Dr. Michael Brashear, CEO of Community Mental Health of Ottawa County, told the board Oct. 24 that a pending state procurement to reshape who manages Medicaid services could change CMH roles and affect local access to care. "We would be a service provider pretty much only of services," Brashear said, describing a shift away from the current co-management model and adding that a court ruling allowed the state procurement to proceed while the judge reviews how CMHs will meet statutory obligations.

Why it matters: Board members were warned that the change could reduce local control over network design and worsen access if outpatient providers decline to accept Medicaid rates. Brashear said some contract outpatient providers already are no longer accepting Medicaid-eligible people, a development he tied to long-unadjusted rates and an unfolding statewide procurement process.

Brashear said the agency has formed a rate review group for outpatient therapy and will analyze how much care might need to be brought back in-house if outside providers do not continue to provide services. He emphasized that residential care accounts for a large share of agency expenditures and identified an underserved subgroup requiring continuous, high-level residential supports; he said that subgroup represents roughly 15–20% of residential consumers and that residential services make up about 30–40% of CMH expenditures.

On local residential capacity, Brashear announced a plan to repurpose the Robert Brown resource with partner Hope Network into a small, specialized residential program called Holland Hope. He said the program will begin by serving one very high-need individual with plans to expand slowly and that the agency will present full details to the PQI committee and the full board before opening.

Board reaction and next steps: Directors pressed for clarity about staffing and mandated positions under the Michigan mental health code; Brashear said a recipient-rights position is approved and a job description is being prepared. He also said the agency will pursue advocacy at the regional and state level to validate and fund the higher level of residential care, and asked residential partners to join those discussions.

A note on sources: Brashear referenced a transcription of a court ruling and an ongoing procurement process; the meeting transcript includes his description but not the formal procurement award list. The board scheduled follow-up committee briefings and a future PQI/full-board presentation on Holland Hope.