A new poll commissioned by the Community Mental Health Association of Michigan and conducted by third-party survey provider EPIC-MRA found 67% of Michigan voters prefer the public mental health system to be managed by public entities who specialize in mental health care vs. turning the system over to private, for-profit companies.

Last year, Michigan Senate Majority Leader Shirkey introduced Senate Bills 597 & 598 which would privatize all Medicaid mental health services by giving full financial control and oversight to for-profit insurance companies. The EPIC-MRA polling shows two out of three Michigan voters would NOT support that change.

The poll was conducted in January 2022 among active and likely November 2022 general election voters across Michigan with a margin error of +/-4%. It comes at a critical time as communities across Michigan and the U.S. face a growing need for mental health support in the wake of the coronavirus. Michigan’s Governor Gretchen Whitmer also prioritized mental health funding in her State of the State address this past January, proposing $361 million to open school-based clinics and fund mental health professionals inside schools and increase access to mental health screenings. Other key data points from the poll include:

• Nearly 3 times as many Michiganders oppose the privatization of the state’s mental health services for Medicaid patients (the purpose of Senate Bills 587 & 598). 67% oppose while only 24% support that privatization.
• 76% of voters are concerned that private, for-profit health plans, do not have a good track record in treating patients with mental health needs and fear they will make matters worse.
• 73% of voters are concerned that high overhead costs of the private health insurance companies (double that of the public system) and the corporate profits that these companies take out of the taxpayer-funded Medicaid system will lead to less mental health services for those in need.
• The data also found factors that make a public mental health care system more cost effective than a private system, including active management of comprehensive services, a person-centered planning approach and high medical loss ratios (low spending on administrative costs to allocate those dollars towards Medicaid beneficiaries).
• Nearly 4 times as many Michiganders are less likely to support their legislator if he/she supports privatization of mental health services for Medicaid patients than those more likely to support that legislator: 40% less likely compared with only 11% more likely.
• Twice as many Michiganders think that Governor Whitmer should veto legislation if it passes than those who think she should sign the bills: 54% favor veto with only 27% favoring signing

“Our members have heard of concerns firsthand from their constituents and these results just confirm voters worry about letting private health plans take control of the services for our most vulnerable populations,” said Stephan Currie, the Executive Director of the Michigan Association of Counties. “It is clear that Michiganders and County Commissioners from across the state believe that keeping a local public mental health system is best.”

For the past 50 years, the mental health system in Michigan has been run and operated by county-based government entities to serve Michiganders with complex mental health, emotional disturbance, intellectual and developmental disabilities, and substance use disorders. The study by the Center for Healthcare Innovation and Integration found that Michigan’s public mental health system has a long tradition of high performance. Each year more than 325,000 Michiganders receive their services and care from the Michigan public mental health care system. The legislation under consideration in the Michigan State Senate would eliminate the existing Michigan public mental health care system and shift $3.5 billion of these state and federal dollars spent annually on this to private for-profit insurance companies based in Missouri, California, Minnesota, Arizona and Indiana.

“When Michigan ultimately develops a better system of behavioral health care, it must be designed around the needs of the individuals and families being served,” said Sherri Boyd, Executive Director of The Arc—Michigan. “While today’s system needs work, the proposed legislation being discussed here reflects the needs of payers first, not people, which is the primary reason it is not being better received by the public. We believe better solutions are out there and look forward to working with our state’s policy leaders to help identify and implement them.”

In a separate report, The National Committee for Quality Assurance (NCQA) gave health insurance companies that provide mental health services for treatment of mild-to-moderate mental health cases 2.4 out of 5 stars. Supporters of the public mental health care system are concerned that health insurance companies will not be able to provide services for adults with severe mental health needs, according to this new poll. Additionally, other states (such as Iowa) who have selected private companies to manage mental health care have found they do not provide the same level of care or understand the unique needs.

“As survey findings underscore, Michiganders strongly oppose Senate Bills 597 & 598. Their concerns revolve around the weak track record that the private health insurance companies have with mental health services and the high overhead costs and profit taking of these companies – syphoning tax dollars out of the system designed to serve some of the most vulnerable Michiganders,” said Robert Sheehan, CEO of CMHA. “Michiganders see through the false portrayal of these bills as improving the lives of the Michiganders. They see the damage that these bills will do to the state’s public Community Mental Health system and, as a result, to the health and quality of life of the 325,000 Michiganders who have long relied on this system for high quality mental health services and supports.”

More than 100 Michigan-based groups oppose the privatization of mental health care, including the Michigan Sheriffs’ Association, the Michigan Association of Counties, over 30 boards of county commissioners, over 50 mental health provider organizations, judicial and school-based organizations, the Michigan Catholic Conference, The National Association for the Advancement of Colored People and organized labor groups.

State commits $1.2 billion to health response on COVID

A supplemental appropriation bill signed by Gov. Gretchen Witmer this week commits $1.2 billion to health care efforts in response to the COVID-19 pandemic.

The bill, now Public Act 9 of 2022, includes appropriations to address health worker recruitment and retention, plus funding for COVID-19 early treatment and various testing supports.

Highlights of the spending bill include:

• $300 million for eligible health care recruitment, retention and training programming for new investments. A health care provider must demonstrate an eligible qualifying need under the rules and regulations of the federal coronavirus state fiscal recovery funding and must not request funds for any investments related to recruitment or retention announced before Dec. 1, 2021. The bill also requires 75 percent be allocated for acute care and behavioral health care providers, which would be administered by the Michigan Health and Hospital Association, and requires 25 percent be allocated to post-acute care providers and Federally Qualified Health Centers.
• $10 million as a competitive grant program for nursing facilities to convert multi-resident rooms into single-resident rooms. Grant awards would reimburse 50 percent of the cost, and the Michigan Department of Health and Human Services (MDHHS) would have to prioritize converting rooms with more than 2 residents into single-resident rooms.
• $29 million to assist nursing homes fund physical repairs and improvements of the facility. There is a $500,000 cap for each nursing home.
• $29.7 million to local and tribal health departments, as well as schools, to support staffing costs of COVID-19 testing and contact tracing. Of this, $14.9 million specifically goes to school districts, public school academies, intermediate school districts and nonpublic schools. The bill prohibits MDHHS from allocating funds to any local public health departments in which a county board of commissioners has passed a resolution rejecting these funds within 30 days of effective date of this act.
• $10 million for programs and planning for a new state public health and environmental science laboratory.

A further detailed analysis can be found here.

For more information, please contact Meghann Keit-Corrion at keit@micounties.org.

 

Governor proposes increase in County Revenue Sharing

State Budget Director Chris Harkins presented Governor Whitmer’s FY 2023 budget recommendations to the legislature this week. The $74 billion budget represents a 6 percent increase over the current 2021-22 fiscal year and includes historic one-time funding and ongoing funding for state departments and local governments. 

County and local governments would get a 10% revenue sharing increase under the proposal- a 5 percent increase in statutory revenue sharing that would be built into the base and 5 percent one-time increase. An additional $376,000 would be provided for county revenue sharing and the County Incentive Program. These funds would be split between Emmet County, the last county to re-enter the state revenue sharing program, and Leelanau County which returned during the 2022 fiscal year.

Other recommendations include:

• $578M in new federal funding for roads, bridges, airports, local and intercity transit, and rail
  • $377.8M would fund road and bridge construction
  • $283.4M for state roads and bridges
  • $94.4M for local roads and bridges
• $500M in Water infrastructure improvements to support lead service line replacements, consolidation of failing septic systems, and contamination risk reduction
• $325M in one‐time funds to design and construct a new psychiatric hospital campus that would ultimately replace the state-operated beds at Hawthorn Center and the Walter P. Reuther State Hospital
• $175M Judicial case management to create a single statewide case management system that aligns with the Trial Court Funding Commission’s recommendations
• $148.9M for Michigan Indigent Defense Commission grants to local funding units for complying with MIDC standards
• $15M for the Jail Diversion Fund which provides grants to local entities to establish and expand jail diversion programs
• $5M for a prosecutorial diversion program affording eligible pretrial defendants an opportunity to obtain and maintain gainful, full-time employment with an eligible employer for a year
• $4.2M for the county veteran service fund

Additionally, the Governor proposed a $51.8 million deposit to the Budget Stabilization Fund, which would bring the rainy-day fund balance to nearly $1.5 billion.

The full executive budget recommendations can be found here.

For more information on the Governor’s budget proposal, contact Deena Bosworth at bosworth@micounties.org.

Healthcare spending bill passed by Legislature; bill sent to governor 

State lawmakers landed on a final version of a $1.2 billion healthcare-focused supplemental bill this week. House Bill 5523 introduced by Rep. Julie Calley (R-Ionia) includes appropriations to address healthcare recruitment and retention, as well as funding for COVID-19 early treatment and various testing supports.

Some highlights of the spending bill include:

-$300 million for eligible health care recruitment, retention, and training programming for new investments. A health care provider must demonstrate an eligible qualifying need under the rules and regulations of the federal coronavirus state fiscal recovery funding and must not request funds for any investments related to recruitment or retention announced before December 1, 2021. The bill also requires 75% be allocated for acute care and behavioral health care providers, which would be administered by the Michigan Health and Hospital Association and requires 25% be allocated to post-acute care providers and Federally Qualified Health Centers.

– $10 million as a competitive grant program for nursing facilities to convert multi-resident rooms into single resident rooms. Grant awards would reimburse 50% of the cost, and DHHS would have to prioritize converting rooms with more than 2 residents into single resident rooms.

– $29 million to assist nursing homes fund physical repairs and improvements of the facility. There is a $500,000 cap for each nursing home.

-$29.7 million to local and tribal health departments, as well as schools, to support staffing costs of COVID-19 testing and contact tracing. $14.9 million specifically goes to school districts, public school academies, intermediate school districts, and nonpublic schools. The bill prohibits the department of health and human services from allocating funds to any local public health departments in which a county board of commissioners has passed a resolution rejecting these funds within 30 days of effective date of this act.

-$10 million for program and planning for a new state public health and environmental science laboratory.

A further detailed analysis can be found here. Gov. Whitmer has signaled she does plan to sign the bill when it officially lands on her desk.  

For more information, please contact Meghann Keit-Corrion at keit@micounties.org.

Binding Arbitration expansion bill clears Senate committee

This week, the Senate Small Business and Economic Development committee unanimously passed House Bill 4725, sponsored by Rep. Robert Bezotte (R-Howell), The bill would expand binding arbitration beyond police and fire labor bargaining units to county correctional officers. The bill is now on the Senate floor awaiting a vote.

MAC has long opposed any expansion of binding arbitration to other bargaining units due to the cost of the process, the long-term liabilities associated with third-party decisions and the unequal treatment such a system provides to those bargaining units. The Michigan Public Employment Relations Act already provides for bargaining rights without tying the hands of the county in binding arbitration.

MAC asks members to use our Advocacy Center to send a pre-drafted message of opposition to their state senators.

For more information on this issue, contact Deena Bosworth at bosworth@micounties.org.

Staff picks

• Solar Energy Property Taxation (Center for Local, State and Urban Policy)
  
  
• State of Michigan Mental Health Facilities (map) (Senate Fiscal Agency)
  
  
• Florida man steals car; train sends it crashing into house (Associated Press)
  
  
• Why buying a car is still such a miserable experience right now (National Public Radio)

Breakout topics released for 2022 Legislative Conference

Attendees at the 2022 Legislative Conference will have a dozen breakout sessions to choose from on trending issues in county governance, MAC announced this week. Each breakout session will be approximately one hour long and include time for questions from the audience of the experts and policymakers presenting at them:

• What’s Coming on Mobility
• Diversity, Equity and Inclusion in County Government
• Opioid Funding from the National Settlement
• The Future of the County Workforce
• Trial Court Funding
• Cybersecurity Threats and Trends
• Primer on the Headlee Amendment and State Taxation
• How Counties Are Investing ARP Funds
• How to Win Millage Elections
• Open Meetings Act Update (joint with MCMCFC)
• Stress Management in Stressful Times (joint with MCMCFC)
• Cultivating an Agribusiness Economy

County commissioners who attend the conference will receive credit in MAC’s County Commissioner Academy.

Click here to start your registration process.

The Michigan County Medical Care Facilities Council (MCMCFC) is offering its members the following additional workshops (all MCMCFC events come with continuing education credits for its members):

• Strategies for Success in the Wake of the COVID-19 Pandemic
• Stress Suppresses Success: SHAPE Your Stress Blueprint
• Regulatory Updates and Other Sizzling Topics Speaker: Vickie Burlew
• State Licensure and Federal Certification Regulatory Update

Gov. Gretchen Whitmer will keynote the 2022 Michigan Counties Legislative Conference, addressing a plenary session of the event on Wednesday, March 23.

The conference also will feature:

• A plenary session address by Larry Johnson, president of the National Association of Counties
• A MAC Legislative Update, led by Deena Bosworth, director of governmental affairs
• Remarks from MAC President Phil Kuyers of Ottawa County and Executive Director Stephan Currie
• A Legislative Reception on the evening of Tuesday, March 22, during which MAC will present its County Advocate Awards for legislative service in 2021

The conference will be an in-person event, though MAC plans to livestream select breakout sessions on Facebook. For the latest conference news, visit the MAC conference page.

 

 

OMA update, protecting mental health services top MAC’s 2022 priorities

Updating the Open Meetings Act to meet the 21st century needs of state residents and preventing an ill-advised attempt to privatize Michigan’s locally directed system of public mental health services head the list of legislative priorities for Michigan counties this year.

Legislative action in 2020-21 allowed county boards and other local panels to address the restrictions imposed by the COVID-19 pandemic, but the changes also resulted in making the act less responsive in 2022 by barring the votes of public officials participating remotely when a physical quorum was present at a meeting.

“Quick action by the state in 2020 allowed county boards to meet remotely during the pandemic in a safe manner, but those changes ended up removing a key option for local officials to participate in governance in specific situations,” explained Deena Bosworth, MAC’s director of governmental affairs. “We will be focused on OMA reform with legislators to resolve this problem as soon as possible.”

MAC also will continue its efforts with a broad coalition opposed to a mental health privatization scheme embedded in Senate Bill 597-598, sponsored by Senate Majority Leader Mike Shirkey (R-Jackson). Boards in more than 40 counties already have passed resolutions opposing privatization of mental health services, which face growing demands for care and persistent state underfunding.

Other goals for 2022 in Lansing are:

• Enacting Reforms to Ensure Proper Funding of Local Courts
• Creating a Fair Revenue Sharing System for Counties
• Compensating Local Governments for Funds Diverted by the Veterans Property Tax Exemption
• Revamping the PPT Exemption to Provide Annual Reimbursement to Locals
• Adopting the MI Roadmap to Use ARP Funds for Historic Investments in Michigan

“These goals reflect months of meetings and discussions by our policy committees of elected county leaders, by our Board of Directors and by our membership,” said Stephan Currie, MAC’s executive director. “These items constitute the ‘Regional Agenda,’ if you will, from Michigan’s original regional governments, our 83 counties.”

For more information on MAC’s legislative strategies, contact Deena Bosworth at bosworth@micounties.org.