By By JOHN EBY / Dowagiac Daily News
CASSOPOLIS - Aug. 17 the Woodlands Behavioral Healthcare Network board of directors voted unanimously to seek a change in substance abuse coordinating agencies, from the five-county Lakeshore Coordinating Council in Grand Haven to Kalamazoo Community Mental Health and Substance Abuse Services (KCMHSAS).
The latter's executive director, Jeff Patton, is a Cass County product. He knows Sheriff Joe Underwood as "Duke" from their school days in Vandalia.
LCC Interim Director Karen Youngs Hartley warned commissioners there could be financial ramifications, if not legal action.
Lakeshore has been managing the capitated Medicaid substance abuse services benefit program for Cass, Allegan, Berrien, Ottawa and Muskegon counties since 1998.
LCC board Chair Beverly DeJonge of Allegan County, in a Sept. 14 letter to Board of Commissioners Chairman Robert Wagel of Dowagiac, asked him not to support the move.
DeJonge said Cass County's representatives, Commissioners John Cureton, R-Dowagiac, and David Taylor, D-Edwardsburg, share her concerns and are "behind me on these issues," such as, "Stated savings from a move should be reviewed for accuracy."
Joining the Kalamazoo-led CA "will place control in outside authorities, without decision-making power in Cass County."
Taylor and Cureton attended a Sept. 5 meeting in Holland.
Since the other four counties are each more than twice the size of Cass, "We enjoy a significant degree of supervisory control over the substance abuse funding for a population of approximately 760,000 people," Taylor said.
Additionally, Woodlands' Steve Lehman and John Gore and Perry Stoops of the LCC advisory board attend regularly and meet with Tim Rosenboom.
In Taylor's analysis, despite Cass County's status as a "fly speck" of 6.7 percent compared to the 250,000 residents of Ottawa County or the 180,000 residents of Muskegon County, the "real reason" Lakeshore does not want to lose Cass is that it uses less than that share.
Taylor doesn't see any cost reductions or benefits from switching to Kalamazoo. "I am a little concerned, however, by the loss of control and contribution by the six individuals who are each somewhat involved."
Taylor has drafted a resolution in support of "self-coordination."
The interlocal agreement specifies at least 90 days notice before a county change. The state law under which the interlocal agreement is structured actually states, "A contract may be terminated by joint action of all parties, or by an individual party not less than one year after its notice thereof in writing to all other parties."
Woodlands Chief Executive Officer Kirt Carter said the request must be approved by Cass commissioners, who would then join Woodlands in making the request to the Michigan Department of Community Health, which ultimately decides.
Allegan, Cass, Kalamazoo and St. Joseph counties with KCMHSAS effectively combines mental health and substance abuse coordination in a four-county affiliation, although Allegan is also part of the LCC.
Increased local control over substance abuse service funds, as KCMHS will delegate substance abuse functions Lakeshore currently administers directly to Woodlands.
Woodlands Controller John Mahan projects an annual $40,000 savings.
Increased opportunity for collaborative substance abuse treatment across both the affiliation and southwest Michigan.
Patton indicated that at least one county commissioner from each affiliate county would be appointed to serve on the KCHHSAS Coordinating Advisory Council.
Carter said this would allow Cass County government to maintain input into the planning and delivery of substance abuse services to this area.
In a memo Youngs Hartley wrote Sept. 8, she estimated a more than $6 million financial impact on Lakeshore from the "realignment" Patton promotes, including $4,302,872 from the state Department of Community Health contract and $1,747,633 from Medicaid ($6,050,505 total).
Based on FY05 allocations, she said Cass ($566,731), Allegan ($771,154) and Berrien ($1,535,946) represent a total of $2,873,831 - 47 percent of the LCC.
If the LCC was reduced to 53 percent of current services funding and administrative operations budgets, the agency would be left serving only Ottawa and Muskegon counties.
Youngs Hartley said she believes there is merit and potential in a closer relationship between public mental health and public substance abuse funding management.
Youngs Hartley said, "For you to expect to do this in a matter of two weeks is unrealistic and also not fair to the other counties involved. This potentially affects 20 counties. While we have worked wonderfully with Woodlands, it's an authority. It's not a county agency. Kalamazoo can't delegate away its responsibility to actually be the managing board. You would not have the same representation or influence you have with Lakeshore.
Patton said, "The idea is to have one door for persons with mental illness and substance abuse and addictive disorders. We do not want to continue fragmenting those service delivery systems. We're ending that in Kalamazoo, and certainly Kalamazoo would not be micromanaging. The county would control those dollars and certainly would have a say in what it wants through its mental health board."
Commissioner Terri Kitchen, R-Silver Creek Township, made the motion to postpone action. She also asked that a committee be appointed.
Chairman Robert Wagel, R-Wayne Township, said it would be hashed out by the Appointments and Resolutions Committee.