The Ottawa County Board of Commissioners on Nov. 21 directed county staff to develop a timeline and recommended strategy to assess whether the county should convert its Community Mental Health (CMH) department into a single-county authority, after legal counsel and CMH leadership warned the county faces significant fiscal risk under current Medicaid managed-care arrangements.

The board's action followed a presentation by corporate counsel Doug Van Essen and CMH CEO Dr. Brashears, who said the county is likely looking at a roughly $5.5 million deficit for fiscal year 2025 and that converting to an authority is a statutory option many Michigan counties have used to limit exposure of the county general fund. "Right now, it looks like we have a $5,500,000 deficit," counsel said during the presentation.

Why it matters: County leaders said the managed-care financing model pays a fixed amount per enrollee but leaves counties responsible for meeting the entitlement of services; under that model unanticipated high-cost cases and changes to benefit rules can produce large deficits. Van Essen and Dr. Brashears said an authority can preserve local service delivery while shifting some legal and fiscal exposure away from the county general fund, but it does not eliminate financial risk for the authority itself.

Details of the plan request: The motion approved by the board authorized the county administrator to "develop and return to the board with a proactive recommended strategy intended to minimize the financial risk to taxpayer dollars, retain quality employees, and ensure the continuation of quality mental health services to our community with a timeline." Commissioners said they expect public education and at least three public hearings across geographic quadrants of the county if the board chooses to pursue the conversion.

What presenters told the board: Van Essen reviewed the legal framework that has allowed most Michigan CMHs to become authorities since 1996 and described statutory language that limits county general-fund liability once an authority is created. Dr. Brashears, who has led CMH services locally, said the primary driver of the county's exposure is the managed-care approach to behavioral Medicaid and programs such as the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which lack reserve funding and can create high-cost cases. "This is a long public process," Brashears said of any conversion, "there will be three public hearings ... and then a resolution would be passed before you create an authority."

Community reaction: Dozens of residents addressed the board during two public-comment periods, pressing for transparency and objecting to holding any part of the discussion in closed session. William Pettit, a former attorney with the Michigan Attorney General's Office, urged the board not to go into closed session and said the notice failed to identify the statute that would justify closing the meeting. "Closed sessions are not normal," Pettit said. Oliver Champine, a Grand Haven resident, told commissioners, "Mental health's important. But how important is it to you guys?" and warned that a structural change could mean staff reductions if not handled carefully.

Next steps: Board members said staff should return with a proposed timeline and a strategic plan that outlines impacts on clients, staff, county services and the millage ballot. Van Essen and Dr. Brashears recommended beginning public education soon because the conversion process can take nine to 12 months and accounting transitions are smoother if timed to the fiscal calendar. The board did not take a final vote on creating an authority; it voted only to direct staff to design the study and process.

Votes at a glance: The board voted to authorize the county administrator to develop and return with a strategy and timeline; the motion passed with one recorded opposition. The board previously voted down a separate motion to go into a closed session to review counsel's opinion on state CMH funding.

What is unresolved: Legal risk remains unsettled. Counsel said his opinion is that the county general fund may be exposed, but he acknowledged courts and state practice have offered mixed signals and no definitive statewide answer. Commissioners asked for a clear legal memorandum they could review as part of staff's next steps.

The board asked staff to proceed quickly and return with a recommended path and timeline to allow public hearings before the next fiscal year begins.