PUBLIC HEARING

IN RE ADMIN RULES FOR SUBSTANCE USE

February 19, 2026

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·1· · · · DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

· · · · · · · BUREAU OF COMMUNITY AND HEALTH SYSTEMS

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· · · · · · · · · · · · PUBLIC HEARING ON

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· · · · ·ADMINISTRATIVE RULES FOR SUBSTANCE USE DISORDER

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· · · · · · · · · · · · ·SERVICE PROGRAM

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· · · · · · · · · · · ·RULE SET 2025-31 LR

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· · · · · · · · · · · · February 19, 2026

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· · · · · · · · · · · · · · 2:00 p.m.

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· · · · · · · · · ·G. Mennen Williams Building

17· · · · · · · · · · 525 West Ottawa Street

· · · · · · · · · · · First Floor Auditorium

18· · · · · · · · · ·Lansing, Michigan 48933

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· · ·RECORDED BY:· · · · · Kevin Lavery, CER-16593

24· · · · · · · · · · · · ·Certified Electronic Recorder

· · · · · · · · · · · · · ·Esquire Deposition Solutions

25· · · · · · · · · · · · ·Firm Registration Number 8035

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PUBLIC HEARING

IN RE ADMIN RULES FOR SUBSTANCE USE

February 19, 2026

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·1· · · · · · · · · · · · · ATTENDEES

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·3· ·Department of Licensing

· · ·and Regulatory Affairs:

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· · · · · · · · · · · · · Tammy Bagby, Manager, Legislative

·5· · · · · · · · · · · · Reporting, Rules, Training, and

· · · · · · · · · · · · · FOIA

·6· · · · · · · · · · · · Kyle Neff, Departmental Analyst

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· · ·Speakers:

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· · · · · · · · · · · · · Sam Price, Ten16 Recovery Network

·9· · · · · · · · · · · · Greg Toutant, Great Lakes Recovery

· · · · · · · · · · · · · Center

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PUBLIC HEARING

IN RE ADMIN RULES FOR SUBSTANCE USE

February 19, 2026

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·1· · · · · · · · · · · TABLE OF CONTENTS

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·3· · · · · · · · · · · · · · · · · · · · · · · · · · · PAGE

·4· ·Proceedings· · · · · · · · · · · · · · · · · · · · ·4

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PUBLIC HEARING

IN RE ADMIN RULES FOR SUBSTANCE USE

February 19, 2026

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·1· · · · · · ·Lansing, Michigan

·2· · · · · · ·Thursday, February 19, 2026 - 2:00 p.m.

·3· · · · · · ·MR. NEFF:· Good afternoon.· My name is

·4· ·Kyle Neff.· I am an analyst for the Bureau of

·5· ·Community and Health Systems in the Department of

·6· ·Licensing and Regulatory Affairs.

·7· · · · · · ·This hearing, regarding the

·8· ·administrative rules for substance use disorder

·9· ·programs is being called to order at 2:00 p.m. on

10· ·February 19th at the G. Mennen Williams Building

11· ·Auditorium located at 525 West Ottawa Street,

12· ·Lansing, Michigan.· The hearing is being conducted

13· ·under the authority of Administrative Procedures

14· ·Act, Public Act 306 of 1969.

15· · · · · · ·The Notice of Public Hearing was

16· ·published in three newspapers: on January 27th,

17· ·in The Grand Rapids Press; and on January 29th, in

18· ·both The Marquette Mining Journal and The Flint

19· ·Journal.· The same notice was published in the

20· ·Michigan Register on February 15th, 2026.

21· · · · · · ·As stated in the notice, "The proposed

22· ·rules add requirements that allow self-

23· ·administration of non-SUD medications for

24· ·individuals with acute and chronic conditions,

25· ·remove the requirements that an individual in a

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February 19, 2026

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·1· ·methadone program has a diagnosis of an opioid

·2· ·disorder for at least one year prior to admission,

·3· ·and to deregulate outpatient counseling programs

·4· ·which also eliminates need for branch offices."

·5· · · · · · ·Regulatory impact statements are

·6· ·available for further explanation of these rule

·7· ·sets.· Copies are available in the hall outside

·8· ·this auditorium, or they can be found on the

·9· ·website for the Michigan Office of Administrative

10· ·Hearings and Rules.

11· · · · · · ·Pursuant to Section 45 of the

12· ·Administrative Procedures Act, MCL 24.245, the

13· ·public hearing is an opportunity for the public to

14· ·present data, views, questions, arguments regarding

15· ·the proposed rules.· The department will use the

16· ·testimony and documents presented at this hearing

17· ·to determine if any changes should be made to the

18· ·proposed rules before they are adopted.

19· · · · · · ·If you have comments, please make sure

20· ·that they relate directly to the proposed rules.

21· ·If you have questions regarding the rules, please

22· ·submit your questions as part of your testimony for

23· ·the department's review.

24· · · · · · ·If you have suggested changes to the

25· ·proposed rules, please include specific reasons why

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February 19, 2026

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·1· ·the changes would be in the public's interest.· If

·2· ·you wish to comment, please complete a white card,

·3· ·available when you enter the auditorium, and submit

·4· ·to Tammy Bagby.· This will help the department

·5· ·prepare the hearing record.

·6· · · · · · ·When you testify, please identify

·7· ·yourself by name and organization, if any, that you

·8· ·may be speaking for today.· Written statements can

·9· ·be submitted directly to me or Tammy Bagby.· The

10· ·department will also accept written statements

11· ·emailed or postmarked until 5:00 p.m. on February

12· ·19th, 2026.· The address information can be found

13· ·in the Notice of Public Hearing that will be

14· ·available in the hall.· If you'd like to testify

15· ·and have not completed a card, please do so now.

16· · · · · · ·Department staff from the Bureau of

17· ·Community and Health Systems includes myself; Tammy

18· ·Bagby, Manager of the Legislative Reporting, Rules,

19· ·Training, and FOIA Section; Matthew Jordan, Manager

20· ·of the Non-Long-Term Care State Licensing Section;

21· ·and Heather Hosey, Division Director of the Health

22· ·Facility Licensing, Permits, and Support Division.

23· · · · · · ·We will now begin the public comment time

24· ·frame.· If you are handing in written comments,

25· ·feel free to summarize and add to your comments.

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PUBLIC HEARING

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February 19, 2026

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·1· ·You do not need to read them, as they will become

·2· ·part of the official record.· Reminder that these

·3· ·comments must pertain to the proposed rules.

·4· · · · · · ·MS. BAGBY:· All right.· The first card we

·5· ·have is from Sam Price.

·6· · · · · · ·MR. PRICE:· Good morning.· Sam Price from

·7· ·Ten16 Recovery Network.· We are an SUD outpatient

·8· ·provider in the middle of the state, so we want to

·9· ·thank you for the opportunity to comment on the

10· ·administrative rules and for opening those up.

11· · · · · · ·In principle, we support the goal of

12· ·modernizing the regulatory framework for SUD, and

13· ·because we have kind of been in the misalignment

14· ·space between MDHHS and LARA regulations when they

15· ·can be at odds with one another, so the

16· ·modernization of that part, we are in support of.

17· · · · · · ·We recognize, being part of the public

18· ·system, that we may not necessarily experience

19· ·significant administrative relief, maybe more

20· ·administrative simplification, because what may get

21· ·released by LARA more than likely may have to be

22· ·picked up by the department in order to meet

23· ·federal regulations for, you know, demonstrating

24· ·that they are working with licensed programs in

25· ·order to be, you know, a federal thing.· So in some

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IN RE ADMIN RULES FOR SUBSTANCE USE

February 19, 2026

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·1· ·ways, it may be more of a burden shift.

·2· · · · · · ·But in the meantime, we do get the

·3· ·simplification of some of those conflicting areas,

·4· ·so we applaud that movement in this.· I guess, for

·5· ·me, more of the cautionary tale or the things we

·6· ·would advise some consideration for in this

·7· ·direction is that -- because for those of us that

·8· ·work in the public space and are contracting with

·9· ·the IHPs, this -- these guardrails are going to

10· ·still be there.

11· · · · · · ·However, for those that are in the

12· ·private marketplace, if this is now opened up and

13· ·anyone can then advertise themselves as being an

14· ·SUD specialist, because these are no longer there

15· ·in place and those standards and expectations are

16· ·no longer there, I think that could create, A, some

17· ·confusion among consumers in terms of, how do I

18· ·figure out who truly is an expert because I

19· ·don't -- all I can do -- I can claim, as a

20· ·practice, that I do that.

21· · · · · · ·So sorting out and figuring out that

22· ·without some kind of protections could make it more

23· ·problematic for those people with commercial

24· ·insurance or self-pay.· So it puts the burden of

25· ·trying to figure out quality on the consumer, and

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February 19, 2026

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·1· ·certainly, they don't have those strengths.

·2· · · · · · ·A kind of an in-the-weeds concern related

·3· ·to that is if a private practice takes on this

·4· ·because they see this as a new opportunity, to what

·5· ·extent do they have an understanding of the 42 CFR

·6· ·regulations that come along with providing supports

·7· ·and services to somebody with that diagnosis?

·8· · · · · · ·I don't know to what extent there is

·9· ·familiarity or understanding, and there could be

10· ·some inadvertent increases in breaches in

11· ·confidentiality or violations of those standards

12· ·because there was unawareness on the practitioners'

13· ·part if that's eliminated.· So even clarifying how

14· ·providers that claim that have to have some kind of

15· ·an awareness of those compliant issues, I think,

16· ·are important.

17· · · · · · ·But I think it's also just kind of

18· ·understanding, particularly, again, in the private

19· ·marketplace, that -- because I've heard it said

20· ·before, well, you know, it's okay to deregulate

21· ·this because if I'm not having a good experience, I

22· ·can just go find another therapist.

23· · · · · · ·But the folks that we serve often come

24· ·with much more complex issues than somebody with a

25· ·mild-to-moderate mental health disorder.· So if

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February 19, 2026

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·1· ·they have a negative experience, that can lead to

·2· ·them dropping out of care.· That can lead into, and

·3· ·research is in support of this, if somebody drops

·4· ·out, then they may develop what's called the "why

·5· ·try?" kind of syndrome.· You know, treatment didn't

·6· ·work for me again.

·7· · · · · · ·So it's some of those maybe unintended

·8· ·consequences, more in the private marketplace, that

·9· ·I think we just -- as you're looking at how this

10· ·unfolds and rolls out, to try and think, are there

11· ·ways that we can still maintain some of those

12· ·protections for those citizens of Michigan as a

13· ·part of this, would be our main kind of cautionary

14· ·tale, if you will, for consideration.· Thank you.

15· · · · · · ·MS. BAGBY:· Thank you, Sam.

16· · · · · · ·Our next person is Greg Toutant.

17· · · · · · ·Is that correct?· Great Lakes Recovery?

18· · · · · · ·MR. TOUTANT:· Yes.· You nailed it.· Thank

19· ·you.

20· · · · · · ·MS. BAGBY:· I was going to say, I don't

21· ·get that very often.

22· · · · · · ·MR. TOUTANT:· Well, good afternoon,

23· ·everyone.· Greg Toutant, CEO for Great Lakes

24· ·Recovery Centers, and I would echo the comments

25· ·provided by Sam Price in the sense that the

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IN RE ADMIN RULES FOR SUBSTANCE USE

February 19, 2026

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·1· ·alignment clarification for outpatient services and

·2· ·that of LARA regulation and PIHP contracting, I am

·3· ·in support.· We are in support of deregulation for

·4· ·outpatient services, and we feel that it may lift

·5· ·some of the administrative burden that is currently

·6· ·out there.

·7· · · · · · ·However, it does come with some other

·8· ·conditional considerations.· Knowing that the

·9· ·Michigan Certification Board for Addiction

10· ·Professionals and the proper certification for

11· ·substance use disorder professionals remain at the

12· ·forefront during an element where program licensure

13· ·would be deregulated but individual practitioner

14· ·certification remain strengthened in the

15· ·transition.· In that way, from a public aspect, we

16· ·know that there is at least a mechanism of training

17· ·and certification support to know that people that

18· ·would be providing services are licensed and

19· ·credentialed to be able to do that.

20· · · · · · ·We understand in a publicly funded

21· ·treatment system, there are some safeguards that

22· ·are in place.· Current PIHP contracting that

23· ·indicates, for Medicaid-funded services, that

24· ·third-party accreditation remain intact for

25· ·providers does mean that there are specific

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February 19, 2026

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·1· ·outpatient guidelines and support there for

·2· ·programs to follow.

·3· · · · · · ·And so it is an element that we hope will

·4· ·help to ease some of the administrative burden and

·5· ·with the caveat of lifting up the Michigan

·6· ·Certification Board for Addiction Professionals and

·7· ·making sure third-party accreditation for

·8· ·outpatient programs remain intact.· It should

·9· ·provide us additional oversight that needs to be

10· ·considered and that we can lean into.

11· · · · · · ·It does help to bring about some

12· ·alignment relative to Medicaid health plans for the

13· ·mild-to-moderate mental health benefit management

14· ·because it is practitioner-based and not

15· ·programmatic licensure for those types of services.

16· ·And we certainly see a lot of folks out there with

17· ·mental health disorders that could be enhanced with

18· ·deregulation.

19· · · · · · ·I would be remiss if I didn't bring up

20· ·one other point relative to the written comments.

21· ·I won't go into those (inaudible) here.· But we do

22· ·want to say to LARA that as you look at the

23· ·alignment considerations between MDHHS, LARA, and

24· ·ASAM, that ample opportunity is also given to

25· ·things that aren't addressed in this phase of

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·1· ·review that (inaudible) management can also give us

·2· ·another look at here in the near future.

·3· · · · · · ·So my comments on those areas are

·4· ·outlined here.· I understand that this won't be the

·5· ·forum to do that today, so thank you.· And as far

·6· ·as the copies of the letters, written comments can

·7· ·be given to Tammy.

·8· · · · · · ·MR. NEFF:· Yes.

·9· · · · · · ·MS. BAGBY:· Yes.

10· · · · · · ·MR. TOUTANT:· Thank you.

11· · · · · · ·MR. NEFF:· Thank you.

12· · · · · · ·MS. BAGBY:· That is the last comment card

13· ·I have.· Do we have anybody else that would like to

14· ·make a comment?

15· · · · · · ·Okay.· Kyle, back to you.

16· · · · · · ·MR. NEFF:· All right.· I would like to

17· ·thank everyone for their comments today.· Each

18· ·comment will be reviewed and evaluated by the

19· ·Bureau, as well as the comments received

20· ·electronically during the open comment time that

21· ·ends today at 5:00 p.m.

22· · · · · · ·We are now adjourned at 2:13 p.m.· Thank

23· ·you very much.

24· · · · ·(Public Hearing concluded at 2:13 p.m.)

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·1· · · · · · · · · · · · ·CERTIFICATE

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·3· · · · · · ·I, KEVIN LAVERY, a Certified Electronic

·4· ·Recorder and Notary Public within and for the State of

·5· ·Michigan do hereby certify that on February 19, 2026

·6· ·before the Department of Licensing and Regulatory

·7· ·Affairs, State of Michigan, I digitally reported the

·8· ·proceedings had, and that said proceedings were

·9· ·accurately captured with annotations by me, taken at

10· ·said time and place.

11· · · · · · ·I further certify that I am not related to any

12· ·of the parties to this action by blood or marriage; and

13· ·that I am not interested in the outcome of this matter,

14· ·financial or otherwise.

15· · · · · · ·IN WITNESS THEREOF, I have hereunto set my

16· ·hand this 2nd day of March, 2026.

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19· · · · · · ·___________________________

· · · · · · · ·KEVIN LAVERY CER-16593

20· · · · · · ·Notary Public, State of Michigan

· · · · · · · ·County of Ingham

21· · · · · · ·My commission expires:· August 28, 2031

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