Mosaic Counseling tells House panel school outreach, sliding-scale model reaches children and uninsured

Mosaic Counseling told the House Appropriations Subcommittee on Medicaid and Behavioral Health that its school-based outreach and a large panel of reduced-rate private therapists let the nonprofit provide rapid, low-cost mental health care to children and adults regardless of insurance status.

The presentation, given by Mosaic Executive Director Sarah Lukowski, explained why Mosaic’s model emphasizes immediate access, a sliding fee schedule and school placements. Lukowski said Mosaic has “never had a wait list” and described a network of roughly 270 licensed private-practice therapists who agree to reduced rates for clients referred by Mosaic.

Mosaic’s model matters because committee members heard it can shorten the time between outreach and treatment and reach populations that otherwise face cost or transportation barriers. Lukowski said the group’s school outreach can place a child with a therapist “within a week or two,” and that placing clinicians in schools removes barriers that prevent many students from getting care.

Details presented to the committee included Mosaic’s operating model and recent local data. Lukowski said Mosaic has nine staff and three interns serving Ottawa and Kent counties; the organization’s lowest copay is $6, and Mosaic makes up the difference to the therapist when clients pay at that reduced level. She said 34 percent of Mosaic’s clients last year were under age 18, and cited Ottawa County community-needs data showing adult respondents reporting mild-to-moderate distress rose from 17 percent in 2020 to 27 percent in 2023, while those reporting severe and persistent conditions rose from 3 percent to 8 percent.

“I have just watched the mental health need just keep rising,” Lukowski told the committee, and she pointed at multiple causes including social-media effects, isolation and the COVID-19 era’s additional stresses.

Mosaic described a handful of programs and partnerships: a school outreach program active in seven districts and 30 schools; an employee-assistance program offered to employers and school districts; QPR (Question–Persuade–Refer) suicide-prevention training that Lukowski said has trained about 12,000 people; and a collaboration with Forest View Hospital to facilitate outpatient follow-up after inpatient discharge. The group also said it has worked with the Grand Rapids Police Department to supply specially made referral cards for officers to hand to people in crisis.

On funding, Lukowski told the committee Mosaic received $200,000 in the 2024 state budget after a year out of the budget. She said Mosaic has proposed a five-county expansion in the current budget cycle—adding Muskegon, Jackson and Washtenaw to its existing Ottawa–Kent footprint—and asked for additional funds to support that growth.

Committee members pressed for more operational detail. Representative Robinson asked how Mosaic classifies “mild to moderate” versus “severe and persistent”; Lukowski replied that severe and persistent conditions are diagnoses such as schizophrenia or bipolar disorder that typically require medication and case management and are served by community mental health centers. Representative Rogers asked about Mosaic’s payer mix; Lukowski said roughly one-third of clients are Medicaid and about 30 percent are uninsured or underinsured, with the remainder covered by private insurance.

On how Mosaic remains financially viable while keeping fees low, Lukowski described a proprietary intake-and-matching portal that identifies available panel therapists by location, presenting issue and payer status; she offered an example in which the organization bypassed insurance to place a suicidal 12-year-old with an available therapist immediately.

Committee members praised the school work and asked about coordination with other school-based providers. Lukowski said Mosaic’s school services are free to students and that other agencies sometimes co-exist in a district—some billing Medicaid or private insurance—but Mosaic’s free model fills gaps for uninsured or underinsured students.

Mosaic’s presentation concluded with a request for expansion funding and a pledge to continue recruitment of reduced-rate therapists. The committee did not take formal action on funding during the meeting.

Looking ahead, Lukowski said Mosaic is ready to scale but that doing so will “require additional funding,” and she asked legislators to consider the proposed five-county expansion in the upcoming budget cycle.