Ideas to Consider #21 – Mental Health Reform is Heating Up in Lansing

One month ago, Senator Aric Nesbitt wrote an op-ed in the Holland Sentinel (https://www.hollandsentinel.com/story/opinion/letters/2021/10/19/letter-medicaid-reform-time-provide-choice-and-integrate-care/8507842002/) arguing it’s time for mental health reform in Michigan.  

He writes:  “Nearly every single insurance plan offered in the commercial market by an employer integrates mental health services with physical healthcare coverage.  Unfortunately, integrated care is not provided for more than 2 million Michigan residents on Medicaid. To receive treatment for severe mental health conditions, these residents are forced to use and rely upon an antiquated government-run patchwork system of state, county and private medical providers. They have no choice or options.”  Later he notes:  Private health plans are not allowed to even offer Medicaid consumers certain mental health services even if the care is more accessible, better quality and or cheaper than the current state-run system.  

As one can imagine, it is impossible for Senator Nesbitt to completely lay out his arguments in a short editorial.  However, his editorial simplifies a very complicated system and needs context for understanding.  It is true that commercial health plans integrate mental health and physical health.  But what Senator Nesbitt does not explain is this:  

  • Commercial plans integrate care, but in the most simple of ways.  Most plans have only two benefits:  an outpatient benefit (talk to a therapist) and an inpatient benefit (hospitalization).
  • Michigan’s Medicaid plans do provide one mental health benefit.  A skinny, outpatient mental health benefit (talk to a therapist) where provider reimbursement rates are so low that private therapists typically will not accept Medicaid patients; and non-profit providers have to raise donor dollars to cover their costs.  All told, there are many people on Medicaid that need outpatient mental health and substance use services that cannot access services because the reimbursement rates are inadequate.  
  • The ‘antiquated government-run patchwork system’ that Senator Nesbitt describes is designed to serve individuals on Medicaid with severe emotional disturbances (SED). Moreover, it is designed to meet local needs, which is why it is county-based rather than state-based.  It provides an inpatient benefit (hospitalization) as well as community based care options. (The outpatient benefit – talk therapy – is provided by the Medicaid plan as noted earlier.)  Community based care options include services like case management; intensive outpatient services; community based, short-term crisis care; mobile response units, and other community based solutions.

Senator Nesbitt is right; our statewide mental health system needs reform and improvement.  Here is a list I would suggest:

  • Integrate the mental health plans, but create minimum reimbursement rates for services.  Specifically, outpatient provider rates need to be raised to cover costs.  Non-profit providers should not have to privately raise money to cover outpatient therapy.  Medicaid health plans say that they have an outpatient mental health service, but unfortunately few can access it.  Hence, each Medicaid’s plan for outpatient therapy either covers other physical health service costs, or is a profit making margin that the health insurance plans count on to return a profit to shareholders.  
  • Integrate the mental health plans, and mandate that Medicaid health plans provide community based care options.  We know that those with SED need more than outpatient therapy, but often less than hospitalization services.  These are the services that County CMHs and non-profit providers (i.e. Easter Seals, Hope Network, Arbor Circle, etc) specialize in providing.  Community based services save the state money because they keep people out of expensive hospitalization, residential care options and/or correctional facilities.  We need more community based care options available for everyone to improve lives and drive down the cost of care.  
  • Ensure reimbursement options include capitated and case rates.  Fee for service reimbursement incentivizes volume of care instead of outcomes.  Case rates require collaboration across services and systems (ie. housing, public safety, etc).  Outcomes should drive reform, not quantity of service.
  • Require that Medicaid insurers collaborate with law enforcement to maintain and expand mental health and substance use options within county correctional facilities.  Too often those that commit crime have undiagnosed or untreated mental health and substance use illness.  We can improve community safety by addressing these in correctional facilities.
  • Reduce the number of Medicaid plans available to choose from.  Medicaid plans require that consumers have a choice of health plans.  Choice is one of two plans, not one of five like it is in the West Michigan region.  The reality is that there is an administrative cost to deliver care.  Driving administrative costs down should be a goal of any reform effort.  Fewer plans should drive an efficiency yield, and provide more money for direct care services.   
  • Create fewer Medicaid regions in the state so that service options are similar throughout Michigan.  The unfortunate truth is that consumers in northern Michigan and the Upper Peninsula do not have as many licensed social workers and mental health clinicians to provide services as those that live downstate.  Therefore, the breadth of services Michiganders receive is limited if we continue to utilize geographic boundaries to deliver services.  Remove the geographic boundaries and open up services across the state.
  • Use data.  The Michigan Department of Health & Human Services (MDHHS) houses Medicaid claims data from across the state, and from different public systems.  Start analyzing it to find out what types of services drive outcome improvements recognizing there are holes in service.  Today we live in a world of data analytics.  MDHHS staff needs to take the lead and get to work.  Is it housing that drives improvements?  Certain community based care options? Medication? High quality providers?  Combinations of service, providers and medicine?  Get us 80 percent of the way there MDHHS, and lead the transformation.  Or get out of the way and let CMHs lead the integration with preferred Medicaid partners.  

Ultimately, Senator Nesbitt is right. We can do better for people who struggle with mental health illness and substance use disease.  Let’s remember this. Two Ideas to Consider:  

  1. Recognize the multiple challenges the current mental health system faces, and stop suggesting that the integration of physical and mental health care is ‘the solution.’  It is misleading.  It may be part of ‘a solution’, but human behavior and the social sector are much more complicated than any single public policy change.
  1. We need to do everything we can to engage people earlier in their journey with mental illness and substance use disease.  More accessible outpatient services.  More community based care options.  Less hospitalization and residential care.  These need to be our north star in any reform effort.  

Ideas to Consider #20 – The Poppy

As many of you know, I watch a lot of the English Premier League, and am a supporter of Everton Football Club in Liverpool.  Their tradition is strong, and for the past twenty years Everton has been intent on recruiting American players to the squad.  It’s the best of both worlds – great English football and tradition with stateside heroes like Timmy Howard, Brian McBride and Landon Donavan.    

For the past two weeks, Premier League teams have been wearing a ‘poppy’ flower on their uniforms as part of Britain’s Remembrance Day.  Further, before each match starts, team captains lay a wreath of poppies down in the center circle as a lone bugler plays in a silent stadium. It’s moving. It’s sobering. It’s respectful.

For years I have watched this tradition, and wondered why a poppy and why Remembrance Day instead of Veterans Day?  

Recently, I learned the poppy comes from a poem, In Flanders Field, by John McCrae.  In it, poppies arise and grow out of the death occurring in the trenches of Belgium during World War I (WWI).  An American WWI volunteer, Moina Michael, read this poem and vowed to always wear a red poppy as a symbol of remembrance for those who fought in and assisted with the war.  Eventually, at the National American Legion Conference of 1920, the poppy was adopted as a symbol of remembrance.  

And why Remembrance Day instead of Veterans Day? The British were the first to establish a day of celebration and remembrance on November 11, 1919 when the armistice was signed to end WWI.  King George V held a celebration at Buckingham Palace, and each year on November 11 at 11:00 a.m. a minute of silence is held in the British Commonwealth to remember the ugliness of war, the loss of life and sacrifices made.  During World War II, many countries changed the name to Veterans Day, while the British Commonwealth continued using the phrase – Remembrance Day.

This weekend I watched parts of a few college and NFL football games.  One of the things I noticed was the marked difference between how American sports and British sports observe November 11.  On the sideline, American football team coaches wore team colors in a form of camouflage.  A single, red stripe was added to the Dallas Cowboys helmet to make a red, white and blue stripe in the middle of the helmet.  Military planes flew across stadiums.  Parachuters descended onto fields.  For me, it was not a remembrance day, but a ‘celebration of military day’ designed to stoke feelings of patriotism and fervor for the United States.

In contrast, Remembrance Day sporting celebrations in the UK are simple and quiet. For me, they stoke deep feelings of sympathy toward the loss of life. Longing and loneliness for loved ones away fighting. The pain and hurt of war.  All of it comes from a moment of silence, a single bugler, and the beauty of poppies.  

Consider this statement.  It comes from a former pastor of mine.  ‘We are what we worship.’ In the case of November 11, do we worship war, planes, parachutes, and camouflage?  Or do we worship remembrance, sacrifice, and rebirth?  

I think it is telling how the public in America, the UK and Europe have diverged when it comes to looking at going to war.  Europeans remember the losses and costs of the battles on their continent.  We celebrate the idea of victory, strength, and conquering the other.  

My Idea to Consider is this:  Language and symbols matter. They define our vision and values.  We have choices to make each day.  Let’s choose wisely what we want to worship.


Ideas to Consider #19 – A Community Rock: Wayman Britt

In July 2005, my life changed for the better. I started working for Wayman Britt.  For 15+ years we worked together as a team.  He was the Head Coach and Captain. I tried to be one of his go to players.  Last year, my health caused me to retire early.  On Thursday, July 22 I am fortunate to attend Wayman’s well-deserved retirement party.

It is hard to describe how fortunate I was to participate with, learn from, and experience several incredible adventures with Wayman. Some events that come quickly into my mind:

  • The beginning of the West Michigan Sports Commission.  
  • The quiet and loud conversations that created the Kent School Services Network and KConnect. 
  • The collaboration with the Road Commission to create a soil erosion ordinance.  
  • The detail required to figure out how to merge Kent County’s Community Development Department and Housing Commission with West Michigan Works! Community Action Division to create Kent County Community Action.  
  • The relationship building skills necessary to see specific millages passed for veterans and early childhood services while increasing the senior services millage to expand its reach.

I also saw his passion emerge as he worked day after day to reduce racial disparities and the ‘pipeline to prison.’  His connection to urban Scouting and the significant fundraising he did and does to support opportunities for young people has been and continues to be incredible.  Wayman’s behind the scenes leadership to get Grand Rapids University Preparatory Academy (GRUPA) off the ground is a story that needs to be shared more broadly.  Without him, I am not sure it would have happened.  He had the right linkages to business, philanthropy, and public institutions to make it work.  The effort that he and another colleague in our office did regarding alternatives to incarceration by the 17th Circuit Court and Sheriff’s Office was priceless. Along with the judges, Court Administrator Jack Roedema and Sheriff Larry Stelma, they showed how Kent County did such a good job with successful alternatives that the Board of Commissioners accepted the recommendation to replace old dilapidated jail beds, instead of the presumed outcome that the County needed to increase the number of jail beds.  Today, the Court and Sheriff’s Office continue their efforts and the Correctional Facility average census is less than it was in 2007 when they issued their report.

Another skill I saw time after time was his negotiating prowess.  I saw him negotiate and close a complex deal with the State of Michigan, Grand Rapids Public Schools, the City of Grand Rapids, West Michigan Works!, ICCF, and community neighbors to get the Kent County Human Services Complex built which improved services to tens of thousands residents annually.

We also spent a good year working on and chasing down $100 million in a federal grant competition related to GR Whitewater, parkland acquisition, and other resilience related projects only to learn we did not get it.  Unfortunately, the federal announcement came the same week the Flint Water Crisis hit national news.  How do you give Kent County municipalities $100 million to improve flooding resilience when another community in Michigan cannot deliver clean water?  The optics were terrible and the federal award went to another community.  Talk about going from a high to a low in a matter of a few hours when we learned what happened.  But Wayman reminded me continuously how we could use what we learned because we went through the submittal process.  His perspective during difficult times often turned a defeating moment into an optimistic vision.

Wayman trusted me to lead a process to improve Michigan’s child welfare system by creating a data-driven, accountable system.  In some ways, this turned into a battle (my word) against many entrenched institutions (where one person with significant power told me they would ‘like to rip my heart out’).  Ultimately, the West Michigan Partnership for Children was created.  

One of the most important memories I have about my time in Kent County was related to this effort.  Wayman testified in Lansing on child welfare policy, and after his remarks we walked from the hearing to the Capitol for the Governor’s State of the State address.  There, we saw first hand how power works and the reality we were up against.  As we walked around meeting state Senators and Representatives from both parties, our noses led us to a smorgasbord of incredible food.  Prime Rib provided by XX Bank. Shrimp Cocktail on behalf of XX Corporation.  Dessert tray and fruit provided by XX Law Firm.  When we walked back to Wayman’s car that cold February night, we heard protesters in the distance chanting ‘Stop the Foreclosures’ outside of the State Capitol.  It was February 2008, and little did we know yet that the Great Recession was in its infancy.   

As I remember it, we both remarked that we were in a unique spot caring about and for abused and neglected children in the midst of the grandeur we just experienced.  And as we drove home, I kept thinking about how we would need to break through the time challenges of legislators who were bombarded with issues related to the financial interests and power of corporations that could spend lavishly.  This was going to take some incredible effort.  Fortunately, Wayman has the most incredible endurance and tenacity of anyone I have ever met, and we broke through.  It took almost a decade from that hearing to when WMPC was officially launched.

Last, before the pandemic raged its ugly head and my illness flared again, we were digging into difficult, county operational areas.  We prepared a Facilities Plan that replaced a ridiculously outdated Parks Office trailer with a modern, first-class building (I understand that it’s on track still) while also recommending the creation of a new Fleet Management facility and a combined northern Kent County outpost for the Sheriff, Health Department and other County departments. We were also ready to share plans on a new downtown County office building along with a revised Master Plan for the County’s Fuller Campus.  

We also began the groundwork to review another divisive issue – the Purchase of Development Rights (PDR) – by considering other options like the Transfer of Development Rights (TDR), and the impacts of housing policy on farmland. To do this, we made a change to the staffing model and insourced the staff position after the program used an outsourced consultant for roughly 20 years.

That’s a lot of teamwork in 15+ years.  But there is so much more.

My language changed during the course of my relationship with Wayman.  I learned the term ‘Running a Boston’.  I started using ‘Waymanisms:’

  • For my children:  ‘Be a leader, not a follower.’  And ‘Embrace the work.’
  • For my wife and other close friends:  ‘We have to learn how to tell people what they need to know, but in a way they can receive it.  We have to learn how to step on their shoes without them losing their shine.’
  • In meetings:  ‘You are who you are because of what you were when’ or ‘A system is powerfully designed to get the results it gets’
  • With close colleagues talking about teamwork:  ‘Two heads are better than one, even if one is a butt head.’
  • In my mind talking to myself:  ‘Lean into the conflict.’

I met incredible people from the national stage solely because I worked for Wayman, and we always tried to learn from them:  

  • University of Michigan Athletic Director Bill Martin and Senator Richard Lugar when we were preparing the Sports Commission report
  • The real Coach Boone of ‘Remember the Titans’ fame on education and opportunity prior to when he spoke at the Fair Housing Center Luncheon.
  • Senator Gary Peters and Secretary Julian Castro on the environment as were researching the $100 million grant opportunity.
  • Coach John Beilein of the Michigan Wolverines on teamwork and culture (Fortunately, we met three times …. I definitely benefited from having a boss who has the Michigan Basketball Defensive Player of the Year Award named after him!)

As leaders, many of us have read or heard about the leadership traits Stephen Covey describes in his book:  The Speed of Trust ( i.e. – Talk Straight.  Demonstrate Respect.  Create Transparency.  Right Wrongs.  Show Loyalty.  Deliver Results.  Get Better.  Confront Reality.  Clarify Expectations.  Practice Accountability.  Listen First.  Keep Commitments.  Extend Trust).  In my view, Wayman has and will continue to live out these principles.  

He always showed up for me when I was sick and ended up in the hospital, and then went beyond to call my wife to check in on her and the kids too.  He demonstrated respect to others even after they disrespected him.  I remember calling out several people because of race related comments they made that I found to be insulting toward Wayman.  While I was hot, angry and bothered, he was able to somehow brush it off his shoulders like President Obama described.  I know it hurt him, but he kept moving forward despite it.  Doing the work, the hard work to make this world a better place.

This website/blog was created to discuss public policy and ways to make the world a better place.  This week though, it needs to be dedicated to the public career of Wayman Britt.  My idea to consider this week is this: 

  • Let’s look inside ourselves and figure out how to live a life similar to Wayman Britt.  

His public leadership will be missed, but I’m confident that the important things he does behind the scenes will continue forever.  It is who he is.

Thank you Wayman for being such a rock in my life.  I will forever be grateful.


Ideas to Consider #18 – Healthcare in America

It hit me like a sledgehammer a few weeks ago:  Americans are dreadful at making healthcare decisions and constructing sound health policy.  

A couple of vignettes:  

#1 – An adult walks into an urban hospital emergency room; undergoes a quick triage to ensure he is not having a heart attack; is told to wear a hospital mask and sit over there (a large entry area with chairs six feet apart from other waiting patients).  For over three hours he sits near a man and women in their 50s and a senior citizen, perhaps 80.  During this time he finds out the two adults are brother and sister, and the senior is their mom.

He learns they came to the emergency room about an hour before he arrived and have been trying to keep their mom from throwing a fit.  It is clear she is agitated, and frustrated like she does not want to be there.  Eventually a nurse comes to take her to see a doctor, and the daughter leaves with her.  After they leave, the son shares: “Mom has Alzheimer’s and came down with a cough.”  He goes on, “With all the COVID out there, we thought she better be seen to make sure she doesn’t have it.”

#2 –  While the adult is sitting uncomfortably, in deep pain and trying to remain calm by taking deep breaths, a nurse starts chatting with a woman who looks pretty rough.  Dirty, disheveled and generally unkempt. It is not that cold outside, but the woman is wearing layers of clothes.  Everyone can hear the conversation between the nurse and woman.  They clearly know each other.  The nurse asks “What’s up tonight?”  The woman says she is really tired and cold, and her head hurts.  The nurse explains that it will be hours before she is seen because they are so busy.  The woman says ok and asks for some pain medicine.  She’s told no, and raises her voice, clearly frustrated with the answer. 

#3 – After three hours plus, the adult waiting in the emergency room is seen by the attending doctor and eventually admitted to the hospital two hours after seeing a doctor. The hospital room is located on a floor which has been transformed from a short stay unit (less than 36 hours) to a COVID plus unit.  Some of the rooms have been retrofitted to serve COVID patients, while others serve traditional hospital patients.  The next morning the patient notices that some of the rooms have been retrofitted with small enclosures (i.e. somewhat like a screened in porch, but with thick plastic and storm doors) where staff can change into and out of personal protection equipment (PPE) before entering the rooms.  The inside of the rooms are super modern, and have a pulley system over the bed to help staff move people in and out of bed. In bold letters, the pulley system has a little sign on it:  “Rated to 400 lbs.” 

After a few days, the patient learns that the short stay unit increased its staffing levels to address the super sick patients. Expensive, visiting nurses were hired from around the country to support existing staff who had to undergo extra training to effectively assist the COVID patients.   

If you know my story, you may have guessed by now that these experiences involved me during my most recent 11 day hospitalization.  And yes – that is correct.  I experienced all of this and more.   

While I was hospitalized I saw the absolute best of American healthcare.  The incredible acute care system where creativity, research, deep science along with technology, skill, art, and ingenuity come together to keep people with healthcare challenges like me alive.  Yet, I also saw the absolute worst of American health policy and culture.  The unnecessary use of the ER system.  The refusal to treat one’s social determinants of health (i.e. homelessness, substance use, food insecurity, et cetera) to assist a patient’s physical and mental health needs. The obesity epidemic which requires hospitals to install pulley equipment in each room to move patients. The inability to stop spreading a virus by masking up, washing hands, and physically separating.  

All of the choices described previously – individual healthcare choices and policy makers choices – increase the cost of our healthcare system by billions of dollars per year.

Instead of going to the ER in the absolute middle of the night for an elderly, mentally and physically challenged woman with a cough to see a doctor due to the fear of having COVID, we need to ensure that each person has a medical home.  A place where a primary care doctor, physician assistant, or nurse practitioner knows their patients well, and can see them within a day.  This may require us to: Train and hire more doctors, PAs or NP; Eliminate medical school debt; or Increase primary care reimbursements.  But this shift in funding would be less expensive than having people visit the ER when there is not a need. 

Instead of having frequent fliers visit ERs due to homelessness and all of the complications life on the street creates, let’s create more supportive housing.  Our housing policies and funding models need to change. We have a wrong pocket problem where hospitals, law enforcement and others end up serving many of the least among us at gigantic costs with terrible outcomes.  Instead if we shifted a portion of the money to supportive housing programs, local, state and the federal government could save taxpayers millions of dollars annually.  For it to be a net savings though, entrenched bureaucracies in healthcare, law enforcement, and certain non-profit industries need to get to ‘Yes in their Heart’ so positive change can occur that may reduce their funding, but help improve people’s lives (which is a goal of public service).  

Instead of subsidizing corn production (as in we need more and more corn syrup to serve as a sweetener in everything), we need to modify our food production model.  How can we incentivize less processed food production, and start supporting the production of more fresh fruit, vegetables, and natural production.  Obesity and its byproducts of diabetes, heart disease, and hypertension cost our healthcare system billions of dollars annually.  (Not to mention the cost of building extra wide doors as well as buying extra large furniture and pulley systems in hospitals.) I am sure this type of change will gore someone’s ox, but courage is necessary since we are seeing life expectancy drops due to the impacts of obesity.

And last, we now have a pretty incredible solution to COVID:  proven vaccines.  At my last count, there are four vaccines which have been developed and approved by regulatory agencies in the western, first world (Pfizer, Moderna, J&J, Astra Zeneca) and two vaccines developed and approved in second world countries (Russia and China).  Science works.  And simple lifestyle changes like wearing masks and washing hands can prevent the spread of COVID as well.  

My idea to consider this week is this:  Let’s move our healthcare system toward a prevention model. Our nation’s hospitals are absolutely incredible.  A true national treasure.  Moreover, our acute care healthcare system will do all it can by providing incredible resources (physical, people, and financial) in an effort to save one’s life. I have personally benefited from this reality.  But so many of our public healthcare challenges can be solved by employing different strategies.  

I would like to see us start this journey with a bit of humility, and begin by taking a problem solving approach to healthcare instead of maintaining our current winner/loser approach.  I know we can do it.  Remember there was a small celebration a few weeks ago where adults and teens from different cultures, traditions and sectors come together to create beauty.  Let’s do it together now on something larger and more complex to improve the lives of so many.


Ideas to Consider #17 – A Small Celebration

We all know the past 15 months have been a slog.  COVID-19.  A summer of necessary protests after the deaths of several unarmed, African-Americans by police.  Economic challenges for many.  A difficult national election.  Insurrection.  But last Friday night – ah, a small, but absolutely wonderful celebration.  Let me explain.

I was at Holland High School’s Vocals Dimensions 2021 concert called Vocal’s Still Standing.  In case you are not aware, the Vocal Dimensions are a renowned show choir, started by a wonderful public school teacher, Kerry Daab, some 41 years ago and led today by Sarah Malone. On stage were 18 incredible students, singing and dancing, telling bad jokes and performing a silly skit or two.  They were full of smiling eyes, in masks, enjoying themselves and making the large crowd grin from ear to ear.

As the choir members sang their last song – Elton John’s I’m Still Standing – tears of happiness started to flow.  In front of me was everything that is right about our country.   Exceptional students whose families came from all over the world.  Cambodia. Mexico. The continent of Africa. The Netherlands and multiple other countries from around the world.  All of them, living right here in Holland, Michigan.

Further, these students demonstrated the incredible resilience that Americans have shown for generations.  They have thrived despite the pandemic, enduring multiple quarantines and changes in public policy about the dangers of singing and rehearsing during COVID to create and perform an amazing show at an incredibly high level.  And they are going places too. Two students received prestigious scholarships to attend Hope and Kalamazoo Colleges.  One is heading off to learn about auto mechanics, and engineering.  Another to Grand Valley State University for physician assistant studies.  Et cetera.  Et cetera.  

But the story gets even better.  Due to the necessary COVID-19 restrictions in place regarding inside performances, the Vocals needed a place to perform outside.  And who stepped forward – a church.  Holland’s First Reformed Church hosted a week of evening rehearsals with nightly teenage dinners, sound equipment being moved in and out daily, multiple supply drop offs, and three weekend shows.  Moreover, the church streamed all three shows so extended family members and others who could not travel were able to enjoy the show live.

And last there is the financial reality of making this all happen. It takes money to produce a show, and selling tickets typically offsets the upfront cost and makes this annual show profitable.  In fact, the Vocal Dimension’s spring concert is the largest fundraiser for Holland Public Schools Vocal Music Department which helps to defray the cost of travel to music festivals, and the like.  In 2020, the concert was canceled which required ticket refunds.  And with the uncertainty of whether a concert could go forward in the ever changing environment, selling tickets did not seem like a prudent move.  But local businesses stepped forward to sponsor the show so that it could be a donation only event.  No tickets required. A community gift.

Back to my tears of joy.  I think we all know that there are ways our community, state and country can improve.  But in that one small moment, I saw the absolute best of our community, Holland, and frankly our country.  Diverse students coming together in an exceptional manner to perform incredibly and provide pure fun for all. The performing arts acting as a gateway to further education, careers, and engaged citizens. The faith community stepping forward to assist local, public schools.  And multiple local businesses investing in the community by providing necessary seed money to get the ball rolling.

This is what we are capable of when we decide to work together.  A diverse, strong community flourishing, full of hope and opportunity for everyone.  

I caught a glimpse of that reality on Friday night, at an outdoor concert, in a church parking lot.  It was beautiful. 


Ideas to Consider #16 – The Past Month

When I started this project in October 2020, I intended to write a weekly essay/column about the social sector.  Well – that has not happened, and I imagine you are wondering what has been going on during the past month because it has been a while since I posted a piece.

The truth is I have found that completing a quality piece takes more time than I have given this project. It requires reaching out to community leaders, conducting research, and writing about timely issues.  My reality has been that between not feeling well, prioritizing wellness activities (walking, lifting weights, stretching, naps, healthy eating) and living life, writing for IdeastoConsider.com has not been the top priority.

Additionally, I have to admit that events during the past few months have frustrated me beyond the normal.  

  • Listening to people rant against the Covid-19 vaccine, and then seeing the Covid infections increase dramatically makes me want to rip out the remaining hair on my bald head.  Please, get the vaccine and wear a mask.  I want to visit people freely this summer and not worry about acquiring Covid due to my underlying health conditions.
  • Seeing elected officials support Marlena and her bistro in Holland, Michigan while she flaunted breaking the law by refusing to close her establishment makes me angry.  Her choices help the virus spread which harms others, especially children when they cannot attend school in person.  
  • Watching the inability of elected leaders to negotiate and compromise about Covid and Infrastructure legislation shows that we lack leaders.  Our political system seems to attract individuals who quest power to meet their narcissist needs.  

This ongoing frustration has made me wonder…Do ideas matter anymore?  Does policy matter?  Who in politics is interested in solving problems rather than finding wedge issues to exploit in some way?  What will it take to change the conversation?

Fortunately, some positive things have happened to me personally during the past 30 days.  I’ve been able to meet with a few former colleagues in Grand Rapids to discuss community efforts, and how to create positive change.  Someone reached out to me about a potential board appointment.  I’ve been able to spend some quality time with my family and college friends.  And my Social Security Disability application was approved.

My Idea to Consider this week is:  For those that are struggling with the noise in Lansing and DC, take a look at what is happening locally.  Good people are working hard to improve the local condition. Yes, we need support from elected leaders in our state capitol and DC, but in the meantime, thankfully we have the opportunity to connect with friends and colleagues to create the world we want locally. 


Ideas to Consider #15 – Affordable Housing Continued

In Ideas to Consider #12, I wrote about housing affordability and the City of Holland’s efforts to update its zoning ordinance.  As I shared, there has been plenty of community pushback with yard signs popping up throughout the town – ‘No to Rezoning’ and letters to the editor claiming that property values will decrease, and Holland will become ‘like Chicago.’

Since my last post, the pushback continues.  More signs.  More letters claiming property values will decrease and the world as we know it in Holland will end.  The same fears over and over magnified louder and louder.

Interestingly, the Salt Lake Tribune published an article on February 22, 2021 entitled: ‘Yes’ in my backyard?  Study shows new Salt Lake County apartments actually boost neighbors’ home values.  In the article, its author Tony Semerad, notes that a University of Utah study found that ‘Homes in Salt Lake County located within a half-mile of a newly constructed apartment building rose by 10% in median value per year between 2010 and 2019, and those farther away rose by 8.6%.’   It further notes that:  ‘While many stereotypes and generalizations about negative impacts are brought up in public settings, high-density development does not actually appear to depress home values.’  (See https://www.sltrib.com/news/2021/02/22/yes-my-backyard-study/?fbclid=IwAR1iP8nXVX8C7jnhoIEI_dg2KQRpqcK6S1wn-eDFP4sp9t5opw06NcIipNk)

Here is my Idea to Consider this week:  It is time to stop fear baiting.  Everyone.  Any side of any aisle.  Let’s use data to drive decisions that help people.


Ideas to Consider #14 – The Slog is Real

The past two weeks have been a real slog, despite the glorious sunshine.  I have not felt very well, and continually exhausted.  Sleep is healing, but too much is frustrating.  And when you do not feel well, your body demands sleep.  Yet, for me too much sleep makes me feel unproductive, which yields lack of purpose and the feeling of ‘yuckiness’.  Moreover, in all of my reading and research, having ‘purpose’ is essential for finding happiness and joy.  Conversely, individuals without purpose are at increased risk for depression and anxiety.

This recent slog has helped me clarify some thinking about COVID-19, and the unending conversations about what we can and cannot do in this pandemic:  

  • Can or should we visit grandparents?  
  • Is it ok for high school sports to start?  
  • When can we go out to eat again? 
  • Can we travel for Spring Break? 
  • Will there be festivals or concerts this summer?
  • Is it ok to go to church?  
  • When will the kids go back to school?  (Depending on where you live, this is probably the most important!)

Then there are the economic issues surrounding furloughs, layoffs, unemployment insurance, health insurance, potential evictions, staying current on investment property payments, the solvency of a small business, etc.  

All these questions and concerns create uncertainty for individuals and families.  And again, based on my understanding of mental health, uncertainty is a significant factor for risk of depression and anxiety.  

And then there is the issue of mask mandates, which is becoming the topic du jour again with Texas and Mississippi lifting mandates and ending most COVID regulations.  This issue, to wear or not wear a mask, along with the argument about whether the government has the authority to tell me to wear one has divided families, neighbors, and communities like no other issue I can think of in my adult lifetime.  

Day in and day out, we are surrounded by the need to determine purpose, continual uncertainty, and an unending argument about a piece of cloth that covers our mouth and nose which will keep us safe.  I know for many of us, life is a slog right now because we are tired and yearn for our normal life again.  

During the past two weeks, this slog has come to a head in our political life in DC and Lansing.  President Biden’s proposal cannot win any GOP support.  Governor Whitmer and the GOP led legislature are bickering over appropriations and tie-barring money to changes in who has the power to open/close businesses.  Yet, ‘regular people’ (the kind that Theo Huxtable defines in that classic Cosby show episode) are struggling with real uncertainty and financial worry.

This inability to work together across party lines and solve real world problems is harming our communities in ways that I do not think we will understand for years and maybe even decades.   (Trust is at an all time low.  No one is willing to give each other the benefit of the doubt.  It seems as though we no longer have any type of shared understanding or life together.) In the meantime, what I do not understand is why our elected Michigan leaders cannot come together and rally around the following:

Hospitality Small Business Support.  Clearly, the pandemic has leveled the hospitality industry.  With the significant cash infusion coming from DC, the Governor, Legislature and Hospitality/Tourism Associations could create clear metrics regarding loss revenue for restaurants, hotels, performance venues and/or art organizations and develop a program to ensure business viability until herd immunity occurs later this summer.  Stop arguing about what percentage a business can be open, and get the financial support to where it is needed.  We are almost to the end of this pandemic, let’s stay safe and help our neighbors rather than spending time arguing about who is right in opening/closing certain businesses.

Eviction Prevention.  Each county in Michigan is served by a Community Action Agency (CAA).  Enlist the CAAs to work with District Courts, tenants, and landlords to lighten the loads on landlord/tenant claims in the District Courts, and ensure that tenants are not evicted when the federal moratorium ends as well as landlords receiving needed payments in a timely manner to ensure they do not default on mortgages tied to an investment property.  We need to prevent homlessness, protect credit, and limit foreclosures.

Education Support.  The Michigan Department of Education (MDE), Michigan Education Association (MEA), American Federation of Teachers (AFT), Michigan Superintendents Association, and Legislature need to create program(s) to address the learning loss that is happening across the state.  No matter whether students are in-person, virtual, or in some sort of hybrid model, the past three semesters have negatively affected students.   As a result, a wide variety of additional supports are needed to address the corresponding learning loss. Our students need support like: Free Summer School. On-site before and afterschool tutors in the 21/22 school year.  No cost trauma based mental health therapists.  What is essential is that there is alignment between teachers, administrators, public policy and funding.  No one will get everything they want, but students and parents deserve a coherent, comprehensive program to assist them in overcoming the learning loss that has occurred during the past three semesters.

We are all tired of the slog.  Lord knows that I am.  But we need to keep fighting and moving forward because we can see the light at the end of the tunnel.  Let’s come together and finish strong, helping our neighbors rather than chastising them.  If we do, Michigan’s residents and businesses will emerge from the pandemic with a strong sense of purpose and certainty that we are in this together, ready for whatever opportunity or challenge comes next.  Michiganians are a gritty bunch.  Let’s do everything we can to build each other up.


Ideas to Consider #13 – Ah…a Public Policy Discussion. Go Senator Romney and President Biden!

It was 1995 and I was in a public policy class.  Newt Gingrich’s Contract with America was all the rage and one of its components included reforming welfare.  We were sitting in a circle discussing potential welfare reform options and what should be included in the upcoming legislation.

Dr. R, an outspoken Republican professor who always wore his capital ‘R’ belt buckle to the right to make sure people knew he was right leaning, was facilitating the discussion.  At the time, it was fairly well known on campus that I was a Republican.  But I was also a sociology major that was coming to terms with the reality that private charity could never replace government spending to support lower income families. The numbers did not work. Yet, I believed the existing system did not work either and supported significant reform.

Many of my fellow students argued for work requirements to receive financial support; Cutting off aid after some time period; Eliminating fraud and abuse.  Pretty standard suggestions.  And in my view, boring recommendations that lacked creativity.  

I suggested something which was considered radical by my peers. Eliminate the social safety net completely.  All the programs. Food stamps.  Aid to Families with Dependent Children (AFDC).  Commodity programs.  Everything, including the bureaucratic workforce who was more worried about program compliance than supporting their neighbors.  As a replacement, I suggested that the government provide direct, universal payments to Americans which would act and guarantee a base income for everyone.  Any other financial support would come for private charity. 

When seriously questioned about this by my peers, I argued that:

  • My proposal would provide everyone with a base to live, and free people from the negative judgment of others. 
  • I argued that it was a conservative proposal because it provided stability to meet people’s basic needs, and allowed them to make personal choices about caring for children either by staying home or working and paying for childcare. 
  • I stated it would allow people to pursue dreams that may be risky but while pursuing it the basic income would ensure that people would not need to worry about becoming homeless. Moreover, when some of these dreams become successful they will create important businesses that yield jobs and tax revenue.  
  • I argued it would be administratively cheaper to have cash transfers rather than employ thousands of people to ensure program compliance, and make determinations of who is and is not eligible for assistance.  At the time the Internet was emerging, and I made the point that it could provide opportunities to drive down administrative costs even further.    

Of course, I was not able to ‘sell’ this idea to my class.  It was too radical for the time.  Too outside the norm.  In fact, it was the first time I heard the term ‘RINO’ because I was called one by several of my classmates.  Fortunately, Dr. R reminded the class that there were different types of Republicans, like Rockefeller Republicans.  And he supported my creative thinking as it related to public policy options.

In the past few years, my 1995 idea has been brought back to life by Andrew Yang and his idea of the Freedom Dividend.  (I don’t think he supported getting rid of the social safety net though.)  And now, Senator Romney and President Biden are both talking about direct payments in the range of $350 a month per child to Americans with young children.  Senator Romney reorganizes existing appropriations into this payment so it is cost neutral.  President Biden’s proposal is part of the Covid-19 relief plan, and does not seem like a transformational reform but an add-on to the current system.

My Idea to Consider for today is this:  Hallelujah!  Let’s have a discussion about a public policy reform that could really assist young families.  Personally, I prefer Senator Romney’s initial ideas because it is a real reform instead of just more.  It is universal so it removes stigma.  And it allows families options that work for them.  There is not judgment whether a mom or dad stays home to care for children, or whether they decide to work.  There is not judgment if they invest these funds into a child’s post secondary education.  There is not judgement if they utilize these funds to move into a house that happens to be in a better school district.

It is exciting to know that someone is thinking about ideas that can improve the social condition.  And that a similar idea is coming from a Republican and a Democrat provides a glimmer of hope that we can work together as Americans and not only as partisans.  Ah…a Public Policy Discussion.  Go Sen. Romney & President Biden!


Ideas to Consider #12 – Housing Affordability

Throughout West Michigan there is an ongoing conversation about the increasing cost of housing, and what to do about it.  

From what I am reading, housing costs are increasing for several factors:

  • Rising commodity prices for items such as lumber, OSB, shingles, copper, et cetera
  • Low interest rates which drive down monthly payments
  • Limited workforce availability
  • Limited supply of available units

Of these four issues, local policy can influence the last two:  limited workforce availability and supply of available units.  Currently, limited workforce availability is something that the education community, workforce development agencies, unions, and the State of Michigan are working on diligently through aggressive marketing, communicating job opportunities, and their associated good wages.  I see an increasing number of students interested in the construction trades, and believe that West Michigan Works, Kent ISD, and the Ottawa Area ISD (among others) are doing a wonderful job promoting the trades and demonstrating the career opportunities available.

In terms of the limited availability of housing units, this is a clear policy issue that currently rests in the hands of local planning commissions and elected township, city and village boards.  State law permits townships, cities and villages to create zoning ordinances which regulate what type of housing can be constructed and where it is allowed.  Zoning ordinances also regulate commercial, industrial and agricultural land use.  All of the zoning ordinances must comply with state and case law, which provides some limitations for local units of government.  But there is significant freedom for local units to craft their own zoning solutions.  

In the City of Holland, the Planning Commission has been working on a rewrite of its zoning ordinance which would permit different types of housing units within its traditional residential zoning.  Options like adding smaller cottages on larger lots, apartments above garages, and/or basement units like ones promoted on HGTVs Income Property.  The Planning Commission and local housing advocates argue that traditional single-family housing development does not meet the needs of today’s consumers.  Families are not necessarily two parents, four kids and a Golden Retriever which require a minimum square footage requirement of 2500 square feet.  They can now be a single dad with a daughter and shitzu who need 1200 square feet.  Or grandparents that want privacy, but also want to support their daughter’s family by living in an attached unit.  Or newlyweds that wants to build an apartment over their garage to help cover the mortgage and provide reasonable housing for a college student, single adult, or senior resident until a time they are ready to use that space for a home office.

The pushback from some existing residents has been significant.  Yard signs say ‘No to Rezoning’.  Letters to the editor in the local paper claim that property values will decrease.  Another letter stated that they moved to Holland to get away from the terrible density of Chicago.  Recently, a letter noted that 1300 units are currently under construction in Holland to meet the housing demand so why make zoning ordinance changes that increase density and permit more rental units.  Moreover, the Holland Sentinel reported on February 18, 2021 that the Holland Planning Commission is considering revising changes to the rewrite to ensure incremental progress rather than having the proposed changes all lost.

Personally, I think the discussion about zoning ordinances, the type of housing needed, and what is permitted where is long overdue.  Additionally, the push-pull of the discussion is healthy if done well.  There is a need for a robust discussion about zoning practices, their impact on costs as well as clarity in purpose on why changes are or are not needed.  This is small ‘d’ democracy in action.  However, the problem is that the discussion is limited to ‘Holland’ because frankly what does Holland mean?  

Does it mean the City of Holland?  Or the City plus Holland Township and Park Township which together are commonly referred to as the northside.  Or what about Laketown Township, the City of Zeeland and/or Zeeland Township which are adjacent to the City of Holland and the northside communities?  Together they make up the Macatawa Area Coordinating Council (MACC) which is the regional metropolitan transportation area and in sum about 100,000 people.  And don’t transportation systems and patterns along with zoning have a symbiotic relationship with one another?   

By the way, where are the 1300 units under construction in ‘Holland’ that was referred to in the letter to the editor?  By eye-sight, I would suggest that the majority of them are in Holland Township whose population is larger than the City of Holland, and has its own planning commission and elected board.  Further, many of these proposed units will be in large apartment complexes rather than dispersed among a larger geographic region.  If history is a guide, they will become hot spots for police calls and the outside investors will not maintain them nearly as well as those that call West Michigan home.

One of the realities in Michigan is that there are over 1200 townships, 270 cities and 250 villages each with its own ability to create zoning ordinances.  This creates a haphazard pattern of development that does not promote cohesive land use patterns, limits the ability for productive agriculture, and basically creates a NIMBYISM (Not in my Back Yard) mentality.

My idea to consider for today related to Housing Affordability is this:  Local elected officials need to have the courage to jointly create regional zoning ordinances with robust public engagement.  

In the greater Holland area, I don’t think people want more 120th Avenue and 136th Avenue Apartment Complex development.  I don’t think people want traditional ‘duplexes’ either.  They want creative solutions to housing affordability that maintain architectural character, natural amenities, and connections to neighbors.  I think that can be accomplished through unique market-oriented solutions if zoning regulations become more flexible.  It’s time for leaders to lead together for the benefit of the 100,000 people that live in greater Holland and expand the conversation beyond the City of Holland geography.