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Delta County commissioners back resolution opposing MDHHS plan to reprocure prepaid inpatient health plan
Summary
After a presentation from Pathways CEO Matt Maskard, the Delta County Board of Commissioners approved a resolution opposing a Michigan Department of Health and Human Services competitive procurement of the state's prepaid inpatient health plan (PIHP), citing threats to local governance, services such as jail diversion, and funding transparency.
Matt Maskard, chief executive officer of Pathways, told the Delta County Board of Commissioners he was asking for their support in opposition to a Michigan Department of Health and Human Services (MDHHS) request for proposals to competitively reprocure the state’s Prepaid Inpatient Health Plan contract. Maskard said the procurement would “fundamentally change how Michigan’s public mental health system is managed” and urged the board to adopt a formal resolution opposing the plan.
Maskard, who described Pathways as a community mental health provider serving roughly 3,000 people annually across Upper Peninsula counties, told commissioners the procurement would remove local governance and county accountability currently embedded in the system. “For over 60 years, counties in Michigan have helped in guiding and overseeing the public mental health systems,” Maskard said. He said PIHPs were created by community mental health organizations and are locally governed to pool risk and meet federal requirements.
Maskard said the procurement appears to favor large private nonprofit health plans and could bar current public PIHPs from applying in their present form. He warned of practical consequences for services that rely on local oversight, naming jail diversion programs and aggressive community outreach as examples of high-cost, low-profit services that a private contractor might curtail. “Those are difficult services and expensive services that a private health plan … may not find as profitable, and may want to curtail,” he said.
On funding, Maskard contrasted overhead rates, saying public mental health PIHPs operate at about 2% overhead while private plans are stated as roughly 15% overhead; he said that difference could “strip away a half a billion dollars out of the system.” He also raised transparency concerns, noting the new private entities would not necessarily be subject to FOIA or open-meetings rules.
After questions from commissioners about ongoing litigation involving NorthCare and MDHHS and about how local allocations could change, a motion was introduced to adopt a county resolution opposing the PIHP procurement. The board took a roll-call vote and approved the resolution.
The resolution directs the county’s opposition to MDHHS’s current procurement plan and aligns Delta County with other counties and advocacy groups that had expressed similar concerns. The board did not enact any regulatory changes at the meeting; the resolution is a formal statement of opposition and will be forwarded as the county’s official position.
The Pathways presentation and the board’s resolution are the most significant policy actions this meeting produced on behavioral-health governance. No further formal actions on PIHP procurement or state-level rulemaking were taken at the meeting; Maskard encouraged ongoing advocacy and stronger support for the public mental-health workforce as the alternative to privatization.
The county set no follow-up deadline in the resolution; next steps will depend on state actions and county coordination with other affected counties and advocacy organizations.
