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H.B. 381 ... SHIFT OF GOVERNANCE TO COUNTIES <br /> <br />· H.B. 381 is a Bill that would shift costs, responsibility, and liability for and <br /> governance of local Mental Health/Developmental Disabilities/Substance Abuse <br /> (IVII-I/DD/SA) Programs from Public Authorities (Area Programs122C) to <br /> counties. <br />· In multi-county programs, one "lead county" will be designated by the other <br /> counties to administer all services, p?0grams, contracts, and employees. It is not <br /> clear how liability and costs would be spread. (Please see the attachment entitled <br /> "Key Points HB 381" which elaborates on the complexities and uncertainties of <br /> establishing "county governance" of MI-UDD/SA through 160A and Intertocal <br /> Agreements). <br />· The two main stated purposes that underlie this legislation are: <br /> <br />1. To force consolidation of very small programs into a minimum general <br /> population base of 200,000. <br />2. To establish county governmental control over local MHIDD/SA <br /> programs because of the perception that some Area Programs are <br /> unaccountable. <br /> <br />Number 2. (above) is questionable. The state already holds and <br />exerts vast reporting and performance authority over Area <br />programs and, ultimately, the Secretary of HHS can remove and <br />reallocate Area Program resources in cases of poor performance: <br />122C-112, (b) (10), (11). This includes the ability to enter into <br />discussions with Area Boards pertaining to performance and <br />accountability. In other words, the state can already enforce <br />accountability. <br /> <br />If the legislature believes Area Programs shouM be more <br />accountable to counties, it can achieve that end by strengthening <br />122C to require what Area Programs must be accountable for in <br />relationship to counties and exactly how to achieve that <br />accountability. This fact raises a question about whether the state <br />may be trying to achieve other, unstated goals by attempting to <br />shift governance to counties. <br /> <br />c) Area Programs across the state have been working with their <br /> counties to determine if counties, in fact, perceive their Area <br /> <br /> <br />