Tracking What’s Disappearing: A Michigan Service Elimination Watchlist
One Michigan service is confirmed gone. Five more items are moving. This is a living inventory families can check, built only from things I could verify against a primary document rather than a rumor.
This is the least glamorous advocacy task in existence and it is the highest leverage one available to a single family. Proposed policy bulletins affecting behavioral health and specialty services are posted there with a comment window attached, usually thirty days. Reading that page for ten minutes a month puts you ahead of nearly every family in Michigan, and a written comment during an open window enters the official record in a way that no phone call ever does.
1
Prevocational services
Removed from the Habilitation Supports Waiver. Beneficiaries get a six month transition to skill building or out-of-home nonvocational habilitation. This one already happened.
PIHP restructuring
The procurement that would have replaced ten regions with three was withdrawn in February 2026 after a court ruling. Withdrawn is not the same as abandoned.
Wage passthrough failure
Michigan’s required direct care wage reached $17.13 on January 1, 2026, built from a $13.73 base plus a $3.40 passthrough. Reporting through 2026 says many CMHSPs have not passed the funding to providers.
The FY27 wage increase
A $1.27 per hour increase effective January 1, 2027 requires $182.2 million in gross Medicaid funding. Like every increase before it, it depends on an appropriation that has to happen again.
New waiting lists nationally
KFF found twelve states across twenty waivers reported new waiting lists in 2025, with five states opening new interest lists for I/DD waivers. When neighbors start listing, pressure moves.
The autism-specific wait
Autism waivers nationally average a 63 month wait, against 37 months for I/DD waivers. That gap is the clearest measure of how this population gets sorted.
The watchlist, with its status
Nobody sent us a letter saying the program was ending. The letter said the service was being transitioned. Six months later there was no provider in our county delivering the thing it was transitioned to, and the answer I got was that the service exists. It does exist. It exists in a document.
Run a watch on your own county
Set this up once, then maintain it
- 1Bookmark the MDHHS Medicaid policy public comment page and check it monthly for behavioral health and specialty services bulletins.
- 2Subscribe to your PIHP and CMHSP board meeting notices. Agendas and packets are posted before the meeting.
- 3Each spring, read the behavioral health section of the House and Senate Fiscal Agency budget summaries.
- 4When a service is named as transitioning, immediately ask your CMHSP for the list of providers actually delivering the replacement in your county.
- 5Submit written comment during any open window, even one paragraph. Written comment is a record; a call is not.
- 6Take three minutes of public comment at a board meeting when an item on this list moves.
Keep a file with these in it
- Every written notice you have received about a service change
- The waiver amendment or bulletin number, if you can find it
- The date the comment window opened and closed
- The list of providers you were told deliver the replacement service
- What each of those providers told you when you called
- Your current plan of service and the one before it, for comparison
- Any correspondence about the direct care wage passthrough
- Dated copies of everything, because dates are the argument
I built this list only from things I could trace to a primary document. If an item is not on it, that means I could not confirm it, not that it is not happening.
A mother in Kent County asked me last spring how she was supposed to know what was coming. She had lost a service that year and found out at a meeting, thirty days before it ended, from someone who assumed she already knew.
She is not disorganized. She is a person with a job and a kid who needs constant supervision, and the system that changed her services published the change in a document she had no reason to know existed. So this post is my attempt at an answer, and I want to be honest up front about what it is and is not.
This is a list of six things. One of them has already happened. Five are moving. Every item on it is traceable to a document you can read yourself, and I cut several items I had heard about but could not confirm against a primary source. A watchlist that includes rumors is worse than no watchlist, because it teaches you to discount the whole thing.
Item one: prevocational services, confirmed gone
This one is settled. Prevocational services were removed from the Habilitation Supports Waiver. The waiver’s transition plan gives beneficiaries who were receiving prevocational services a six month window to move to alternatives, specifically skill building or out-of-home nonvocational habilitation.
On paper, this is a substitution. In practice, a substitution only counts if the replacement has a provider willing to deliver it in your county, at a rate that makes delivering it survivable, with staff available to run it. Ask a family in the middle of that six month window how many providers called back.
What to do: if you receive any notice using the word transition, immediately ask your CMHSP, in writing, for the list of providers currently delivering the replacement service in your county. Then call every one of them yourself.
Item two: PIHP consolidation, withdrawn but not renounced
MDHHS issued a procurement that would have replaced Michigan’s ten prepaid inpatient health plan regions with three super-regions. On January 8, 2026, the Court of Claims found it conflicted with the Michigan Mental Health Code. MDHHS withdrew it on February 6, 2026.
I wrote about that fight separately, and the reason it belongs on a watchlist rather than in a history file is that the ruling was about how the RFP was drafted, not about whether the department may restructure at all. The state has now paid for the analysis and learned exactly which provision failed. A second attempt will be faster and will not contain that provision.
What to do: know your PIHP region. Put one board meeting on your calendar. That is the whole assignment.
Item three: the wage passthrough that is not arriving
Michigan’s required direct care worker wage reached $17.13 per hour on January 1, 2026. That figure is a $13.73 base rate plus a $3.40 cumulative passthrough, assembled from three separate appropriations across several budget years.
Reporting through 2026 indicates that many community mental health services programs have not provided the additional funding to providers and families. The state funded a wage increase. Whether the wage increase reached a paycheck is a different question, and it is being answered county by county.
What to do: ask your provider directly whether they received the passthrough for the current period. If the answer is no, that is a finding your CMHSP board should hear during public comment.
Item four: the FY27 increase that needs an appropriation
A $1.27 per hour increase is scheduled to take effect January 1, 2027, and it requires $182.2 million in gross Medicaid funding to happen.
This is the structural problem with how Michigan raises direct care wages, and I have written about it at length elsewhere. Every increase sits on top of the base rate as an add-on rather than being built into the rate methodology itself, which means every increase has to be re-funded. The FY27 number is not a plan. It is a request.
What to do: read the behavioral health section of the fiscal agency budget summaries each spring. When this line appears, it is a moment where a letter matters.
Item five: new waiting lists opening around us
KFF’s November 2025 waiting list survey found twelve states, across twenty waivers, reported new waiting lists in 2025. Five states opened new waiting or interest lists specifically for waivers targeting people with intellectual or developmental disabilities.
Michigan’s Habilitation Supports Waiver remains capped at 7,481 slots allotted by region, which is its own kind of list whether or not your county calls it one. The national trend matters because it tells you which direction the pressure is moving. States do not open new I/DD waiting lists in a year when funding is comfortable.
Item six: the 63 month autism wait
In the same KFF work, autism waivers nationally averaged a 63 month wait. I/DD waivers averaged 37 months. The overall average across all populations was 32 months.
Autistic people wait longer than any other group tracked. Almost twice as long as the I/DD average, which already includes many autistic people. That gap is not an accident of one bad state. It is a durable pattern, and it belongs on any list of things families should be watching, because it is the clearest single measure of how this population gets sorted when capacity is scarce.
How to keep this list alive
I will update this page as items resolve or new ones confirm. But the version that matters is the one you keep for your own county, because the six items above are statewide and the thing that ends your daughter’s program will be local.
Check the public comment page monthly. Subscribe to two board meeting notices. Read one budget summary a year. Ask for provider lists in writing whenever you hear the word transition. That is maybe ninety minutes of attention across a whole year, and it is the difference between finding out with thirty days and finding out with six months.
The mother in Kent County did everything a reasonable person does. The system just does not tell reasonable people things. So we tell each other.