Social Work Advocacy Alert. SBs 597 & 598 will wipe out YOUR local CMH

Senate Bills 597 and 598 – legislation spearheaded by Senate Republican Majority Leader Mike Shirkey to overhaul the state’s public mental health system have resurfaced and we need your advocacy! We anticipate that these bills will be up for a committee vote later this Wednesday. 

Senate Bills 597 & 598 attempt to reboot and expand the failed “Section 298” effort of several years ago. This legislation would privatize all Medicaid mental health services by placing private, for-profit health plans in charge of mental health services. We oppose Senate Bills 597 & 598.

We are asking members to oppose SB 597 & 598 by submitting cards of opposition.

Senate Bills 597 and 598 would create amendments to the Mental Health Code and the Social Welfare Act. The Mental Health Code (Code) is the part of state law that talks about “all things mental health.” Chapter 2 of the Code talks about the way a community mental health services provider (CMHSP) is formed and what it is supposed to do. In the Shirkey proposal, there are significant changes to Chapter 2 of the Code, which looks like a Specialty integrated plan (SIP) is equivalent to a CMHSP. The SIP may then control the state general fund dollars currently given to the CMHSPs. General fund dollars are provided so that CMHSPs can provide non-Medicaid services, such as crisis evaluation and inpatient psychiatric hospitalization for individuals without insurance. CMHSPs are also mandated to provide jail diversion services as well. 

Why we Oppose

NASW Michigan supports the need for improvements within the current system. However, this proposal does not achieve the level of service improvements individuals need.

• Integration MUST begin and on the ground, not at the financial level.

• Client needs must be individualized, and services MUST BE coordinated

• Mental health care cannot be treated in similar ways as physical health, because without coordination of services, care is siloed. When care is siloed, no one receives the care they need.

• There MUST be public accountability / public governance to protect Michigan’s most vulnerable citizens. 

• The Bills do nothing to ACTUALLY integrate care. Real health care integration occurs on the ground at the point of service delivery. SBs 597 & 598 only integrates the funding. A New Dartmouth Study even shows that greater financial integration generally is not associated with better healthcare quality . https://geiselmed.dartmouth.edu/news/2020/new-dartmouth-study-shows-that-greater-financial-integration-generally-not-association-with-better-healthcare-quality/

Ways the legislature can improve the current mental health system:

1. Address & expand access to mental health and addiction services. Access to services is an enormous problem for those who are not in the current Medicaid CMH system. Medicaid health plans for those with mild/moderate needs only benefit those with commercial insurance, and the services are very limited. Address the desperate need for more inpatient care settings for those most in need, by creating the need for more crisis and residential services.

2. Find ways to dramatically expand and increase the mental health and addiction workforce shortage, especially social workers, whose demand is expected to increase through 2030. Improving these areas would have an immediate impact on people’s lives across the state.

3. Improve the areas that can have an immediate impact on Michiganders lives, such as our Certified Community Behavioral Health Clinics, Behavioral Health and Opioid Health Homes, and Crisis Response Teams, all which must be part of the solution. These programs are patient-centered initiatives (true models of integration) that can save long-term dollars for our state.

You can submit a card of opposition by:

Emailing Scott Jones, Committee Clerk, at OfcSCC@senate.michigan.gov . State your name and position (OPPOSE) and organization (NASW Michigan member, social worker, your organization etc).