The Winds of Change by James Haveman, Director, Michigan Department of Community Health

With all of the changes coming from the Affordable Care Act, we are currently in the middle of some very tense times for healthcare. No matter where your party affiliation lies, there’s no denying that right now is an important and historic time in this industry. We are facing a major overhaul in the way services are provided and coverage is offered, and at the Michigan Department of Community Health, we are busy preparing for all of the changes headed Michigan’s way.

Recently, the Michigan legislature has made a decision on the future of an exchange in our state and we will now be pursuing a federally run exchange. With this, our focus at MDCH has turned to expanding Medicaid to an additional 470,000 currently uninsured Michiganders and educating our legislative partners about the importance of this. We know that our uncompensated care costs in Michigan have skyrocketed over the years and in turn our healthcare system has suffered. Businesses are now facing higher healthcare premiums, and as our residents go uninsured, our population as a whole has become much unhealthier.

Governor Snyder is committed to an expansion of Medicaid up to 133 percent of the federal poverty level. As a CPA, Governor Snyder made the smart decision to set aside funds in a Health Savings Account to help run the expansion even as the federal match declines. That said, many of the concerns we have heard around expansion revolve around the commitment from the federal government. The good news is that since 1966 when Medicaid began in Michigan, the federal financial commitment has not once waivered. History is on our side and changes from the Affordable Care Act are coming. The Governor’s proposed plan to expand Medicaid in Michigan makes good financial sense for our economy and good physical health sense for our residents.

Further, by improving our healthcare system in Michigan, we know we will see improved economic impacts as well. Healthcare is a huge economic engine. Hospitals are big employers in our communities, good health decreases our healthcare costs associated with chronic diseases, and wider healthcare benefits attract talent to our state. By focusing on reinventing our healthcare system, as Governor Snyder has charged the MDCH with doing, we can and will build a stronger Michigan.

We are shifting our focus from a curative model to one of prevention. Our mission at MDCH is to protect the health, wellness, and safety of Michigan residents. In order to do so, we have to educate them about the steps they can take to prevent illness and disease, as well as prepare our state for any unexpected outbreaks or health risks. Healthcare is not solely focused on coverage of services, but also ensuring that our residents are routinely receiving checkups to detect problems earlier, or are leading healthier, more active lifestyles to prevent chronic diseases.

In the fall of 2011, Governor Snyder charged the MDCH with addressing the rising obesity rate in our state and the chronic diseases associated with obesity. Since then, MDCH has released the Michigan Health and Wellness 4 x 4 Plan which includes a variety of strategies to improve the health status of Michigan residents. One of those strategies includes an awareness campaign to educate and motivate Michiganders.

MI Healthier Tomorrow was designed to do just that and since its launch in January 2013, more than 20,000 Michigan residents have pledged to lose 10 percent of their body weight, 17,000 have opted in to receive regular health tips via email, and 20 public and private partners have joined in the effort to improve the health and wellness of our state. An awareness campaign will not move the needle on its own but we know that by giving Michiganders the tools, encouragement, and motivation to make changes in their lives, we are helping them to improve their overall physical health. You are welcome to join in our efforts for a healthier Michigan.

In addition to a focus on physical health, MDCH has closely been looking at the integration of mental health and physical health care. Prevention does not just apply to a person’s physical health and wellness. Our mental health is another critical component to ensuring we have an overall healthy population and health professionals recognize that we cannot treat physical and mental health separately.

In his proposed budget, Governor Snyder calls for $5 million in new mental health services in the MDCH budget. With these funds, we want to place a larger focus on the identification of mental health illness using the Mental Health First Aid program. This program involves working with families and parents, community leaders, clergy, and educators to identify risk factors and warning signs of mental health illnesses. It also includes a component specific to law enforcement so that we can place youth in appropriate treatment rather than the jail system.

We have a number of important health items in the Governor’s proposed budget for fiscal year 2014 as mentioned above, and MDCH is working daily to educate both our legislative partners and Michigan residents about the critical importance of good overall health and wellness. Rising healthcare costs affect every Michigan citizen. Even the business community has begun to recognize the importance of good health for their employees and its effect on their bottom line. Employers can influence their healthcare costs and slow their growth by focusing on the health and wellness of their employees and encouraging healthy behaviors.

This also means that Michigan needs healthier communities with quality health and wellness opportunities, but our hospitals cannot do this alone. In our local communities, we need to activate better urban and rural planning that incorporates activity into health. Gyms, buildings, parks, schools, and shopping areas must encourage and welcome social motivation and activity.

A strong health infrastructure is critical to an overall strong state and we all need to be a part of the conversation as Michigan moves forward. To see the progress MDCH continues to make or what you can do to help, visit our website at www.michigan.gov/mdch. For more information about Governor Snyder’s proposed budget and the important health measures included in it including Medicaid expansion, visit www.michigan.gov/mibudget2014.

With all of the changes we are facing in the healthcare industry today, now is not the time to sit by and wait for the changes to sort themselves out. We need to be active in shaping the growth and future of Michigan. As Governor Snyder has said, a healthier Michigan is a stronger Michigan, and we truly can improve both our economy and healthcare system by working together.

posted by PAA Online , Friday, April 5, 2013 9:34 AM
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Detroit Faces Continuing Deficits Even With High Revenues

A report released by the Citizens Research Council shows that Detroit has managed to overspend its annually incurred revenues every year since 2003. The amount of revenue Detroit takes in is greater than most of its counterparts in total and also per capita. Detroit takes in approximately 60 percent of the state’s revenue sharing while also collecting about $1,200 per resident in various taxes. The closest per capita tax collections among cities with greater than 50,000 residents are $750 for Ann Arbor and Dearborn. Additionally, Detroit has lost both state revenue sharing and income tax revenue every year since 2002; with total revenues over that period declining 21.8 percent.

At the same time, Fitch Ratings downgraded two bond issues for the city’s water and sewerage department. The agency had previously rated a $1.9 billion bond issue as an A rating but have now revised it to a BBB+. Also, a $1.1 billion bond issue previously was rated as A- but was dropped to BBB.

Possible solutions to the problem will not consist of increasing tax rates or expanding the tax base because there is little political backing for either action. However, the state could help play a role by drafting legislation to require businesses outside of the city limits to withhold income taxes from city residents. The role Detroit’s emergency manager will play in all of this is unclear as well as his ability to correct the city’s finances without a bankruptcy.

posted by PAA Online , 9:31 AM
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State's Request to Dismiss ACLU Lawsuit on Right-To-Work is Denied

The state’s request, filed by the Attorney General’s Office, to dismiss the ACLU lawsuit aimed to invalidate the Right-To-Work law was denied by Ingham Circuit Court Judge William Collette. The lawsuit brought on by the American Civil Liberties Union of Michigan is centered on the notion that the Right-To-Work law is in direct violation of the Open Meetings Act.

The Open Meetings Act is designed to provide full access to legislative proceedings and violations occur if the Legislature moves forward with the process even though it is flawed. Also, under the Open Meetings Act a court possesses the power to invalidate an action taken by a public body while violating the act.

The ACLU lawsuit specifically considers two allegations from the plaintiff perspective. First, that the Department of State Police shut down the Capitol Building in early December when Right-To-Work legislation was being proposed. Second, that staff members of Republican legislators filled up the galleries in the House to prevent opponents of Right-To-Work legislation from observing the proceedings.

Judge William Collette ruled to keep the case moving after hearing remarks from both Assistant Attorney General Michelle Byra as well as ACLU attorney Michael Pitt. Mr. Collette stated that the case merited proceeding with depositions but that overall the case faces an uphill battle to prevail. Mr. Collette scheduled a conference to be held on April 11^th to set up depositions for the case.

posted by PAA Online , 9:31 AM
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March 29th Survey Results

In the March 29^th edition of PAAdvisory, readers were asked, “given U.S. Senator Carl Levin’s recent announcement that he will not be seeking re-election, considerable speculation remains with regard to who will run for the Democratic and GOP nominees to run for the open seat in 2014. Who do you believe will be the Republican nominee?”

An overwhelming 75 percent of respondents believe U.S. Representative Mike Rogers (R-Brighton) will receive the Republican Party’s nomination. Former Secretary of State Terri Lynn Land received 19 percent of the vote. U.S. Representative Justin Amash (R-Cascade Township) received no votes.

posted by PAA Online , 9:30 AM
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PAAdvisory Briefs

Greimel Makes Staff Changes

Newly elected House Democratic Minority Leader Tim Greimel announced Thursday that he had removed his Chief of Staff Adrian Hemond as well as Constituent Relations Director Ben Miller. The terminations caught the quiet Capitol by surprise after the Minority Leader’s office simply stated Mr. Hemond and Mr. Miller were no longer on staff. Trouble had been brewing for a few weeks after some Democratic Caucus members were upset with the roll-out of the Democrats “Michigan Middle Class Plan” released March 25^th. Members were unhappy with the lack of involvement they had in the final document.

Michigan Film Office Approves New Film

Oscar-nominated actor Ryan Gosling will begin his film writing and directing career in Michigan with his new film, “How to Catch a Monster”. The film features Christina Hendricks (“Mad Men”), Saoirse Ronan (“Atonement”), and Eva Mendes (“The Place Beyond the Pines”). The film is projected to hire 104 Michigan workers and will start shooting in metro Detroit this spring. The Michigan Film Office approved an incentive of around $1.75 million on more than $6.23 million of projected in-state expenditures for the film.

Four Appointments Announced by Secretary of State

Secretary of State Ruth Johnson announced that there have been four additions to her government affairs and constituent outreach team. Brandy Nash of Lansing has been appointed Director of Public Affairs and Lindsay Esson of Haslett has been appointed Director of Constituents Relations. Gary Koutsoubos of Birmingham has been named the new Executive Office Representative while David Richmond will be the new Legislative Liaison in the Office of Government Affairs.

County Road Association Elects New Officers

The County Road Association’s Board of Directors unanimously elected Dennis Kolar as President; as well as electing Bradley Lamberg as Vice-President and Dorothy Pohl as Secretary-Treasurer. Dennis Kolar is currently working as Managing Director of the Road Commission for Oakland County and has greater than 33 years of road business experience. Bradley Lamberg and Dorothy Pohl are both currently Managing Directors; the first of the Barry County Road Commission and the latter of the Ionia County Road Commission.

posted by PAA Online , 9:29 AM
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Question of the Week 4/5/2013

posted by PAA Online , 8:49 AM
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