WKTV Staff

As part of his Jan. 5 presentation to the Kent County Family and Children’s Coordinating Council, Scott Gilman, executive director of Network180, went into detail as to the reason for the funding shortfall being experienced by county’s mental health provider, as well as the immediate and possible near-future impacts.

According to information provided by Gilman and other sources, Network180 is expected to make approximately $10.7 million in reductions due to declining revenue at the Lakeshore Regional Entity, of which it is a member.

The Lakeshore Regional Entity manages a contact with Michigan Department of Health and Human Services (MDHHS) to provide services to Kent, Allegan, Lake, Mason, Muskegon, Oceana, and Ottawa counties. The contract is to provide mental health services people with mental illness, developmental disability, and substance use disorders who have Medicaid or are under insured. It is one of 10 Prepaid Inpatient Health Plans (PIHP) in the state.

Gilman’s presentation stated that Medicaid revenue for the mental health system declined state-wide due to thousands of Michigan resident’s insurance status changing from Disabled, Aged and Blind (DAB) to Healthy Michigan. Even though benefits are similar, Healthy Michigan is paid at a much lower rate. An independent study — funded by nine of the 10 PIHPs — by the Grand Rapids based Rehmann Group estimated a $97 million state-wide revenue shortfall, and a $7.8 million loss for the Lakeshore Regional Entity.

But, Gilman repeatedly pointed out, despite cuts and delays basic individual services legally must still be provided. Network180, to that end, sent a letter out on Dec. 22, 2017 to individuals served in the county as well as families and other care providers.

“I want to emphasize that all individuals served by Network180 have important rights as beneficiaries of the public behavioral health system,” Gilman wrote in the letter. “It is essential that everyone understand that individuals in treatment must be informed of their rights and we all work to make sure each individual is supported to exercise their rights. Service and supports that are medically necessary can’t be reduced based on financing.”

“Clients will still get what they are entitled to get,” Gilman said Jan. 2. “We have to fight for that, and we have to protect that. What they are not going to get are things that are better than the basic package they are entitled to.

What is going to be cut, he added is “more discretionary programs. … anywhere where we had creative community benefit programs.”

Among the cuts being considered by Network180 are clinical Staff at permanent supportive housing projects, the Clubhouse program for adults with mental illness, nursing home monitoring, Native American Community Services staffing grant, Nuevo Camino Hispanic outreach, staffing the Center for Integrated Medicine, respite services for families, facility based skill building CLS and Life Skills, substance use disorder services such as methadone treatment, as well as a delay expansion of Children’s Mobile Crisis Team, Delay expanding of DD Enhanced Healthcare.

Another point stepped by Gilman is that while some clients and care providers knowingly switched from DAB Medicaid to Healthy Michigan Medicaid, for reasons including dental coverage and easier qualification, some may not know they have been switched. He urged clients and care providers to check with the MDHSS for details on which Medicaid plan they are on.

“There are all different reasons, the one that really scares me is individuals that say ‘I have no idea’,” Gilman said. “Because then I wonder if they are making informed decisions as to what is best for them. … It is ease of access. It is just so easy to get Healthy Michigan than it is DAB. People just take the path of least resistance.”

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