County counsel warns of uncertain legal risk tied to Medicaid-managed care; commissioners seek written summary

County corporate counsel presented a legal opinion at the Nov. 21 special meeting arguing that the county faces potential exposure under current Medicaid managed-care and PIHP arrangements if CMH remains a county department.

Counsel reviewed statutory language and past litigation involving other Michigan counties and said the legal position is complex: "I can't guarantee you're gonna win, and that's the concern," he told commissioners when asked whether the county general fund would ultimately be found liable in court. Commissioners asked staff to prepare a condensed legal rationale and to include litigation precedents so they can assess the risk more concretely before any final decision.

Several speakers noted that statutes cited in the presentation provide different levels of protection for authorities versus county departments; presenters and attendees referenced prior 2018 cases (Muskegon, Washtenaw) as examples of how outcomes can vary. The board requested a clearer, public-facing summary of counsel's opinion to help commissioners and the public evaluate whether a structural change is warranted.