Mosaic Counseling urges expansion of school-based, low-cost therapy after Kent County rollout

The Michigan House Appropriations Subcommittee on Medicaid and Behavioral Health heard a presentation from Mosaic Counseling on the organization’s school-outreach program and a statewide expansion proposal, emphasizing rapid access to sliding‑scale therapy for students and community members.

Mosaic Counseling Executive Director Sarah Lukowski told the committee the group’s model places vetted private‑practice therapists into schools and community settings to remove barriers such as cost, wait lists and transportation. “We have never had a wait list regardless of insurance status,” Lukowski said, and she described a matching intake process intended to get people connected to an appropriate therapist “within a week or two” when a provider is available.

The presentation said Mosaic (founded in 1978) operates several programs: professional counseling for all ages, a school outreach program that serves students in seven school districts and 30 schools, an employee assistance program for employers and school staff, suicide‑prevention training using QPR (question‑persuade‑refer), and mental‑health advocacy. Lukowski said Mosaic has a panel of about 270 licensed private‑practice therapists who agree to reduced rates for Mosaic referrals; Mosaic’s lowest copay is $6 and the program’s negotiated rate with panel therapists is described in testimony as $60.

Why it matters: committee members pressed the group on rising need among children and adults and on Mosaic’s capacity to serve people regardless of insurance. Lukowski showed county survey data the group uses to target services and told members that mild‑to‑moderate adult mental‑health needs in Ottawa County rose from 17% (2020) to 27% (2023) in survey responses she cited. She said 34% of Mosaic’s clients last year were under age 18.

Committee questions covered data and operations. Representative Jennifer Robinson asked how Mosaic distinguishes “mild to moderate” from “severe and persistent”; Lukowski replied that severe and persistent diagnoses are conditions such as schizophrenia or bipolar disorder that generally require ongoing specialty services (community mental health) and medication and case management, while mild to moderate describes the broader set of needs Mosaic serves. Representative Rogers asked about payer mix; Lukowski estimated roughly one‑third uninsured/underinsured, one‑third Medicaid and one‑third private insurance, and confirmed the organization has expanded operations into Kent County.

Lukowski described partnerships that support referrals and continuity of care, including a collaboration with Forest View Hospital—an inpatient facility that discharges about 16 patients daily—and a new initiative to provide specially made cards to Grand Rapids Police Department patrol officers to give to people in crisis with direct scheduling information for Mosaic intake. She also said the state placed Mosaic back in the 2024 budget at $200,000 after prior funding pauses.

Committee members and the presenter emphasized prevention and crisis response. Lukowski said Mosaic provides crisis care in schools after events such as a death and has trained about 12,000 people through brief QPR suicide‑prevention sessions; she told the panel that QPR’s “refer” step is nationally constrained by limited outpatient capacity, which Mosaic tries to address by expanding provider panels and school outreach.

Operational details and limits: Lukowski said Mosaic’s staff is small—nine staff and three interns for Ottawa and Kent counties—but that the organization scales capacity through its vetted therapist panel. She said the portal Mosaic uses for intake and matching lets staff find available, appropriately credentialed therapists quickly and sometimes, in urgent cases, skip insurance to get a client seen the same day. Lukowski described telehealth as an important modality but did not provide a precise split for in‑person versus teletherapy for all services (she estimated telehealth is “probably 40%” for some services).

Next steps: Mosaic presented a budget proposal to expand into five additional counties (Ottawa, Kent, Muskegon, Jackson and Washtenaw were named) and asked for continued legislative support to help scale the model. Committee members invited follow‑up with more detailed payer‑mix, utilization and implementation cost data.

Ending: The presentation concluded with committee members thanking Mosaic for the overview and noting interest in school‑based mental‑health models as an element of broader behavioral‑health and Medicaid policy work in the House.