Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

40% Of Health Clinics Saying No To Opioids

Doctors in Michigan are writing fewer opioid prescriptions, but the state’s death rate continues to climb. Also, more than 40% of the health care clinics have a sign on their doors: We do not prescribe opioids.

Those are two of the major takeaways from a three-hour presentation at the Spring Scientific Convention sponsored by the Michigan Osteopathic Association earlier this month.

A trio of physicians told the members that many doctors are “afraid” of being prosecuted by the state for alleged overuse of the addictive painkillers. To avoid any such action, they just stopped writing those scripts.

On any given day, 20% of the state’s adult population is experiencing chronic pain and the death rate from these overdoses has risen just over 9% last year and 170% in the last six years.

Dr. David Neff, who has been on the front line of the opioid crisis for years, reports a patient faces possible addiction after only seven to 10 days of taking the drug. For those who are addicted and are able to break the habit, he reported it can take up to four years for the human brain to rewire itself back to normal.

That’s why the treatment of this addiction should not stop, if and when the patient is past the addiction phase.

The positive news is 65% of those who are prescribed the drug never misuse it. Another 25% abuse it and about 10% become addicted to it.

Dr. Stephen Bell, the newly elected MOA president, advised his colleagues to “bulletproof” all of the documents they have on their opioid patients as a defense against action by the state Attorney General’s office, the Department of Human Health and Services and or the Department of Licensing and Regulatory Affairs.

Dr. David Best suggested that an extensive “risk-benefit” analysis be done on each potential patient before opioids are used.

Nationwide there were 70,000 drug overdose deaths last year, with 70% of those traced to legal and illegal use of opioids.

Michigan Could Create New Paramedic Exam

Michigan would create a separate training and testing program for future paramedics to be eventually licensed, under legislation that was heard in a House committee this month.

The point of HB 6086, sponsored by Rep. Jeff Yaroch (R-Richmond) and HB 6088, sponsored by Rep. Greg Markkanen (R-Hancock), is to create a separate process from the national registry and the current programming run through Lansing Community College and other schools.

Yaroch told the House Workforce, Trades, and Talent Committee that the licensing process for the national registry has gotten so expensive, it’s shut smaller programs down. He said that’s created a shortage of opportunities for those looking to be paramedics, which is contributing to the state’s shortage.

“We need to remember there’s a lot of people out there working hard to serve the people,” said Yaroch, a former EMT. “We need more paramedics, and there was a lot of great paramedics that were trained in programs that didn’t take the national registry.”

Ralph Ortiz and Monty Nye from the Michigan Firefighters Union testified in support of the bills, saying the paramedics and EMTs have been suffering from a major staffing crisis. Nye said the Michigan Firefighters Union is focusing on getting students into ambulances to help as much as possible. Angela Madden, executive director for the Michigan Association of Ambulance Services, restated the need for paramedics and EMTs, saying her workforce has been worked extremely hard in the recent months.

“I think the people who are supporting the bills are working to get a solution,” Yaroch said. “We have a great shortage of paramedics, which means we can’t keep doing things the same old way. We need to try to act and I think a number of EMS professionals believe this is a good option.”

Marvin Helmker, Erik Lyons and Bryan Harmer, all representing Lansing Community College, testified in opposition of the bill, saying that a new exam would be a waste of time and money for the students.

Healthy Michigan Numbers Expected To Plummet After Pandemic Protections End

The Michigan Department of Health and Human Services has said more than 1 million people are being served by Healthy Michigan, but that number could plummet in October as the pandemic ends.

Rep. Mary Whiteford (R-Casco Twp.), chair of the House DHHS Appropriations Subcommittee, said the federal government offered to match Medicaid dollars with states that agreed not to unenroll people during the pandemic. After Sept. 30 an estimated 250,000 people will no longer qualify for either Healthy Michigan or Medicaid.

“With more people working and unemployment rates declining, there will be even more who no longer qualify for the Healthy Michigan plan,” Whiteford said.

The Healthy Michigan plan is available to people age 19 to 64 who make 133% of the poverty level, which is $18,754 for an individual or $36,908 in a family of four. They cannot qualify for other Medicaid programs.

Jennifer Wagner, Farah Erzouki and Sarah Lueck, with the Center on Budget and Policy Priorities, said state governments, like Michigan, have a chance to act to help people with Medicaid coverage. The Healthy Michigan program is the expanded portion of Medicaid made possible by the Affordable Care Act.

After the pandemic orders end, which is expected in September or October, Healthy Michigan will have to go through a process Lueck called “unwinding” where the Medicaid program checks all eligibility and removes the people no longer qualified.

Erzouki said many states would have to deal with overtime or increase staff to deal with the unwinding process.

Whiteford said they have approved money that would be used for the unwinding period in the state.

“We want to make sure that this doesn’t happen all at once,” she said.

Wagner said that process could take around a year in most states and during that time many of the changes or updates could become known, such as creating a better application process or making that process streamlined.

MDHHS has already streamlined the process, which is available online.

Wagner said the loss of coverage would come from three groups, people who have jobs, people most likely to get coverage through an employer, and people who sit just above the coverage threshold.

“Agencies need to make sure that these individuals have clear information about their options and help where possible to move into that other coverage,” she said.

The third group are the people who are still eligible, but are at risk of losing coverage because of faulty paperwork or other issues that could cause them to miss the renewal deadline.

Erzouki said the best way to reach people below the poverty line is through text messaging and not through the mail. Many of the poor have moved during the pandemic and would not get a letter.

“Text messaging is quickly becoming the norm for how individuals want and expect to receive updates,” she said.

Wagner said a ruling from the Federal Communications Commission in 2021 would allow states health programs to send text messages because they are exempt from the Telephone Consumers Protection Act.

Whiteford said the number of people has increased by 650,000 between Medicaid and Healthy Michigan and there are 2,045,000 on Medicaid and 998,000 on Healthy Michigan, for a total of 3,043,000 people enrolled between the two programs.

Whiteford said that Healthy Michigan should only be used as a safety net for people with no other option.

“There should not be anywhere close to 1 million residents relying on it,” she said.

Masks Recommended For Detroiters As COVID Cases Rise

Detroit is recommending residents return to wearing masks indoors as new COVID-19 cases continue to rise across Michigan. Detroit, Wayne County and 15 other Michigan counties are now being classified by the Department of Health and Human Services (DHHS) as being high-level, community spread designations.

Michigan Department of Health and Human Services officials reported 29,267 new cases and 78 deaths over a seven-day period. While the number of deaths has plateaued, the daily average number of cases, 4,181, increased 10 times the yearly-low of 419 at the end of March.

The last time daily case rates were this high was a couple days after Groundhog’s Day. Back then, daily death rates in Michigan were 104 a day. Today, they are 11 a day.

“The numbers are showing a rise in cases which we know can cause stress on local hospitals,” said Detroit Health Department Chief Public Health Officer Denise Fair Razo. “We have worked hard to reduce the spread of COVID-19 and taking these precautions will help us continue to thrive.”

Along with masks indoors, Detroit Health Department officials recommended getting tested if you are exposed, if you test positive talk to a doctor about antivirals and monoclonal antibodies and get a COVID-19 vaccine and booster.

The COVID-19 Vaccine Dashboard states 67.1% of Michiganders have taken at least one dose of a vaccine, as of Tuesday, and 60.8% of residents are fully vaccinated.

There are 4,293 sites administering the vaccine across the state. Vaccine appointments can be made at the MDHHS website. There is also a list of upcoming tests online.

County Jails Get COVID Testing Funds As Cases Keep Rising

The State Administrative Board approved federal funds this month for 11 county jails to continue COVID-19 testing as new cases continue to rise across the state.

Michigan Department of Health and Human Services officials reported 27,705 new cases and 76 deaths from the virus over a seven-day period. The average daily number of cases has risen to 3,958, which is a more than 68% increase in cases since the start of May.

MDHHS spokesperson Lynn Sutfin said the health department was expecting the rise in cases as a subvariant of the Omicron variant, which is more transmissible, washed over the state.

“What happens next depends on the severity of cases during this uptick and who is getting infected,” Sutfin said.

She said If the state saw an increase in reinfections of people who had previously had the virus, younger healthier people, and vaccinated people it was possible hospitalizations and deaths would not see a dramatic increase, such as the one during the winter.

The number of weekly deaths did rise slightly from last weeks from 62 to 76. However, average weekly deaths has been around 70 since mid-March.

The health department continued to urge anyone not vaccinated to get their shot and continue to follow COVID-19 protocol.

The state COVID Vaccine Dashboard showed, as of Tuesday, 67.1% of Michiganders had received at least one dose of vaccine. It also showed 60.7% of Michiganders are considered fully vaccinated, which includes one booster.

Dr. Natasha Bagdasarian, MDHHS chief medical executive, encouraged Michiganders to have a COVID-19 plan, which includes having masks and talking to your doctor about treatments in case you are infected.

“We recommend Michiganders test if they have symptoms or if they have been exposed to someone with COVID-19, and stay home if they are ill,” Bagdasarian said.

Michigan is still in a post-surge recovery, with only Grand Traverse County showing a high rate of community transmission.

“We are closely watching the numbers and will keep the public updated if the situation changes,” Sutfin said.