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Regional mental-health agency warns of deficit as Medicaid enrollment falls
Summary
The six-county community mental health agency told commissioners it served nearly 11,000 people but faces a budget shortfall as Medicaid enrollment declines and workforce costs rise; the agency said Medicaid accounts for roughly 93% of its revenue and that risk reserves and regional assistance will help bridge deficits.
Representatives of the six-county community mental health agency addressed the Clare County Board on Sept. 18, describing services, outcomes, and near-term financial pressure.
Brian Foden, the agency’s executive director, said the agency served nearly 11,000 people across six counties last year and supports about 2,500 jobs either directly or through contract providers. He told commissioners the agency is governed under the Michigan Mental Health Code and has maintained Joint Commission accreditation since 1996. Foden said Medicaid — which he said provides roughly 93% of the agency’s revenue — has seen enrollment declines since the pandemic, and that falling enrollment combined with rising workforce costs has produced a fiscal-year deficit that is expected to continue into the next year.
Sarah Nacelli Sorensen, who the agency’s director introduced to speak about local work in Clare County, highlighted specific programs: school-based therapists embedded in Harrison and Farwell school districts, a clinical-supervisor contract through the regional ISD to provide oversight for school-based providers, a Family Stabilization pilot that engages families early in crises, a jail-diversion specialist working in Clare and Gladwin counties, and trauma-informed parenting programs in partnership with the local Child Advocacy Center. Sorensen gave concrete client examples — including an adult who maintained six months of sobriety and a juvenile who benefited from school-based therapy — to illustrate the agency’s outcomes.
Foden said the agency is associated with the Mid-State Health Network, which is required to hold a risk reserve; he noted that seven of the 12 CMHs in the region are reporting deficits, which places pressure on the regional reserve. Commissioners thanked the presenters and noted the county contribution (Foden referenced a recurring Clare County contribution figure in the packet) while acknowledging concerns about workforce recruitment, enrollment-driven funding, and long-term sustainability.
The presentation was given as part of the meeting’s public presentations and will be entered into the county packet; staff and commissioners discussed budget timing and the county’s continued support to maintain local services.
