The Northern Michigan Regional Entity is a prepaid inpatient health plan that contracts with the state of Michigan. It manages behavioral health services for people enrolled in Medicaid. The NMRE covers 21 counties in northern lower Michigan, including Wexford and Missaukee counties. Those behavioral health services include treatment for substance use disorder (SUD).
The NMRE also manages block grants and funding made possible through collection of liquor taxes, which are then spent on SUD treatment. Approximately 50% of a county’s liquor tax revenue is directed to the NMRE to be used to offset SUD funding shortages, prevention initiatives, or treatment and prevention services directly requested by counties through licensed prevention or treatment providers.
Prior to Medicaid expansion a few years ago, liquor tax funds were used for prevention and treatment, but also to offset grants for services for people without insurance or found to be indigent. Since most of those people are now covered through the Healthy Michigan Plan provided through Medicaid funding, counties are finding that they have a surplus of liquor tax proceeds. Wexford County has about $450,000 and Missaukee County about $66,000 of surplus proceeds.
In May, the NMRE and our two counties began discussing ways in which to use these funds to provide addiction/SUD treatment services for those involved in the criminal justice system.
In June, I led a meeting with our two counties’ sheriffs, prosecutors, public defenders, commissioners, administrators, our community corrections manager, district court judges, Catholic Human Services, the NMRE, and the Michigan Department of Corrections. The objective was to discuss ideas and ways in which to implement these funds to help those caught up in addiction while they are in the criminal justice system.
Addiction and SUD are alarming problems in Wexford and Missaukee counties. Methamphetamine and narcotic crimes, including opiates like heroin and fentanyl, account for nearly a third of all felonies in the two counties. Many property crimes are also related to drug addiction, such as shoplifting, larceny and home invasion, making the severity of the problem is larger than drug crimes statistics alone may show.
Addiction/SUD spreads like a disease from person to person, community to community. It was here before and during the COVID pandemic; and it will likely long out-live the pandemic as well. It may be naive to think mankind’s struggle with drugs and intoxicants will ever end. The best for which we can hope is to beat back against the tide and help those caught in the current.
Our group identified access to treatment for pre-trial and post-conviction defendants as a significant issue. The local rehabilitation resources, while present and dedicated, are overburdened and under resourced. The issues are both the amounts of resources as well as the lack of access for those struggling with addiction/SUD to the resources. Therefore, we explored alternative means of bringing the services directly to those in need while they are in the criminal justice system.
On July 30, an application was filed with the NMRE to use the surplus funds to initiate a program partnership with Catholic Human Services. The application is expected to be approved in mid-September. The funds will be used to employ a counselor through Catholic Human Services to provide addiction/SUD counseling and treatment to those in pretrial and post-conviction confinement in our local jails and those in Community Corrections transitional housing. While CHS already provides some services in the jails, this will allow significant expansion of services to those caught in the criminal justice system and bridging the access-gap.
During the pandemic, the world saw an increase in online counseling services to continue to meet the need and overcome access issues. Some of the funding will be used to purchase technical infrastructure, such as computers and online programming, to allow the counselor to provide services to those in the jails and transitional housing.
Upcoming changes in the law may provide felony defendants to receive a sentencing benefit if they take advantage of such treatment made available to them while in confinement.
This has been a collaborative process with all participants covering our two counties to address a shared need to help those within our communities in overcoming their addiction and improving their futures.
Jason Elmore is the 28th Circuit Court Judge for Wexford and Missaukee counties.