NORTHPOINTE BEHAVIORAL HEALTH System has offices in Dickinson, Iron and Menominee counties, including this facility in Kingsford. (Terri Castelaz/Daily News)

IRON MOUNTAIN — Dickinson County may yet offer a resolution objecting to a change in the way mental health service contracts in Michigan are managed.

The county board discussed the issue over the summer but shelved a resolution suggested by Northpointe Behavioral Healthcare System CEO Mandy Padget. After hearing Padget’s update Monday on Northpointe’s services, Commissioner Joe Stevens said the resolution should be revisited.

“We cannot let this go private,” he said.

The fate of the restructuring plan may depend on court decisions.

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

Northpointe and other mental health agencies say this opens the door for private, non-profit health plans or managed care organizations to take control of services.

According to the MDHSS, 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.

Padget told the county board Monday the MDHHS plan “doesn’t reduce the budget,” but “simply moves the money.”

Marquette-based NorthCare Network is the regional PIHP for the Upper Peninsula, overseeing Northpointe 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. Those boards, in turn, are appointed by the respective county boards.

A resolution presented by Padget in July said counties across Michigan have historically played a vital role in the governance, funding and oversight of the public behavioral health system. Maintaining a locally governed system is “essential to ensuring that individuals with mental health and substance use needs receive timely, appropriate, and high-quality care,” it states.

In reducing the number of PIHP regions from 10 to three, the existing PIHPs say they’re effectively locked out of the bidding process unless they completely restructure themselves under new entities. A group of mental health agencies sought a court injunction to block the bidding, but it was denied last month.

Gongwer News reported that Michigan Court of Claims Judge Christopher Yates told MDHSS attorneys he thought the RFP was “terribly unwise but quite probably legal.” Yates, at the same time, noted a competitive PIHP procurement system is regarded as the preferred nationwide model.

A hearing is scheduled Dec. 8 to address the legality of the language in the Michigan RFP. The plaintiffs have also asked for a reconsideration of whether MDHHS has the authority to reduce the number of PIHP regions.

Padget, in her update to the board, described Northpointe as “at risk.”

She offered a summary of the agency’s behavioral health services for adults and children, including emergency services. Within the three counties, anyone experiencing a mental health emergency may call or present to one of Northpointe’s three main clinic sites during business hours. After business hours, walk-in crisis services can be accessed at Aspirus Iron River, OSF St. Francis, Bay Area Marinette or Marshfield-Dickinson.

Northpointe’s crisis staff are licensed professionals with specialized training in crisis intervention to assess the nature of the crisis and develop a response plan, Padget said. In Dickinson County, Northpointe’s office is at 715 Pyle Drive, Kingsford.

Under Michigan’s mental health code, Northpointe’s services are directed to people who have a serious mental illness, serious emotional disturbance or developmental disability. Anyone enrolled or eligible for enrollment in Michigan Medicaid is eligible for services. Those who do not have Medicaid may receive limited case management or limited therapy.

From January through October of this year, there were 503 staff contacts in Dickinson County for crisis services, Padget said.

In addition to other services, Northpointe directly operates two specialized residential homes in Dickinson County, providing care for 18 people. The tri-county agency has 209 employees, 80 of whom reside in Dickinson County.

One issue that arises with privatization is whether non-billable services would still be provided or available, Padget said.

Sheriff Aaron Rochon said his experience in dealing with risk assessments and other issues handled through Northpointe indicate “it really has been run pretty well.” Department transports to mental health facilities is “just a fraction of what we deal with,” he added.

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