This month’s newsletter includes a rundown of recent notable activity at MDHHS, a conversation with Alex Rossman, External Affairs Director at the Michigan League for Public Policy, and information about the nurse strike at the University of Michigan.
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State of Reform
1. MDHHS works to increase COVID health equity, support justice-involved youth
MDHHS announced last month the formation of 11 Regional Health Equity Advisory Councils that will focus on addressing COVID-related health disparities in underserved communities throughout the state. “This is an important initiative, because it decentralizes decision making away from organizations and institutions and concentrates it at the community level,” MDHHS said of the councils, which will be operational by May 31st, 2023.
Other recent MDHHS activity includes the issuance of an RFP soliciting applicants that can help communities implement programs to promote community placement of justice-involved youth to deter their placement in out-of-home settings. Applications are due on Oct. 6th, with MDHHS aiming to award up to 3 organizations that have experience providing treatment like Multisystemic Therapy and Functional Family Therapy.
2. Q&A: MLPP’s Alex Rossman on Whitmer’s directive to lower premiums under IRA
Last month, Gov. Whitmer directed the Michigan Department of Insurance and Financial Services to require health insurance carriers to lower their already-filed 2023 rates, citing the Inflation Reduction Act’s continuation of ARPA subsidies as reasoning. In this Q&A, Alex Rossman, External Affairs Director at the Michigan League for Public Policy, discusses what this change means for patients and health plans.
“The IRA and the premium tax credits are going to have this direct impact on consumers, but are really going to benefit the marketplace and participation as a whole, and ultimately the insurers as well. I think what we’re trying to do and what the governor and the Department of Health asserted is that both anticipated benefits and savings should go back to the consumers,” he says. Rossman also emphasizes that the IRA’s provisions to allow Medicare to negotiate the price of certain prescription drugs and cap out-of-pocket prescription drug spending to $2,000 will greatly benefit Michiganders.
3. What They’re Watching: Melanie Brim, Michigan Health Council
In addition to her organization’s work to expand clinical training capacity for health professionals in Michigan, Melanie Brim, President & CEO of the Michigan Health Council, says MHC’s implementation of implicit bias training earlier this year is a key solution for improving health equity.
MHC’s implicit bias training program was designed to comply with Michigan’s requirement for all health professionals to receive implicit bias training—which took effect this summer. “[Implicit bias training] is such a huge piece of answering the health equity question … We’ve created a training program to bring that training to all the health professionals in Michigan to make [providers] cognizant of the biases they bring as providers in their interactions with patients.”
4. U of M nurses protest against unsafe workloads
A union representing 6,200 University of Michigan nurses voted by a 96% majority last week to strike against the university hospital system, though no work stoppage has currently been scheduled. This vote comes as a result of the nurses’ claims that the university is refusing to bargain over nurses’ workload ratios in contract negotiations. Renee Curtis, President of the U of M Professional Nurse Council, told State of Reform that the number of patients assigned to a nurse is directly tied to patient safety concerns.
“Nurses across the state report having to take care of an unsafe number of patients too often,” Curtis said. “There is no law that limits the number of patients a nurse can be assigned, and hospitals take advantage of that … It’s urgent that we make hospitals places of safety and healing by solving the rampant, intentional nurse understaffing that the hospital industry has engaged in for years.” The union intends to go through with a work stoppage “if we believe it is absolutely necessary.” The nurses will attend the next university Board of Regents meeting on Sept. 22nd.
5. New legislation aims to reduce wait times for psychiatric care
Rep. Graham Filler introduced a bill last month that would require preadmission screening units for inpatient psychiatric care to conduct mental health assessments within 3 hours of being notified by a hospital of a patient’s need for behavioral health care. If screening units aren’t able to perform a screening within the 3 hours, the bill would allow a “clinically qualified individual” at the hospital to conduct the assessment.
The legislation aims to reduce the prevalence of untimely behavioral health care provision resulting from prolonged wait times for admission to psychiatric care. The Michigan Hospital Association expressed their support: “The MHA supports HB 6355 because it addresses the ongoing issue of long wait times for emergency department behavioral and mental health patients. This legislation should help shorten the difficult wait times between the evaluation and beginning services.” The bill currently awaits a second reading in the House Health Policy Committee.