Hello, All!

There are some fairly terrifying aspects of the proposed 2017 Michigan budget, specifically Section 298 – which eliminates Prepaid Inpatient Health Plans (PIHP’s) in our state and puts the money into the HMO’s. Like Massachusetts and New Jersey, we do not want our local mental health and substance use providers to end up closing outpatient practices because of inadequate reimbursement rates and insufficient business. Section 298 will cut off access to a modality of services in order to keep the rest of the providers’ operations intact.

Michigan’s behavioral health system is considered a leader in innovation and integrating high quality care for over 300,000 citizens. Michigan is the only state that is completely managed care and has integrated mental illness, intellectual/developmental disabilities, and substance use disorder services into one system. According to a 2015 Public Sector Consultants report Michigan is pioneering advances in care that is innovative, cost-effective and evidence-based. However, despite Michigan’s many successes in behavioral health care, the FY17 executive budget recommendation includes section 298 of the Michigan Department of Health and Human Services Budget – a proposed change without any initial research or analysis that would transfer management responsibilities of all Medicaid behavioral health dollars ($3 billion) from the current publicly managed PIHP system to the privately managed Medicaid health plans by the end of FY17. This change would significantly harm an already underfunded system of care for Michigan’s most vulnerable citizens.

Please take a moment to review the letter below, copy and paste it into the body of an email, place your information in the areas provided, and send an email to your representatives – This is URGENT!!! We want Section 298 to be removed from the 2017 FY budget!

Following the end of the letter will be two links. One will provide a list of representatives, the other is an article from Crain’s Detroit Business.

Thank you all for your time!

You can also post this message on your social media sites, as well as ask friends, family and neighbors to join your advocacy efforts by emailing their state legislators.

Boilerplate 298 talking points are attached to help you better educate the community about the negative impact this change will have on the more than 300,000 people in Michigan with an intellectual/developmental disability, mental illness, or substance use disorder who receive public mental health services.

Thank you in advance for your support to protect Michigan’s valuable public mental health system for valued people.

February 16, 2016

The Honorable Senator/Representative [FIRST NAME] [LAST NAME]

Dear Senator/Representative [LAST NAME],

I oppose the drastic changes laid out in Section 298 of Governor Snyder’s Health & Human Services FY17 budget. It will gut our current efficient, top-rated system in favor of a less-efficient for-profit model. The state has made these types of cost-cutting decisions before and it has not ended well.

The current public management and oversight of Michigan’s behavioral health system provides the best quality of care for consumers and ensures the most money is spent directly on consumers’ needs. The publicly operated system reinvests resources back into services, not profits.

Michigan’s Prepaid Inpatient Health Plan (PIHP) system has on average an overhead cost of six percent, giving them a medical loss ratio of 94 percent, which is significantly better than any for-profit entity. Section 298 would result in the largest cut to behavioral health services ever in Michigan – $300 million, the difference between PIHP overhead of six percent compared to health plan overhead, which is 15-17 percent.

The management or delivery of public behavioral health services by private companies simply to save money has not been effective in other states, and many have even seen increased costs and inefficiencies through policies that seek to limit access to care. States that have saved money have done so by moving from a fee-for-service model to a managed care model. Michigan’s public behavioral health care system transitioned to managed care almost 20 years ago, meaning that any promised savings would be significantly, if not completely, reduced.

Furthermore, most states that have moved behavioral health services under physical health care managers only moved small sub populations whose needs were more mild/moderate because they are less expensive to serve. Michigan’s current mild/moderate behavioral health carved-in benefit that is managed by Medicaid health plans often under performs when compared to the publicly managed behavioral health services, as they lack a history of serving those whose needs are outside of the traditional medical realm.

Michigan’s behavioral healthcare system is interwoven into the fabric of the communities, maintaining a close working relationship with education, law enforcement, judiciary, housing and homeless services providers. Local Community Mental Health Service Programs (CMHSPs) are also public entities. Private entities have no public oversight or accountability of the resources and no connection to the county safety net.

From both a fiscal and social perspective, the language in Section 298 of Governor Snyder’s budget is incomprehensibly irresponsible. I urge you to remove it from the Health and Human Services Budget.



Article From Crain’s Detroit Business


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