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Conversion Therapy Ban Moves Again, Less than 24 Hours Later
Bills that ban conversion therapy for minors were voted out of the House Health Policy Committee after being voted out of a subcommittee less than 24 hours prior.
Conversion therapy, the practice of attempting to change an individual’s sexual orientation, gender identity or gender expression to align with heterosexual or cisgender norms, is not therapy at all, said Rep. Felicia Brabec (D-Ann Arbor), chair of the Behavioral Health subcommittee.
The bills are an explicit ban on “saying to someone, ‘who you are is not OK, and it’s wrong.’ That’s not what we do in therapy,” Brabec said.
Rep. Graham Filler (R-St. Johns) asked about how the ban would affect an individual seeking therapy to rid themselves of homosexual or transgender feelings.
Brabec said therapy is client-led and affirming to allow a “safe, welcoming space” for clients to explore their identities.
Rep. Jamie Thompson (R-Brownstown) asked if a conversion therapy ban would mean a 6-year-old having transgender thoughts or feelings would have their suspicions “affirmed,” and Brabec said the affirming environment of therapy is “one of trust and it’s affirming no matter what folks are coming in for.”
Testimony during a recent Behavioral Health Subcommittee meeting explained the physical forms of conversion therapy that are used to “train” an individual out of homosexuality or being transgender, such as being counseled to not speak to feminine relatives for years, applying heat or ice to genitals in response to pornographic imagery, taking performance-enhancing medication to encourage sexual desire for a particular gender and electroshock therapy.
“I found it very compelling to hear the details of conversion therapy. I was unaware of the physically torturous practices that take place,” said Rep. Carol Glanville (D-Grand Rapids) who serves on both the committee and subcommittee.
Ottawa County Health Officer Firing May Be Legal After All
The Michigan Court of Appeals vacated an April order prohibiting the Ottawa County Board of Commissions from removing Adeline Hambley as the county’s health officer.
“Under MCL 46.11(n), a county board of commissioners has authority to remove a health officer in limited circumstances and when certain processes are given,” read the order from Judge Mark T. Boonstra.
The appeals panel granted the county’s request to appeal on an expedited basis, but limited it to the issues of whether the trial court erred in awarding judgment to Hambley on her claim for declaratory relief and whether the trial court erred in granting Hambley’s preliminary injunction prohibiting her removal.
The appeals panel stayed trial court proceedings as the appeal continues.
Judge Jane Markey concurred.
Judge Christopher Yates concurred in the modification of the trial court’s injunction, but would deny the application otherwise.
Hambley filed a lawsuit in February challenging the conservative Ottawa Impact-backed commissioners, who tried in January to fire her. Those members want to replace Hambley with Nathaniel Kelly, but his appointment must be approved by the state health department, which had not received his application as of press time.
In April, Muskegon County Circuit Court Judge Jenny McNeill granted Hambley’s request for a preliminary injunction, allowing her to keep her job as the health officer.
ACA Consumer Protection Bills Get Hearing
Health insurance companies would not be able to rescind coverage from a customer unless there’s proven fraud or misrepresentation, under legislation discussed in a Senate committee.
The legislation is part of a three-bill package that puts into state law the consumer protections established through the Affordable Care Act in case the federal statute is weakened by the U.S. Supreme Court or a future Congress.
These bills would mean consumers have access to certain information when making decisions about their health insurance. It also standardizes the coverage levels under the platinum, gold, silver, and bronze plans.
In general, the platinum plan has a high premium, but fewer out-of-pocket costs when health care is needed. The bronze plan has a low premium, but more out-of-pocket costs when health care is needed.
The bills are part of a larger bi-cameral package that includes related, but not identical, bills that are moving through the House, said Joe Sullivan, the legislative liaison for the Department of Insurance and Financial Services.
“At a minimum, you’re providing that certainty to consumers that these protections will remain in place,” Sullivan said. “If something were to overturn those protections, they would be upheld in states with these types of statutes,” Sullivan said.
Other groups supporting the bills are: The Michigan Primary Care Association, the Disability Rights of Michigan, Michigan Academy of Family Physicians, the ARC Michigan and Michigan Counsel for Maternal and Child Health, the Michigan Nurses Association and the Michigan League for Public Policy.
The National Federation of Independent Businesses was opposed to the bills as introduced.
New Psychiatric Hospital In Caro Receives Whitmer’s Blessing
Gov. Gretchen Whitmer attended the open house to celebrate the completion of the $85 million Caro Psychiatric Hospital last month.
The 130,000-square-foot facility replaces the Caro Center, which was built in 1913 and served as the only residential treatment center for seizure disorders in Michigan until 1997. It is one of the five inpatient mental health hospitals in the state.
“Ensuring Michiganders have access to vital physical and mental health resources are key focuses of my administration,” Whitmer said. “Michiganders deserve mental health resources when and where they need them.”
The new Caro facility has updated building security and video surveillance. The $85-million, 100-bed Caro Psychiatric Hospital has a “downtown-themed” area that offers patients a hair care salon, exercise room and a greenhouse.
The Caro Psychiatric Hospital offers four separate patient neighborhoods and units, each decorated with therapeutic colors reflecting seasonal color schemes for winter, spring, summer and fall. The rooms are mainly single-bed suites with private bathrooms, with some double rooms and others set up to care for geriatric patients.
“The new Caro Psychiatric Hospital is an important investment in behavioral health services in Michigan for both our families in need and the Caro Community as an employer,” Whitmer said.
Four years ago, construction of a planned 200-bed facility in Caro was paused as the new Whitmer administration considered whether building a psychiatric facility in the Thumb would “best meet the needs of Michigan citizens”
After a summer of lobbying by the employees in Caro, Whitmer’s Department of Health and Human Services conceded to a bed-for-bed replacement of the 100 that were at the old facility. After watching the Whitmer team take credit for a new facility that nearly didn’t happen because of them, Rep. Phil Green (R-Millington) said, “The irony was not lost.”
That said, Green commended the new facility and conceded that it will improve the care given to the patients. However, the state has hundreds of people with psychiatric problems waiting in emergency rooms in Michigan for spaces like those in Caro to open up.
“There doesn’t seem to be a response from the administration to address the crisis that we’re in,” Green said.
Second Half Of ‘Healthier Michigan Plan’ Headed To House Floor
A Rep. Graham Filler (R-St. Johns) bill allowing collaborative incentive programs for Medicaid recipients practicing health-positive behaviors was the second half of a Healthy Michigan Plan reform package that moved unanimously out of the House Health Policy Committee last month to the House floor.
Instead of the Department of Health and Human Services creating incentives for Medicaid recipients who practice positive health behaviors, HB 4496 would require the DHHS to work with contracted health plans to create them.
Incentives under Filler’s bill could include practicing healthy behaviors, completing screenings or undergoing procedures to improve health outcomes.
His bill would also remove mandatory requirements for Medicaid health maintenance organizations to use DHHS-created monetary incentive programs for chronic disease.
Currently, HMO contracts are required to include monetary incentives for meeting health targets for chronic disease, which is intended to increase the number of Medicaid recipients practicing positive health behaviors.
The bill would make HMO contract incentives voluntary and remove the requirement that priority is given to strategies for preventing the 10 most common and costly ailments.
Filler’s bill was voted out one week after the other half of the package, Rep. Will Snyder (D-Muskegon)’s HB 4495 , which would remove some requirements put in place by former Gov. Rick Snyder under the Healthy Michigan Plan.
Both bills in the package were supported by the Michigan Health and Hospital Association.
MHA Senior Advocacy Vice President Adam Carlson said changes include an elimination of cost-sharing requirements that are rarely collected and a burden for administrators, the striking of a provision that DHHS must keep administrative costs below 1% of the department’s appropriation for the state Medicaid program and new options for enrollees to complete health risk assessments electronically and without penalty.
The bills were also supported by DHHS, the Michigan State Medical Society’s Legislation and Regulatory Policy Committee, the Michigan Association of Health Plans, the Center of Civil Justice, the Food Bank Council of Michigan, the Michigan Council for Maternal and Child Health, Molina Healthcare, AARP, the Health Alliance Plan, McLaren Health Plan, Blue Cross Blue Shield Michigan, Trinity Health Michigan, Priority Health and the Upper Peninsula Health Plan.
Snyder’s bill was voted out of committee on May 18. It received a 12-0 vote in favor, with six Republican members passing.
Filler’s bill was held back, however, in need of an amendment.
The bill originally included language removing work requirements for Medicaid recipients, which Filler said wasn’t the focus of the legislation and was added by mistake.
A Rep. Julie Rogers (D-Kalamazoo) bill removing Medicaid work requirements was recommended out of Health Policy on March 16, though it did not receive Republican support.
Filler’s amendment also removed language referencing dual-eligible Medicaid participants, which he said was in response to constituent conversations.
Behavioral Health Centers Call On Legislature for Support
Behavioral health providers struggling to maintain talent and receive funding to provide comprehensive services are calling on legislators to address these challenges.
Leaders of behavioral health centers are seeing their practitioners burdened by low monetary incentives and large loads of administrative work.
Many of the professionals that the health centers have lost are “no longer attracted” to providing services to individuals covered by Medicaid due to the “administrative challenges” that lead them to work for an organization that doesn’t accept Medicaid, said Debora Matthews, President and CEO of the Children’s Center in Wayne County.
Behavioral health clinicians average 40% of their working time doing paperwork getting authorizations for care or creating service plans, said Sean de Four, President and CEO of Southwest Solutions.
“That seems egregious to me that we’re not using their talents and expertise in a way that it was meant to,” said Rep. Felicia Brabec (D-Ann Arbor), who worked as a therapist before taking office.
Master’s level clinicians at Family Service and Children’s Aid in Jackson are getting paid approximately $46,000 per year, said President Bob Powell.
“They can make more money supervising at a nearby Starbucks. Why would they take on student loans and go through all the trauma of working with traumatized kids and families?” Powell said.
He said organizations like his need help incentivizing graduate programs in counseling and social work to retain workers in public mental health systems without losing them to privatized care.
Southwest Solutions and some other organizations have become Certified Community Behavioral Health Clinics through expansion grants from the Substance Abuse Mental Health Services Administration.
Each presenter at the House Behavioral Health Subcommittee meeting called on legislators to support legislation to fund the state’s expansion of the number of CCBHC sites.
CCBHCs provide comprehensive behavioral health care regardless of ability to pay, place of residence or age and must provide care in one location to eliminate the need for multiple providers.
De Four said, as a result of the grant, 500 more children per year are able to receive care who would not have qualified for services in the publicly funded system because their health needs “weren’t severe enough.”
The state’s criteria to become certified as a CCBHC leaves out organizations like Southwest Solutions.
De Four said the SAMHSA grant will run out of funding in September, meaning they will not be able to afford to provide the services.
“That’s 500 kids per year, that’s 80 more people that may die from opioid disorder,” de Four said.
Steckloff’s Plea For Oral Chemotherapy Parity Pays Off
Rep. Samantha Steckloff (D-Farmington Hills) once again provided testimony about her battle with breast cancer and the need for oral chemotherapy parity, this time on the House floor before her bill passed, 70-37.
She spoke for approximately eight minutes about her HB 4071 , telling a story that brought several House members to tears.
Steckloff’s bill places a cap on co-pay for orally administered anticancer drugs, which she said changed her quality of life after spending over a year on IV chemo.
“When you’re in the hospital for three weeks at a time, every few days they have to remove it and put it somewhere else,” she said, adding that she only had one viable arm for blood draws and infusions. “To save my arms, I would get blood draws in my neck, my upper thigh, my foot. We were unsuccessful through the toes.”
Like her testimony before the House Health Policy Committee, Steckloff explained how “everything is taken away from you that you feel as a woman.
“Your hair, your eyelashes or eyebrows, your toenails, fingernails, your bras, your fertility,” she said.
But she said oral chemotherapy gave her life back, allowing her to return to work and spend time outside the hospital.
Currently, many oral chemotherapy medications are only covered by insurance if an IV alternative is unavailable, and IV therapies are cheaper because they’re billed as a service, while oral chemotherapy can come with higher out-of-pocket costs.
She said intravenous chemotherapy at a hospital or clinic is covered by insurance and is cheaper because it’s billed as a service. But oral chemotherapy is not covered unless it’s the only choice, and it often comes with a higher out-of-pocket cost because it’s billed as a drug.
Steckloff said her bill will do the same for other Michiganders fighting cancer by placing a $150 cap on co-pay for a 30-day supply of oral chemotherapy drugs beginning Jan. 1, 2025.
The bill includes language ensuring that increasing cost-sharing requirements or stricter treatment limitations would be the response from health insurance providers.
After 14 years of insurance parity conversations on chemo drugs, which had been paused due to concerns from the Michigan Chamber of Commerce and other business groups about skyrocketing prices, the legislation passed the House, 70-37.
Following the vote, Steckloff opened the board for co-sponsorships, and received 53, including two Republicans.
After session, Steckloff was asked what memories were going through her head at the moment the bill passed.
“There was a moment where I was in the hospital for three weeks at a time,” she responded. “The immense amount of pain that my body went through, bone pain, is so excruciating, and I remember being in the car almost screaming on the way to the hospital on the passenger side because I was in so much pain.
Steckloff said it was two days after she was discharged that she was fired for running out of medical leave.
“All I kept thinking is that no one has to go through that again,” she said.