This month’s edition of “5 Things We’re Watching” includes coverage of notable bills in the legislature, newly instituted implicit bias training for health care workers, and some key items from Michigan’s FY 23 budget, which is currently awaiting Gov. Whitmer’s signature.
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State of Reform
1. Reforms to BH parity reporting and nursing home surveys in the legislature
The House Health Policy Committee recently considered a bill package that would make it easier for the state to access behavioral health parity information. The federal government currently collects data from health plans in all states detailing how they’re funding behavioral health compared to physical health. The 3 bills would require plans in Michigan to provide this information to the state too, giving state regulators greater access to BH parity information to ensure plans comply with state parity law. The bills have yet to move out of committee.
Lawmakers are also advancing a bill that would require LARA to create an annual nursing home certification process and implement quality assurance monitoring for surveys. According to Karli Zubek, Legislative Director for bill sponsor Rep. Kahle, Michigan is among the states with the highest frequency of nursing home citations, despite leading the country in nursing home quality. The bill aims to improve care quality and staff morale by ensuring nursing home citations are fair and reducing inconsistencies in surveyor practices.
2. Health funding in FY 23 budget
The legislature recently adopted the Conference Committee’s negotiated $69 billion state budget and approved the FY 23 budget bill, which now just awaits Gov. Whitmer’s signature. MDHHS is receiving a $200 million funding increase from last year, totaling $33.4 billion.
A prominent focus area of the budget is behavioral health, with $16.8 million in total funds allocated to expand the Health Homes initiative. The number of counties with behavioral health homes will grow from 37 to 42, and the number of counties with opioid health homes will grow from 40 to 49. The budget also directs $325 million in total funds to establish a state psychiatric hospital as well as $10 million in total funds for BH provider loan repayment programs ($15 million less than Whitmer’s budget asked for).
3. What They’re Watching: Nina Abubakari, Advantage Health Centers
Nina Abubakari, President and CEO of Advantage Health Centers in Detroit, discussed her organization’s integrated model for primary care, dental care, behavioral health care, and more to treat underserved people in a cost-effective fashion. In this edition of “What They’re Watching,” she emphasized that the health centers are committed to addressing the social determinants of health through this work.
Abubakari said the pandemic exacerbated the impacts of stress and lack of access among their patients, but also affected staff through COVID contraction and workforce shortages. However, she said Advantage is pushing through and doing all they can to keep their community out of the emergency room. “If we were not there, a lot of the patients in our communities would not get any care. They would be storming to the emergency rooms in higher droves than they already are.”
4. Implicit bias training now required for health professionals
As of June 1st, Michigan health care professionals are required to complete implicit bias and disparity reduction training in order to receive or renew their license. “While technical knowledge and clinical skills should always be held to a high standard, it is equally important that health professionals understand the ways in which they view and interact with the communities they serve,” said LARA Director Orlene Hawks.
The requirement has been two years in the making, beginning with Gov. Whitmer’s 2020 directive for LARA to promulgate rules for implicit bias training requirements. New licensure applicants will need to complete 2 hours of training, while professionals renewing their existing license will need to complete 1 hour of training for each year of licensure.
5. Workforce: PA rotation programs and nursing pipeline funding
Looking to standardize Michigan’s process for regulating its physician assistant clinical rotation programs—which stakeholders say vary greatly in how they’re funded—the Michigan Health Council conducted a survey of all 10 of the state’s PA rotation programs. The survey found that Emergency Medicine and Women’s Health were the most expensive of the programs due to a lack of preceptorships combined with high demand for patient positions. MHC recommends greater collaboration between local leaders and institutions to increase the number of preceptors for these high-cost programs.
In other workforce news, the nearly finalized FY 23 state budget included a request from advocates for $56 million to fortify the nursing pipeline by increasing access to BSN programs at community colleges and universities. The allocation will allow students to receive 3 years of nursing education at community college and 1 year at a university. The $56 million will be distributed into $2 million payments for each of Michigan’s 28 community colleges.