*This testimony was provided on behalf of 18 community mental health providers in Wayne County, Michigan on behavioral health, on Monday February 29, 2016 before the:

Michigan State House of Representatives
Joint House Appropriations Committee
Medicaid Subcommittee + Health Services Subcommittee
of Health and Human Services

 

Good morning, Mr. Chairmen and members of this joint committee.  Thank you for the opportunity to testify today on the state of behavioral health services in the State of Michigan. I am Daniel Cherrin and I lead a collaboration of 19 community mental health organizations in Wayne County.  

Together, these providers serve over 50 percent of the state’s Medicaid population.  Collectively this group represents over 72,000 consumers and employs over 12,000 people.

The care they provide runs the gamut-- Servicing adults with mental illness, children and adolescents with serious emotional disturbance, persons with developmental disorders, and persons with substance use disorders throughout Detroit and Southeast Michigan.

I hope all of you around the table chose public service and elected office to help people. In addition, we all like stability.  Knowing that tomorrow we will have the chance to return to the same job we had today or knowing that your son, daughter, brother, sister, aunt or uncle living with a developmental disability are being taken care of with quality care.

Everyday, these providers are helping people live a quality life full of meaning and working hard to ensure some form of stability in their lives.

However, whenever a new budget Is introduced, a new mental wellness commission is convened or funding for mental health is threatened in any way, that stability is at risk.  Since the budget was first announced earlier this month, providers have been hearing from their consumers.   

·      Will I have to change my doctor?

·      What clinic will I go to?

·      Are their additional hoops we have to go through?

From an operations perspective, as providers, not knowing what the system will look like in 2017, prevents them from planning for the long term or recruiting a talented workforce.

I know there is a lot going on in this state. And as lawmakers, before you vote on a budget proposal, you need to evaluate what is already out there.  If you pass this budget as written, what will happen to existing programs you recently approved, such as MI Health Link, that is piloting integrated health in four locations in Michigan (including Wayne County), or other programs that you have funded.

Under the current funding structure, these providers are able to not only provide a full range of behavioral health services, they are also able to provide extensive support and outreach for the basics that have to be in place for their clients to survive and thrive.  This includes, providing access to safe housing, supported employment, coordination with primary care, on-site integrated care, and advocacy for financial entitlements, in addition to overall navigation through a very complex social system.   The flexibility these providers have in providing an array of services is extremely important to their consumers.

The current system is neither perfect nor is it ideal, but for the consumers we serve and the families we support, it works. To make it work, these providers take the money you appropriate to the CMH and make that money grow through grants they secure from foundations such as Kellogg, Flinn, Kresge and others, in addition to private philanthropy. 

To be blunt, the funding you appropriate is not adequate for these organizations to provide the quality of care you would expect or the quality the Governor and Lt. Governor are asking for in their current budget recommendation.  But we make it work.

Likewise there is a lot of talk about integrated care.  In fact, there is a lot of talk nationally about it. But here in Michigan we are already doing it. Take for example, a “School Based Mental Health Initiative,” that was recently established in Wayne County, in which several mental health organizations are funded to provide “on school site” staffing support for the provision of Mental Health and Prevention services to children, youth and their families.   A total of 77 schools will be served through this initiative.  This is an example of integration and coordination of services with several Wayne County school districts, The Detroit Wayne Mental Health Authority, mental health providers and parents.  I can offer other examples of integrated care, where mental health providers have formal relationships with physical care providers, such as FQHCs, to imbed full time behavioral health staff in clinics

The providers I work with have a lot to be proud. As I mentioned, they take the funding you appropriate and leverage additional federal and foundation funding.  Take for example Southwest Counseling Solutions.  They raised over $7 million in federal funding this year alone and have raised even more through their sister agency, Southwest Housing Solutions, to renovate over 25 abandoned apartment buildings in Detroit and created over 500 units of affordable housing, many of which are set aside for individuals / families with serious mental illness.

As providers and as elected leaders, we both need to put people first and focus on the communities we serve.  Good government should be about creating better opportunities for people in our state and I strongly encourage each of you to seek out the providers in your district, visit them, talk with the consumers and their families, and get a strong sense of the vital role you play in the direct care of our consumers.

Thank you. I will be happy to answer any questions you have.

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