Ottawa County CMH board asks county commissioners to press state on Medicaid shortfall; approves mid‑year budget adjustments

The Ottawa County Community Mental Health Board voted unanimously Friday to forward a resolution to the Ottawa County Board of Commissioners asking the county to press state leaders to address a statewide Medicaid funding shortfall that board members and staff say is destabilizing local behavioral‑health services.

The action followed a detailed briefing by CMH CEO Dr. Michael Brashears, who described rising inpatient psychiatric costs, changes from Medicaid redeterminations after the COVID public‑health emergency and uncertainty about planned changes to Michigan’s regional Medicaid management structure. The board also approved a mid‑year Medicaid revenue adjustment and a separate substance‑use disorder (SUD) budget adjustment.

Why it matters: Board leaders said the resolution is intended to consolidate local support and send a unified message to Lansing and state agencies that inadequate Medicaid payments and rising residential care costs are threatening local service capacity. The adjustments the board approved this month increase the authority to recognize higher Medicaid and CCBHC (Certified Community Behavioral Health Clinic) supplemental revenue the regional entity projects, and to add federal and local SUD grant funds now available to the agency.

Dr. Brashears told the board the board association materials he circulated — including a position paper titled “Protect People Over Profit” and a separate document about Michigan’s Medicaid system — were intended to educate the public and board members about competing views on how the state should restructure regional Medicaid management. “This is more than just a health plan,” Brashears said. “These services are the safety net and lifebread of our community.”

Board members discussed the timing and potential tradeoffs of increasing local provider rates while the state’s funding picture remains unsettled. Several members urged caution but agreed that raising rates for specific, high‑need residential placements was necessary to avoid immediate provider closures and loss of placements for residents. The board approved three contract amendments to raise rates in targeted residential cases and accepted new revenue projections from the Lakeshore regional entity that increased CMH’s projected Medicaid revenue by roughly $8.5 million for the year, primarily tied to CCBHC supplemental payments and other adjustments.

The board voted to forward a proposed resolution to the Ottawa County Board of Commissioners asking county leadership to transmit the county’s concerns about the funding shortfall to Governor Gretchen Whitmer, the Michigan Department of Health and Human Services (MDHHS) and legislative leadership. Board members said the resolution is both an educational step and a request that county officials consider county‑level advocacy to protect the regional CMH system.

In separate votes the board: - Approved a mid‑year Medicaid budget adjustment that recognizes $8.5 million in projected additional Medicaid/CCBHC revenues the region provided; board members said associated expenditures will be tracked and reported in later statements. - Approved a SUD budget amendment adding roughly $797,000 in block grant SUD funding and $505,000 in local PA 2 (liquor tax) dollars for substance‑use services. - Approved the annual procedural request to set the millage tax rate that funds the local mental‑health millage for fiscal year 2026 (this vote authorizes the agency to request collection of the maximum allowable mills under the existing voter‑approved millage).

Board members pressed staff for detail on how the region’s internal service fund (ISF) and the state’s “risk corridor” work, and Dr. Brashears said he will present a diagram for the board explaining where regional and state protections apply when Medicaid expenditures exceed projections. Brashears also told the board he intends to continue negotiating residential rate changes with providers and the regional entity in the coming months and will present more detailed proposals for next fiscal year.

The board’s motions carried on roll call and were recorded as approved by the full membership present.