Posted July 24th, 2025
FOR IMMEDIATE RELEASE:
July 24, 2025
MEDIA CONTACT:
Mary Hare, 586-469-5126
mary.hare@macombgov.org
Macomb County Board of Commissioners Adopts Resolution Opposing MDHHS Plan to Implement Competitive Procurement Process for PIHPs
This afternoon, the Macomb County Board of Commissioners (BOC) adopted Resolution 2025-13775: A Resolution to Oppose the Michigan Department of Health and Human Services Plan to Implement a Competitive Procurement Process of Prepaid Inpatient Health Plans.
Currently, the State of Michigan operates a publicly managed and community-based system for the delivery of specialty behavioral health services through ten Prepaid Inpatient Health Plans (PIHPs). These PIHPs are responsible for managing Medicaid mental health, developmental disability, and substance use disorder services. The Michigan Department of Health and Human Services (MDHHS) recently announced plans to initiate a competitive procurement process for the management of these PIHP functions, which could open the door to private, non-profit health plans or managed care organizations (MCOs) assuming control over behavioral health services. Private health plans typically have much higher overhead costs – around 15 percent, compared to just 2 percent in the current system – which has the potential to divert more than $500 million each year away from services and into administrative costs.
The Resolution was first introduced at the BOC Government Oversight Committee meeting on Tuesday. At the meeting, Macomb County Community Mental Heath (MCCMH) CEO, Traci Smith, addressed the Board, asking for their support.
“MCCMH is committed to enhancing the quality, access, and accountability of mental health and substance use services,” said Traci Smith, CEO of MCCMH. “However, shifting control of the public mental health system, whether through privatization or by eliminating community-based oversight, raises serious concerns for the well-being of those who depend on these services.”
MCCMH provides a variety of mental health, developmental disability, and substance use disorder services to over 18,000 people annually as one of the state’s ten PIHPs. MCCMH also administers a Community Mental Health Services Program and a Certified Community Behavioral Health Clinic. PIHPs demonstrate value, local accountability, and community engagement while successfully managing costs and improving health outcomes for vulnerable populations.
Commissioner Phil Kraft, Chair of the CMH Board, introduced the Resolution and successfully secured the support of all Commissioners, who added their signatures to the Resolution. “This has been going on for a long time,” said Commissioner Kraft during the committee meeting. “It directly affects us—both as local commissioners and in determining who serves on the board.” Currently, Commissioner Kraft serves with Commissioner Antoinette Wallace as two of the twelve CMH Board members, all appointed by the BOC, who oversee MCCMH.
The proposal to privatize could disrupt longstanding relationships between local mental health authorities, providers, and the communities they serve, and jeopardize the person-centered, recovery-oriented approach that has been cultivated under the public system. Many stakeholders, including individuals receiving services, advocates, local officials, and providers are concerned about the potential impact of a competitive procurement process on care quality, access, local control, and transparency.
“This isn’t just about contracts—it’s about people,” said Joe Sabatini, Chair of the Board of Commissioners. “A competitive bidding process could sideline the person-centered, recovery-oriented care model that has taken years to develop, sacrificing quality, accessibility, and transparency in the name of efficiency.”
Counties across Michigan have historically played a vital role in the governance, funding, and oversight of the public behavioral health system, and any change to that structure without meaningful county input undermines the principle of local governance. Maintaining a publicly accountable and locally governed behavioral health system is essential to ensuring that individuals with mental health and substance use needs receive timely, appropriate, and high-quality care.
A copy of the Resolution can be found here: A RESOLUTION TO OPPOSE THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES PLAN TO IMPLEMENT A COMPETITIVE PROCUREMENT PROCESS OF PREPAID INPATIENT HEALTH PLANS
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