LANSING, Mich. — Lawmakers and health officials told the House Oversight Subcommittee on Public Health and Food Security on May 13 that Michigan is facing a shortage of inpatient behavioral-health bed capacity that is leaving patients waiting in hospital emergency departments for days or weeks.

The issue drew testimony from hospital representatives and the National Alliance on Mental Illness (NAMI), who described lengthy ED waits, a burdensome preadmission screening process for Medicaid patients and persistent workforce shortages that limit how many beds can be staffed even when they exist.

Why it matters: Committee members heard that the shortage affects urgent care for people in crisis, increases strain on emergency departments and hospital staff, and forces families to seek care far from home for children and adults who need inpatient treatment.

Taylor Alpert, government relations manager for the Michigan Health & Hospital Association (MHA), said MHA member data show “every day we know at least 155 people are waiting in emergency for bed placement.” He testified that Medicaid patients experience longer waits than commercially insured patients, and that “over 40 percent of Medicaid patients wait longer than 24 hours in an emergency department” for inpatient psychiatric placement.

Adam Carlson, senior vice president of advocacy for MHA, described the process that hospitals must follow when a Medicaid patient needs an inpatient bed: an ED clinician refers the patient to a preadmission screening unit, which may send a screener with a range of credentials to evaluate the patient. If the screening unit and hospital disagree, a peer-to-peer review can delay placement. Carlson said the result is that Medicaid patients may spend extended periods in EDs while clinicians and administrators complete administrative reviews.

Hospital officials also cited staffing limits as a cause of unavailable beds. Carlson said Michigan hospitals still report thousands of open nursing positions and more than 1,200 open physician positions that include psychiatrists, and noted that some facilities must keep beds offline because they lack staff or because higher-acuity patients require additional safety measures.

Regional disparities and children’s beds: Kate Dahlstrom of the National Alliance on Mental Illness, testifying from Northern Michigan, told the committee that Michigan’s historic inpatient capacity has declined sharply. She said the state once had roughly 22,000 psychiatric beds and now has about 600 state psychiatric beds and about 2,400 private psychiatric beds, for a total she said is “approximately 3,000 beds.” Dahlstrom said Northern Michigan’s 21 counties have no inpatient beds for children and that Grand Traverse County has 17 adult beds, and argued that local families often must travel long distances to access inpatient care.

Committee members asked state officials and witnesses whether the shortage has reached a crisis point. Representatives and witnesses described individual cases of children and adults waiting in EDs for days, and MHA witnesses said Michigan ranks near the bottom of states in per-capita state behavioral-health bed supply. MHA identified several policy levers — including statutory changes to the preadmission screening process (a bill cited in testimony: Senate Bill 316) and workforce-development initiatives — that it said could reduce delays and expand capacity.

What the committee recorded as formal business: At the start of the meeting Representative Green moved to approve minutes from a joint 10:30 a.m. May 13 meeting; hearing no objection, the motion was approved. Representative McDonald moved to approve minutes from a noon May 13 meeting; hearing no objection, the motion was approved.

The testimony did not include a department-issued inventory of current state psychiatric bed totals or a binding timetable for adding beds; witnesses recommended legislative and budgetary steps to expand capacity and to simplify placement for Medicaid patients.

Next steps: Witnesses and committee members discussed follow-up requests, including state data on total state psychiatric beds and pending bills to revise preadmission screening rules. Several legislators said they planned to seek additional information from the Michigan Department of Health and Human Services and to review proposed legislation and budget options that could expand capacity or change screening procedures.