster Family Home
$ 1,287.42
718.03
($347.06)
($1,421.20)
Mt. Pleasant MVA
$8,127.80
Multiplicative Parameter - PIHP
Access Alliance
CMH Affiliation of Mid-Michigan
CMH for Central Michigan
CMHSA Network of West Michigan
Detroit-Wayne
Genesee
Lakeshore Affiliation
Lifeways
Macomb
North Care
North Country
Northern Lakes
Oakland
Saginaw
Southeast Partnership
Southwest Alliance
Thumb Alliance
Venture
Example 1: 55 year old Access Alliance non-MPC SIP enrollee
who lives in Bay Co.
Base
Age
RLA
MultiFactor MPC
$4,601.04
$0.00
$1,287.42
1.0000
=
CapRate
$5,888.46
Example 2: 33 year old Saginaw 9-1-09 MPC-Exit who resides in
in a Spec Res Facility in Saginaw Co.
Base
Age
RLA
MultiFactor MPC
$4,601.04
$0.00
($347.06)
1.2627
$8,127.80
=
CapRate
$13,499.30
Example 3: 17 year old Saginaw 4-1-09 MPC-Exit who resides in
who lives in a Foster Family home in Bay Co.
Base
Age
RLA
MultiFactor MPC
$4,601.04
($942.29)
($1,421.20)
1.0000
$8,127.80
=
CapRate
$11,307.64
0
1.0000
1.0973
0.8188
0.8764
1.0973
0.8764
1.0973
0.5473
0.7977
1.2307
1.1936
1.0973
1.1936
1.2627
0.8764
0.8188
1.2627
1.0000
Page 16 of 18
PIHPs & AFFILIATES
PIHP
CMH
Affiliated CMHSPs
and/or
Counties
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH
AFFILIATION
CMH CENTRAL
MICHIGAN
network180
Pathways CMH
North Country CMH
Northern Lakes CMH
Central CMH
Kent CMH
Pathways CMH
(Alger, Delta, Luce,
Marquette)
Copper Country CMH
(Baraga, Houghton,
Keewanaw, Ontonagon)
Hiawatha CMH
(Chippewa, Mackinac,
Schoolcraft)
NorthPointe CMH
(Menominee, Dickinson,
Iron)
Gogebic CMH
North Country CMH
(Antrim, Charlevoix,
Cheboygan, Emmet,
Kalkaska, Otsego)
Northeast CMH
(Alcona, Alpena,
Montmorency,
Presque Isle)
AuSable CMH
(Oscoda, Ogemaw, Iosco)
Northern Lakes CMH
(Crawford, Grand Traverse,
Leelanau, Missaukee,
Roscommon, Wexford)
West MI CMH
(Lake, Mason, Oceana)
Central CMH
(Clare, Gladwin,
Isabella, Mecosta,
Midland, Osceola)
Kent CMH
PIHP
ACCESS ALLIANCE
OF MICHIGAN
THUMB ALLIANCE
CMH AFFILIATION OF
MID-MICHIGAN
SOUTHWEST MI URBAN &
RURAL CONSORTIUM
SAGINAW
COUNTY CMH
AUTHORITY
CMH
Bay-Arenac CMH
(Bay, Arenac)
St. Clair CMH
CEI CMH
(Clinton, Eaton, Ingham)
Kalamazoo CMH
Saginaw CMH
Kalamazoo CMH
Allegan CMH
Woodlands CMH
(Cass)
St. Joseph CMH
Saginaw CMH
Affiliated CMHSPs
and/or
Counties
Bay-Arenac CMH
(Bay, Arenac)
Huron CMH
Tuscola CMH
Montcalm CMH
Shiawassee CMH
St. Clair CMH
Lapeer CMH
Sanilac CMH
CEI CMH
(Clinton, Eaton, Ingham)
Gratiot CMH
Ionia CMH
Newaygo CMH
Manistee-Benzie CMH
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
17 of 18
PIHPs & AFFILIATES
PIHP
VENTURE BEHAVIORAL
HEALTH
CMH PARTNERSHIP OF
SOUTHEAST MICHIGAN
LIFEWAYS
LAKESHORE
BEHAVIORAL
HEALTH
GENESEE
COUNTY CMH
SERVICES
CMH
Summit Pointe CMH
(Calhoun)
Washtenaw CMH
LifeWays CMH
(Hillsdale and Jackson)
CMH Services of
Muskegon CMH
Genesee CMH
LifeWays CMH
(Hillsdale and Jackson)
CMH Services of
Muskegon CMH
Ottawa
Affiliated CMHSPs
and/or
Counties
PIHP
CMH
Affiliated CMHSPs
Summit Pointe CMH
(Calhoun)
Barry CMH
Berrien CMH
Pines CMH
(Branch)
Van Buren CMH
DETROIT-WAYNE
COUNTY CMH
Washtenaw CMH
Lenawee CMH
Livingston CMH
Monroe CMH
Genesee CMH
OAKLAND COUNTY CMH MACOMB COUNTY CMH
SERVICES
AUTHORITY
Detroit-Wayne CMH
Oakland CMH
Macomb CMH
Detroit-Wayne CMH
Oakland CMH
Macomb CMH
and/or
Counties
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2010
18 of 18