Latest push to reform Michigan’s mental health system finds criticism

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Pallone said the current system doesn’t work for the people who are enrolled in it, it doesn’t work for the administrators who administer the program, and it doesn’t work well for the taxpayers who end up footing the bill at the end of the program. day at both state and federal levels.

The Pallones organization reported that in 2018, nine of the 10 PIHP states had structural deficits that collectively amounted to nearly $ 107 million.

By reducing administrative costs and turning to an experienced insurance industry to manage care, the state can save money which, in turn, can be diverted to creating more services, said Tim Michling from the Citizens Research Council of Livonia.

The non-partisan public affairs research group released its review of the state’s mental health system for children and youth last month.

To maintain quality, he said, the MDHHS must clarify what it expects from private insurers and ensure that they do so, he said.

In addition, the use of private health plans will integrate physical and mental health, thus facilitating a warm transfer, he said. For example, a primary care physician may be more easily able to refer the patient who has sought help for heart disease to a mental therapist in the same health plan for depression that the physician has ideally noticed in the. same establishment.

It’s a winning proposition, not only to save money, but to treat patients better, he said.

There’s another reason behind the momentum to overhaul the state’s mental health system: A federal judge ordered it.

In 2018, the Lansing-based nonprofit Disability Rights Michigan filed a class action lawsuit, KB against Lyon, accusing the state of Michigan of staggering failures in its children’s mental health system, including allowing children to go there with too little or no care. until they get violently out of control and faced with detection of minors, psychiatric hospitalization and approaching adulthood, permanent damage to their lives.

While the complaint was filed on behalf of children receiving mental health services under Medicaid, Disability Rights also demanded sweeping bureaucratic changes as they craft a settlement agreement.

Citing the lawsuit, MDHHS officials declined to take a position on Shirkey and Whiteford’s plans, saying instead that they were eager to work with our legislative partners. Gov. Gretchen Whitmers’ office also did not come up with any specific plans for change. On the contrary, a spokesperson wrote in an email that the governor is always open to working in a bipartisan fashion on such issues.

Back in Oakland County last week, the group that gathered around Grapes, Biscuits and Dunkin Donuts argues that the two plans simply replace an existing layer of bureaucracy that serves local needs through the Regional PIHP by a single layer of bureaucracy.

For this and other reasons, all the cost savings are overstated, they said.

A better solution is to get rid of the PIHP layer altogether, leaving decision making entirely to local community mental health agencies who are best equipped to make local decisions.

These mental health agencies would be directly overseen by the Michigan Department of Health and Human Services, suggested Bob McReavy, a longtime advocate whose son suffers from mental illness and now lives in a group home.

You put the ministry in its place. You hand the responsibility over to the state, he said.

He and others also argue that the lack of adequate funding for mental health is the biggest barrier to quality care, rather than bureaucracy.

We spend so much time talking about structure without talking about the fundamental issue, which is access, said Nick Ciaramitoro, a member of the Macomb County Community Mental Health Council. Ciaramitoro, a former prosecutor, state representative and union leader, was among those who met at the Oakland County MAI offices last week.

This lack of funding brings the argument back to one of accountability, Ciaramitoro told Bridge.

Shirkeys plans to move from a public to a private system, burying responsibility within private insurance companies that respond first to shareholders rather than taxpayers, he said.

The head of a Detroit-based community mental health program agreed, saying a provider business model can have a significant impact on care.

We can’t keep money in our coffers because we don’t have shareholders and so on. Everything we save is reinvested in the people we serve, said Eric Doeh, interim CEO of the Detroit Wayne Integrated Health Network, formerly known as the Detroit Wayne Mental Health Authority, which operates as a provider. of services and PIHP.

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