ADRIAN — Changes to Michigan’s public mental health system proposed by the Michigan Department of Health and Human Services could have a major impact on the way services are provided by that system, which includes the Lenawee Community Mental Health Authority.

The MDHHS has released a Request for Proposals to restructure the state’s Prepaid Inpatient Health Plan (PIHP) system that LCMHA Executive Director Kathryn Szewczuk said could disrupt the system in ways that are detrimental to the clients served by that system.

“It’s just not good for our people,” she said. “It’s not good for Michigan.”

LCMHA will hold a town hall meeting on the issue from 9-11 a.m. Tuesday, Sept. 16 at the Align Center, 440 E. Church St., Adrian. 

LCMHA’s specific mission is to serve people who have Medicaid insurance, who are enrolled in MIChild or the Healthy Michigan Plan, or who have no insurance and cannot afford services. But the agency will also help people with other insurance find the mental health services they need.

“We are a huge part of the safety net for all of Lenawee County,” Szewczuk said.

Currently, there are 10 PIHP regions in Michigan. Lenawee, Livingston, Washtenaw, and Monroe counties make up one of those regions. In addition to each county having its own board, the regions have their own boards made up of representatives from the local communities, and certain services are shared throughout each region. 

The state’s proposal, which currently is slated to go into effect Oct. 1, 2026, would shrink those 10 PIHPs down to just three: one for the Metro Detroit tri-county area, one for the entire Upper Peninsula and the northern part of the Lower Peninsula, and one for the rest of the Lower Peninsula except for Metro Detroit, south of a line stretching from Mason County on the west side of the state to Arenac and Huron counties on the east side.

That would put Lenawee County into a PIHP made up not of just four counties, as is currently the case, but 44 counties instead.

Additionally, according to a fact sheet containing information provided by the Community Mental Health Association of Michigan, the proposal would remove local decision-making authority and allow new regional entities, including private health plans, to manage Medicaid Specialty behavioral health funding and services.

The result, the fact sheet said, means “effectively dismantling the public health system that has existed for over 60 years.”

Current PIHPs are specifically barred from being part of this new system, “so that only leaves health plans, or hospitals,” Szewczuk said. “We should be working together to figure out how to support people, not to privatize the system.” 

MDHHS in February conducted an online survey of those who are part of the current system — Medicaid beneficiaries and their families, providers, and other interested parties — and says that the proposal addresses the concerns raised in that survey.

Respondents, for example, said there are issues with provider availability, with accountability and transparency, and the amount of paperwork required.

Szewczuk said, however, that most of those survey results “have nothing to do with the goals of the proposal.”

MDHHS says those goals are to provide high-quality, timely services; to improve choice and consistency across regions; to ensure accountability and transparency; and to simplify the system with reduced bureaucracy.

The first goal, Szewczuk said, “is what our system does right now. In the new system, we’ll be part of 44 counties,” and who will represent Lenawee County in that system is an unknown. As for the second goal, “the issue that we find is that there aren’t enough providers in the state,” which means improving choice isn’t so easy.

Additionally, she said, if an entity such as a private insurer is managing a 44-county region, that might impact other agencies currently serving local clients and make the geographic distance to a provider hard for a client to manage.

“Are they still going to contract with Goodwill? Or the substance abuse providers in Lenawee County?” she asked.

When it comes to the third goal, accountability and transparency, “we have a public board,”  Szewczuk said. Anyone can come to the board’s meetings and the governmentally required audits are all publicly available.

On the other hand, she said, if a private insurer takes over the system, that entity is not subject to measures such as the Open Meetings Act or the Freedom of Information Act.

As to the fourth goal, of simplifying the system, the MDHHS survey apparently found that “the current administrative burden is too much and needs to be fixed,” Szewczuk said. “I said, ‘yes, it does.’ The state requires so much information. But that could be fixed now, at any time.”

It’s unclear right now exactly what LCMHA’s role will be if the new system goes into effect. “They haven’t posted any of the details,” Szewczuk said. “All we know is the system will be dismantled.”

But both she and LCMHA board chair Amy Palmer said they’re certain the proposed changes are going to greatly affect the clients their organization serves.

“We know there are holes in the system, but disassembling it isn’t going to solve anything,” Palmer said.

“This is just going to add to the stress that [clients and their families] are having.”

Szewczuk and Palmer urged Lenawee County residents to contact their state legislators to oppose the proposal and to attend the Sept. 16 town hall at the Align Center. Additionally, Szewczuk will make a presentation to the county commission at its meeting at 1:30 p.m. Wednesday, Aug. 13. 

With thousands of Michigan residents set to lose Medicaid funds, including many of the people in Lenawee County who rely on LCMHA, “this is the worst time to change how people access services. … We should be focused on what do we do to help people who lose Medicaid, because they’re still going to need [mental health] help,” Szewczuk said.