Mid-Michigan mental health providers concerned about attempts to privatize system – The Morning Sun

Joseph Sedlock said the privatization of the state’s mental health system would cause considerable, if not irreparable harm to over 390,000 mid-Michigan residents.

Sedlock, chief executive officer of Mid-State Health Network, the mental health service provider for 21 Michigan counties, including Isabella, Gratiot, and Clare, said the proposed legislation, if enacted, would significantly undermine a public mental health system developed over the last 58 years.

Two pieces of legislation floating around the halls of the Michigan State Capitol would alter the way the state’s $3.6 billion Medicaid-funded mental health system functions, potentially changing how 300,000 low-income, mentally ill Michiganders are supported and treated.

Last summer, Senate Majority Leader Mike Shirkey (R-Clarklake) and Sen. John Bizon (R-Battle Creek) introduced two bills that would shift how Michigan’s public mental health system is managed, transitioning from the 10 state-created, community-based mental health providers to commercial for-profit health insurers. Essentially, the proposals seek to integrate how the state’s mental and physical health care services are funded and managed.

“Beneficiaries of the public mental health system will be subject to increased stigma and isolation, and loss of trust,” added Sedlock. “If enacted, there will likely be significant and ongoing confusion at the community level about where to receive services and which private entity is responsible for their care.

He added that the state’s mental health provider networks, like Mid-State Health Network, would anticipate considerable additional barriers that will keep individuals from finding treatment and getting the help they need.

In Michigan, mental health services are administered by 10 community-based mental health providers, including the Mid-State Health Network. The community-based providers contract with the Michigan Department of Health and Human Services (MDHHS) to deliver publicly-funded mental health services with dollars funneling down from the federal Centers for Medicare and Medicaid Services to MDHHS and then to the community providers.

Under the Republican-sponsored bills, senate bills 597 and 598, care would be supervised by insurance companies or a similar entity that would assign a person a single care coordinator, a single list of providers, and a single 1-800 phone number they can call when they need either physical or mental-health care.

Since April 2020, the U.S. Census Bureau and National Center for Health Statistics have conducted bi-weekly Household Pulse Surveys to understand how the COVID-19 pandemic has affected mental health in the community.

According to the data, the percentage of Michigan adults, age 18 and over, who reported symptoms of anxiety or depression has fluctuated between 16% in May 2021 and 45% in December 2020. Between April 2020, and January 2022, the average percentage of Michiganders surveyed that reported mental illness was 29% while the U.S. average was 27%.

As of July 2021, 2.68 million Michiganders were on Medicaid, up 10.7% from 2020, according to data from the federal Centers for Medicare & Medicaid Services.

Under these bills, the state’s 10 community-based mental health providers would be stripped of their status after 10 years and returned to their community health center role. Management of the state’s public mental health system would transition to private health insurers.

In 2019, Republican lawmakers inserted a provision into the state budget that would have, in part, privatized Michigan’s public mental health system. But Gov. Gretchen Whitmer vetoed the provision, saying it would damage care to low-income residents receiving mental health services.

Supporters

Proponents of privatizing Michigan’s mental health system say the plan will save money by keeping patients healthier and out of emergency rooms, and by reducing administrative costs.

Supporters say allowing insurers to manager costs, rather than the PIHP system, will lead to cost savings for taxpayers, simplify the system for consumers, and provide better care for those in need of mental health services

Brian Mills, deputy director of commercial market affairs for The Michigan Association of Health Plans (MAHP), a Lansing-based industry group that promotes the interests of member insurors such as Aetna Better Health of Michigan and Meridian Health, said these bills don’t hand over the keys to private providers, but provides for a process where managed care providers and others can bid with the best entity for providing integrated care chosen by MDHHS.

“If PIHPs believe they can offer more services than what is already required they should come to the table and offer suggested additions to the bills,” he said. “So far, they refuse to be part of the discussions with lawmakers.”

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