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Barry County mental health director warns state bid for regional PIHPs could reduce local control and services
Summary
Rich Temke, director of Barry County Community Mental Health, told commissioners on April 22 that a state proposal to bid out regional PIHP contracts could lead to privatization, reduced funding for direct services and loss of local control.
Rich Temke, director of Barry County Community Mental Health, told the Barry County Board of Commissioners on April 22 that the Michigan Association of Counties (MAC) and his agency oppose a state proposal to competitively bid out the regional prepaid inpatient health plans (PIHPs).
Temke said MAC’s concern — echoed by his agency — is that shifting PIHP contracts to competitive bids could encourage privatization and the pursuit of profit, which he said could reduce funds available for direct consumer services and curtail local decision‑making about service types and programs.
"Privatization usually means you're making a profit, which means less money for direct services for the consumers that we provide service to currently," Temke said during public comment.
Temke and subsequent comments from a community mental health speaker also highlighted one program often cited as an example of local, higher‑cost service with strong outcomes: an Assertive Community Treatment (ACT) program. Temke said data collected by the program showed a 55 percent reduction in hospitalizations for people enrolled in ACT over a year; he noted an inpatient hospitalization can cost roughly $1,000 to $1,200 per day.
A county mental health presenter later clarified differences between traditional CMH funding and the Certified Community Behavioral Health Clinic (CCBHC) rate structure. The speaker said the recent surplus reported by the county’s CMH was largely due to the set rate for the CCBHC program; while the overall budget showed a net gain, the CCBHC portion of the budget ran a few hundred thousand dollars in the red and the surplus may be used to offset those deficits.
No formal board action was taken on the PIHP bidding proposal during the meeting; Temke asked commissioners to contact MAC or his office for more information.
Ending: Temke recommended commissioners seek further information from MAC and county CMH staff if they want to track the proposal and potential local impacts.
