Vantage Policy Watch of September 21, 2025

Issues to Watch, State & Local Responses & Events...

By Jamelia Hand MHS CADC CODP I

As federal executive policy is relatively quiet this week, the spotlight remains on state and local developments shaping behavioral health and substance use services. These are the places where policy meets community, where implementation burdens are felt, and where innovation or resistance can have outsized effects. Tracking what’s happening now in states and counties gives an early view of how services, funding, oversight, and equity may shift especially under pressure from privatization, new mandates, and resourcing gaps.

Issues to Watch

• Privatization and Local Oversight in Michigan- Michigan’s Department of Health & Human Services is proposing to rebid contracts for its 10 regional Prepaid Inpatient Health Plans (PIHPs). Critics, including community mental health authorities and many county boards, warn this move could reduce local oversight, privilege larger nonprofit or out-of-area entities, increase administrative overhead, and reduce transparency.

  
  

• Housing Instability as a Behavioral Health Driver- In Manistee County, Michigan, growing housing insecurity is being tied directly to mental health deterioration (depression, anxiety, substance use), as people struggle with affordability, criminal history or lack of documentation, and instability. Local service providers are integrating housing navigation and transitional housing supports into behavioral health response.

• Universal Mental Health Screenings in Schools (Illinois)Illinois has passed SB 1560 which mandates annual mental health screenings for public school students in grades 3-12 beginning in the 2027-28 school year. Schools will get the screening tools and materials from the state at no cost. Parents can opt out. The State Board of Education will develop the materials by roughly September 2026. Some key tension points include privacy and confidentiality concerns, resource capacity (e.g. trained personnel, follow-up services), opt-out logistics, ensuring equity (so all schools, including under-resourced ones, can effectively implement).

  
  

• Potential Gaps in Behavioral Health Funding and System Capacity- With Michigan’s proposed contracting changes and broader stressors (housing, workforce shortages), there is risk that services will be disrupted, delayed, or become less accessible in rural or underfunded areas. Also, counties opposing state plans may face budget or legal pressures.

Recent activity at the state and county level is increasingly defining how behavioral health and substance use care will be delivered, overseen, and funded. From Michigan counties pushing back against contracting changes to Illinois preparing for school-based mental health screenings, local momentum is shaping not just policy, but how communities will experience services. These developments offer early signals of where service gaps, legal friction, and opportunities for innovation may emerge.

State & Local Responses & Events

• Manistee County, Michigan- The Manistee County Board has formally opposed MDHHS’s plan to rebid the region’s PIHPs, arguing loss of local oversight. The county has joined a lawsuit (or committed to non-financially supporting one) to block the changes. Local agencies (e.g. Centra Wellness Network, Manistee Friendship Society) are deepening attention to how housing insecurity worsens behavioral health outcomes.

  
  

• Illinois State• Gov. JB Pritzker signed SB 1560 into law, enacting universal mental health screening in schools, grades 3–12, starting in 2027-28, with free tools provided by state. Parents opt-out allowed. Illinois State Board of Education is tasked with developing screening tool / guidance, and readiness resources are being mapped (governance, oversight, policy, tech). Advocacy groups (e.g., NAMI Illinois) are engaging with implementation planning, emphasizing equity, privacy, appropriate referral & follow-up services.

  
  

• Other Local / Community-Level Events and Pressures• In Michigan, counties beyond Manistee (such as Osceola) are formally opposing the PIHP rebid. Service providers are warning of adverse effects if funding shifts or contracting changes reduce local control or increase bureaucracy.

How Vantage Can Help

• Policy Tracking & Early Warning: Monitor state bills, county resolutions, bid proposals, and legal challenges (e.g. in Michigan) so our partners can anticipate changes and adapt (staffing, contracting, advocacy).

  
  

• Implementation Support for New Mandates: Help local providers and school districts prepare for Illinois’ universal mental health screening law — share best practices on screening tools, privacy, opt-out architectures, staffing, referral pathways.

  
  

• Technical Assistance & Capacity Building: In places facing privatization or contracting shifts (like Michigan), Vantage can assist local agencies with analyzing bid/RFP documents, cost models, and identifying partners to strengthen local oversight and ensure community voice.

  
  

• Equity & Access Analysis: Evaluate how proposals or mandates will affect under-resourced or rural counties, marginalized populations, especially those facing housing instability, criminal justice involvement, or limited access to behavioral health services.

  
  

• Communications & Stakeholder Engagement: Help frame messages that clarify what proposed changes mean for communities, help reduce fear, ensure transparency; also help providers engage with policymakers and public.

State and local arenas are where many of the most meaningful changes or threats in behavioral health and substance use policy are playing out. As Illinois rolls out universal screening and Michigan sees community resistance to privatization, the decisions made now will ripple into how people access care, how equity is preserved or lost, and whether public systems remain accountable. Vantage stands ready to partner with stakeholders to anticipate those shifts, support smooth implementation, and ensure that reforms serve people, not just systems.

#BehavioralHealth #SubstanceUsePolicy #MentalHealthInSchools #EquityInHealth #StateLevelPolicy #CommunityVoice