Mental health groups worry about privatization

Chris Ehrmann
Associated Press
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Lansing — Community mental health groups fear that their funding and management could be transferred to private insurers under a budget proposal that emerged in the past week.

The Senate Appropriations Subcommittee on Health and Human Services’ budget plan suggests it would align with Gov. Rick Snyder’s proposal last year to eventually move $2.5 billion of Community Mental Health Medicaid money and service management to private insurers in the state’s Medicaid Health Plans.

Mark Reinstein, president and chief executive officer of Mental Health Association in Michigan, said the subcommittee added a section that sets a goal by 2020 to have a system for Medicaid behavioral and other medical care run by the plans.

“Now that is the exact opposite of what 14 months of state-initiated review and analysis has yielded and it’s incredibly disappointing that the people that voted for that today would ignore all of that,” he said.

Reinstein said that three different reviews were completed last year after Snyder proposed his plan. He said each rejected the governor’s proposal. He added that the first review was done by Lt. Gov. Brian Calley’s task force. It concluded that if Michigan were to have one entity getting the money for people with behavioral and other medical needs, it should be the community mental health groups and not the Medicaid Health Plans, as proposed by Snyder.

Dominick Pallone, executive director for the Michigan Association of Health Plans, said the health plans would be better than the flawed system the state uses now and they would help consolidate administration costs and savings could be used for the services.

The House subcommittee on Wednesday revealed its budget plan, which would have a pilot program — the Senate’s plan also called for a pilot program — in Kent County involving all Medicaid managed care organizations in the area and a local mental health group. Reinstein said he and other community mental health advocates much preferred the language in the House’s plan compared to the Senate’s.

Kevin Fischer, executive director of the National Alliance on Mental Illness in Michigan, and other mental health leaders have voiced their concerns about having the health plans in charge.

“I think it’s incredibly important that you hear from us and continue to hear from us how important it is that our public mental health system remains public in Michigan,” Fischer said. “We want to make sure that we continue to provide the best quality of public mental health services in the state.”

Community mental health programs are governmental entities that were set up to be a safety net for people with significant behavioral problems and adults with mental illness, among other behavioral-specific needs, Reinstein said.

One concern was that, unlike the community mental health groups, Medicaid Health Plans are private insurers and some are profit driven. Additionally, advocates for community mental health groups say they have over 40 years of experience with severe behavioral disabilities, as well as dealing with the special needs of children. In a commentary report sent out by mental health groups, they also note that private insurers are less transparent because they are not subject to the Freedom of Information Act and have less accountability than the community mental health groups.

“The lives of maybe Michigan’s most vulnerable population ought not be up for grabs here,” said Dohn Hoyle, director of public policy for The Arch Michigan.

Robert White, who has two adult sons who receive public mental health services, participated in the work group sessions. He said in a news release that he is worried about what might happen for Michigan if such services are privatized.

“I don’t understand how our elected officials can let that happen, not when we tell them what we want and we voted for them to be our voice in Lansing,” he said. “That to me is totally unacceptable.”

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