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News & Press: Legislation/Policy

Governor-Elect Transition Team - MDHHS Advisory Group

Friday, November 30, 2018   (1 Comments)
Posted by: Melissa Wagner
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Dear Ms. Stewart and Ms. Yager,

Thank you for the opportunity to meet with the Governor-Elect Transition Team to discuss ways to improve health and human service delivery in the state of Michigan. The National Association of Social Workers – Michigan Chapter (NASW) is a membership organization of professional social workers practicing in various critical health and human service settings, including child welfare, schools, hospitals, substance abuse treatment agencies, mental health, and domestic and sexual violence victim services. NASW supports policies that improve the health, safety, and well-being of all members of society – particularly the most vulnerable. Social workers provide more than 60 percent of behavioral health services; we understand the needs of our clients and have a tremendous stake in ensuring that services are provided in a way which best serves their needs. There are more than 24,000 licensed social workers in Michigan. NASW sets the standards for the profession, including the Code of Ethics, and provides professional development through trainings, certificate programs, and continuing education.

As the new administration prepares for office, there are some areas of concern NASW would like to draw your attention to as well as positive aspects of the Department of Health and Human Services that should be highlighted:

Healthy Michigan Plan and Work Requirements

  • The Healthy Michigan Plan (HMP) was one of the greatest accomplishments of the current administration, which Governor-Elect Whitmer is aware of through the hard work she put into making it a reality. It has been instrumental in preventative care and has allowed many low-income Michiganders to recover from illness.
  • However, the cost-sharing mechanisms that were added and recently expanded do little to offset the cost of the program and are a burden to low-income families who cannot afford them. NASW recommends these fees be eliminated.
  • While we are grateful for the current administration’s willingness to listen to our concerns about the addition of work requirements to receive HMP, NASW does not support this policy.
  • We have submitted proposals to improve the stipulations of the Medicaid work requirements. We hope to see the new administration work toward implementing some of these suggestions if the law goes into effect. For instance, allowing engagement in specialized case management services that help overcome barriers to work count towards meeting requirements.
  • Existing case management services (work first) and those we propose above need to be adequately funded and resources made available in order to be effective.

Staff Funding

  • The hardworking DHHS staff is a positive facet of the department as it currently operates.  Though there is not enough available funding to support the staff and what they are trying to accomplish, NASW recognizes that the team has been working hard to achieve what they are able to with limited resources.  
  • NASW is aware of staff burnout and client caseloads of over 800; therefore, we recommend the hiring of additional staff.

Deaf, Hard of Hearing, and Deaf Blind

  • There are tremendous concerns across all systems for this population. We have developed a task force to address issues within MDHHS such as demanding access to culturally and linguistically appropriate services. This has happened to some extent, but much more needs to be done. We would like an opportunity to broker a conversation between the incoming administration and this community.

Child Welfare System Reform

  • Unfortunately, issues that existed over 25 years ago still exist today. Over the years, the state has reduced funding to child welfare, including foster care, to the point where only federal funding exists. With a greater investment from the state, more federal dollars could be leveraged. NASW has formed a task force around this issue and would appreciate an opportunity to broker a conversation with the task force and the incoming administration.
  • The Children’s Rights lawsuit has placed a tremendous administrative burden upon already overworked and under trained CPS staff. While the criticism was certainly warranted, the lawsuit demands need to be quickly met by increasing the funding and quality control of this department - including an increased number of social work trained staff.

Community Mental Health Restructure

  • Our Community Mental Health system has done a tremendous job caring for the 200,000+ recipients with severe and persistent mental illness and intellectual and developmental disabilities. However, much more needs to be done. Unfortunately, when the hospitals were closed, many people ended up in jails and prisons instead of the CMH system.
  • While it has its faults, the CMH system needs to be protected and improved - not dismantled. Section 298 gives too much control to Medicaid Health Plans (MHPs). MHPs are not equipped to care for this population. Additionally, the addition of a profit motive is very concerning.
  • One big issue that needs to be addressed - without taking power away from the public system - is the bifurcation that’s occurred between severe mental illness treatment (administered by CMH) and mild to moderate mental illness (administered by MHPs). This bifurcation causes clients to be shifted from one payer to another as each does not want the burden of paying for the patient.
  • In addition, there must be more options for substance use disorders, in general. Resources are thin. LARA is proposing changes that could prove harmful. And the SUD services get little attention within the PIHPs because of their relative size and different treatment system.
  • There is also a need for a larger hospital system for those with mental illness; a hospital system for those with mental illness would keep people out of the criminal justice system, reduce recidivism, and allow people to be treated within their communities.  

Transgender Healthcare

  • Improvements in transgender health care are essential.  Presently, those who identify as transgender are not treated with equity by the healthcare system, and the incoming administration should take steps to improve this injustice.

 

Social Work Presence

  • With the strong presence that social workers have in the health and human services settings, NASW believes that social workers should have a voice at the table with regard to policy reform and decisions that impact our profession and our clients.
  • Because of the large impact of social workers, NASW recommends that more social workers are hired within the MDHHS and that social workers are offered fair wages.  

NASW is thankful for the opportunity to provide our recommendations to the Governor-Elect Transition Team.  We look forward to working with the MDHHS Advisory Group in the future.

 

Sincerely,

Maxine Thome, PhD, LMSW, ACSW, MPH
Executive Director
National Association of Social Workers - Michigan Chapter 

Comments...

David R. Schneider says...
Posted Tuesday, December 4, 2018
Could your group take a look at the Michigan Veterans Affairs Agency and see how we can add a "human services" dimension to it?

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