Chad Livengood's Jan. 31 commentary advocating splitting up the Michigan Department of Health and Human Services misses how much good has been done by the combined department.
Splitting up the department would do nothing to address the legitimate issues Livengood raises. Instead, we believe such an approach would reduce the ability of the Department to address the most critical public health issues of the day.
If nothing else, COVID-19 has emphasized the importance of the integration of health and human services. Those who have suffered the most from COVID-19 are those who also face the greatest challenges from social determinants of health.
The Centers for Disease Control defines social determinants of health as the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes. The programs run by the human services side of the MDHHS are those that have the greatest impact on these conditions — cash assistance, food assistance, emergency relief, child-care and the like.
Over the past year, the Michigan Department of Health and Human Services has implemented myriad innovative programs focused at reducing poverty and improving living conditions for those most in need.
From reforming eligibility criteria to make it easier for families in crisis to apply for help, to better supporting community college students with high rates of food insecurity, the department has been responsive to the needs of struggling Michiganders.
Early in the COVID-19 crisis as unemployment spiked, federal legislation enabled states to deliver added food assistance to families struggling to make ends meet, especially those with school-aged children missing out on school meals. The New York Times reported that Michigan was the first state to run the gauntlet and get these extra dollars out to families. The state has surpassed $1 billion in added federal food benefits sent to struggling families since COVID struck.
Families also were worried about utilities in the last year. MDHHS, the Michigan Public Service Commission, and the major utilities providers worked with the Governor to ensure that no low-income family faced shutoff in the spring into summer. Since the moratoriums expired, MDHHS also worked to streamline its statewide energy assistance program.
Using new federal funding, MDHHS worked with DTE, Consumers Energy, SEMCO and UPPCO to on an innovative direct payments program, to 41,000 low-income families facing shutoffs across the state. Michigan's utility providers were active partners, agreeing to forgive 25 percent of the past-due balances, a total of $5 million in forgiveness.
A major priority for the department now is cross-enrollment. Sometimes those in need are connected to benefits that can help with the health and nutritional needs of babies (like WIC) but not connected with food assistance (Family Assistance Program) or health care (Healthy Michigan) for the rest of the family.
A major priority of the department is to make sure families know what programs there are so they are empowered. Splitting a department up almost never helps units within them communicate better. Don't we want to make it easier, not harder for these programs to work together?
These initiatives have tremendous potential to improve individual and public health. Indeed, Michigan Medicaid, like Medicaid programs across the country, is encouraging health plans to expand their financing of benefits beyond covering medical care services to including support for certain human services interventions as well.
Having health and human services integrated in one department provides greater opportunities to better address race equity and social mobility, two goals essential to improving public health. The current structure of MDHHS has put clear leadership in place for health and for human services that have allowed these programs to thrive and improve outcomes for those most in need.
Organizational change is disruptive, time-consuming and more resource-intensive than many realize. Reorganizing major state departments affects morale and focus, and can distract from the pressing issues that need to be addressed on behalf of the citizens of Michigan.
While there could be good reasons to make such an organizational change, doing so in the middle of a pandemic with a stressed work force would be a hardship on many with unclear impacts that would not address the issues of concern raised by Livengood in his column.
We believe that MDHHS is working remarkably well with the current structure. We would be saddened to see the progress that has been made on recognizing the connections between health and human services reversed. It would be a shame to lose sight of all that has been accomplished along with the opportunity to accomplish even more.
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Guest column: MDHHS merger a success, don't break it up - Crain's Detroit Business
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