Splitting from the four-county district health department may not be such a good idea for Mackinac County, Commission Chair Dawn Nelson is now saying. She told other commissioners at a meeting Monday, November 23, that she is not sure that splitting from the Luce, Mackinac, Alger, Schoolcraft (LMAS) District Health Department would be in the best interest of Mackinac County.

She and Commissioner Calvin "Bucky" McPhee, who both represent Mackinac County on the LMAS health board, had announced last month that they wanted to split from the agency after reports surfaced that the department is being investigated by Medicare for overcharging and might be liable for reimbursement. They held a public hearing November 4 to test the wind, but offered no information about how Mackinac County would operate its own health department or what it would cost. Mrs. Nelson said then that the Michigan Department of Community Health had given the county permission to split.

Monday, Mrs. Nelson said that after she spoke Friday with attorney Dave Stoker of the Cohl Stoker Toskey and McGlinchey law firm in Lansing about a split from LMAS and the formation of a separate health department, she is unsure how much it would cost the county to follow through on the action. She told The St. Ignace News that the county will have to pay $84,000 to remain with LMAS, but does not know how much more it might cost to operate an independent health department, or how much it may cost to break away from LMAS.

Several other matters will have to be negotiated, she said, such as how, or if, assets would be divided if a separation were to occur. The county has paid for cameras, laptop computers, and printers, but she doesn't know if the county could keep such equipment if it were to leave LMAS.

Mrs. Nelson refused to say what Mr. Stoker said to her concerning the split and also refused to comment on what legal steps would have to be taken before the division could occur.

Mr. McPhee said he does not expect any action to be taken on the matter for at least six months while the issue is examined further.

The other commissioners continue to support a split from the struggling department. Commissioner Mike Patrick said he thinks overcharges could again be billed by LMAS and that the county should follow through with its original plan to leave the department. By establishing its own health department, he said, the county would have greater control and would be able to provide a greater degree of oversight.

Commissioners Carl Frazier and Lawrence Leveille also continue to support leaving the department, but Mr. Leveille said the commission must ensure that leaving is the right thing for Mackinac County.

Mr. Frazier said at the commission's November 12 meeting that LMAS was struggling back when he had served on the board and he fully supports the split.

In a letter from the Curtis Area Chamber of Commerce that was read Monday, John Townley said his membership advises against a split and explained Curtis has received "expedient and excellent service from them in the past," and that it would be difficult for residents of the township to travel to St. Ignace to receive service. The letter asked the board to take those who are happy with LMAS service into account when arriving at a decision.

The chamber letter is not the first show of support for LMAS from Curtis residents. Pat O'Grady of Curtis said during the November 4 public hearing that he received excellent service from the Newberry office and that he could not support a split with the limited information offered on the proposal.

Mrs. Nelson said Monday she would like to see home health offered by a Mackinac County health department if the county were to leave LMAS. Commissioners have received calls from constituents saying they would like to have the service, she added.

Home health was a major factor in the troubles LMAS experienced, particularly with Medicare overcharges, and it is not a required service of district health departments in Michigan. Mrs. Nelson said that if the county handled it, it would have more control over the service and could provide more oversight. She did not say how.

At the November 12 meeting, Al Garavaglia, supervisor of Hudson Township, told commissioners he is concerned about how the funding required to start a new health department would be obtained, and inquired about how service would be provided to the western portion of the county.

Mrs. Nelson suggested at that time that Mackinac Straits Hospital, with a clinic in Naubinway, might be able to offer some services.

She also alleged then that LMAS administrators fed selective information to the county commissioners who sit on that health board, so they were not aware of the extent of the financial problems at LMAS.

Commissioner Frazier assured citizens November 12 that the county would investigate the costs involved in leaving LMAS.

"We're not going to just jump in the water and try to swim," he said.