Reviewing Governor Whitmer’s new MDHHS budget, we can see what she values. This is equally true of legislators who voted for it.

What’s in the MDHHS Budget?

Yesterday, MDHHS highlighted the budget’s mental health spending in a press release, “MDHHS Director Elizabeth Hertel speaks to behavioral health at Detroit CIT Conference.”

$10 million for loan assistance to attract and retain behavioral health professionals.
$3 million to continue to implement MiCAL statewide, a behavioral health crisis intervention and support call center available to individuals and families.
$223.1 million in one-time funding for programs such as:
- McLaren Northern Michigan adolescent partial hospitalization ($5 million);
- U of M Medicine children’s emergency psychiatry and day program for children and adults ($11 million);
- Team Wellness adolescent behavioral wraparound health care program ($8 million);
- Bay County pediatric psychiatric inpatient ($5 million); and,
- Detroit Children’s Hospital psychiatric ($5 million).
$57.8 million in funding to improve access to community-based and inpatient behavioral health care such as: Purchase access to private inpatient community-based services ($29.7 million);Employee funding to oversee community-based programs ($750,000); Two additional units at Hawthorn Center ($10.5 million); and,Behavioral health homes in new counties ($16.8 million gross). …
$279.7 million to expand Certified Community Behavioral Health Clinics, which serve anyone who requests care for mental health or substance use, regardless of their ability to pay. There are currently 13 CCBHCs in Michigan.
$45 million to improve facilities for school-based health services and $28.9 million to continue school-based mental health services on campuses.
$5 million for the Michigan Crisis and Access line.
$5 million to offer scholarships for those going to college studying behavioral health and strengthen the health care workforce.

Michigan is also working with the federal government to add a benefit to the state Medicaid program for youth and adolescents with complex behavioral health conditions….

There is more – much more.

My preferred source for figuring out the big picture is the Senate Fiscal Agency summary. MDHHS budget information starts on Page 54.

Here are the basics:

This budget adds the equivalent of 169 full-time employees.
Total state spending is up 5.7% from last year.
Both federal and private/local funding dropped.
Gross spending is $35,734,583,000, down 1.1%.

Note: this is the Initial Appropriations Bill. There may be more!

The Omnibus Bill (HB 4437) legislative process and full text are here.

What will the effect be?

MDHHS says this budget will “strengthen health care access” and “make Michigan the best place to raise a family,” but are these claims credible?

Government spending always comes with strings attached.

MDHHS is first and foremost a regulatory agency. As such, it raises the financial and human costs of healthcare.

For example, MDHHS healthcare spending created and maintains the nightmarish Medicaid system. Through it patients must apply and try to get care, and clinicians must document and try to be reimbursed.

The regulatory burden extends beyond state programs through standardization (of forms, for instance). MDHHS regulation contributes to shortages when it exhausts patients and providers, and deters entry to the professions.

Just as troubling is the effect of MDHHS programs on families. The intact family is the “original Department of Health, Education and Welfare.” (Michael Novak)

But the MDHHS budget puts well-marketed state health programs into competition with families in all these areas.

Ultimately, spending = control. Healthcare spending = control of healthcare.

Stressed by high-cost, low-access care, many families accept encroaching control of their children’s healthcare without realizing the full implications.