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DHHS must save mental health care

As Michigan undergoes Medicaid redetermination, mental health providers across the state, including the Northeast Michigan Community Mental Health Authority, are facing significant financial shortfalls.

The $52 million deficit facing Michigan’s public mental health system was reduced from $93 million after the Michigan Department of Health and Human Services announced Tuesday that they would send out $41 million to the public mental health system.

However, the remaining funding gap will cause safety-net mental health organizations across the state to make difficult decisions in the weeks and months to come — budget-balancing decisions that affect staff and those they serve.

We are at a critical juncture where, without immediate Medicaid funding increases, the fiscal stability of NeMCMHA will be significantly weakened. With dwindling fiscal reserves and insufficient relief in sight, the ability of the Northeast Michigan Community Mental Health Authority to ensure access to mental health care to the more than 62,196 members of our community and their families who rely upon us for their mental health care is seriously weakened.

Without prompt action to adjust the Medicaid funding of the system to the level determined (at the start of the fiscal year by DHHS) to be needed to adequately serve Michiganders, the Northeast Michigan Community Mental Health Authority will be forced to make significant budget reductions that would severely impact the services that we are able to provide.

This is not just a financial crisis. It directly threatens the well-being of our most vulnerable community members.

Michigan’s public mental health system is funded not based on the number of persons served but based on the number of Michiganders who are covered by Medicaid each month.

To ensure access to health care during the coronavirus pandemic, Medicaid re-enrollment requirements were put on hold across the country, resulting in a temporary surge of Medicaid beneficiaries. With the end of the pandemic, the reinstatement of the redetermination process has now seen more than 700,000 Michiganders lose Medicaid coverage.

So, while the basis for the financing of the public mental health system was dramatically reduced, and along with it the financing received by the system, the number of persons seeking mental health services from this system grew, as did the costs of providing that care.

The greatest cost drivers have been increased demand for care and the increased costs of wages to attract and retain the thousands of dedicated staff who provide that care.

The mismatch of the funding reductions to the system, resulting from the dramatic reduction in the size of Michigan’s Medicaid rolls and the increased costs associated with increased demand for services, has left a sizable gap in funding for the public mental health system.

Some key challenges:

∫ Lower enrollment, lower funding: As Medicaid beneficiaries drop off, the public mental health system’s funding is reduced, even though the demand for services grows.

∫ Urgency of the funding gap: The number of people losing Medicaid coverage, the basis for the formula used to fund the state’s public mental health system, has far outpaced DHHS’s projections, creating an urgent need for revised Medicaid payment rates to offset the loss in funding. The fiscal year in which those financial losses are mounting ends on Sept. 30.

∫ Local impact: If the financial losses continue into the new fiscal year, we will be faced with a significant reduction in our ability to provide necessary services to adults with serious and persistent mental illnesses, children and families with serious emotional disturbances, and adults and children with intellectual and developmental disabilities. In addition to the services we provide to those populations in our clinics, in the community, and within their homes, we also operate nine adult foster care homes for the intellectual and developmentally disabled population, providing 24-hour care.

We need adequate funding to continue to provide care for all the vulnerable individuals we serve.

The Northeast Michigan Community Mental Health Authority applauds DHHS for the steps taken to close part of the funding gap faced by Michigan’s public mental health system.

We are calling on Michigan legislators and Gov. Gretchen Whitmer to take swift action and urge DHHS to complete the gap-filling work and increase the rates paid to the public mental health system.

Those steps are needed to close the remaining $52 million revenue gap.

Those adjustments must be made to reflect the reduction in revenues to the state’s public mental health system — reductions that were far greater than expected with the volume of people losing Medicaid coverage and are critical to preventing further service disruptions, layoffs, and adverse impacts on our communities.

We need those rate adjustments now to close the funding gap our organization and others across the state projected months ago.

Without it, the ability of our organization to continue to provide needed mental and behavioral health services to the residents of Alcona, Alpena, Montmorency, and Presque Isle counties will be seriously compromised.

Nena Sork is executive director of the Northeast Michigan Community Mental Health Authority.

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