By State Rep. Mary Whiteford, RN, Chair of the DHHS Budget Subcommittee
All too often, we hear of heartbreaking deaths resulting from suicide and drug abuse. These unfortunate instances have increased because of the isolation, fear and lockdowns caused by the COVID-19 health crisis. Thousands of children are living in foster care as their parents fight addiction and we hear of increased acts of violence by both children and adults plagued with mental illness. Billions of taxpayer dollars are dedicated to mental health care every year, yet the situation continues to worsen.
We must invest our resources in finding proactive solutions. Over the years, I have talked to hundreds of people in my communities, state and even other states. Two years ago, I put together a plan and I’d like to update you on the progress that has been made since then.
Michigan Integrated Crisis and Access Line (MiCAL)
Frequently, individuals and their families do not know where to go for help during a mental crisis. That’s why I introduced my plan to establish the Michigan Integrated Crisis and Access Line, which was signed into law and is currently being implemented. I developed the idea when I learned that if someone reaches out for help and doesn’t get it, it’s unlikely that they will ask for help again. This leads to worsening mental anguish, self-medicating with drugs or alcohol, self-harm, harm to others, or even suicide. This new centralized system will connect callers to necessary local behavioral health professionals 24 hours a day, 365 days a year. It also serves as an IT hub housing the newly developed Inpatient Psychiatric Bed Registry, which I was honored to help establish, providing an up-to-date status of every psychiatric hospital bed in the state.
Crisis Stabilization Units (CSUs)
It can take hours to days to find an appropriate place to care for a person experiencing a mental health crisis. During that time the person may receive no treatment at all as there is a shortage of psychiatric beds in Michigan and long waiting lists. Because there are many levels of crisis for people, we truly need several layers of psychiatric care.
Legislation I sponsored that was signed into law in January will create a licensing structure to create free-standing Crisis Stabilization Units. Under this plan, individuals experiencing a crisis will be evaluated and treated by trained professionals and a decision will be made about whether to admit them within 24 hours so that if a longer stay is necessary, an inpatient bed can be requested. The individual can stay for up to 72 hours before being discharged with a follow up appointment scheduled. Most people can be stabilized this way and go home with professional follow up care in place. My hope is that CSUs will be located throughout our state to provide this very necessary care.
Psychiatric Residential Treatment Facilities for children under 21 years of age
I’ve heard repeatedly about the lack of psychiatric support available for children, especially in hospitals. Many children who are discharged from inpatient care are not quite ready to go home without support. PRTFs are treatment facilities in a home-like setting that have no more than 12 residents at once. An infrastructure for licensing encourages additional facilities to be established across the state. My hope is that the long waiting lists for children’s psychiatric beds will decrease as stable children are transferred to a PRTF, saving hospital beds for those who need them most.
Mental health discharge plans for individuals leaving prisons on parole
Sadly, 20 percent of our prison inmates have severe mental illness or are developmentally disabled. Without necessary mental health care, recidivism can be quite high. House Bill 4700 of 2019 was created to ensure a smooth transition for former inmates re-entering society by connecting them with the mental health care they need. I worked with the Department of Corrections to develop a framework that utilizes electronic medical records to facilitate coordination of care. Unfortunately, this bill was not passed out of the full senate last term, but I plan to reintroduce it.
Better care for our children
Childhood trauma often leads to mental illness when they are adults. We must help our kids heal and cope before it’s too late. That’s why I prioritized funding for a pilot program providing necessary services to traumatized Michigan children and their families. About 75 percent of children in the program are in the foster care system.
Additional funding was also made available to child advocacy centers and court-appointed special guardians (CASAs) through this budget. CASAs are volunteers assigned to provide support to an abused child throughout the entirety of his or her legal process.
School-based health clinics that include behavioral health services have proven to be crucial for our children. We are adding clinics throughout the state and I will always support this.
Combatting the shortage of behavioral health professionals
There is a shortage of behavioral health professionals in Michigan. I listened to these professionals and learned it is difficult to offer services to individuals on Medicaid and the Healthy Michigan Plan due to low reimbursement rates. Some practices are able to diversify their clients in order to make up this difference, but many can’t. With at least 25 percent of Michigan’s population on Medicaid, many being children, I set out to improve the reimbursement rate. All pediatric behavioral health professionals are now being reimbursed at 100 percent of the Medicare rate. My hope is that more professionals will offer services to children in need and I will always support efforts to address this.
Incentivizing public-private partnership
There is a behavioral health services company in Michigan that fundraises in the communities they service so that they never have to turn away a person in need of care, regardless of their ability to pay. It’s a great initiative that I am hopeful other organizations will adopt. To incentivize other companies to follow the same public-private partnership model, our DHHS budget provided grants that will match the funds raised this way.
It won’t be easy to solve our mental health crisis in Michigan, but by working together, especially during extraordinary times, we will continue to accomplish great things. I hope that this information is helpful. Please feel free to email me questions, concerns and solutions at [email protected].
State Rep. Mary Whiteford, chair of the House Health and Human Services Budget Subcommittee, today announced the launch of the Michigan Crisis and Action Line, with the rollout beginning in Oakland County and the Upper Peninsula. Whiteford introduced the legislation that created the hotline and has overseen its development for years.
Rep. Whiteford talks about her new, bi-partisan legislation, that she will co-sponsor with Dearborn Democrat Rep. Abdullah Hammoud, that will ban the billboard advertising of marijuana products. Rep. Whiteford says a similar ban on billboard tobacco advertising has been in place for decades.
Rep. Whiteford, who chairs the House Appropriations Subcommittee building the $31 billion budget for the Michigan Department of Health and Human Services for the 2022 Fiscal Year, says the spending plan is seeing a significant infusion of federal dollars while continuing to serve as the state’s safety net.
Rep. Whiteford talks about passage this week of House Bill 4359, which expands the scope of practice for Certified Registered Nurse Anesthetists to improve patient access to safe anesthesia services. The legislation was part of a bipartisan package of health care reform legislation.