LANSING LINES

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

House Education Focus On COVID-19 Policy Is ‘Waste Of Time,’ Dems Say

More bills limiting mask mandates and vaccines in schools are “wasting time” on issues that won’t help students, Rep. Darrin Camilleri (D-Brownstown Twp.) said after the House Education committee voted out a package on COVID-19 policy in schools.

SBs 600-603 would prohibit mandatory vaccinations, face masks or testing for students to attend school or school events.

The bills were all reported with recommendation from the committee on a 7-5 vote.

But Camilleri, who voted no, said moving forward with the legislation is a waste of time when no Michigan schools require mask mandates.

“I think it was another day where we were wasting time on culturally divisive issues that will not improve the outcomes for our students in our public schools,” Camilleri said.

Instead, he said the committee should focus on more pressing issues, like the teacher shortage or student learning loss.

“Why are we talking about mask mandates and vaccines?” he asked.

Camilleri said House Democrats have introduced many bill packages addressing teacher shortages and expanding school libraries, among other things, but many of them are yet to get a hearing.

“I will always remain hopeful that we can work together to solve these problems,” he said. “But today, we still did not see that.”

The Detroit school district will be starting the 2022-23 school year without masks after requiring it for the balance of the 2021-22 year, according to Chalkbeat Detroit. The Ann Arbor public school district is also making masks optional for the 2022-23 school year, according to WDIV.

Rep. Pamela Hornberger (R-Chesterfield Twp.), who chairs the House Education Committee, said there are no guarantees that schools won’t return to these policies. She said parents need to be allowed to opt-out, particularly in cases when masks or vaccines are not required for “literally everywhere else in town.”

“We don’t want this to be a mandate,” Hornberger said of potential mask requirements. “It could happen again and we want to be in front of this.”

 ‘Most People Never Tell The SOS,’ Bills Address Driving With Seizures

Drivers who have had seizures could return to the roads sooner under a pair of House bills that would reduce the six-month suspension after an epileptic episode.

HB 6217, sponsored by Rep. Jack O’Malley (R-Lake Ann), would limit the suspension period to three months if the patient provided a physician’s statement within 30 days of the last seizure to the Secretary of State.

The statement would require certification that the seizure is under control by medication or another treatment method, and that symptoms affecting motor vehicle operation are corrected.

The SOS could also further reduce the suspension if the seizure is a result of changes to medicine, is only present while the patient is sleeping or doesn’t interfere with consciousness.

The bills would allow citizens more independence to get to work or school, said O’Malley, who also chairs the House committee. He added that the only options for patients now is to be dependent on others or to “screw it,” and break the law.

O’Malley said a fear of losing their license makes some drivers hesitant to report seizures.

“This is probably the dirty little secret,” O’Malley said. “The vast majority of people don’t even tell the Secretary of State.”

Drivers who do report are faced with a six page form from the department, and physicians are required to fill out the majority of it.

Dr. Gregory Baekley, interim chair of neurology at Henry Ford Hospital, said that ambiguity from current legislation leads to many physicians erring on the side of, “just say no.”

But most people living with seizures can drive safely with a little extra concern, said Brianna Romines, executive director for the Michigan Epilepsy Foundation. The foundation supports the bill.

She said there are many different types of seizures with varying degrees of control, and nearly 109,000 Michiganders live with them. Anyone can develop them, and some have “no identifiable cause,” she said.

People with epilepsy list driving a car as one of their main concerns, and say it’s critical for employment, socialization and self esteem, Romines said.

“People with epilepsy, physicians and regulators share the responsibility of protecting the public while still providing reasonable opportunity for individuals with seizures to drive a car,” Romines said.

But the Secretary of State had some concerns about the bills, including the reliability of physicians, said Jenita Moore, the department’s legislative liaison.

“We don’t always receive the best information or great documentation,” Moore said. “All doctors are not equal.”

She said the department wants to ensure there is a standard for physicians making decisions on driving abilities.

HB 6216, also sponsored by O’Malley, would allow physicians to voluntarily report patients they believe are a driving risk due to epileptic seizures or other mental and physical health concerns.

Physicians could recommend an examination of a patient’s ability or a period of license suspension. The resulting suspension would be at least six months, or 12 months for commercial license holders.

Reporting would be voluntary, and physicians would be immune from criminal and civil liability both if they report and if they do not.

The bills are awaiting action in the House Transportation Committee.

Michiganders’ Teeth Could Feel Relief Through Proposed Medicaid Reform

Each year, between a million and a million and a half Michiganders do not get necessary dental treatment due to a coverage void caused by low reimbursement rates, administrative burdens and lack of covered procedures in the state of Michigan’s Medicaid dental plans.

But two proposals to improve access to Medicaid dental benefits could bring relief for troubled teeth if the $68.6 million general fund dollars in the Gov. Gretchen Whitmer proposed executive budget is signed off on by the Legislature.

Ellen Sugre-Hyman, director of the Michigan Oral Health Coalition, said in a press conference today that now is the perfect time to fund the proposed measures with the COVID-19 relief funds and the projected budget surplus.

If approved, the proposals would receive a total of $243.3 million, with the remaining $174.7 million coming from federal matching dollars.

One of the proposals would combine Michigan’s three Medicaid dental plans, Healthy Kids Dental, Fee-for-Service Dental and the Healthy Michigan Plan Dental for adults, into one single managed care contract. The other would raise Medicaid reimbursement rates for providers.

The state of Michigan has not raised Medicaid dental reimbursement rates for 30 years, said Sugrue-Hyman.

“The (reimbursement) rate for (an oral exam) is $14.89 in the adult fee-for-service program,” she said. “I’m not even sure that’s enough to clean the office between dental visits. It certainly doesn’t cover the dentist or other staff.” The oral exam rate in Michigan is more than half the rate of the average for the Midwest, which is $35.

“Add in the extra personal protective equipment that we now need with the COVID pandemic and increased labor costs and the administrative complexities when dealing with the Medicaid program, it’s no wonder that very, very few private dentists are able to treat patients with Medicaid,” said Dr. Michael Campeau, a solo practitioner in Fremont.

Because of the small number of private practice providers who accept Medicaid, community centers and federally qualified health centers are overburdened and have wait times upwards of two months, with many not taking new patients or operating on a walk-in basis only, Campeau said.

He told a story about Lori, identified by first name only, a patient of his who was midway through her denture treatment when her dentist died shortly after extracting all her teeth. The process of finding a new dentist who accepted the Michigan adult Medicaid dental plan and then waiting for an appointment put her care on “indefinite hold,” Campeau said, and during that time, Lori went without any teeth.

“This resulted in months of inadequate nutrition, social embarrassment and limited employment prospects,” he said.

Dr. Melanie Mayberry, a professor at the University of Detroit Mercy School of Dentistry, said that evidence and science prove that poor dental health has much farther-reaching impacts than most people know.

“Whether we’re talking about the impact of poor oral health on diabetes, poor oral health on cardiovascular disease, poor oral health on preterm birth and low birth weight, we know that oral health is essential to overall health,” said Mayberry, a professor at the University of Detroit Mercy School of Dentistry.

Another issue that would be addressed by the proposed reform is to expand dental procedures covered by Medicaid. Michigan’s plan currently doesn’t cover gum disease and other services, such as root canals, crowns and implants. This leaves providers with only one option: the removal of teeth prematurely.

“Someone who’s in dentures at 28 or 30 years old, will have a denture that slides around like a hockey puck on a rink by the age of 45,” said Dr. Lauren Johnson, DDS, chair of the Michigan Dental Association’s Access to Care Committee.

“It would be tremendous for Medicaid to include these other benefits going forward. But included at a repayment rate that dentists can afford to accept and still keep their lights on,” she said.

Implementing a combined managed care contract for the three dental programs, another aspect of the proposed reform, would allow the State to model the two adult dental programs after the most successful of the bunch: Healthy Kids Dental.

It would also help ease the administrative burden by streamlining the cumbersome reimbursement process and helping parents access the same providers and services that their kids already do.

Sugrue-Hyman said about 70% of private practice dentists in Michigan take Healthy Kids Dental and less than 10% take the adult Medicaid dental plans.

“Anyone that has Medicaid would have the same dental program, where now there’s many dental programs for people that have Medicaid,” Sugrue-Hyman said.

“So, if there’s a family, the parents and children would have the same dental program, which is really valuable because even when kids are served by Healthy Kids, if their parents aren’t able to access care or don’t have a dental home, they’re much less likely to go to the dentist or take the kids to the dentist,” she said.

A separate recommendation of $4.3 million would “increase the dental procedure reimbursement rate” at hospitals and surgical centers statewide, furthering access availability for patients.

“Sen. Rick Outman (R-Six Lakes) put forward a proposal that actually was like two and a half times the governor’s recommendation on that issue,” Sugrue-Hyman said.

The dental reform proposals have broad Legislative support with a multitude of other Legislators working with the Coalition on getting the reform.

“They’re really taking the opportunity that we have funding and figuring out how we can serve Michiganders who have these needs.”

Nessel: Nursing Home COVID Deaths, Flint Water Crisis Come Down To Evidence

During the Michigan Policy Conference on Mackinac Island, MIRS sat down with Attorney General Dana Nessel and asked about claims her office wouldn’t prosecute Gov. Gretchen Whitmer over a nursing home policy but was going after former Gov. Rick Snyder in the Flint water crisis.

Nessel said her office couldn’t open a criminal case against Whitmer over a policy to move COVID-19 patients to nursing homes, because the policy never went into effect. She also said the complaints received by her office were only about not liking Whitmer’s policy, nothing more specific.

“Listen, I support the governor, but I will go after her in a second if I think she has violated the law,” Nessel said. “There is no evidence of this.”

Whitmer’s policy to place COVID-19 positive people in nursing homes was introduced in June 2020 and later revised by the Michigan Department of Health and Human Services to make sure the patients were separated. The idea was universally panned by Republicans, who quickly made it a battle cry against the governor.

A short time later then-Sen. Pete LUCIDO passed legislation to make sure COVID-19 positive people were put into a dedicated facility, and Whitmer signed another executive order creating the Nursing Home Task Force to determine how COVID-19 patients should be treated in nursing homes.

Nessel pointed to now-Macomb County Prosecutor Lucido’s investigation not turning up any concrete evidence. In March, Lucido asked for people to talk to him about why their loved one died. MIRS placed calls to Lucido to see the current state of the investigation, but had not heard back by deadline.

“We have reviewed this from every perspective and have not found evidence of criminal activity,” Nessel said.

She gave the example of what happened in New York with former Gov. Andrew Cuomo being found to have misrepresented the numbers of COVID-19 deaths in nursing homes.

Nessel said she does not have the details of what is going on with the evidence in the he criminal case against Snyder and Nick Lyon because of a conflict wall in the office, but has faith in Solicitor General Fadwa Hammoud and special prosecutor Kym Worthy.

“The initial evidence that formed the basis of the charging came through the grand jury process and, of course, that’s being litigated,” she said.

The constitutionally of a one-judge grand jury is in the hands of the Michigan Supreme Court.