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A Little Fire Smoldering Over Surgical Smoke
The House Health Policy Committee watched a demonstration last month showing how quickly surgical smoke can accumulate when a cautery device is used without a smoke evacuation system.
The presentation accompanied testimony on HB 4779 , which would require health facilities performing smoke-producing procedures to develop and implement a policy to clear the air of these surgical areas.
During the demonstration, a representative from the medical device company Stryker used a Bovie cautery device inside a sealed container to simulate what occurs in an operating room when tissue is cut or blood vessels are cauterized. Within moments, smoke filled the enclosure. When the smoke evacuation unit was switched on, the plume was captured at the source.
Rep. Pauline Wendzel (R-Watervliet), the bill sponsor, told the committee members that the surgical smoke plume contains 16 EPA priority pollutants and more than 150 identified chemicals. Her testifier, (former Rep.) Ben Frederick, from Stryker, compared the amount of smoke generated over the course of a typical operating room shift to the equivalent of 27 to 30 cigarettes.
Frederick added that research indicates standard surgical masks do not adequately filter microscopic particles found in surgical smoke.
Among the testifiers was Ellie Kercher, a certified operating room nurse, who described headaches and respiratory irritation that she believes were caused by the surgical plume. She told lawmakers that while many facilities have smoke evacuation equipment available, its use is not always consistent. The bill, she said, would establish a uniform safety standard rather than leaving use of the equipment to individual discretion.
“We have been breathing this problem for too long, and it’s time to clear the air,” Kercher said.
Frederick told lawmakers that, according to survey data cited during testimony, 97% of operating rooms in Michigan already have smoke evacuation equipment available. He estimated capital equipment costs between $2,000 and $5,000 per unit, with disposable cautery attachments costing between $14 and $23 per procedure.
There were also those who testified in a neutral position. Jessica Rodriguez and Cara Erickson of the Michigan Ambulatory Surgery Association said they support smoke mitigation, but urged flexibility in how policies are written. They said some lower-plume procedures may be appropriately managed with alternative mitigation methods, such as in-line HEPA filtration, rather than a mandated smoke evacuation pencil for every case.
The two pointed to the demonstration shown earlier, suggesting that it was misleading because the cautery settings used appeared higher than typically used in practice, causing more smoke. They said that smoke levels can vary by procedure and disagreed with the price points that were mentioned earlier.
Lawmakers asked about regulatory oversight and potential implementation timelines. Testimony indicated other states have enacted similar requirements, with effective dates typically six months to one year after passage.
In other business, the committee also heard testimony on HB 5302 , sponsored by Jay Deboyer (R-Clay), which would revise funding parameters for certified Recovery Community Organizations (RCOs).
Testifiers said the grants are supported through a combination of state dollars and opioid settlement funds and described RCOs as independent, nonprofit, peer-led recovery groups that are not clinical providers and are not eligible for Medicaid reimbursement.
The bill would remove an existing $150,000 cap, establish a minimum $250,000 grant amount and limit funding to no more than 50% of an organization’s operating budget, while requiring reporting to the Legislature.
After 5 Years, Roth’s Fertility Fraud Bills Finally Move To Senate
A fertility clinic specialist who uses somebody else’s embryo or gamete to induce a pregnancy would face a 15-year, $100,000 felony under legislation that finally passed the House after five years of trying.
The lead bill in the Rep. John Roth (R-Interlochen) five-bill package narrowly passed, 61-48, with Rep. James Desana (R-Carleton) joining most Democrats in voting no. Reps. Sharon MacDonell (D-Troy), Samantha Steckloff (D-Farmington Hills), Mai Xiong (D-Warren) and Peter Herzberg (D-Westland) joined most Republicans in support.
The package — HB 5035 , HB 5036 , HB 5037 , HB 5038 and HB 5039 — would create new criminal penalties, civil liability provisions and professional sanctions related to assisted reproduction procedures. Under the bills, lying about the donor’s identity or medical history would be a five-year, $50,000 felony.
The bills would also allow individuals injured by false representation in assisted reproduction to seek economic and non-economic damages, punitive damages and attorney fees. The package would extend the statute of limitations for prosecution, add the new crimes to Michigan’s sentencing guidelines and require disciplinary action by the Department of Licensing and Regulatory Affairs for health professionals found in violation.
Roth said that he has worked on the package for five years, including collaborating with the attorney general, doctors and the Michigan State Medical Society, and making language changes requested by medical professionals. He said certain amendments adopted clarified that a doctor would have to knowingly violate the law to be held accountable.
“I am very proud of our caucus. They voted to protect women in this service,” Roth said, noting that he remains confused about why others have continually opposed this legislation.
Rep. Laurie Pohutsky (D-Livonia) was among the opponents, voting no on each bill in the package. While she said that she supports addressing fertility fraud, she was against the package due to liability concerns.
She said the bills could hold donors liable in ways that create “really unfair expectations” about disclosing detailed family medical history, including conditions involving extended relatives. Pohutsky gave the example of a donor who may not disclose a condition that runs in their family simply because they are unaware of it. While the bill includes the term “knowingly,” she said she does not have confidence that the standard would ultimately be interpreted that way under the current language.
She added that unless liability concerns are addressed, she would not prefer the bills move forward in the Senate.
Speaker Matt Hall (R-Richland Township), however, congratulated Roth, praising his years of dedication to the package.
Two additional bills passed with Rep. Steve Carra (R-Three Rivers) casting the lone “no” votes:
- HB 4530 modifies the deadline for mental health professionals to release mental health records or information relevant to a child abuse or neglect investigation to the department.
- HB 5220 requires continuing education for mandated reporters in child abuse and neglect detection.
Separately, HB 4981 passed unanimously. The bill would update the Public Health Code to change the title “limited licensed counselor” to “limited licensed professional counselor” and add the corresponding protected initials, without altering qualifications or scope of practice.
Bellino: Donating An Organ Shouldn’t Cost An Arm And A Leg, Too
Without Senate Majority Leader Winnie Brinks (D-Grand Rapids) giving him days off for pre-operation appointments, Sen. Joseph Bellino JR. (R-Monroe) said he could never have been an organ donor to his brother-in-law, to whom he gave a kidney in summer 2024.
Today, the Senate Health Policy Committee heard testimony on Bellino’s SB 301 , allowing Michigan employers to claim income tax credits worth 100% of wages they pay to a worker gone on “organ donation leave.” The time period related to the claim could be up to 12 weeks for the employee on leave, taking place before, during and after the organ donation.
During the meeting, Bellino explained how, in December 2014, his brother-in-law shared on Facebook that he needed a kidney donation, and wasn’t a good candidate for dialysis.
According to the American Transplant Foundation, dialysis treatment is a “less-than-perfect replacement for an actual human kidney.” Also, because kidneys from diseased donors don’t work immediately in some cases, patients may need.
“I put my name on the list. Now, I got to be honest, it was two or three days after it came out. I waited for a bunch of nieces and nephews who are younger than I am to get on,” Bellino said. “But soon they were all rejected. Their blood type, they wanted to have more children … all kinds of things. And then it got to me. Then a few months later, I was going to give a kidney.”
Bellino said the real barrier preventing many individuals from becoming donors is the loss of income during recovery.
He described SB 301 as a corporate income tax credit for Michigan employers providing fully paid leave to employees donating organs. He added that the leave must be offered in addition to existing benefits like paid time off or vacation, and must be verified by a physician.
“This legislation does not mandate employers participate. It simply creates an incentive. Employers who choose to step up and support employees making an extraordinary life-saving decision receive a tax credit in their return,” Bellino said.
Bellino gave a special shoutout to Brinks, putting time on the Senate’s schedule last term for him to talk to doctors and make pre-operation appointments ahead of the transplant operation.
“In fact, the day of my last pre-op was a voting day, and I went to her and said ‘look, the doctors need me there all day long.’ She changed the day for me,” he said. “SB 301 reflects a simple principle — if someone is willing to save a life, the least we can do is ensure they’re not financially penalized for doing so.”
SB 301 was also supported by business groups like the Michigan Chamber of Commerce and the Detroit Regional Chamber.
One of today’s testifiers was David Galbenski, co-founder of the Living Liver Foundation, a small association aimed at educating folks at becoming living donors. Galbenski, a Grosse Pointe resident, received a liver donation from his brother-in-law six years ago.
Galbenski said Michigan has already shown what meaningful progress looks like, such as through the 2023 passage of legislation protecting living donors from discrimination by life, disability and long-term care insurers.
He also mentioned the passage of reform in 2024, creating a one-time nonrefundable credit of up to $10,000 for unreimbursed donation-related costs, like travel, child care and lost wages. The tax credit kicked off at the start of last year.
Galbenski said that SB 301 fills a gap “for a very practical problem with the existing tax credit.”
“Because the tax credit is non-refundable and cannot be carried forward — talking about the $10,000 state tax credit — its value depends on how much state income tax a family owes in a single year,” he said. “Most donors will never owe the $10,000 in state income tax, so even if their donation-related costs reach that amount, they may (only be) able to claim a fraction of the credit.”
He said that many donors need four to 12 weeks away from work to recover, and when wages stop during leave, families’ finances are hit immediately.
Dr. Mona Doshi, a kidney specialist with University of Michigan Health, said that live kidney transplants can save Medicare and Medicaid taxpayer dollars. For example, dialysis costs around $60,000 annually, while the upfront cost of a kidney transplant is a high of $100,000 due to the surgery.
“But thereafter, the cost is $10,000 a year just for the medications. So after three years, dialysis is far more expensive than kidney transplant, and far inferior treatment than kidney transplant,” Doshi said.
Doshi described meeting a woman who wanted to donate to her daughter. However, after hearing she would need four to six weeks off of work to do so, the mother told Doshi she couldn’t be her daughter’s living donor, as she lived paycheck to paycheck and couldn’t afford the time off.
“That was very appalling, and that’s what got me into this advocacy role,” Doshi said. “Also, the time off depends on the job. So if they have a desk job, then perhaps some can even return (in) three weeks, four weeks after donation, and some may take longer.”
Based on surveys, Doshi said it’s estimated that the average loss of income was around $5,000 per donor in 2024.