Van Buren Community Mental Health Authority’s History

Prior to the passage of state laws enabling community mental health boards, a group of interested citizens of Van Buren County formed a committee to arrange for local mental health services from Kalamazoo Child Guidance Clinic. This committee raised donations to pay for the services, and space was provided by the Intermediate School District. In 1969, this volunteer group was called upon by the Van Buren County Board of Commissioners to survey mental health needs in the county, set up services, and evaluate results. Eleven months later on February 10, 1970, the Board of Commissioners passed a resolution designating that committee as the Van Buren County Community Mental Health Services Board, under the terms of Public Act 54, of 1963.

Services began with a small staff doing assessment and diagnostic services, mostly with children, and grew steadily over the next decade. Outpatient counseling for children and adults was added, as were aftercare services, such as the day activity program for people being discharged from state psychiatric hospitals.

In the 1980s, the movement to community-based alternatives from inpatient psychiatric made dramatic strides in Van Buren County. The continuum of services offered grew to include partial day treatment, residential services, case management and recipient rights services.

At the beginning of the fiscal year in 1986, Van Buren Community Mental Health Services Board took a step that significantly changed the agency’s span of control. The Board elected to change the contract with the then Michigan Department of Mental Health and assume full responsibility for all mental health care for county residents, state-provided inpatient services as well as community-based services. As a result of this decision, the agency took a giant step forward in terms of growth and development. Many services were developed or expanded in an effort to avoid unnecessary hospitalization of its citizens, particularly in state psychiatric institutions. This necessitated the development of new services. Up to then, standard outpatient mental health services were the dominant mode of service delivery. From that point forward, services to persons with the more persistent and serious mental illnesses became the focal point for the organization. The continuum of care grew to include prevention services, 24-hour crisis response and stabilization services, specialized residential services, assertive community treatment services, wrap-around services, customer-operated business services, integrated employment services, jail diversion services, treatment services for persons with co-occurring mental illness and substance abuse disorders, and hospital care management services.

The program for persons with developmental disabilities has a similar but slightly different genesis and history. Services for developmentally disabled persons were begun in the mid-1950s by the Association for Retarded Citizens. In the mid-1960s, the Intermediate School District took on responsibility for programming for developmentally disabled people age 26 and under. A few years later, the adult program developed an affiliation with the McKercher Rehabilitation Center in Comstock, which developed work services for them. In 1970, the program for adults became the responsibility of Van Buren Community Mental Health Services. Over the course of the next three decades, services were expanded to include 24-hour crisis response and stabilization services, specialized residential services, support and service coordination services, day programming services, personal care services, children’s waiver services, and habilitation supports waiver services, prevocational and vocational services, and integrated employment services.

In 1994, Van Buren Community Mental Health Services was awarded accreditation for the full range of its programs and services from The Commission on Accreditation of Rehabilitation Facilities (CARF). CARF is a nationally recognized not-for-profit organization which sets standards for and monitors the quality of services for people with disabilities across the country.

In 1996, Michigan law was amended to require “Person-Centered Planning” (PCP) within the mental health system. PCP has evolved as the vehicle through which customers in Van Buren County experience self–determination and the freedom to choose, to participate and to achieve within their communities.

In 1998, the Michigan Department of Community Health (MDCH) initiated a prepaid, capitated system of managed care with more stringent accountability standards and reporting requirements for community mental health. In an attempt to meet these new standards and continue to provide high quality services to customers, Van Buren Community Mental Health joined in a partnership with Community Mental Health Authorities in Barry, Berrien, Branch and Calhoun Counties. This partnership, called Venture Behavioral Health, was created to achieve efficiencies and economies of scale while responding to the standards and requirements of MDCH. Some of Venture’s accomplishments include the development of a five-county customer service system and provider network system, and enhanced quality improvement and information technology systems.

In 1999, the Van Buren County Board of Commissioners passed a resolution converting the county mental health department into a community mental health authority. Van Buren Community Mental Health Authority thus legally became a separate governmental entity from the county. The authority status provides greater legal latitude and responsibility for the authority, and limits the financial obligations of the county for mental health services.

In October, 2002, Michigan created a new method of securing behavioral health benefits for Medicaid recipients. With the consent of the federal government, specifically the Center for Medicare and Medicaid Services (CMS) through waivers from the basic federal Medicaid program, the state (through MDCH) has changed how they purchase Medicaid behavioral health benefits for eligible Medicaid recipients.

Venture Behavioral Health became the administrator of Medicaid behavioral health (mental illness, developmental disabilities, and substance abuse) benefits acting as the MDCH’s regional administrator for the Medicaid benefit plan. Venture Behavioral Health was a separately administered program of Summit Pointe, Inc., the Community Mental Health Authority of Calhoun County. An Administrative Advisory Board from the five Community Mental Health Authorities assisted in the governance of Venture. Each CMH transferred their Medicaid benefits management responsibilities to the Host Board (Summit Pointe).

In the fall of 2012, The Michigan Department of Community Health (MDCH) set into motion a number of transformative changes to the public behavioral health and physical health delivery systems, driven by the goals of greater access, improved quality of care, and integration of behavioral and physical health care. MDCH realigned the Medicaid Health Plan (MHP) and Prepaid Inpatient Health Plan (PIHP) regions in Michigan, into a more consistent regional model for both health plan types. Within the new model, ten (10) regions exist where there used to be 18 PIHPs.

On January 1, 2014 Southwest Michigan Behavioral Health (SWMBH) became the Regional Entity for the Community Mental Health Authorities (CMHAs) within 8 counties of Southwest Michigan, including Van Buren. A Regional Entity is defined in the Michigan Mental Health Code, and was formed by the action of the partnering CMH Boards. The CMHs and SWMBH maintain their independent organizational status, and SWMBH fulfills benefits management functions for the CMHs in the region. (Thus, SWMBH took over these functions and Venture Behavioral health ceased to exist. As the Regional Entity, SWMBH is our Prepaid Inpatient Health Plan (PIHP), our Coordinating Agency (CA) for Substance Use Services, and provides benefits management functions for our region. Each participating CMH elects one Board member to serve on SWMBH’s Board.

The CMHs within SWMBH are:

Barry County Community Mental Health Authority,
Branch County Community Mental Health Authority d/b/a Pines Behavioral Health,
Berrien Mental Health Authority d/b/a Riverwood Center,
Calhoun County Community Mental Health d/b/a Summit Pointe,
Cass County Mental Health d/b/a Woodlands Behavioral Network,
Kalamazoo County Mental Health and Substance Abuse Services,
Community Mental Health and Substance Abuse Services of Saint Joseph County and,
Van Buren Community Mental Health Authority.

The annual Medicaid budget for SWMBH will be over $200 million. Geographically SWMBH covers 4,494 square miles with an estimated population of 837,000. Of the total population, more than 145,000 are Medicaid eligible. Historically the CMHs served more than 25,000 people a year with serious mental illness, intellectual/developmental disabilities, substance use disorders or severe emotional disturbance, and the Coordinating Agency providers served approximately 4,300 individuals.

On October 3, 2016, VBCMH began providing Substance Use Disorder (SUD) Treatment and Prevention Services. Staff at VBCMH worked for over a year with staff at the Van Buren/Cass District Health Department to move staff and services to VBCMH from VBCDHD. SUD services are located at the Human Services Building East in Paw Paw in Suite B.

Today, Van Buren Community Mental Health Authority is a $22 million operation with approximately 195 full-time, part-time and contractual employees, working out of eight different sites throughout the county. It provides over 25 distinct services for persons of all ages with mental illnesses, emotional disorders, or developmental disabilities, serving over 2,400 such customers each year.