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AMOUNT OF FUNDING PAID TO PIHPs March 10, 2010
AMOUNT OF FUNDING PAID TO PIHPs (FY2010 Appropriation Bill - Public Act 131 of 2009) March 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 February 2010 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 20,533,901 28,116,256 13,974,431 26,227,106 123,143,985 30,237,281 20,429,448 10,289,490 50,985,014 31,718,732 22,448,371 11,905,734 13,769,914 68,316,876 13,147,736 23,849,731 20,000,086 22,604,112 $551,698,202 DAB SA 247,836 301,116 189,034 310,239 3,852,310 720,282 302,557 145,868 768,099 553,993 198,692 218,896 185,644 686,810 342,115 406,013 158,704 345,655 $9,933,865 Combined 20,781,737 28,417,372 14,163,465 26,537,344 126,996,294 30,957,563 20,732,005 10,435,359 51,753,113 32,272,725 22,647,064 12,124,630 13,955,558 69,003,686 13,489,852 24,255,744 20,158,790 22,949,767 $561,632,067 TANF 202,126 313,875 140,277 265,213 1,486,650 316,095 228,849 117,168 354,083 332,036 143,705 155,100 147,252 363,861 135,711 254,459 165,959 298,260 5,420,679 DAB & TANF 281,750 436,584 202,311 361,798 2,104,428 435,743 307,841 162,442 484,220 457,141 214,366 221,461 206,078 521,075 198,749 346,861 218,886 418,921 7,580,655 MH 3,587,894 4,709,220 2,050,036 3,180,369 13,002,056 2,671,819 1,697,304 1,495,660 4,393,545 2,887,341 3,236,431 1,456,214 2,596,895 5,776,546 833,597 2,973,284 3,162,168 2,811,906 $62,522,285 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 79,624 122,709 62,034 96,585 617,778 119,648 78,992 45,274 130,137 125,105 70,661 66,361 58,826 157,214 63,038 92,402 52,927 120,661 2,159,976 HSW 1,777 1,742 2,613 3,253 5,618 1,806 1,137 1,268 2,131 815 1,746 2,056 843 3,742 560 2,205 1,382 1,583 36,277 TANF SA 359,162 349,900 156,645 395,929 1,367,802 745,226 328,357 219,221 634,078 377,861 203,001 211,409 196,142 568,851 227,403 374,067 278,487 400,742 $7,394,284 Combined 3,947,056 5,059,120 2,206,681 3,576,297 14,369,859 3,417,045 2,025,661 1,714,881 5,027,623 3,265,202 3,439,432 1,667,623 2,793,037 6,345,398 1,061,000 3,347,350 3,440,655 3,212,648 $69,916,569 MH 24,121,795 32,825,476 16,024,467 29,407,474 136,146,041 32,909,100 22,126,752 11,785,150 55,378,558 34,606,073 25,684,802 13,361,948 16,366,809 74,093,422 13,981,334 26,823,015 23,162,254 25,416,018 $614,220,487 DAB & TANF SA 606,998 651,016 345,679 706,167 5,220,112 1,465,508 630,914 365,089 1,402,177 931,855 401,693 430,306 381,786 1,255,661 569,518 780,080 437,191 746,398 $17,328,149 Combined 24,728,793 33,476,492 16,370,146 30,113,642 141,366,153 34,374,608 22,757,665 12,150,240 56,780,736 35,537,927 26,086,495 13,792,253 16,748,595 75,349,084 14,550,852 27,603,095 23,599,445 26,162,416 $631,548,637 HSW 8,089,160 9,248,842 10,031,627 13,504,449 30,092,339 7,224,764 5,913,204 3,025,731 7,770,629 3,340,243 9,184,875 10,937,389 4,149,387 19,174,041 3,506,528 8,222,937 7,492,522 7,411,257 $168,319,923 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 Michigan's Medicaid Speciality Services and Supports Waiver 418 REPORT - FY2010 Monthly MEG Summary Report Period: January 2010 Capitation Paid (including adjustments) TOTAL MH 4,116,754 5,616,257 2,801,474 5,270,647 24,640,986 6,041,472 4,102,245 2,054,549 10,272,694 6,378,392 4,488,706 2,383,600 2,748,954 13,744,602 2,625,597 4,767,740 4,012,532 4,514,813 $110,582,016 DAB SA 49,718 60,228 37,938 62,409 771,544 144,090 60,879 29,164 155,049 111,413 39,790 43,858 37,089 138,467 68,351 81,248 31,889 69,111 $1,992,234 Combined 4,166,472 5,676,485 2,839,412 5,333,056 25,412,530 6,185,561 4,163,124 2,083,713 10,427,744 6,489,806 4,528,496 2,427,458 2,786,043 13,883,069 2,693,949 4,848,988 4,044,421 4,583,924 $112,574,251 TOTAL DAB 16,081 24,629 12,484 19,547 124,537 24,024 15,942 9,070 26,485 25,280 14,197 13,352 11,841 31,807 12,671 18,583 10,685 24,225 435,440 TANF 40,834 62,743 28,330 53,771 300,188 63,489 45,888 23,509 72,524 67,066 28,949 31,310 29,487 74,159 27,339 51,243 33,569 59,513 1,093,911 DAB & TANF 56,915 87,372 40,814 73,318 424,725 87,513 61,830 32,579 99,009 92,346 43,146 44,662 41,328 105,966 40,010 69,826 44,254 83,738 1,529,351 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 725,444 941,927 414,397 644,831 2,624,286 536,769 340,222 300,299 900,471 583,104 652,364 294,461 520,399 1,178,136 167,900 599,044 640,124 561,261 $12,625,438 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 348 346 522 646 1,115 360 225 253 420 163 350 414 166 745 111 439 275 318 7,216 TANF SA 72,976 70,158 31,833 80,579 276,957 150,149 65,982 44,163 130,889 76,450 41,045 43,092 39,502 116,577 45,984 75,619 56,679 80,270 $1,498,905 Combined 798,421 1,012,085 446,230 725,410 2,901,242 686,918 406,204 344,462 1,031,360 659,554 693,409 337,553 559,900 1,294,713 213,884 674,663 696,803 641,531 $14,124,343 MH 4,842,198 6,558,184 3,215,871 5,915,478 27,265,272 6,578,241 4,442,467 2,354,848 11,173,165 6,961,497 5,141,070 2,678,061 3,269,353 14,922,739 2,793,497 5,366,784 4,652,655 5,076,075 $123,207,454 DAB & TANF SA 122,695 130,386 69,771 142,988 1,048,501 294,239 126,861 73,326 285,938 187,863 80,835 86,950 76,590 255,044 114,335 156,867 88,568 149,381 $3,491,139 Combined 4,964,893 6,688,570 3,285,642 6,058,466 28,313,773 6,872,480 4,569,328 2,428,174 11,459,104 7,149,360 5,221,905 2,765,012 3,345,943 15,177,782 2,907,832 5,523,651 4,741,224 5,225,455 $126,698,593 HSW 1,563,681 1,730,388 1,955,145 2,613,667 5,817,701 1,382,142 1,102,111 600,274 1,508,924 636,563 1,797,078 2,178,237 786,728 3,801,555 646,061 1,604,668 1,463,374 1,442,939 $32,631,234 Monthly MEG Summary Report Period: February 2010 Michigan's Medicaid Speciality Services and Supports Waiver 418 REPORT - FY2010 Capitation Paid (including adjustments) TOTAL MH 4,140,060 5,663,204 2,825,434 5,326,105 25,020,659 6,100,406 4,127,417 2,076,027 10,439,519 6,412,296 4,505,963 2,406,617 2,768,313 13,991,332 2,651,226 4,806,443 4,065,961 4,564,350 $111,891,335 DAB SA 50,013 60,625 38,232 62,992 783,266 145,478 61,116 29,452 157,290 111,934 39,831 44,231 37,293 140,859 68,983 81,791 32,304 69,756 $2,015,446 Combined 4,190,074 5,723,830 2,863,667 5,389,097 25,803,925 6,245,884 4,188,533 2,105,479 10,596,809 6,524,230 4,545,795 2,450,848 2,805,606 14,132,191 2,720,209 4,888,234 4,098,265 4,634,106 $113,906,781 TOTAL DAB 16,066 24,717 12,551 19,621 125,432 24,135 15,954 9,119 26,599 25,289 14,189 13,418 11,866 32,106 12,717 18,628 10,745 24,353 437,505 TANF 41,010 62,853 28,555 54,158 300,549 63,520 46,248 23,629 72,848 67,149 29,205 31,195 29,726 75,358 27,259 51,351 33,733 59,752 1,098,098 DAB & TANF 57,076 87,570 41,106 73,779 425,981 87,655 62,202 32,748 99,447 92,438 43,394 44,613 41,592 107,464 39,976 69,979 44,478 84,105 1,535,603 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 727,184 942,723 417,451 649,395 2,621,421 536,392 342,579 301,782 902,361 583,668 658,910 293,071 524,126 1,194,499 167,332 598,849 642,604 563,064 $12,667,409 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 354 347 517 648 1,129 363 229 252 432 162 350 411 173 747 112 443 278 318 7,265 TANF SA 72,413 69,777 31,872 80,768 273,336 148,912 65,959 44,227 129,391 76,094 41,458 42,661 39,655 117,095 45,527 74,687 56,364 79,952 $1,490,149 Combined 799,597 1,012,500 449,323 730,163 2,894,757 685,304 408,538 346,009 1,031,752 659,762 700,369 335,732 563,781 1,311,595 212,859 673,536 698,968 643,015 $14,157,558 MH 4,867,244 6,605,927 3,242,885 5,975,500 27,642,080 6,636,798 4,469,996 2,377,809 11,341,880 6,995,964 5,164,874 2,699,688 3,292,439 15,185,831 2,818,558 5,405,292 4,708,565 5,127,413 $124,558,743 DAB & TANF SA 122,426 130,402 70,105 143,759 1,056,602 294,390 127,075 73,679 286,681 188,028 81,290 86,892 76,948 257,955 114,510 156,478 88,668 149,707 $3,505,595 Combined 4,989,670 6,736,329 3,312,990 6,119,260 28,698,682 6,931,187 4,597,071 2,451,488 11,628,561 7,183,992 5,246,164 2,786,580 3,369,387 15,443,786 2,933,068 5,561,770 4,797,233 5,277,121 $128,064,339 HSW 1,767,586 2,271,286 2,147,761 2,939,719 6,735,062 1,750,153 1,471,643 627,417 1,660,968 793,267 2,047,432 2,257,520 1,041,321 3,854,129 949,469 1,744,822 1,593,013 1,722,443 $37,375,011 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