Detroit Free Press Examines Mental Health Services in Detroit-Wayne County

The Detroit Free Press on Aug. 16 reported on the Detroit-Wayne County, Michigan, mental health system, which serves more than half the state's residents who utilize public mental health and disability services. The system is dealing with a 10%, or $50 million, reduction in funding for this year. At the same time, county administrators are working to set up HMOs to manage care for people with mental illnesses and developmental disabilities. Under the new system, called Your Choice, uninsured county residents with mental or developmental disabilities can receive services through one of six competing mental health HMOs. The HMOs are paid a per-client fee based on the client's past need for services. Advocates are concerned that the new system will make it harder for people to receive immediate services and that the budget reduction has "shifted the burden of care for the mentally ill from hospitals and community-based counselors to prisons." State officials last week visited the county to evaluate whether the current mental health system should continue or be privatized (Askari, Detroit Free Press, 8/16). Under the state's mental health system, the state contracts with local Community Mental Health Service Programs to administer community-based services for Medicaid beneficiaries. The contracts last for two years, and the state is reviewing proposals from the programs to continue their contracts. The community health department in June recommended 16 of the 18 proposals be approved, but it did not approve programs in Detroit-Wayne County (Kaiser Daily Health Policy Report, 6/10). The state Specialty Services Board is expected to vote on the future of the Detroit-Wayne County system on Aug. 27. Patti Kukula, interim director of the Detroit-Wayne County Community Mental Health Board, said she believes state officials will give the county the "green light" to continue its current system (Detroit Free Press, 8/16).