Community mental health seeks support from Mecosta County

BIG RAPIDS – Community Mental Health for Central Michigan seeks support from the Mecosta County Board of Commissioners with a resolution opposing two laws in the Michigan House and Senate.

House Bill 4925 would amend the Mental Health Code to create a Behavioral Health Oversight Council within the Department of Health and Human Services to advise the DHHS in the development and execution of behavioral health policies, programs and services.

It would also allow DHHS to contract with an administrative services organization, which would take on certain responsibilities of DHHS and community mental health entities designated by DHHS.


Internal Bills 4925 to 4929 would have a big fiscal impact by switching to an ASO instead of using 10 prepaid inpatient health plans.

Local PIHPs and their network of community mental health service programs currently operate specialized behavioral health supports and services funded by Medicaid.

With an ASO administering specialized behavioral health supports and services, local CMHSPs would no longer be responsible and reimbursed for the administrative costs of managing Medicaid-funded behavioral health supports and services.

Senate Bill 597 Would Amend Social Welfare Act To Require DHHS To Integrate The Administration And Delivery Of Medicaid Physical Health Care Services And Specialized Behavioral Health Services Through The Creation Of Plans integrated specialists, and that it contracts with each CMHSP in its service area to provide specialized behavioral health services.

Senate Bill 598 would amend the Mental Health Code to include SIPs as well as local public behavioral health entities as eligible providers of state-funded behavioral health services, and require DHHS to establish a competitive contract and procurement process outlining the eligibility conditions of entities to request to provide services as SIP.

Under the bill, Medicaid physical and behavioral health coverage for these populations would ultimately be covered exclusively by PIS.

The function of PIHP would be phased out as a responsibility of Medicaid behavioral health services for these populations.

“We are here today to ask for your support for a resolution to oppose two legislative proposals that will undermine local control and result in reduced funding,” Director John Obermesik told county commissioners in a recent meeting. “The opposition is rooted in the planned transfer of $ 3 million from the public system to private mental health providers in the state. They intend by law to fund community mental health agencies, and we cannot have it.

Obermesik said the Community Mental Health for Central Michigan has served the community for more than 50 years as a public mental health safety net.

“We provide services for serious mental health problems and illnesses, using evidence-based practices for families and individuals, and help people live independently in the community,” he said. . “We are now embarking on a two-year process to expand this role to serve people with mild to moderate as well as severe needs. We pride ourselves on our partnerships with hospitals, doctors, prison services, schools and a wide range of other organizations. “

The resolution, unanimously approved by the board of directors, states, “Michigan’s community mental health system has pioneered mental health innovation and promising practices not available outside the system and provided them effectively and efficiently for the benefit of consumers and taxpayers. ”

Recent proposals in the House and Senate “fundamentally change the public behavioral health system by ending public oversight, direction and accountability,” the resolution says.

Both proposals, as they currently stand, threaten the CMH’s ability to deliver services and shift responsibility for the management of public services to private health plans and the state, thereby damaging oversight and control at the government level. county level.

In addition, he states that “the public system is clearly and significantly more efficient at shifting taxpayers’ money into services and not into administration, infrastructure or profit.”

In a letter to the Senate Committee on Government Operations, the Michigan County Association said the bills “would privatize the system and threaten to eliminate key elements of care at the local community level.”

The proposed changes do “very little to improve care and access for people with mental illness or addiction” and focus “only on the administrative / managed level of care and not on the direct level of service”.

The letter urges policy makers to “give the system a chance to grow by encouraging additional collaboration to focus on integrating care…, improving access… and prevention and diversion.”

“WE HAVE BEEN EFFECTIVE”

The Michigan Community Mental Health Act of 1963 allowed counties to form community mental health councils to support and treat people with serious mental illnesses, developmental disabilities, and addictions outside of hospitals and mental institutions.

By law, counties could create CMHs jointly with other counties or on their own.

The CMHCM was created by the Mecosta County Council of Commissioners, as well as the councils of the counties of Clare, Gladwin, Isabella, Midland and Osceola. It is run by a board of directors appointed by the councils of each participating county and includes commissioners and citizens from local communities.

Since 1965, the number of CMHs in the state has grown from 12 to 46, covering all 83 counties.

Medicaid is the primary source of funding for the state-funded mental health system of Michigan, and care under a CMH is an eligible benefit under Medicaid.

Care for non-Medicaid people uses general state funds. General State Fund dollars are allocated to each CMH on the basis of funding formulas which are modified at the discretion of the State.

“The CMHCM exists because you created it under the state’s mental health code,” Obermesik said. “This mental health network is based on community health dollars and is the transfer of approximately $ 700 million in Medicaid funds, distributed to 11 different community mental health agencies.”

Obermesik said that in 2020, the agency served more than 10,000 people in the six-county area that were high priority – 1,461 of those served were in Mecosta County and 2,800 were children.

“Like other healthcare entities and essential services, our agencies have remained open during the pandemic to serve individuals, provide support and coordinate urgent needs,” he said. “Our staff handled more than 2,870 urgent calls, an increase of 55% over previous years. “

He added that in addition, the agency had reduced hospital admissions by 7% and the number of people using emergency rooms by 33% in the previous 12 months.

Using the additional general funds available, he said, they were able to hire additional professional staff, including a prison diversion specialist, an admissibility specialist and a new intervention specialist.

“We are investing these funds in areas of community collaboration, such as diversion, as well as working with schools and other community physicians not funded by Medicaid,” Obermesik said.

Catherine Beagle, program director for Mecosta County Center, told the board that the CMHCM Intervention Specialist program, serving both Mecosta and Osceola counties, continues to grow.

“They’re in schools and courts, working with young people to identify those at risk, and working to connect them with services across the community,” Beagle said.

She said that thanks to the prison diversion program, in 2020 they were able to divert 74 people from prison to more appropriate options for better mental health.

“We have been successful in finding all of the alternatives available to divert individuals from the prison system,” Beagle said. “He (diversion specialist) is there to be a consultant to prison administrators, law enforcement and medical staff, as well as to advise incarcerated people.

“Whereas previously people had to wait to be released to get an assessment, he is able to do the assessment directly in the prison and coordinate the agency for those who may be homeless or have other critical needs, ”she said.

The resolutions state that the board calls on policymakers to support, improve and strengthen the public behavioral safety net system and to support improvements to regional and community systems governed and operated by the state.

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