The Michigan Mental Health Code

LifeWays operates under the Michigan Mental Health Code (Act 258 of 1974, MCL 330.1001 - 330.2106), which mandates that Community Mental Health Service Providers (CMHSPs) prioritize individuals with serious mental illness, serious emotional disturbance, or developmental disabilities, particularly for Medicaid recipients. LifeWays has since expanded its consumer base to schools, courts, and jails.

Enacted in 1974, the code provides a legal framework for mental health services, ensuring access to mental healthcare, protecting patient rights, and regulating treatment processes. The code consists of 13 chapters, addressing infrastructure, administration, community mental health services, and specific protections for patients in psychiatric care.

Major provisions in the code include:

• Required Community Mental Health Services Programs (CMHSPs): Every Michigan county must have a Community Mental Health (CMH) agency or authority to provide mental health services. These agencies are responsible for assessing local mental health needs, delivering services—primarily therapy—and ensuring compliance with the code.

• Person-Centered Planning: CMHSPs must by statute use a person-centered planning approach, involving patients in decisions about their treatment. This includes identifying goals and preferences. Person-centered therapy, developed by Carl Rogers in the 1940s, is a humanistic approach to psychotherapy emphasizing the client's inherent capacity for growth and self-actualization. It is grounded in the belief that individuals possess the resources to understand themselves and resolve their issues when provided with a supportive environment. Unlike directive therapies, the therapist does not offer advice but facilitates the client’s “self-discovery.”

• Funding Assessment: CMHSPs must conduct annual needs assessments to identify mental health needs and submit plans to the state and county boards of commissioners. Counties approve funding requests, which may include state and federal (Medicaid) funds.

The History of LifeWays

• 1970s—Establishment of Jackson-Hillsdale Community Mental Health Board (JHCMHB): In response to the Michigan Mental Health Code and federal mandates, Jackson and Hillsdale Counties formed the JHCMHB to oversee mental health services.

• Mission and Services: The JHCMHB offered services including therapy, case management, and crisis intervention, primarily for Medicaid-eligible residents.

• 1996—Rebranding to LifeWays Community Mental Health: The JHCMHB officially changed its name to LifeWays Community Mental Health, adopting a broader mission to “inspire hope and promote life-enhancing recovery.”

• 1990s—Formal Establishment as an Authority: The Jackson and Hillsdale County Boards of Commissioners signed an enabling resolution under Public Act 290, establishing LifeWays as a formal CMH authority. This granted greater administrative autonomy compared to county-affiliated CMHs.

• 2000s-2010s—Service Expansion:

  • LifeWays began offering on-site pharmacy services.

  • The organization contracted with the Michigan Department of Corrections to administer the Michigan Prisoner Re-Entry Initiative.

  • Court Partnerships: Mental Health Court: LifeWays collaborated with Jackson County Courts to establish one of Michigan’s first six Mental Health Courts, diverting individuals with mental illness from incarceration to treatment.

  • Juvenile Drug Court: In partnership with Hillsdale County Courts, LifeWays developed a Juvenile Drug Court to address substance use among youth through treatment and rehabilitation.

• Legislative Advocacy: LifeWays supported the passage of House Bill 4862, which allowed the integration of community mental health and substance use disorder services, expanding the organization’s scope.

• 2017–2018: LifeWays successfully attained mental health millages in both counties. Jackson County voters approved the millage in 2017, followed by Hillsdale County in 2018, with implementation in 2019. These millages generate approximately $2.7 million annually, primarily for therapy in jails and schools.

• 2010s–2020s: LifeWays became a Certified Community Behavioral Health Clinic grantee through the Substance Abuse and Mental Health Services Administration, expanding its capacity. The CCBHC designation, formalized by 2023, emphasizes “wellness,” “trauma-informed care,” and “physical-behavioral health integration.”

The Organization Today

• Services: LifeWays provides an array of services, including:

  • Therapy

  • Crisis intervention

  • Case management, psychiatric evaluation, and medication administration

  • Substance use disorder treatment

  • Community education

• Size: LifeWays has over 230 employees and a network of more than 70 service providers. It operates offices in both Hillsdale and Jackson counties, with primary facilities at 1200 N. West Ave., Jackson, and 25 Care Drive, Hillsdale, until the new facility is built.

• Funding: LifeWays is funded through Medicaid, Healthy Michigan Plan, mental health millages.

  • According to its projected 2025 Fiscal Year budget, LifeWays expects to receive just over $8 million per month in federal, state, and local tax funding, approximating $100 million in annual income.

Can Hillsdale County Decertify LifeWays?

LifeWays is the Michigan Department of Health and Human Services (MDHHS)-designated CMHSP for Hillsdale and Jackson Counties, with contracts for Medicaid and state funds. Replacing LifeWays with another CMHSP would require MDHHS to reassign the designation. The county cannot bypass LifeWays to directly fund another agency for CMHSP duties, as LifeWays holds the MDHHS contract. The process to change providers is outlined as follows:

1. Dissolving the Joint Authority:

   • Hillsdale County could vote to dissolve its joint relationship with Jackson County, ending LifeWays as a shared CMHSP.

   • Dissolution would require:

     • A majority vote by the Hillsdale County Board of Commissioners.

     • Coordination with MDHHS to establish a new CMHSP (single-county or joined with another county).

     • Ensuring no disruption to services, as mandated by MCL 330.1206.

   • Post-dissolution, Hillsdale could form a new CMHSP or contract with another, and would involve the reallocating of Medicaid contracts and millage funds.

Additional Barriers to Decertification

• 2025 Bond: The $15.5 million bond for a new LifeWays facility would tie Hillsdale County financially to LifeWays for 20 years (approximately $1 million/year debt service). Dissolving LifeWays could leave the county liable for bond payments without LifeWays’ operational support, complicating a switch.

Alternatives to Decertification

Instead of replacing LifeWays, Hillsdale County could:

• Influence Provider Contracts: Push LifeWays to contract with local providers like Hillsdale Hospital for specific services, enhancing community integration.

• Improve Oversight: Use its funding role (millage, bond) to demand transparency or service adjustments, as seen in quarterly millage reporting.

Jacob Bruns

Related Links:

In 3-2 Vote, Commissioners Approve LifeWays Bond Despite Public Protest

LifeWays to Solicit $15.5 Million Bond from Hillsdale County Commissioners

LifeWays Likely to Solicit County Board Again for a Bond at Tuesday's Meeting

LifeWays to Solicit County Backing for Building Bond Next Week

Commissioners Move Forward with LifeWays Bond Request

County Would be Liable for LifeWays Building Bond, Says Bond Counsel

Commissioners Set to Vote on $15.5 Million LifeWays Building Bond