GOP Lawmakers Think DHHS Caro Study A Sham
Two Republicans representing Tuscola County say the state has already made up its mind about moving the replacement Caro Center, based on emails published by a TV station.
ABC 12 got its hands on emails from Gov. Gretchen Whitmer administration officials discussing the future of the proposed replacement for the psychiatric facility, including messages from Robert Gordon, director of the Michigan Department of Health and Human Services.
According to the report, Gordon in January “increasingly believes that closing Caro entirely is the correct path forward.”
In another email “within weeks,” Gordon suggested the idea of forming a commission “that would help us get the right answer, building support for that answer, and perhaps hold off the Legislature from doing anything rash,” according to the report.
It was in that same email that Gordon said a leading idea was to instead expand the Center for Forensic Psychiatry in Saline and build a smaller location in a better location than Caro.
In mid-March, the state publicly announced it would halt construction on the new Caro Center and hire a consultant to study where best to locate the project.
The state had already broken ground under the previous administration on a new psychiatric facility located close to the site of the existing facility.
Local lawmakers had protested the possibility of relocating Tuscola County’s second-largest employer, and those same lawmakers saw the ABC 12 report as confirming the state has its sights already set on moving the facility elsewhere.
“That they had to connive and come up with this elaborate plan to ‘do another study’ in order to come to the conclusion they have already made is the epitome of dishonesty and fiscally irresponsible,” Rep. Phil Green (R-Millington) said in a statement.
The other local lawmaker, Sen. Kevin Daley (R-Lum), said in a statement, “This is pure executive overreach and it is not Director Gordon’s job to approve funding or influence opinions—especially when the result clearly puts rural communities at a disadvantage.”
DHHS spokesperson Lynn Sutfin said Gordon has told the consultants—identified as Myers and Stauffer LC—“that their only job is to study the history and the facts and to propose the best location for the residents of Michigan, including the Thumb,” and “they were not even informed of the opinion expressed in that email, and they certainly were not asked to act upon that opinion.”
Sutfin said Gordon decided to bring on the consulting firm to “assist with fact finding” after “extensive dialogue” he had with “state hospital employees, mental health professionals, legislators, and residents in need.”
At the time of the construction halt, the DHHS said it was going to bring on the outside consultant through an existing contract to help advise on what needs to happen to “best meet the needs of Michigan’s citizens.”
The department had cited concerns about staffing, the ability for patients’ families to be involved in their treatment and water accessibility as reasons for why the project was halted after $3 million had already been spent.
The state had also noted Michigan’s “overall state psychiatric hospital census,” when it comes to state hospital patients county-by-county, shows “significant clusters far from Caro,” such as southeast Michigan and Washtenaw, Jackson, Ingham, and Kent counties.
Low Pay, Long Hours, High Turnover Causing A ‘Caregiver Crisis’
There is a “caregiver crisis” in multiple programs within the Department of Health and Human Services resulting from low pay and long hours, members of the House DHHS Appropriations Subcommittee were told.
“Last year we had to terminate services to 31 people due to a lack of staffing,” said Scott Schrum, CEO of the Residential Opportunities, Inc. in Kalamazoo. “Consumers of the Community Mental Health system across the state are receiving reduced services or having services terminated as a result of the direct care workforce crisis that we are experiencing.”
Committee Chair Mary Whiteford (R-Casco Twp.) referred to it as “forced charity” when caregivers are not reimbursed at the rates they deserve.
Anne Richardson, executive director of Arc of Livingston, asked for enough of an increase in Medicaid to provide a 50-cent per hour increase in wages for direct care workers.
“Family members live in fear that because they can’t find reliable staff they’ll end up having to quit their jobs and become the sole care providers for their loved ones, placing their families at risk economically, or worse, that their loved ones will be forced to move out of the county into a more restrictive setting, such as group homes or long term care facilities. Over the last year, over 10 Livingston County residents—more than 10—have already experienced this due to the caregiver crisis,” Richardson told the committee.
She contended that although that would require a $22 million increase in the budget, it would actually draw matching funds from the federal government on a two-to-one basis, “resulting in an additional $45 million in federal dollars coming back to the state of Michigan.”
Rep. Jon Hoadley (D-Kalamazoo) agreed with that and said, “there are places all over the Health and Human Services budget where, by investing more at the state level, we could be bringing more of our taxpayer dollars back to Michigan and providing more care.”
He said the crisis exists in multiple programs within DHHS.
“That was an entire room full of people testifying that we are at a crisis point because if you have loved ones that need care we are running out of caregivers who, even though they love doing it, can’t afford to give that care,” Hoadley said.
The committee was just starting to dig into the executive budget recommendation for the department’s proposed $26.2 billion budget with 16,007 full-time equivalents for Fiscal Year 2019-20. That is a $676.5 million increase over FY 2018-19 with 64.3 additional FTEs.
Whiteford said the committee will figure out where it is headed with the budget over the next few weeks. When asked if she would propose additional funding for caregivers and other programs, she said she was “non-committal” at this point.
“It is very tough for me . . . Why people aren’t getting paid appropriately? That is something, at least in the behavioral health silo, that we have that we are going to be addressing this fall. We have a series of hearings. Everybody is clamoring for more funds. I have permission from my chair as well as the speaker to use my committee to do more of a deep dive,” Whiteford said.
Schrum said his organization currently has 64 vacancies and turnover last year was 30 percent. The average pay for direct care workers is $10.45 per hour.
“Providers need to be in at least a competitive position with McDonald’s, Costco, Target and others. We also need a strong benefits package if we expect staff to stay,” he said. “Please fully fund at least a 50-cent-per-hour wage increase for this population. This would bring the average wage across the state to about 11 per hour.”
Georgia Callis, vice president of Guardian Care, Inc. and spokesperson for Michigan Guardianship Association, said the pay is even worse for court-appointed guardians.
“A professional guardian is someone that gets appointed by the court to take over and care for someone’s life decisions. We make medical decisions, housing decisions, obtain identification, we apply for Medicaid and Social Security. We make end-of-life decisions. We are doing everything that families do for someone . . . if they have no one else in their life,” she explained.
If the person is in a nursing home, the guardian is paid $83 per month, which works out to $2.76 a day, she noted. There is no reimbursement for a client who needs a public guardian but can live in his or her own home.
“These clients, and there are 4,500 of them across the state of Michigan, being served by public guardians, we get paid $0. Rep. Whiteford, I heard you say something that I’ve never heard before, that it’s forced charity. For 30 years, the Michigan guardians have been taking care of community mental health clients for free. Sometimes we pay to take these clients.”
In Illinois, the public guardianship program “collapsed,” replaced with state workers at a cost of $100 million annually, Callis said.
Michigan had 300 guardians 10 years ago. There are less than 140 now. She believes Michigan system is on the verge of collapse, as well.
“The top line messages are really clear. The policies that Michigan has had for past eight to 10 years has not prioritized the programs that do caregiving or the caregivers that are actually staffing those programs,” Hoadley said.
Ambulances Sounds The Alarm On Low EMT Wages
Emergency medical technicians are paid slightly better than a McDonald’s burger flipper, and it’s chasing young medical professionals out of the business. It’s causing staffing shortages across the state and could end up increasing ambulance response times, a Macomb County ambulance official told a Senate committee in late March.
With EMTs averaging $32,000 a year or $15.56 an hour, many of the state’s 250 ambulance providers are struggling to retain quality staff, testified Jeffrey White, the chief of emergency medical services for Richmond and Lenox townships. That $32,000 figure includes overtime. Many EMTs work 48-hour or 60-hour work-weeks.
“Especially in our rural areas, the safety net that we all sleep under every night has many holes in it,” White told the Senate Department of Health and Human Services Appropriations Subcommittee. “We simply cannot find enough paramedics and EMTs to staff our ambulances and to respond to our 911 calls. The reason has been the amount we’re able to pay or unable to pay to our staff.”
At White’s 48-employee shop in Northern Macomb County, the staffing shortage is at 10 percent. He said he would hire four to five people today if he could find them. Statewide, the Michigan Association of Ambulance Services estimates 500 paramedic openings. Those are just paramedics averaging around $40,000 a year.
The number of students graduating from paramedic training in the state has dropped from 1,200 per year to 250 in the past three years, according to the Michigan Bureau of EMS, Trauma and Preparedness.
White did not have his hand out to legislators for more money, however. Rather, he asked the Legislature to reauthorize a Quality Assurance Assessment Program on ambulance services that lawmakers approved in 2015 that increased provider rates by 20 percent starting last year.
The change came with an estimated $10.3 million for the ambulances after federal money was drawn down. Of the 250 ambulance providers, 209 saw more Medicaid funding from the QAAP, but for those who don’t have a significant number of Medicaid patients, the either saw no increase or a slight funding decrease.
The QAAP is slated to expire Oct. 1 and White is urging that it be reauthorized.
“When there’s no cost of living increase, it’s hard to pay for fuel and tires when those costs keep going up and we we’re told there just wasn’t money for in the budget,” White said. “The only way we’re able to make this work is through the QAAP, where we could assess our members in order to leverage these federal dollars . . . It’s still not where we would like it to be, but going backward would be devastating.”
The Northern Macomb, White’s shop is 25 miles from the nearest hospital. The average run costs $1,000. Medicare reimburses at between $400 and $450. Medicaid reimburses at $150 to $225.
Sen. Tom Barrett (R-Potterville) suggested bringing more former military medics into the profession, which White said he’d love to do. But after a few months at $32,000 a year, these experienced workers tend to move on for higher pay. Having firefighters trained as EMTs was suggested, as well.
White said the industry has looked for ways to cut costs. Combining services. Working with county health departments. Finding ways to treat patients on site so they do not need a hospital run. White said, “We can’t do any more. We are out of money. Most of us are not making money in the ambulance business; in fact, many are losing money.”
LSSU’s New Cannabis Curriculum ‘Not A Stoner Program’
Lake Superior State University in March approved a business-centered “cannabis curriculum.”
That comes in the wake of Michigan’s fall ballot proposal that legalizes recreational marijuana and is in addition to the school’s cannabis chemistry degree program announced in January.
Northern Michigan University started a medicinal cannabis degree program in 2017. So far, no other Michigan universities have expressed similar interest, said Dan Hurley, the chief executive officer for the Michigan Association of State Universities.
Lake Superior students are interested.
“We ran a special topics chemistry course last spring and we got about 40-plus students to enroll despite the steep science prerequisite course requirement including organic chemistry,” said David Myton, the associate provost and interim dean of the college of science and the environment at Lake Superior State University. “So that was an indication of success.”
The cannabis degree program is a standard four-year track that allows students to graduate with a baccalaureate or associate degree in cannabis chemistry. The newly announced program is for a degree in cannabis business.
Students are already interested in the pilot program with 20 or more pre-enrolled for the fall, Myton said.
The university is working to change the perception that it is not a rigorous program or that it may be a stoner-program, he said.
“We’re interested in helping students prepare for the analytical side of cannabis—the testing side,” Myton said. “They’ll be testing for herbicides, pesticides, heavy metals, solvents and residues and extracts for regulatory purposes. We focus on regulation, enforcement, public health and safety.”
Growers have to send their products to labs for testing before they are sold, and this program will prepare students for jobs working in those labs, he said.
The cannabis business degree program will help students understand business practices within the confines of the unique laws surrounding cannabis, said Kimberly Muller, the dean of the College of Innovation and Solutions.
Students take business courses like cannabis economics that discuss the effects of legalized cannabis. There are also courses in cannabis law and policy, cannabis entrepreneurship and business policy, Muller said.
The cannabis chemistry courses include general chemistry, toxicology, organic chemistry and cannabis chemistry, Myton said.
“This is an industry that will grow about 28 percent within the next 10 years and we want to prepare our students for that,” she said.
Northern Michigan University’s medicinal cannabis program has gotten mixed reactions from the public, said Brandon Canfield, an associate professor at Northern Michigan University.
“The traditional freshman coming in seem to have the full support of their parents as people begin to recognize this as a growing industry,” he said. “Schools contact us that are interested in piloting similar programs, like Minot State University in North Dakota, but we haven’t gotten any here in Michigan.”
Other schools haven’t expressed interest in similar programs, said Hurley, at the Michigan Association of State Universities.
“We oversee the academic program review process but nothing related to cannabis is coming up soon other than Northern Michigan University and Lake Superior State University,” Hurley said. “I haven’t heard anything about any other universities considering this kind of program anytime soon.”
There is not a lot of interest coming from Michigan farmers either, according to the Michigan Farm Bureau.
“The Michigan Farm Bureau policies don’t support the legalization of recreational marijuana,” said Theresa SISUNG, associate field crops and advisory team specialist. “We don’t do work with medical marijuana either. Our members haven’t pushed for any policy changes.”
Michigan State University’s statewide Cooperative Extension program provides educational outreach to farmers statewide. The program has seen some interest in farming industrial hemp, said Sean CORP, its communications and marketing manager. The program is interested in research in industrial hemp, but with the fibers from marijuana.
MSU Extension educators are not allowed to give farmers assistance in marijuana growing or anything related, said Diane BROWN, an extension educator for Mason County.
As federally funded programs, LSSU and Northern Michigan University follow the federal law regarding marijuana. They don’t allow marijuana on campus outside of research, both Myton and Canfield said.
Forbes recently reported that the U.S. is expected to have a 110 percent nationwide increase in marijuana-related jobs by the year 2020.
(Contributed by Capital News Services Correspondent Zaria PHILLIPS.)
Whitmer Gets The Ball Rolling On State PFAS Standards
Gov. Gretchen Whitmer March 26 announced the first steps down the path of creating Michigan-based standards governing PFAS levels in drinking water.
Environmental groups and others have been calling for the state to do something beyond the federal government’s 70 parts-per-trillion health advisory level in terms of acceptable PFAS quantity in the water people drink. The Michigan Environmental Council said the “science is clear” that the federal level is “not sufficiently protective of the health and wellbeing of Michigan residents.”
Whitmer did not come out with a specific PFAS level. But she did charge the Michigan Department of Environmental Quality to get moving on the rulemaking process to establish “enforceable” maximum contaminant levels for PFAS in drinking water.
She asked the Michigan PFAS Action Response Team to form a science advisory workgroup to study “health-based drinking water standards” to inform the rulemaking process.
Whitmer wants the advisory workgroup to finish its work by July 1, and wants the new rules “completed on an accelerated schedule” and no later than Oct. 1.
The governor, along with U.S. Rep. Debbie Dingell (D-Dearborn), both said the state’s action was important because of what they described as a lack of movement from the U.S. Environmental Protection Agency to establish a nationwide standard.
“Michigan has long advocated that the federal government establish national standards to protect the nation’s water from PFAS contamination, but we can no longer wait for the Trump Administration to act,” the governor said.
The MEC described the Governor’s announcement as “critical action,” and the Michigan League of Conservation Voters lauded it as a “key step.” Clean Water Action also applauded the move March 26.
Whitmer’s announcement drew bipartisan praise from Reps. Sue Allor (R-Wolverine) and Jim Lilly (R-Macatawa) as well as Sen. Winnie Brinks (D-Grand Rapids).
“Enforceable standards based on the best science available put us on the right path—one that holds polluters accountable, deters further contamination and keeps the hardworking people of Michigan safe,” Brinks said in a statement.
Senate Majority Leader Mike Shirkey (R-Clarklake) said in a statement that the Whitmer administration rules “will be vetted and scrutinized by the Senate and will be subject to the regular rule-making process.”
Shirkey also said it’s “imperative” the government “rely on scientific research and facts to establish standards for drinking water,” a sentiment echoed by the Michigan Chemistry Council, which called for heeding “sound science” and a “careful review process.”
The governor, speaking to reporters at a March 26 event, said any decisions on PFAS standards for drinking water should be left to the experts and not anyone else, saying, “I think we need to rely on experts and scientists to advise us.”
She said that’s why she has tapped three state agencies—the DEQ, MPART and Department of Health and Human Services—to be engaged in “an unprecedented coordination and analysis and make a recommendation. It’s a serious issue and is having a greater impact more and more,” she warned.
Prescriptions For Controlled Substances Down 11% Since MAPS
Many in the medical community were not happy when the Legislature in 2017 required that doctors check a patient’s history on the Michigan Automated Prescription System every time they prescribed a controlled substance such as an opioid.
When House Health Policy Chair Hank Vaupel (R-Fowlerville) heard this week the reform may be working, he was “elated.”
According to statistics from MAPS, controlled substance prescriptions in Michigan were down 11.5 percent last year from 2017, Kim Gaedeke of the Department of Licensing and Regulatory Affairs told Vaupel’s committee this in late March.
“We’re seeing a huge dip. While 11 percent might not seem to be (much), it is especially since we are now under 18 million overall prescriptions for Schedule 2 controlled substances being dispensed and given to patients,” Gaedeke said. “. . . The good news is we are seeing a dip, but still 17.647 million is so high that means roughly one-and-a-half to two of these prescriptions are in the hands of every one of our citizens in the state. Still high, but we are seeing a decline, and that’s a good sign.”
Other numbers in the report were even better. Prescriptions specifically for opioids dropped 15 percent. Even more significant declines were reported when numbers were broken out individually for “some of our most commonly abused controlled substances.”
“For example, we are seeing a 44 percent decline in prescribing Promethazine with Codeine. That’s really good news because those are highly abused in this state as well as in the country,” Gaedeke said.
Promethazine with Codeine is a combination medication for the common cold, flu, allergies, sinusitis and bronchitis, according to WebMD.com.
Promethazine is an antihistamine and Codeine is a narcotic cough suppressant with addictive qualities.
Prescriptions for the painkiller Oxymorphone 40 mg are down 30.7 percent; Oxymorphone 30 mg down 23.2 percent. Prescriptions for Carisoprodol, a painkiller and muscle relaxer, are down 37.2 percent.
“The last package of opioid bills last session, there was a lot of opposition on some of them,” Vaupel said. “I think the medical community didn’t like them because they limited what could be dispensed. And so it is really, really gratifying to see at least the supply of opioids that is out there has dropped so much.”
Vaupel admits that with the old MAPS system, checking for a patient’s prescription history was a slow process, taking five to 10 minutes to respond with the information.
Gaedeke told the committee response times now are down to between four-tenths of a second and eight-tenths of a second.
She said she’s heard from health care providers that they thought the system wasn’t working properly because it was bringing up the information too fast.
“We are seeing not only less of these prescriptions being prescribed and filled, but that also means less excess of these drugs that are unused picked up by the patient. A lot times the patient does not need the full amount that is being prescribed to them, so what do you do with the unused drugs?” Gaedeke asked.
But she also acknowledged to the committee that as prescription drugs become less available, indicators show some addicts are going to the street to buy drugs.
“We have a huge, huge problem and it was just getting worse and worse and worse,” Vaupel said. “There are refinements that have to be made in the statute. There are some things that have driven some people to the street to get their illicit drugs, but I think one of the huge problems is that 80 percent of them originally abused drugs that create addiction were from legitimately, ethically written prescriptions. So by lowering the supply out there as much as has been, I think that’s huge and I think that will be very beneficial in fighting the addiction situation.”
Study Breathes Life Into Raising Smoking Age To 21
A University of Michigan study released in late March concludes that hiking the smoking age to 21 could produce 198,000 fewer smokers in Michigan over the next five years.
The University of Michigan study also pinpoints the saving of 17,000 lives from smoke-related deaths by moving the age up from 18. Compared to the national average, 20 percent more Michigan 12th graders have smoked a cigarette or cigar, used smokeless tobacco or vaped an e-cigarette.
The new data breathed some additional reinforcement behind Rep. Tommy Brann’s (R-Wyoming) HB 4039 to raise the age from 18 to 21, a move that would put Michigan in line with seven other states.
House Health Policy Committee Chair Hank VAUPEL (R-Fowlerville) and Rep. Julie Calley (R-Portland) are among the bill’s co-sponsors. The study and the bill were highlighted to coincide with March 20 being “Kick Butts Day,” a drive spearheaded by health groups to lower smoking rates.
“A rapidly increasing number of cities, counties and states around the country are passing Tobacco 21 laws,” said Holly Jarman, assistant professor at U-M’s School of Public Health. “We urge them to do it in a way that supports young people and communities in our state. That means implementing Tobacco 21 as part of a comprehensive tobacco control policy.”
The findings also suggest that 11,000 teens would not start smoking under the proposal and 60 percent of the teens surveyed said they would support the boost in the age.
Some lawmakers may worry about the loss of tobacco tax revenue if fewer persons smoke, but the report suggests one way to counteract that is to link any taxes to inflation, which would automatically produce more money without necessarily raising the tax.
Meanwhile, the Gov. Gretchen Whitmer administration is reportedly looking at reclassifying e-cigarettes as a tobacco product and then the state could tax that, too.
Detroit’s Health Director Named State Medical Executive
Dr. Joneigh Khaldun, director and health officer for the Detroit Health Department, was named the state’s chief medical executive as well as chief deputy director for health.
Khaldun has served at the Detroit Health Department since 2017 and previously served as its Medical Director. She’s also a practicing emergency physician.
Prior to Khaldun, former Democratic gubernatorial candidate Abdul El-Sayed ran the city’s health department.
Khaldun will oversee the Population Health, Medical Services, and Behavioral Health and Developmental Disabilities administrations within the Michigan Department of Health and Human Services, as well as the Aging and Adult Services Agency.
The chief medical executive is a member of the governor’s cabinet, and the new role of DHHS chief deputy director for health is one of three new deputy roles created by Director Robert Gordon as part of his reorganization of department leadership.
“Dr. Khaldun has done great work for the city, rebuilding the health department and tackling challenging problems like the opioid epidemic, teen pregnancy and infant mortality,” said Detroit Mayor Mike Duggan in a statement.
The DHHS March 21 also announced Erin Frisch as the department’s new chief deputy for opportunity, where she’ll oversee the Field Operations Administration and the Children’s Services Agency. She has served as the Title IV-D Director for Michigan and Director of the Office of Child Support.
The other new leadership position—chief deputy for administration—was filled by Elizabeth Hertel.
The DHHS also added Jonathan Warsh as chief of staff, where he’ll lead strategic planning, support coordination across the department and serve as a key advisor for the director, said DHHS spokesperson Lynn Suftin.
Warsh comes from McKinsey & Co., where he was an engagement manager working actively in the state government and health care practices, and he carries a doctorate in population health from Oxford University, where he was a Marshall Scholar.
New Caro Hospital Construction Halted Pending Outside Review
The state has paused building a new psychiatric facility to replace the existing facility in Caro to allow for an outside evaluation of the $115 million project to figure out how to “best meet the needs of Michigan’s citizens,” according to a release March 13.
There has already been $3 million spent to build the replacement of the current Caro Center at the same site. The project broke ground in October 2018.
In the run-up to approve money for the project, northern Michigan lawmakers lobbied for something a bit closer to home, but former Rep. Ed Canfield wanted the hospital to stay in his region, which is what ended up happening.
Canfield’s successor in the 84th House District, Rep. Phil Green (R-Millington), called the decision to pause the Caro project “devastating to our community.”
“I am disgusted at the blatant disregard for rural Michigan and Thumb residents,” Green said in a statement, who added Caro is the second-largest employer in Tuscola County. Sen. Kevin Daley (R-Lum), who also represents Tuscola County, expressed his disappointment for the state’s decision to “re-examine the need for the Caro Center project.”
Green criticized Gov. Gretchen Whitmer for the move, saying she has shown she is “interested only in helping the residents of areas that were instrumental in electing her.” And Rep. Shane Hernandez (R-Port Huron), the House Appropriations Committee chair, said he hopes Whitmer is not “simply trying to move the facility to a more politically connected area.”
“I will not play politics with the mental health of Michigan citizens,” Hernandez said in a press release.
Green said Caro was chosen for the new hospital because it is “centrally located for more than 80 percent of the center’s patients and the majority of its employees” and because it has access to “power and water services.”
But the Michigan Department of Health and Human Services cited “concerns about staffing, ability for patients’ families to be involved in their treatment and water accessibility” as reasons for halting construction and bringing in the outside consultant.
According to the DHHS, there are “staffing shortages and barriers to recruitment of staff at the hospital.” There’s no active permanent psychiatrist on staff at Caro, and psychiatrists from the state’s other hospitals have been pulled in to help.
DHHS spokesperson Lynn Suftin said the staffing challenges have been “the driving issue” behind the re-examination, who added a new facility “will most likely not change that situation.”
Sutfin said the state’s “overall state psychiatric hospital census,” when it comes to state hospital patients county-by-county, shows “significant clusters far from Caro,” such as southeast Michigan and Washtenaw, Jackson, Ingham, and Kent counties.
DHHS said 30 percent of the facility’s 86 patients and their families live within 75 miles of Caro. State officials also say finding a “safe, sustainable water source at an acceptable cost” has caused a delay, and could end up adding $2.4 million to the already-budgeted $115 million.
The state is expecting a recommendation on Caro by the end of June. The outside consultant has not been selected yet, Sutfin said, as DHHS is looking at using an existing contract to hire the consultant.
The new hospital was scheduled to be completed in 2021 and serve 200 adults, an increase of 50 beds from the existing facility, according to DHHS.
Legislature’s Only Doctor Asks: Why Aren’t We Getting Healthier?
The Legislature’s only remaining medical doctor took aim at the state’s Medicaid program March 13, noting that state-collected numbers would seem to indicate that state government isn’t doing enough to make its residents healthier.
Sen. John Bizon (R-Battle Creek) expressed frustration with the two Medicaid officials testifying at a Senate subcommittee March 13 that numbers advertised on the former governor’s dashboard website shows the percentage of obese Michiganders hasn’t moved from 31 percent.
Numbers connected to diabetes, smoking, and hypertension also have shown no improvement.
“I have to admit that we need to get our population more healthy,” Bizon said. “Many of the measures we use to declare success in a program is how often someone goes to a doctor and I would argue that the outcome from our health program should be a healthy population . . . There’s more work that we have to do.”
Bizon had been questioning Kathy Stiffler, acting senior deputy director for Medical Services at the Department of Health and Human Services, and Farah Hanley, DHHS’ senior deputy director of Financial Operations during the Senate Appropriations DHHS Subcommittee.
The dashboard numbers Bizon referenced are for all Michigan resident and not just Medicaid recipients. When MIRS mentioned that to Bizon, he concurred that was a good point.
“I’m not trying to isolate one particular segment of our population, but I will say that not every sector of our population asked me to pay for their health care,” he said.
DHHS officials note that they are committed to and have implemented a “robust healthy behavior incentive program within the Healthy Michigan Plan.” They are reporting that a “vast majority” of HMP enrollees are actively engaging in healthy behaviors—going to the doctor preemptively, ending smoking, cutting weight, and eating better.
“It is through the health plan contracts we can do this best and is how the vast majority of the population is served,” said DHHS spokesperson Lynn Suftin.
Sen. Curtis Hertil Jr. (D-East Lansing) said DHHS should present other numbers that show Medicaid enrollees and the savings found through the Healthy Michigan Plan in decreased emergency room visits. He asked for data that balances the picture.
Bizon did not stop there, though. He also said that the fee-for-service Medicaid reimbursement rates for dental services haven’t been changed since 1996. Dentists are reimbursed at 21 percent of a patient’s overall bill, which explains why many dentists do not take Medicaid patients.
He concurred that bumping up the rates haven’t been a priority for “many, many years,” but made the statement to make the point that “If access is important, why are we are not seeing things to increase access proposed by the administration?”
Sutfin said DHHS’ health plan was expanded to include dental coverage for pregnant women, which “significantly improved” access for this vulnerable population.
“We are committed to continuing to work with dental providers to increase access for additional populations,” she said.
And, finally, Bizon was “disappointed” that the Medicaid officials didn’t have numbers at the ready on how much of the co-pays and deductibles DHHS had collected from its Healthy Michigan recipients. He had numbers in the 30 to 35 percent range. Sutfin later said since the program began in 2014, 43 percent of co-pays and 33 percent of the contributions assessed had been collected.
Bizon conceded this is a poor population, but “Often we value things by how much we pay for them. Sometimes, if you get something for free you don’t value it as much.”
He spoke to the current Medicaid dental plan having a 50- to 60-percent participation rate. In the past, when the dental benefit plan cost people $4 a month, participation was around 90 percent.
“I would ask, ‘What is the difference between the two plans? Why is one so well participated in and other not so much?” Bizon asked.
Healthy Michigan program participants earn less than 133 percent of the federal poverty level or $15,000 a year for individuals. Sutfin argued that the $21 million they have received from this population “represents a significant amount.”
Family Feud Brewing At Wayne State University MAR12
It turns out the board at Michigan State University is not the only one involved in a battle with its president. Wayne State University is right behind the Spartans, according to Crain’s Detroit Business.
The publication wrote about a public dispute between President M. Roy Wilson and some of the members of the board of governors, three of whom voted not to extend his contract last December. The trio included Republican Michael Busuito, Democrat Dana Thompson and Democrat Sandra Hughes-O’Brien.
Crain’s reports an “escalating drama” on campus is growing over a disagreement over efforts by the president to forge a new contract with the Henry Ford Health system that some feel may be at odds with the school’s “sometimes rocky relationship with the Detroit Medical Center.”
WSU Board President Kim Trent has issued a statement supporting the president saying, “Roy Wilson’s integrity and strong leadership have taken us from worst to first.”
The President cited a board “code of conduct” in how members should engage with the media, adding it was “outrageous that a board member . . . would make unfounded charges about the president” to a member of the media.
The trio of governors along with a newly elected member, Dr. Anil Kumar, offered this statement regarding Wilson: “We have seen mistakes of presidential leadership at Michigan State University . . . Here at Wayne State University, Roy Wilson, the president, must and will be held accountable by those of us who were elected to govern.”
Trent responded by saying she was outraged that four board members would compare the scandal at MSU to issues facing WSU. “There is no scandal here.”
Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.