On February 2nd, Michigan’s House Committee on Health Policy held its first meeting of the new legislation session. The meeting featured presentations by the Michigan Association for Local Public Health, the Michigan Primary Care Association, and the Michigan Health and Hospital Association.
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Rep. Julie Rogers (D – Kalamazoo), who chairs the newly Democratic-controlled committee, introduced herself and the committee’s newly formed Behavioral Health Subcommittee, which will work on mental health issues and is chaired by Rep. Felicia Brabec (D – Pittsfield ), who is a psychologist.
Norm Hess, executive director of the Michigan Association for Local Public Health, spoke to the committee regarding their public health services in Michigan. Hess listed common questions he regularly answers to the committee, which include questions like: “Who does my health department report to?” “Where do they get the authority to do that?” “Why aren’t local health departments led by doctors? What do they do, and are we prepared for the future and what could make [them] stronger?”
“There are 2,800 health departments in the United States and every state has a different way of organizing those services,” Hess said. “In some states, all the local health departments are units of the state government, and they report directly to the state health department. In Michigan that is not the case, we have what’s called a decentralized system and every health department reports to a local governing entity.”
Hess spoke in detail about how there is one city health department in Detroit (which reports to Detroit’s city council), 30 single-county health departments across the state who report to county commissions, and fourteen multi-county districts serving from two to 10 counties who report to a local board of health, which is comprised of commissioners from each member county.
Hess mentioned that there’s a general misconception that local health departments exist to serve people with very limited incomes. However, he said their services are focused on families or individuals and are targeted to the entire residency of the county or the district.
Hess finished his testimony by explaining that there are three current challenges facing this industry, which include public perception—because residents are divided in their opinions of public health—the workforce shortage, and funding for things like essential services, infrastructure, and funding existing programs.
Anne Scott, health center operations officer for the Michigan Primary Care Association (MCPA), and Chris Drake, executive director of Ingham Community Health Centers and member of MCPA, provided testimony about the main needs for primary care in Michigan.
Scott spoke about how Michigan’s federally qualified health centers (FQHCs) provide high quality affordable and comprehensive medical services to everyone regardless of who they are, their insurance status, or their ability to pay. He said the services provided by FQHCs are comprehensive, meaning that the centers provide both medical services, oral health, and behavioral health.
Scott said FQHCs provide whole-person supportive services including transportation assistance, language and interpreting services, and care management. He testified that they have provided $1.3 billion in economic stimulus for the communities in which they operate.
“Health centers play an essential role in keeping the most vulnerable populations across the state of Michigan on a path to a higher quality of life,” Drake said. “Health centers meet people where they are in life and serve as a one-stop destination for people we serve. Health centers are able to function as one-stop destinations by offering a variety of services.”
Drake added that MCPA’s health centers are facing a continued workforce shortage and uncertain long-term financial viability.
Laura Appel, executive vice president of the Michigan Health and Hospital Association, briefed the committee on the overlap between public health and the healthcare delivery system, specifically as it pertains to hospitals.
“The state and local departments take the lead on public health, hospitals bear the cost of poor public health, and lack of funding in our core public health programs slowed our response to the COVID-19 pandemic, [and] exacerbated its impact particularly in low-income communities, communities of color, and for older Americans,” Appel said.
Appel said MHA is creating a dashboard on their website to help Michigan’s local public health partners better understand what’s going on in their communities by posting hospitalizations from the flu and from COVID.