People with disabilities deserve better from the state of Michigan

Last week, the Michigan Legislature put forward two competing visions of how to best spend billions in Medicaid funds in the state budget.

These funds are used to serve adults who have a developmental or intellectual disability, a mental illness, or a substance use disorder. They also go to aid children with serious emotional disturbances or mental illnesses.

This debate is not simply an important discussion. It will frame life and death decisions for thousands of Michigan residents.

As the executive director of Michigan Protection & Advocacy Service Inc., Michigan’s private, nonprofit organization advocating for people with disabilities, I urge Michigan lawmakers to focus their hearts on their needs.

Over the past year, disability advocates, service providers and representatives of health plan companies met at the invitation of Lt. Gov. Brian Calley to honestly exchange ideas on how Michigan could design and implement the nation’s best array of the services needed by people with disabilities.

Although the task was a challenge, we maintained a polite and respectful discussion. The 298 Work Committee (as it has been called) took the work seriously. The members recognized that we could be a part of a positive “life change” opportunity for people with disabilities to help them reach their dreams.

Unfortunately, as the months evolved, the values expressed by the disability advocates, including self-determination, person-centered planning, and full community inclusion, were not embraced by the Michigan Association of Health Plans and other for-profit insurance interests.

Let’s be honest. Businesses are in business to make a profit.

Like others, I support people who can turn a decent profit where they provide a valuable good or service. But turning people with disabilities into commodities that can be manipulated on a profit-and-loss statement is simply offensive. It drains even more scarce resources away from people’s needs and creates a system that responds not to people with disabilities and their families, but to shareholders.

Let’s also be honest in admitting that the current design of the Community Mental Health and the Prepaid Insurance Health Plan system is a maze that forces limited funds through numerous agencies.

The fractured design of the Community Mental Health system perpetuates a situation where services can be provided in one geographic area yet may not be available in a neighboring county. It is virtually impossible to determine if allocated funds are originally sufficient or not to meet the client’s needs. Only pennies on the dollar are available for direct services after duplicative overhead is paid.

Disability advocates are insisting that Michigan create a public, responsible, and efficient system that is designed and built — with no apology — on self-determination, person-centered planning, and full community inclusion. We believe the 298 Report recommends important changes in our current system to help Michigan reach those goals.

The reality is clear. The health insurance plans cannot attempt to maintain a credible role if they insist on including a profit incentive that jeopardizes the lives of the people served.

Elmer L. Cerano serves as executive director of Michigan Protection & Advocacy Service Inc., the independent, private, nonprofit organization designated by the governor of Michigan to advocate and protect the legal rights of people with disabilities. He is a nationally recognized advocate for people with disabilities.