Battle rages over Oakland County’s plan to take crisis services in-house

Oakland Community Health Network is set to bring its crisis care services in-house starting next year
Common Ground, which currently runs Oakland County’s crisis services, says no transition plan is in place
Forthcoming changes in Michigan’s mental health care administration are creating pressures for organizations to adapt

TROY —- Crisis care advocates are sounding the alarm over a plan to take Oakland County’s adult mental health services out of the hands of a local nonprofit and move them in-house. Doing so, they fear, could bring about disaster.

On a cold November evening, dozens of concerned volunteers, employees and crisis care advocates came together in Troy to protest the move.

Leadership at Oakland Community Health Network (OCHN), a quasi-governmental organization tasked with funding and managing care for approximately 30,000 Oakland County residents, announced this week that it would bring crisis services in-house starting in January.

For years, the network has farmed out crisis services to nonprofits, including Common Ground, a Bingham Farms organization that operates a crisis center in Pontiac. Under the plan, the Oakland Community Health Network would take over operation of that facility.

In a press release announcing the transition, OCHN said its goal was to provide “a more coordinated, compassionate, and accessible crisis care system for all residents of Oakland County.”

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“One of our goals is to enhance and improve those services and to create a full crisis continuum,” health network CEO Dana Lasenby told Bridge Michigan.

”We’re responsible for ensuring that the services are provided, and it’s primarily to individuals with mental health challenges, intellectual and developmental disabilities, children with serious emotional disturbances and everything in between.”

The plan has several critics — including both Republican and Democratic state lawmakers — who urged a pause in the transition amid calls for more transparency and concerns about service interruptions.

At Tuesday’s public meeting in Troy, some of Oakland County’s current mental health care providers were blunt about the stakes.

“People will die,” Anne Bradley, director of development at Common Ground, told the OCHN board.

$12 million contract at stake

Common Ground has been working with Oakland County since 2012 as its primary crisis service provider, with officials championing the organization’s 50-year history of mental health care expertise and its response to some of Michigan’s biggest tragedies, like the mass shootings at Oxford High School and a splash pad in Rochester Hills.

The nonprofit stands to lose out on a $12 million contract with the county as a result of the planned change, according to CEO Heather Rae. That’s about 48% of the organization’s overall funding.

“This is a huge change,” Rae said. “How do we make sure services continue? How do we make sure our 175 employees who work in the OCHN system aren’t leaving because they’re worried about their jobs?”

People sitting in a room. — Common Ground CEO Heather Rae (left) speaks to the OCHN board, including CEO Dana Lasenby (third from right) (Eli Newman / Bridge Michigan)

Rae is skeptical that Oakland Community Health Network has the experience to deliver the services its setting out to absorb, telling the organization’s board on Tuesday of the “adversarial nature” of its ongoing negotiations.

“I’m concerned that there isn’t a transition plan that has been agreed upon or publicly reviewed or discussed,” Rae told Bridge, explaining that Common Ground is currently on a “month-to-month” contract with Oakland County during the transition.

Trisha Zizumbo, OCHN’s chief operating officer, said the network is “actively hiring, interviewing and building up that capacity” to meet the new service demands. As of Thursday, the organization had 37 job openings listed on its website, including positions for physician assistants, triage nurses and crisis clinicians.

Future of crisis care

The debate over Oakland County’s crisis care future comes against a backdrop of significant reform in how Michigan administers behavioral health care services and support.

In August, the Michigan Department of Health and Human Services unveiled its request for proposals to overhaul the state’s Prepaid Inpatient Health Plans (PIHPs). These quasi-governmental organizations are responsible for administering Medicaid funding to about 300,000 Michiganders dealing with substance use disorder, intellectual and developmental disabilities, and serious emotional disturbances.

The restructuring would reduce the number of PIHPs in operation by October 2026 and force the organizations to bid for the opportunity to administer Medicaid funds in the future, a decision that has generated lawsuits and drawn the ire of several county commission boards.

“I am 100% against the privatization, or pseudo-privatization, of our mental health authority,” said Dave Woodward, chair of the Oakland County Board of Commissioners, which passed a resolution opposing the plan earlier this year.

Woodward said he is “still gathering information” about OCHN’s plans to absorb the crisis care services, acknowledging that the board of commissioners lacks the authority to stop any forthcoming changes.

OCHN is uniquely situated in the state as both a PIHP and a Community Mental Health Service Program, meaning the organization both administers funding to providers and delivers those services itself.

Critics of the state’s current system have pointed to potential conflicts of interest in the model. But Oakland Community Health Network CEO Lasenby assured the public on Tuesday that the organization she leads today has “firewalls” in place to make sure the funding and service arms do not “cross over.”

But she acknowledged the Michigan health department’s plan to restructure the PIHP system is forcing her organization to make a choice.

“Right now, we have a contract to do both these things,” Lasenby told Bridge. “If that changes, either we’re one or the other, and we have to be ready to act and move based on that.”

A future where OCHN leads Oakland County’s crisis services instead of Common Ground worries Lisa Kowalski, a disability awareness advocate living in Rochester Hills.

Lisa Kowalski sits at a table — Lisa Kowalski addresses the OCHN board of directors about her concerns of the network bringing crisis services in-house (Eli Newman / Bridge Michigan)

Kowalski, who has an adult son with autism, said she became his “case manager” in traversing a vast array of providers and services to assist in raising him as a child. She worries that the Oakland Community Health Network is not ready “in any way” to set out on its planned crisis care expansion and fears it may jeopardize other services in the area.

“Just because they’ve been a funding source for them, doesn’t mean they have the know-how.”