Gov Mulls How To Enforce Mask-Wearing
Gov. Gretchen Whitmer said July 9 she is reviewing the state’s current mask-wearing requirements to consider “whether or not we need to take this a step further to strengthen compliance.”
The governor led off her COVID-19 update press event with a picture from the Diamond Lake sandbar party from the over the weekend and said she wanted to make it “very clear” the law still requires people to wear masks in enclosed places of accommodation.
“Make the mask. Make the mask with a political statement saying ‘I hate masks’ if you want. But just wear it,” the governor said toward the end of the press conference.
Whitmer said “we do actually have penalties under the law,” but it comes down to enforcement, which she said comes at the local level. She said “we have the ability for a misdemeanor and a fine” but she said she is considering what’s going to be the “most helpful to encourage compliance.”
She added that “the last thing I want to do is be doling out lots of penalties.”
Meanwhile, Chief Medical Executive Dr. Joneigh Khaldun said statewide COVID-19 data trends “is not looking so good” and while Michigan is not in the “extreme situation we were in this past spring,” she said we need to “get back on track.”
Khaldun said the 610 cases reported July 8 were the highest since May. Today’s case count is 446, along with nine deaths, bringing statewide totals to 67,683 cases and 6,024 deaths.
She said the Grand Rapids region’s rate 45 of cases per million people per day is the highest among all the regions in the state. She also said the Upper Peninsula is seeing higher rates of COVID cases than at any point during the pandemic thus far.
Khaldun said COVID-19 outbreaks have been traced to places like bars, food processing plants, a casino (she did not disclose which one), religious gatherings and congregate care facilities.
The chief medical executive also said there is “evidence of general community spread.”
In other COVID-19 related news:
—Whitmer signed Executive Order 2020-145 to outline workplace safety guidelines for meat and poultry processing facilities. The Governor noted “meatpacking plants — where employees work in very close quarters — has proven to be a hotspot for COVID-19 infections in other states.”
—Whitmer signed an order extending protections for vulnerable populations in county jails, local lockups and juvenile detention centers through Aug. 6. The order temporarily suspends transfers into and from Michigan Department of Corrections facilities unless jails adopt certain risk-reduction protocols. It also allows local officials more flexibility in releasing vulnerable populations who do not pose a threat to public safety.
SCOTUS Affirms ACA Cut Back On Birth Control Access
It could be more difficult for women to get access to birth control under their health plans if their employer cites religious or moral objections to contraceptives.
The U.S. Supreme Court today affirmed 7-2 a Trump administration rule that cuts back on the Obama-era Affordable Care Act requirement that insurers provide free birth control coverage as part of health care plans.
“We hold that the Departments had the authority to provide exemptions from the regulatory contraceptive requirements for employers with religious and conscientious objections,” Justice Clarence Thomas wrote in the majority’s opinion, referring to the U.S. Departments of Health and Human Services, Labor and the Treasury, who jointly administer the relevant ACA provision.
“. . . We further hold that the rules promulgating these exemptions are free from procedural defects,” Thomas wrote.
Justice Ruth Bader Ginsburg, with concurrence from Justice Sonia Sotomayor, dissented.
“Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree,” Bader Ginsburg wrote. “. . . Destructive of the Women’s Health Amendment, this Court leaves women workers to fend for themselves, to seek contraceptive coverage from sources other than their employer’s insurer, and, absent, another available source of funding, to pay for contraceptive services out of their own pockets.”
The ACA required employers to offer a health plan that provided certain “minimum essential coverage.” After its passage, the departments crafted rules including the so-called contraceptive mandate, which initially automatically exempted churches and synagogues from the birth control insurance mandate, but not nonprofits with religious affiliations, such as hospitals.
A final rule in 2013 provided an opt-out provision for employers with religious objections, which religious objectors claim was the same as authorizing the use of their plan for birth control.
When President Donald Trump took office, his administration issued new rules giving broader exemptions from the birth control mandate to nonprofits—a move the country’s highest court has said is a reasonable accommodation between church and state.
James Esseks, director of the ACLU, said the July 8 decision will affect the LGBTQ community.
“While the Supreme Court has made it clear that it is against the law to fire someone for being LGBTQ, today they made it easier for religiously-affiliated employers to discriminate—including against LGBTQ people,” he said in a statement. “The court also opened the door to broader denials of health care, an area where LGBTQ people—particularly transgender people—already face alarming rates of discrimination.”
The Thomas More Society, who represented a group of women scholars supporting the Catholic charitable organization Little Sisters of the Poor, a plaintiff, said the court’s decision upholds religious and women’s rights and it “is to be applauded.”
Lawsuit Alleges Medicaid Fair Hearing System Is ‘Hamster Wheel’ For Recipients
A Medicaid petitioner’s guardians allege Michigan’s fair hearing system is a “hamster wheel” that allows petitioners to “win” without providing relief, such as additional service hours or specific dollar value for services.
The federal lawsuit, filed in U.S. District Court Eastern Division on behalf of Kevin Wiesner of Washtenaw County, alleges administrative law judges (ALJ) do not order specific relief in service denial appeals under programs administered by the Michigan Department of Health and Human Services.
“Under this system, Medicaid petitioners ‘win’ in the fair hearing, but they get no relief,” the court filing reads. “On remand, the agency can (and frequently does) ‘comply’ with the ALJ’s order by simply conducting a reassessment and ordering exactly the same amount of services as before (or less) . . . This is Michigan’s fair hearing ‘hamster wheel.'”
Wiesner, 23, receives home- and community-based services under the Medicaid-funded Community Living Supports services under the state’s Medicaid Habilitation Supports Waiver, which is administered by DHHS.
In March 2019, he told Washtenaw County Community Mental Health that his budget wasn’t sufficient to implement his service plan and he requested an increase to pay staff who provides his required services, according to the court filing.
That request was denied and Wiesner sought a fair hearing, which was held in December. In January, an ALJ issued an opinion finding Wiesner had “proven by a preponderance of the evidence” that his CLS authorization was insufficient to meet the goals of his service plan, but the order left implementation to the same entity that denied Wiesner appropriate services for at least five years, the court filing noted.
Named defendants include Michigan Department of Health and Human Services Director Robert Gordon, WCCMH Director Trish Cortes, and James Colaianne, chief executive officer of Community Mental Health Partnership of Southeast Michigan as well as the mental health departments.
House Votes To Ban ‘Surprise Medical Billing;’ More House News
The House voted June 24 to outlaw a practice billed as “surprise medical billing,” in which a bill arrives to a patient from an out-of-network provider—like an anesthesiologist—who assists in a procedure performed by an in-network doctor or in an in-network hospital.
Rep. Roger Hauck (R-Union Twp.), sponsor of two pieces of the four-bill package, said one out of every seven patients gets a surprise medical bill, and sometimes they can be for thousands of dollars.
House members gave strong support to Hauck’s HB 4459 and HB 4990 as well as Rep. Frank Liberati’s (D-Allen Park) HB 4460 and HB 4991.
“We live in a world where one of the leading causes of bankruptcy is medical expenses,” Hauck said in a floor speech.
He said a bad situation is made worse when families get an unexpected medical charge they didn’t know wasn’t part of their plan’s network. Sometimes it’s an emergency when the patient can’t select the providers or facilities that treats them. Other times, a patient receives planned care from an in-network provider, but another treating provider like the anesthesiologist, radiologist or surgical assistants are brought in.
Hauck said one of his constituents did all the right things before having knee surgery, calling ahead to determine the facility was in his insurer’s network.
“Unfortunately and unbeknownst to him, one of the doctors who assisted with the surgery that day was not. My constituent was hit with a $2,000 bill that he hadn’t anticipated and couldn’t afford to pay,” Hauck said.
Without legislation to ban the practice, health care providers may actually have a financial incentive to stay out-of-network because they can avoid signing contracts with insurance companies setting a fee schedule for services, according to testimony given in the House Health Policy Committee.
Hauck said the legislation takes the patient who has insurance out of the middle of billing disputes between out-of-network providers and insurance companies. The legislation would allow out-of-network provider to bill insurance companies either for 150 percent of what Medicare would pay for the procedure or what the average payment is to in-network providers, whichever is higher.
Hauck’s bills address emergency procedures; Liberati’s address non-emergencies.
HB 4459 passed 101-5. Dissenting were Rep. Ben Frederick (R-Owosso), Rep. Steven Johnson (R-Wayland), Rep. John Reilly (R-Oakland), Rep. Bradley Slagh (R-Zeeland) and Rep. Rodney Wakeman (R-Freeland).
HB 4460 passed 106-0. HB 4990 and HB 4991 passed 104-2 with Johnson and Reilly dissenting.
Although popular with House members, the bills were not well received by the Michigan State Medical Society.
Julie Novak, chief executive officer of MSMS, issued a statement saying the bill had been written by health insurance companies at the expense of physicians and their patients.
“The physician community stands with Michigan patients against out-of-network bills and has proposed a fair process that removes the patient from being caught in the middle, while providing for an equitable dispute resolution process,” Novak said. “Instead, the one-sided legislation completely eliminates a physician’s ability to negotiate with the biggest insurance companies in the state. Make no mistake, physician practices will close, and patients will lose access to care as a result.”
Flavors Are The Hot Issue In E-Cigarette Debate
Whether vaping products can contain flavors is the main stumbling block for a package of bills intended to keep e-cigarettes out of the hands of minors while allowing their use by adults, Senate Minority Leader Jim Ananich (D-Flint) told the House Regulatory Reform Committee June 23.
“Personally, I have a very strong libertarian streak, so I don’t really care what the flavors are. But there is some consternation around flavors in general. That is the area we are working on the most, trying to get all the different groups involved, along with the Governor’s Office,” Ananich said.
Gov. Gretchen Whitmer issued an executive order last September to ban flavored vaping products, although the courts have since overruled her.
“I think there is a middle ground that we can find that allows for some flavors but not those that are specifically targeted to kids. I think we can find that. We haven’t yet . . . That is the area we have to work on the most. I think we can find the answer, but I don’t think it is in this current version, yet.”
Currently, the bills allow vapor products flavored as tobacco, menthol, and fruit or a combination of common fruits.
Ananich is the lead sponsor on a six-bill package to update tobacco laws and outlaw the sale of vaping products to minors, SB 0781-SB 0786. The bills would raise the age for purchase of tobacco products or vaping products to 21, set the tax rate for e-cigarette consumables at 18 percent and set fines for those sell nicotine products to minors.
Separately, it would raise the tax on cigars from 50 cents per cigar to 65 cents for one year and to 75 cents in November 2021. The package also removes a sunset. Were the sunset to expire, the cigar tax would jump to 32 percent of the wholesale price, an increase Ananich said would price Michigan cigars out of the market.
The key point of discussion was about vaping and flavors.
“Study after study has found that flavors increase use in minors. This section would go against all of those findings,” Jared Burkhart of the Michigan Chapter of the American Academy of Pediatrics, told the committee. “. . . You will hear all kinds of stories about how e-cigarettes are amazing, 95 percent safer than smoking. There are numerous studies now that conclude e-cigarettes are as harmful to children as regular stick tobacco, traditional cigarettes.”
High school teacher Tylise Black told the committee she can smell fruit flavors on students at school. Then she realized she smelled those flavors on her own daughter only to find vaping equipment in her daughter’s purse.
“I hope that I have captured your attention so that we combat this crisis as a team because our children have been gravely affected. This crisis is something that we have allowed to happen,” Black said. “Today, it is more important than ever that states like Michigan ban all flavored e-cigarette products to prevent a new generation of teens from becoming addicted to these flavored devices. There are currently over 5 million children vaping e-cigarettes, according to a national youth tobacco survey.”
But others were on hand to defend vaping products as well as flavors. Paul Weisberger, General Counsel for Wild Bill’s Tobacco, told the committee his company sells only to adults and 97 percent of the e-cigarette products that are sold are of flavors other than tobacco or menthol.
“This is because those that are converting from combustible cigarettes to noncombustible cigarettes or vaping devices prefer the taste of vape. Again 97 percent of our sales are flavored vaping products,” Weisberger said.
Ronald Pease, of Mister-E-Liquid LLC, an e-liquid manufacturer in Grand Rapids, said his company offers 185 different flavors.
The largest group of his customers, 35.63 percent, are in the 55-plus age range and less than 1 percent is under age 24.
Yet fruity flavor is the most popular, 61.1 percent; candy, 26.1 percent; and dessert, 24.3 percent. Other flavors include mint, 29.6 percent; tobacco, 25.7; coffee, 7.8 percent: and no flavor at all 2.6 percent.
Regulatory Reform Chair Michael Webber (R-Rochester Hills) did not call a vote on the bills. He said the package will “work through this process.”
Juneteenth Festivities Call To Declare Racism a Public Health Crisis
In commemoration of Juneteenth, leaders from an array of civil justice organizations expressed their support around SCR 0027—a concurrent resolution to declare racism a public health crisis in Michigan.
On June 18, Michigan United—a civil rights coalition—went so far as to host a mock funeral for the resolution at Horace Blackman Park in Jackson. While they were equipped with a small casket to symbolize its premature death, other groups tied their Juneteenth festivities to advocating for the resolution and its relevance.
The resolution, SCR 27, was referred to the Senate Government Operations Committee on June 10 after being introduced by Sen. Marshall Bullock (D-Detroit) the week before.
Similar resolutions have been passed by city councils in Denver, Indianapolis and Cleveland and San Bernardino County of California and Montgomery County of Maryland.
The Michigan National Association for the Advancement of Colored People (NAACP) and Black Lives Matter Michigan hosted a webinar event titled “Racism: a Public Health Pandemic Press Event.”
“I’m just really glad we’re finally addressing racism as a public health pandemic,” former Flint mayor Karen Weaver said.
She reminisced on a Black Psychology class she taught 25 years ago at the University of Michigan-Flint. Weaver and her classroom had t-shirts made that read, “Racism is an illness. Are you sick?”
According to the U.S. Census, 57 percent of Flint’s population is Black and 40 percent of its residents live below the poverty line. When officials switched Flint’s water system in 2014, some 9,000 children were exposed to the highly corrosive and contaminated water from the Flint River and aging pipes.
“You look at the thousands and thousands of people that were poisoned—and yes, I use the word ‘poisoned’—by lead in our water system and it’s come to where, ‘If we can’t shoot you, we’ll poison you. If we can’t poison you, we’ll put our knee on your neck,'” Weaver said.
She said water and infrastructure were symptoms of the root cause of systemic racism.
During a June 10 session, Bullock said flaws in crowded and segregated housing and predatory housing practices have constrained Black America’s means for healthy living.
A 2016 statement from the Harvard T.H. Chan School of Public Health exhibits that Black individuals experience higher rates of heart disease, diabetes and hypertension than other populations.
The analysis was titled “Health disparities between blacks and whites run deep” and presents how Black children have a 500 percent higher death rate from asthma than their white counterparts.
Australyah Coleman, the NAACP Youth Activist of the Year, said the youth movement is demanding a more distinguished and immediate culture for empathy.
“If a white person is getting pulled over, do they have the same fear that I feel when I get pulled over? Do they have that same reaction? Are they feeling the same way that I’m feeling?” Coleman said. “I think that’s something we need to teach because a lot of times people can feel something that our counterparts are never going to understand.”
Michigan United kicked off an online initiative through FastAction, titled “Demand that elected officials act to declare racism a public health crisis.”
Through this outlet, Michigan United is requesting individuals submit messages to Sen. Majority Leader Mike Shirkey (R-Clarklake) and Jackson County commissioners David Elwell and Steve Shotwell. Its objective is to widely encourage the advancement of proposals emphasizing and centered on the resolution’s purpose.
Participants are allowed to personalize the message after providing their name, contact information and full address.
“While we cannot wave a magic wand to uproot racial inequity, we can, at the very least, acknowledge its existence and begin to craft policies that address the impact it has on Black lives,” the pre-written statement provides.
Gilda Jacobs of the Michigan League for Public Policy said racism is deeply embedded in the government, its policies and institutions. She said it has impacted Black and Brown Michiganders in the form of police violence, inefficient healthcare, housing, education and more.
Jacobs said the League recognizes SCR 0027 as an essentially step toward “dedicating and rededicating sources equitably.”
“We stand ready as the League. We’ve been fighting this for 108 years and, clearly, we’re tired of fighting this as well. We want to be part of a solution to stand for the next 108 years in our state,” Jacobs said.
Could COVID-19 Patients Be Put In Their Own Facility?
Eight facilities statewide would be designated as only being for COVID-19 patients, under Sen. Peter LUCIDO’s (R-Shelby Twp.) SB 0956, which was discussed in the Senate Health Policy and Human Services June 18.
Lucido told the committee that he’s talked with those who operate nursing homes and assisted living facilities in his area, and they’ve said they were not equipped to deal with the challenges presented by the COVID-19 pandemic.
“Hospitals got the PPE (personal protection equipment) before nursing homes,” Lucido pointed out. “(Nursing home officials) said they were never trained to do this. They said, ‘We don’t know how to do this.
“So, who was talking for these patients who couldn’t talk for themselves and were separated from their relatives who usually talk for them?” Lucido asked. “At the end of the day, we have so many of these facilities, but do we have the best practices?”
The Shelby Township lawmaker also ticked off the statistics for other states—Massachusetts, where 59 percent of COVID-19 deaths were nursing home residents, New Jersey, where 52 percent were.
“In New York it was so bad the governor already knew a change had to be made,” Lucido commented.
Lucido stressed that his legislation has nothing to do with being critical of the governor. It’s about finding a better way of handling the crisis going forward.
“I don’t want to damn the past,” he asserted.
Michelle Stricker of St. Clair County testified about her sister, who caught COVID-19 while in a nursing home and died eight days after testing positive.
“Somewhere in April I became aware the [facility] was taking COVID-19 positive patients,” Stricker said. “I contacted the governor’s office and the health department. The health department assured me that my sister was being isolated from those who had the virus. On May 13 she tested positive. She was taken to an ICU facility all by herself. We couldn’t see her.”
“She died May 21,” Stricker continued. “She was vulnerable to the flu and this COVID and she didn’t have a chance.”
Dr. Rebecca Wasington Coffee testified in favor of SB 0956 along with Sen. John Bizon (R-Battle Creek).
“With one-third of the deaths in Michigan being in nursing homes, obviously this (the current policy) is not working,” Coffee said.
Fairly early in the hearing, Bizon avoided an opportunity to criticize Whitmer for setting the policy that SB 0956 would change.
“This (dealing with COVID-19) has been a learning process,” Bizon asserted. “As the governor said, if we could get in a time machine . . .”
Sen. Curtis Hertel Jr. (D-East Lansing) brought up the potential problem of moving COVID-19 positive individuals out of the nursing homes where they are used to being taken care of.
“Can I suggest we look at nursing home transfers before going forward?” Hertel asked. “There is an amount of studies that have been done in terms of nursing home transfers—the pain it causes a person and the likelihood of death because of it.
“This is why it’s so hard to figure out what best for that person and what’s best for everybody else around them,” Hertel continued.
Sen. Curt VanDerwall, R-Ludington, agreed and said he believed the date Hertel was speaking of could be obtained.
Sen. Ruth Johnson (R-Holly) told the committee nursing home residents in Livonia had the highest death rate in the nation—perhaps in the world—at over 18 percent and asserted that the state’s current policy has to be altered.
Sen. Winnie Brinks (D-Grand Rapids) questioned whether adequate facilities or personnel would be available to provide for the separate care SB 0956 anticipates.
Lucido repeatedly pointed out that Michigan has $2.5 billion from the federal government to work with to make it happen.
Vaping Regulation Package Rolls Out Of Senate
The Senate June 17 passed a six-bill package that would create a regulatory framework for vaping products. Under the legislation vaping products would be taxed at 18 percent by the state, which is less than the 32 percent at which non-cigarette tobacco is currently taxed.
This package moved out of the Senate Regulatory Reform Committee on June 16. Under its measures, vaping products would fall under a regulatory structure that’s only “similar to” but not the same as that of tobacco products.
Back in February when the package was first introduced, the Keep MI Kid Tobacco Free Alliance called for an increased 42 percent tax on non-cigarette tobacco and vaping products, an increase from the current 32 percent on non-cigarette tobacco and the initial package was more stringent.
However, the legislation that’s now headed to the House is somewhere in between what the health groups wanted and the vaping industry. The goal of the package was to continue to allow vaping as a less dangerous alternative to tobacco smoke for adults while keeping it out of the hands of kids.
“For decades we’ve seen the terrible and often deadly impact of youth tobacco use in Michigan and across the country,” said Sen. Dale Zorn (R-Ida). “The concern now is the alarming use of vaping products by minors and reports that these devices are just as dangerous as traditional tobacco products. This bipartisan package is designed to clear up any confusion about the use of e-cigarettes or vaping devices in our communities while also protecting the health of our children and young adults.”
Meanwhile, the American Cancer Society still opposes the bills.
“As an organization dedicated to saving lives, ACS CAN was disappointed to see senators pass senate bills 781-786,” said Andrew Schepers, director of government relations in Michigan for the American Cancer Society Cancer Action Network (ACS CAN). “As passed by the Senate ACS CAN does not support these bills as they fail to effectively protect kids from tobacco’s harms.”
“Michigan’s kids deserve perfect when it comes to legislation to prevent the tobacco industry’s addiction or predatory practices,” Schepers added. “It’s time for our legislature to choose between Michigan’s kids and Big Tobacco.”
SB 0781, which created the new vaping tax, passed today on a 35-3 vote with Sen. Tom BARRETT (R-Potterville), Sen. Dan LAUWERS (R-Brockway) and Sen. Lana THEIS (R-Brighton) voting “no.” Barrett cast the only “no” vote on SB 0782.
SB 0783, which allows for flavored vaping for those 21 and older, passed on a 24-14 vote with all the Democrats except Senate Minority Leader Jim ANANICH (D-Flint) and Senate Appropriations Committee Minority Vice Chair Curtis HERTEL, Jr (D-East Lansing) voting “no.”
Last September, Whitmer captured national headlines when she banned flavored vaping in an emergency order. That order has since stalled in court.
The final three bills of the package—HB 0784, SB 0785, and SB 0786—passed unanimously.
State To Mandate Nursing Home Testing; Deaths Make Up 34% Of MI’s COVID Total
The state will mandate – for the first time – regular COVID-19 testing of nursing home residents as part of a Michigan Department of Health and Human Services (DHHS) order announced June 15.
The DHHS also reported it has confirmed 10,296 total COVID-19 cases among nursing home patients and staff since the beginning of the year, as well as a total of 1,967 deaths, as part of its “comprehensive effort to validate” nursing home data.
That means nursing home COVID-19 deaths make up 34 percent of the state’s total deaths, and nursing home cases make up 17 percent of the state’s total cases, according to statewide COVID-19 data as of June 15. Statewide, there have been 60,064 cases and 5,772 deaths.
Yet, DHHS Director Robert Gordon said the state’s updated nursing home data is “generally consistent” with similar data from other states.
The Health Care Association of Michigan—a statewide organization representing long-term skilled nursing facilities—said the numbers released “show Michigan is still below the national average for COVID-19 deaths in nursing facilities.”
On May 27, it was reported 23 percent of the state’s COVID-19 deaths came from nursing homes, and roughly 9 percent of cases.
The DHHS said the 7,163 cases and 1,947 of the nursing home deaths are attributed to patients, with 4,919 patients recovered or recovering. Another 3,133 cases and 20 deaths were attributed to nursing home staff.
The order requiring more nursing home testing was issued by Gordon, who said that prior to this order, there wasn’t a specific state mandate to test, but rather, there was guidance encouraging it.
Gordon said this order is the first of its kind to implement the mandate. To back it with the force of law with $1,000-per-incident penalties for noncompliance goes farther than the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services.
Asked why it took as long as it did to mandate testing, Gordon said the DHHS wanted to wait until the state’s COVID-19 testing capacity was adequate for such a requirement.
The DHHS order will require initial testing of all residents and staff, testing of all new or returning residents during intake unless tested within 72 hours of intake, as well as testing of any resident or staff member with symptoms or suspected exposure, according to the press release issued June 15.
Testing also will be required weekly for all previously negative residents and staff in facilities with any positive cases among the residents or staff, until 14 days have passed since the last new positive result. Weekly testing of all staff in regions considered medium or higher risk will be required, as well, as testing of all staff in the state’s designated regions 1 through 5 and 7 at least once between the order date and July 3.
Nursing facilities are required to submit plans for testing by June 22 and to implement those plans by June 29, according to the DHHS.
HCAM said it “strongly supports the state’s testing strategy” and that it worked with DHHS to develop a comprehensive plan.
“Universal testing of staff and residents must be the next step as it is the most effective way to prevent the spread of COVID-19 in facilities,” said Melissa Samuel, president and CEO of HCAM, in a statement.
Paula Cunningham, the AARP state director, said in a statement the organization “strongly supports the testing mandate in Michigan nursing homes.”
What didn’t change in today’s actions is the state’s practice of allowing non-COVID and COVID-positive patients under the same roof–even if isolated from each other at designated regional hubs—something the state has taken ongoing criticism for.
Sen. Jim Runestad (R-White Lake) expected to introduce a resolution “denouncing” the policy to return COVID-positive patients to nursing homes, Senate GOP spokesperson Amber McCann said.
Asked about this, Gordon said to keep non-COVID and COVID-positive patients at separate facilities is “very easy to say and it is extremely difficult to do in the real world.”
To do such a thing, Gordon said it would involve identifying new facilities that would need to be staffed up, or have facilities with a mix of patients to become either an all-negative facility or an all-positive facility, but that would involve “force transferring people” which could cause physical or psychological harm to those patients.
The DHHS said today it will begin decommissioning some regional hubs “due to reduced demand.”
Also, the DHHS announced “direct support for rapid response staff” to provide immediate support to facilities that are facing “urgent staffing shortages” because of the pandemic.
Starting in southeast and west Michigan, the DHHS will “help to make available” staff for up to two weeks.
DHHS also is coordinating with Doctors Without Borders to help long-term care facilities that need assistance with infection prevention and control practices, according to the press release issued June 15.
Also, on June 15, Gov. Gretchen Whitmer extended to July 12 her previous order that created the regional hub approach for COVID-19-affected residents. It also requires nursing homes to take special precautions when a resident exhibits symptoms of COVID-19, according to the release.
Alternative Offered For Those In A Mental Health Crisis
A person going through a mental health crisis could be taken to a standalone facility called a “crisis stabilization unit”—as opposed to an emergency room or jail—where they could receive treatment, under legislation a House committee is slated to take up June 16.
Rep. Mary Whiteford’s (R-Casco Twp.) HB 5832 is up for action in the June 16 Health Policy Committee meeting. So far, the legislation creating a new type of license for these facilities has received positive feedback from advocates who see large holes in the current system.
For a person in a mental health crisis, going to jail only increases the trauma, according to Beverly Ryskamp of Kent County’s Network 180.
“Secure crisis stabilization units provide a much-needed option when a person in crisis encounters law enforcement,” Ryskamp told the House Health Policy Committee recently. “Interactions with law enforcement or having to go to jail generally increases the trauma for individuals and makes their crisis worse, by no fault of law enforcement, it is just the nature of experiencing a crisis and then being in a system that isn’t designed to provide treatment.
“Crisis stabilization units provide an alternative that is needed for someone in a behavioral health crisis, and that is immediate access to experts and a safe treatment setting.”
Whiteford described them facilities as free-standing units, separate from emergency rooms or county jails, where people experiencing a mental health crisis could be housed and get treatment for up to 72 hours. The cost would be covered by Medicare, Medicaid, private insurance, or out of pocket.
“When an individual is facing a mental health crisis, there are few options,” Whiteford said. “They go to the emergency room that is unable to provide immediate care . . . A police officer may find them and take them to jail because they have no other place to go. Or a person may not get help at all, where they may just fall into despair.”
That can lead to self-medicating, substance abuse disorder, self-harm or harm others, Whiteford said.
The crisis stabilization units provide professional help. Services could include prescreening, providing clinical services designed to improve behaviors or reduce acute symptoms as well as provide immediate short-term intensive care.
Health Policy Chair Hank Vaupel (R-Fowlerville) noted that when the House studied mental health services in the state last session, it learned the number one place where people are treated for mental health problems is county jails.
“There simply is no place for them to go in most areas other than jail or the hospital emergency room. Then, if they are not able to find a short-term unit to go to after that, they are in the hospital utilizing hospital services and rooms that are not designed for mental health,” Vaupel said.
When Michigan’s current mental health code was written, crisis stabilization units did not exist. But Whiteford said such facilities are being used in other states.
“This would be a jail diversion program,” Whiteford said. “If a police officer has nowhere else to go, they may go and book this person. But if they take them to a crisis stabilization unit, they are not booking them. They are not being arrested. They are finding the proper place.
“It would be the same if they took them to the emergency room because they did not break any laws. This would also be a way, if you see someone who is suicidal, that you can take them to an emergency room or a stabilization unit. So this will be a pure jail diversion program.”
Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.