Macomb County highlights 988 mobile crisis, SUD engagement center and opioid‑settlement funded jail programs

Macomb County Community Mental Health and Community Corrections presented a joint overview of crisis response, substance use disorder (SUD) services and the county's use of opioid settlement funds to expand jail diversion and reentry services.

Tracy Smith, CEO of Macomb County Community Mental Health, told the committee Macomb operates a standalone 988 crisis line for calls originating in the county; callers are routed to Macomb County staff unless the line rolls over to the national center. Smith said the county also operates a long‑standing 24/7 local crisis number ((586) 907‑9100) that received the most calls last year. Overall, the department reported roughly 17,000 crisis calls and assistance episodes last year across all crisis levels.

Smith described Macomb's adult and children's mobile crisis teams, which deploy two‑person teams (a master‑level clinician plus a peer or parent partner) and provide on‑site response in two hours or less when indicated. She said the adult mobile crisis team went to 24/7 operations in April and that, in a short period after the change, the teams served several dozen callers (the presenter cited roughly 21 adults and 40 children in the early months). For children, Smith said the program served about 400 children last year who received in‑person mobile crisis services and that only about 1 percent required hospital admission after evaluation.

Smith also described plans for a 24/7 SUD engagement center in Sterling Heights intended as an alternative to the emergency room or law enforcement custody for people experiencing substance use crises or seeking immediate engagement in treatment. The engagement center will offer walk‑in intake, on‑site linkage to treatment, and an on‑call psychiatrist for urgent medication needs.

Barb Keske, director of Community Corrections, summarized partnerships inside the Macomb County Jail and the county's opioid settlement–funded programs. Keske said jail‑based recovery coaches (peers with multi‑year recovery experience) have enrolled 451 participants over two years; a medication‑assisted treatment (MAT) program operated with Sacred Heart served 384 individuals in 18 months; a cognitive/behavioral curriculum (MRT) had 79 participants in 18 months; transitional housing programs placed 76 formerly incarcerated individuals in the last 18 months. Keske described other supports including SPARK navigation for people with intellectual or developmental disabilities, crisis intervention training (CIT) for first responders, prescription disposal and deactivation bags for the medical examiner, Narcan distribution, and strengthening families scholarships to reduce child risk factors.

Keske and Smith said opioid settlement deposits from 2022 and 2023 totaled just over $13 million; a year‑to‑date 2024 deposit figure reported earlier was $8,712,000 for that year alone; adjusted fund balance presented in committee materials was $15,336,380 after program expenses. The current annual opioid budget cited was about $2.5 million, with spending at roughly 22 percent in the first quarter and an expectation to be largely expended by year end. The presenters said they are seeking sustainability through Medicaid waivers and other reimbursements to replace some settlement funding where possible.

Committee members asked about staffing for CMH colocated in Community Corrections, the decision process for allocating opioid settlement dollars (presenters said planning involves CMH, the executive's office, the health department and sheriff's staff), and how the teams coordinate with schools and law enforcement. Presenters noted community mental health staff are embedded in schools in some cases and that trainings such as Mental Health First Aid and CIT are offered to schools, first responders and community groups.

The committee voted to receive the report on file; the committee's recorded recommendation to file was approved in committee.