During a recent Huron County Board of Commissioners meeting, Commissioner Steve Vaughan talked about how he spoke with some state leaders in Lansing about current efforts to privatize the state’s community mental health services. And he did not have good things to share.
“There is no support to not privatize it, for the simple reason that most CMH’s in Michigan are either broke, they can’t manage money, or they misappropriated funds,” Vaughan said.
Two bills that were introduced in the state legislature last year, Senate Bills 597 and 598, would introduce significant changes to how mental health services operate. As Huron Behavioral Health CEO Tracey Dore put it when speaking at a past commissioner’s meeting, it would take away additional community benefits they provide and simply make HBH a mental health service provider that private health care systems and decide whether to contract with.
There have not been any votes yet on the bills in either the House or Senate.
Dore explained that the premise of this legislation is that the mental health system is not working and there needs to be better access, consistency, and outcomes. The solution for that is integrating the public sector with the private sector in an effort to provide better choices, where money would be freed up by eliminating 10 prepaid inpatient health plans across the state, have their services offered privatized, and contract with community mental health providers.
“It sounds wonderful, but I’ve seen in practice that it eliminates providers since the funding isn’t there,” Dore said, adding that it actually takes away people’s choice in the process. “When they say enhancing integration, it’s only financial. It doesn’t get to the ground that helps individuals.”
Initiatives Huron Behavioral Health partakes in, like certified behavioral health clinics, are meant to serve members of the population who fall through the gaps of private health providers. A loss of funding as a result of these bills passing would not allow Huron Behavioral Health to take on as many of those people.
At least five other states have systems allowing privatized mental health care, Arizona, Arkansas, California, Iowa, and Ohio. Dore that in those states, providers have gone out of business since they have not been adequately funded to provide the care needed.
“I hope that won’t happen here, but you never know,” Dore said.
In 2016, state lawmakers tried a similar measure to what is being proposed, Section 298, which aimed to give public mental health dollars to private sector plans. Mental health providers similar to Huron Behavioral Health advocated against this measure and it was eventually removed from the state’s budget language.
Vaughan brought up how the Saginaw County Mental Health Authority bought a former golf course with money appropriated for the state. Reports from 2012 said the purchase was worth $280,000 and used to expand business operations, not patient services.
“They said the only two that are viable in the state of Michigan are Tuscola and Huron County,” Vaughan said. “We’re actually doing a good job. Therefore, the only way they figure to fix the problem is to have someone else fix the problem.”
Vaughan feels that as a result, Huron County does not stand much of a chance of being able to run its own community mental health service. More recently, he said that 61 of Michigan’s 83 counties have passed resolutions in favor of privatization.
Dore responded by saying that most, if not all, community mental health groups are doing the things they should due to the accountability and oversight in place, that everyone is doing the best they can.
She did acknowledge that in any system, there are going to be a few mismanaged things that do happen and trickle down, which has everyone assume there is more mismanagement. Dore mentioned how the Muskegon-based Lake Shore Regional Entity has had its problems, but it was also historically underfunded, with a large part plaguing systems being that funding has not been there to meet the needs of health improvement services they provide.
There are also several certifications and accreditations that’s mental health service providers have to go through, with annual reviews and several reports sent to the state on a regular basis.
“There’s a lot of oversight and accountability that goes with federal and state dollars,” Dore said.
If the bills in question were passed, Dore said that Huron Behavioral Health would still be around, but what it would look like depends on what the language of final bills is.
“If we’re just a provider of services, it depends on what we’re allowed to provide,” Dore said.
Passage would also allow other private mental health providers to set up in Huron County. Huron Behavioral Health would still be guaranteed funding from the state general fund, but it could no longer rely on getting guaranteed Medicare dollars to help fund it. It would also take away other services that the provider does for the community, such as needs assessment, being aware of trends in the area that impact mental health and sitting collaborating for various community needs. Huron Behavioral Health also acts as a first responder to community mental health crises.
According to people Dore talked to in Lansing, they believe that once the bills make it to the house, they will not advance further since they do not have bipartisan support.
“We’ve been doing enough advocating that senators feel that this isn’t a good move for our areas,” Dore said.
