Mike Bach, executive director of Copper Country Mental Health Services, speaks to the Houghton County board about proposed Michigan Department Health and Human Services changes that would require mental health patients to go to one agency for assessment and planning and another for service delivery. Garrett Neese/Daily Mining Gazette.

HOUGHTON — The executive director of Copper Country Mental Health Services spoke out Tuesday against a state decision he said would impose new barriers on people seeking help.

Mike Bach brought a CCMHS resolution to the Houghton County board opposing a decision by the Michigan Department of Health and Human Services that would require mental health service providers to separate service assessment and planning from service delivery. That would require people to go to two separate agencies for the services, now both being performed locally by CCMHS.

MDHHS introduced the proposed change in response to federal rules from Centers for Medicare and Medicaid Services (CMS) regarding conflict of interest. The 2014 rules apply to beneficiaries obtaining home- and community-based services.

“The concern that the department has, is that because Medicaid is a state-federal venture, that state conflict of interest guidelines apply to that — which we agree with,” Bach said. “But they’re concerned that in order to meet those conflict of interest requirements, you really have to dismantle the system.”

MDHHS did not respond to a request for comment submitted Wednesday morning.

Commissioner Glenn Anderson asked how the proposed MDHHS policy would affect services locally. If the changes went into effect, Bach said, some other agency would have to become a Medicaid provider to do assessments and treatment planning.

“You’d have to have not only the clinicians, you’d have to have the IT support, the HR support,” he said. “It’s really problematic. I don’t know where these folks would come from.”

Bach said even in larger counties, services are provided directly at the same agency, or contracted out to another agency working in-house.

“This would be a total revamp of the system,” he said.

Bach said the CMS guidelines are largely intended to address private fee-for-service systems. He gave a hypothetical of a company assessing a person, referring them to the same company, and submitting those services for reimbursement. The public mental health system is funded differently, where it’s based on the total number of Medicaid recipients, Bach said.

“It doesn’t matter if we provide one therapy a week or 20 a week, our funding doesn’t change based on that,” he said.

The Houghton County board also discussed the funding appropriation request for CCMHS at its meeting Tuesday. It will be acted on in September as part of fall appropriations.

The $164,495 amount has been the same since 1996, said Commissioner Roy Britz, who also sits on the CCMHS board.

“It hasn’t changed in that time, and of course we know the services are fantastic here in Houghton County,” he said.

Bach said he believed the existing conflict-of-interest regulations already in place are working. Those include barring case managers from authorizing services, or saying a person can’t provide services to a relative.

Bach said the proposed changes are also inconsistent with the state’s Mental Health Code. That requires a community mental health services program to provide a “comprehensive array of mental health services.”

“Splitting that up would be a big burden on consumers,” he said. “It’s difficult to ask for help, and to go and tell your story and have to do that at one agency and then turn around and do that basically at another (agency).”

Administrator Ben Larson said he would draft a resolution based on Bach’s and add it to the agenda for the board’s August meeting.

“The more local the better … however we can help support you, I think the board should do that,” said Commissioner Joel Keranen.

Baraga County approved the resolution Monday night, joining other counties in the state such as Ionia and Iosca. The Community Mental Health Association of Michigan proposed an alternative in March that would build on other federally approved conflict mitigation strategies.