There is another health care crisis in America exacerbated by COVID-19. While doctors work to keep our emergency rooms clear, neglecting community-based mental health and other community-based social services will cause a further strain on hospitals that will soon be at capacity if they too do not get relief soon from the state.
We all have a role to play in ensuring the health and safety of people in our community. While the focus is on those currently impacted directly by COVID-19 and the hospitals in need of supplies, it is the job of community mental health providers to keep people out of the hospital. Without a staff to provide services and without any assurance from the Michigan Department of Health & Human Services (MDHHS) or Detroit Wayne Integrated Health (DWIHN) to support its provider network, the behavioral health system in Wayne County will be overwhelmed, understaffed, and underserved.
These providers have always been on the front line of protecting the health and safety of our community. In many communities across our state, they are the primary source of healthcare for individuals with mental illness and substance use disorder.
Providers are contracted by Prepaid Inpatient Health Plans (PHIP) and Community Mental Health (CMH) agencies to provide a range of services including, case management and case coordination, home visiting, crisis counseling, skill-building, residential and psychiatric services to children and adults diagnosed with severe issues of mental illness, developmental disabilities, and substance abuse disorders. They are reimbursed by the PHIP/CMH under a fee-for-service system. Under a pandemic, such as COVID-19, the fee-for-service system does not work. While providers work to transition to a telehealth model and appreciate the state relaxing certain guidelines, some of the services they provide cannot be provided through telehealth systems.
With providers in Wayne County already facing a 7-percent rate cut imposed by DWIHN effective May 1, and notice from DWIHN that providers will not get paid for services they don’t provide, these nonprofits some of which have served our community for over 100 years, will be forced to lay off staff, close programs, and stop providing valuable services – Placing a further strain on our hospitals.
The psychological impact on our children and others now confined to their homes and the anticipated rise of psychiatric disorders, such as depression, anxiety, and posttraumatic stress disorder, in COVID-19 survivors, frontline healthcare workers, and many others is just the tip of the iceberg, if these community-based providers cannot find the resources to employ their workforce and keep their programs open.
We need our state’s help to stabilize the state’s provider network and prevent any layoffs of (behavioral) health care workers and keep health care options for our state’s most vulnerable people. We need them to remove the regulatory rules and barriers that prevent on-the-ground providers to effectively perform their job and take away the strain from our hospitals during a crisis. This includes considering an 1135 Medicaid waiver. We encourage the MDHHS to remove any additional barriers that give the PIHPs authority to make payments to pay providers so that our community-based providers can continue to focus on the health and safety of their staff and consumers.
Daniel Cherrin is the lead facilitator for the MI Behavioral Health & Wellness Collaborative.
