IRON MOUNTAIN — Dickinson County is now among dozens of counties in Michigan that have passed resolutions protesting a change in the way the state’s mental health services contracts are managed.

According to Community Mental Health Association of Michigan, at least 41 counties are on record in opposition to a move by the Michigan Department of Health and Human Services to restructure the public mental health system through competitive bidding. Critics say it will open the door to private, non-profit health plans or managed care organizations taking control of behavioral health services.

A resolution adopted Tuesday by the Dickinson County Board cites “significant concerns about the potential impact of a competitive procurement process on care quality, access, local control, and transparency.”

The state has 10 regional Prepaid Inpatient Health Plans that are charged with managing a region’s behavioral health Medicaid funds. But MDHHS in August opened contracts for PIHPs to competitive bidding. The RFP, or request for proposals, will reduce the number of plan regions from 10 to three.

Several service providers have filed a lawsuit over the RFP. The Michigan Court of Claims has allowed the bidding process to move forward, but the underlying legal issues remain under review.

Marquette-based NorthCare Network is the regional PIHP for the Upper Peninsula, overseeing Northpointe Behavioral Healthcare System as it serves Dickinson, Iron and Menominee counties. The NorthCare Network Governing Board is comprised of three delegates from each of the five U.P. community mental health service program boards, including Northpointe. Those boards, in turn, are appointed by the respective county boards.

Dickinson County’s resolution states the restructuring could “jeopardize the person-centered, recovery-oriented approach that has been cultivated under the public system.” It urges the state to halt any plans for privatization and instead work collaboratively with counties and other stakeholders to allow only “public organizations with experience in managing Michigan’s public mental health system to be part of any bid process should one occur.”

According to MDHHS, the shift to competitive bidding is meant to “address issues within the current PIHP system that compromise service quality, accountability, and efficiency.”

The Michigan Association of Counties, however, claims private health plans operate at a higher cost than their public counterparts.

Critics of the RFP also say states that have shifted Medicaid behavioral health systems in a similar manner have faced problems, including an increased reliance on emergency rooms and jails.

Dickinson commissioners discussed the contract issue over the summer, but initially shelved a protest resolution presented by Northpointe CEO Mandy Padget. After receiving an update from Padget last month on Northpointe’s services and the impact of a potential restructuring, there was a consensus to draft a resolution in support of the current PIHP system.

Padget, at that time, described Northpointe as “at risk.”

MAC, meanwhile, has responded to the state’s RFP by submitting a bid to offer a collaborative option based on local control. According to MAC’s Board of Directors, this is an effort to maintain as much of the current system as possible within the RFP criteria.

MAC, though, still opposes the direction MDHHS has taken in putting the system out to bid and asks that the RFP be pulled back.

Michigan’s specialty behavioral health care system provides health care coverage to approximately 300,000 Michiganders, including adults with serious mental illness, children with serious emotional disturbance, individuals with substance use disorder and individuals with intellectual and developmental disabilities, according to MDHHS.

In announcing a deadline for the state’s RFP in September, MDHHS Director Elizabeth Hertel said PIHPs are responsible for making sure people receive the behavioral health care services and support they need. “A competitive procurement process for the state’s Prepaid Inpatient Health Plan contracts will help create a more accessible and person-centered system of care dedicated to ensuring Michigan residents a healthier future,” Hertel said.

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Jim Anderson can be reached at 906-774-2772, ext. 85226, or janderson@ironmountaindailynews.com.