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

MDHHS Receives Part Of $800M Opioid Settlement Payment

The Michigan Department of Health and Human Services was approved to spend $39.2 million of the $800 million that would go to state and local governments from the $26 billion settlement from the three largest pharmaceutical distributors and Johnson & Johnson.

MDHHS said the funds would be spent toward treatment providers, recovery supports, harm reduction, and prevention programs for people with substance abuse disorders.

“In Michigan, we are using this long-term funding to address the multi-generational impact of the opioid epidemic as well as address racial disparities that exist as part of the opioid crisis,” MDHHS Director Elizabeth Hertel said.

MDHHS will also use the opioid settlement funds to expand capacity for treatment.  The expansion would include a review of expanding treatment facilities, which can’t be done with federal funds.

The $800 million would be paid to the state over 18 years.

All 83 county governments and several local governments will split $400 million, which is 50% of the initial payment.

The settlement agreement was reached in 2021 and the first payment was made in 2022.

Nursing Home Workers Get $1.50 Hourly Raise In Budget

The proposed $35.5 billion 2024 budget for the  Michigan Department of Health and Human Services would provide more than $300 million to increase wages for people working in nursing homes.

Gov. Gretchen Whitmer proposed $210.1 million to go toward increasing the wages of direct care professionals at nursing homes across Michigan. Another $90 million would be going to increase the wages of non-direct care nursing home staff.  In all, this would increase the average by $1.50 per hour.

“Long-term, statewide strategies to keep direct care workers on the job are long overdue and this proposal is a great place to start,” said Robert Stein of the Michigan Assisted Living Association.

Stein said the association is looking forward to working on the pay increase.

“Michigan’s vulnerable individuals and their families are relying on it,” he said.

On the governor’s call for a $1.50 hourly wage hike for direct care workers, and a $1 boost for all other indirect day care employees, the lobbyist for the Hope Network  is expressing approval of the move although former Rep. Joe Haveman reflects, “anything is better than nothing.”

That is his way of saying that a bigger increase is needed, but he quickly added, “I’m not going to criticize the governor because she is trying” and in the end he will take that.

The Network represents about 3,000 workers in hospitals, nursing homes, rehab centers and the like and he is hoping the potential raise, if lawmakers agree, “will trickle down to the private sector,” as well.

He said he expects to get a better reception from the new Democratic-controlled legislature on all this than he might have gotten had the R’s kept control.  This is coming from a Republican who now considers himself, “a man without a party.”

Of the proposed $35.7 billion MDHHS budget, $6.3 billion is funded by the General Fund. One-time funding makes up $257.5 million, which has $236.1 million coming from the state. There would also be six programs cut from the budget, including $250 million in funding for the Adoptive Family Support Network.

Several other items are housed in the budget, which would be increased from 2023 by $2.3 billion if passed as it is currently.

The spending plan has MDHHS creating a new office called the Office of Community Violence Intervention Services, which would be responsible for reducing violence, such as gun deaths.  It will have a $10.8 million budget and $2 million will go to prevent gun deaths.  $8 million will be used for grants to community violence prevention agencies.

Victims service programs would get $7.9 million.

“This budget also provides new tools and supports for foster families to allocate funds to direct reimbursement for adoptive families, guardians and foster parents,” Budget Director Chris Harkins said.

Foster families would receive $19.3 million in financial support, which Harkins said would be an 8% increase. Another $15.1 million would go to provide short-term care with a specialized caregiver support system for foster parents.

The Child Welfare Information System would see $12.6 million go to a cloud-based computer data storage system.

“Funding in the budget will help the department continue the transformation it has made to the child welfare system that has resulted in improved safety for children and families since the inception of the federal lawsuit,” said MDHHS spokesperson Bob Wheaton.

The Racial Disparities Task Force recommended programs would cost $58 million, including $2 million to develop equity training in the department and $10 million to improve data collection on equity.

The task force also recommended $18.5 million for the creation of a neighborhood health grant program, $18.1 million for local healthy community zones, which would provide access to healthy food, affordable housing and safety networks.  A one-time $2.5 million grant would go to support sickle cell services.

Michigan’s drinking water system infrastructure would get $100 million to support ongoing plumbing replacements for places with lead pipes.

“The delivery of safe and clean water is the top priority of every municipal water system in Michigan,” said Michigan Municipal League Executive Director Dan Gilmartin.

Gilmartin said the budget would go a long way to removing lead service lines from municipalities across the state.

“In Michigan, our water is part of who we are, and that means we must ensure all communities, regardless of zip code, have safe, clean and affordable drinking water,” said Lisa Wozniak, executive director of the Michigan League of Conservation Voters.

The proposed $6.2 million would fund the Medicaid Plan First! program, which would expand access to family planning services for nearly 25,000 Michiganders.

“Affordable access to birth control is a vital tool for health, economic opportunity and reproductive freedom,” said Kathy Bacon, Arnold Ventures director of contraception choice and access.

Local health departments would get $30 million and $22.5 million would go to respond to environmental public health threats.

Mental health recruitment would get $5 million for funding scholarships and other tools.  There would be $5 million for mental health services for first responders.

Medicaid reimbursement would see $129.7 million.

“The budget also supports families covered by Medicaid and the Healthy Michigan Plan. Governor Whitmer’s budget will ensure more Michiganders have the support they need to get and stay healthy,” Wheaton said.

Insulin, Cannabis-Testing Lab Proposed By Governor

A state-run cannabis testing laboratory and a separate insulin-producing laboratory are a pair of proposals Gov. Gretchen Whitmer laid out in her $79 billion budget proposal.

During the State of the Union address, President Joe Biden talked about lowering the cost of insulin to $35 for Medicare recipients and it appears the proposed $150 million to subsidize an insulin laboratory in Michigan could help do just that in Michigan.

“Insulin can cost 10 times as much as in other nations and prices have tripled over the last decade,” Whitmer said.

She said making insulin in the state would provide savings for diabetics and other people who need it “hundreds of dollars per month.”  American Diabetes Association data from 2022 showed nearly 1 million Michiganders have diabetes and nearly 60,000 are diagnosed every year.

The plan was backed by the Michigan Association of Health Plans.

“Increasing competition will ensure everyone who needs insulin has more access and affordable options. The governor’s budget proposal to curtail the escalating costs of insulin is bold leadership that should be commended,” said MAHP Executive Director Dominick Pallone.

The plan isn’t new, but it is the first concrete move since Whitmer signed an executive directive in October asking state departments to look at how to lower the cost of insulin.

There is a precedent for creating a state-subsidized medicine facility.  Until 1996, a state laboratory made vaccines for tetanus, rabies, pertussis, diphtheria, typhoid and anthrax. The same lab also produced fractionated blood plasma.

Cannabis Regulatory Agency  Proposal

The proposed $33.8 million budget for the Cannabis Regulatory Agency would include $4.4 million to create a Cannabis Regulatory Agency Reference Laboratory to address issues required by audits and safety recalls, among other things.

“This reference lab will also support CRA enforcement investigations without placing undue financial burden on CRA-licensed safety compliance facilities; we project this reference lab will cut our timeline of illicit product investigations by 50% or more,” CRA spokesperson David Harns said.

The laboratory use for investigations was proposed by CRA Director Brian Hanna as part of a call from the industry to crack down on black-market cannabis entering the regulated market.

Vaccines Are Free For Medicare Adults Under IRA

“On my 68th birthday, I woke up with shingles,” said Linda Hamacher, a Genesee County senior who spoke during a Protect our Care Michigan webinar last Thursday about how the recently-implemented federal Inflation Reduction Act allows no-cost access to vaccines for adults on Medicare.

Her own experience, which included waking up with a stiff neck and inflammation on her face, was painful, and “I never thought I would be one of the 33% of people who are going to get shingles.”

The scary, painful few weeks that Hamacher said were caused by the stress of caring for her sick husband led her to get a shingles vaccine and hopefully stop future outbreaks. She said the two-dose vaccine was $120, even with healthcare coverage.

“I understand that it was up to just under $500 for some people,” she said, “so that would certainly be a deterrent to someone who is on a fixed income.”

But Joseph Palm, regional director for the U.S. Department of Health and Human Services, said Medicare and state Medicaid programs will now cover the cost of all vaccines recommended by the Advisory Committee on Immunization Practices, including the shingles vaccine, under the passage of the Inflation Reduction Act.

He said this policy will boost access to vaccines for older adults, along with capping the cost of insulin for diabetic Medicare beneficiaries at $35 per month, which he called a “gigantic change for people living on fixed incomes.”

Hamacher shared stories of friends who currently take reduced insulin dosages or share with their partner to make it go further, “because they haven’t been able to afford the up-to-$6,000 a year that this has been costing,” she said, “and when that happens, the kidneys began to be affected. Circulation is directly affected and people can very easily and fairly easily and fairly quickly end up in kidney failure.”

Palm referenced a study that found a cap on insulin in 2020 would have saved 66,726 Michiganders an average of $403 a year, with savings totaling $27 million statewide.

He said the Act’s implementation will also fix a “family glitch” that if the head of household had employer-provided insurance, their children or spouse were ineligible for tax credits even if the employee insurance was unaffordable.

“No one wants to put a family in that situation. Our nation is supposed to be about upward mobility,” he said. “That’s why nine years after the marketplace opened, that regulation was recently changed, which opened the marketplace to thousands of more people.”

In addition to new benefits for Michiganders through the federal passage, state Department of Insurance and Financial Services Director Anita Fox said 2022 was another year for increased Michigan enrollment through the Health Insurance Market.

Michigan saw a 6.2% increase from the previous open enrollment period with 322,272 enrollees, Fox said.

“Michigan’s marketplace numbers were on a downward trend with annual decreases between 2017 and 2021,” she said. “We were able to reverse that trend in 2021, and we’ve seen continued growth for the last three open enrollment periods.”

She added that going into 2023, Michigan has the fourth largest benchmark health insurance rates in the country, and has consistently been in the lowest 10 since 2016.

“Although we don’t yet have final numbers for 2023 savings, in 2022 we know that 85% of enrollees qualified for extended and expanded subsidies,” Fox said, “with many people able to find a comprehensive health insurance plan for less than $10 per month, with an overall average savings of more than $400 per month.”