Strategic Planning for the Detroit Wayne Mental Health Authority

A meeting of the Detroit Wayne Mental Health Authority (DWMHA) strategic planning committee was held on Wednesday, 9/21/16 in Detroit. Ed Diegel, a parent and advocate for people with developmental disabilities, commented on the proposed structure of the MCPN (Managers of Comprehensive Provider Networks - regional providers of services within Wayne County).

I think Ed’s comments are representative of what most families want: choice, reasonable control of costs, accountability, and individualized care without the overlay of an ideology that tends to dictate choices and limit the availability of appropriate services.

These comments were forwarded to the strategic planning committee by email: Strategicplan@dwmha.com . I assume that the committee will accept written comments from other residents of Wayne County affected by strategic planning. 

Comments from Ed Diegel:

The current MCPN configuration offers advantages which should be maintained regardless of the final plan design.

• The current model offers choice; choice between MCPN’s, case workers and providers. Each consumer can seek out the highest quality MCPN, case worker and provider combination for meeting individual needs
• Competition: MCPN’s and providers are driven to perform better by responding to the competitive marketplace.
• Personal touch – the CLS (Community Living Supports) case workers visit with clients in work and residential settings to see the dynamics of client life first hand.

There have been several disadvantages to the current model which need to be addressed in the plan:

• Redundant costs—each MCPN develops its own policies, documentation procedures and payment routines. These costs could be eliminated at the MCPN level if the tasks were performed by the MCPN. Furthermore, savings would be realized at the provider level from having to deal with only one set of requirements.
• Funding inequities—there can be significant (greater than 50%) payment rate variances between MCPN’s for the same service. In addition, an MCPN has given favorable payment rates for the same service when comparing ‘partners’ to non-partners.
• Accountability – MCPN’s have passed rate decreases to providers in years when there has been no funding decrease from the state. In addition, when the Authority recommended terminating the contract of an MCPN, the Authority Board overrode the decision, sending a weak accountability message through the system.
• Ideology - one MCPN refuses to fund clients in larger homes even when the client expresses a desire to live in these residences and the residences have a long and proud history of quality and are located in the heart of local communities from which they draw support and the opportunity for inclusion not available to many persons living in small homes and apartments. This stance does not reconcile with the basic Person Centered Plan philosophy. This same bias applies against individuals who choose to work in so called congregate work settings.