CON - MHA | Michigan Health & Hospital Association

Behavioral Health Supplemental Budget, Policy Bills Advance

June 17, 2022June 20, 2022 Member News

The Michigan Legislature advanced several hospital-related bills during the week of June 13. Most notably, the Senate advanced a $590 million supplemental appropriations bill related to behavioral health. Several other policy bills the MHA is watching also received committee action in the House and Senate.

The supplemental funding bill that includes the MHA’s request to support behavioral health was approved by the state Senate. Senate Bill (SB) 714, introduced by Senate Majority Leader Mike Shirkey (R-Jackson), would appropriate $590 million and includes several MHA-supported one-time line items for behavioral health. Included in the supplemental bill is $100 million in infrastructure grants for pediatric inpatient psychiatric services, $20 million in infrastructure grants for hospital behavioral health intake enhancements, $25 million to prepare for the expansion of the essential health provider loan repayment program, and $30 million to expand the state’s apprenticeship program for new behavioral health staff. The legislation now moves to the House for its consideration as the Legislature continues its work on the fiscal year 2023 state budget.

The House Health Policy Committee took testimony on a package of Certificate of Need (CON) bills that were reintroduced from the 2019-2020 session. Senate Bills (SBs) 181, 182, 183 and 190 would remove psychiatric bed capacity from CON oversight, increase the threshold for capital expenditures, increase the number of members on the CON Commission and remove air ambulance services from CON. The bills were introduced by Sens. Curt VanderWall (R-Ludington), Lana Theis (R-Brighton) and Michael MacDonald (R-Macomb Township). The MHA opposes the tie-barred package of bills and provided written testimony to the committee in support of Michigan’s current CON program. No votes were held on the bills.

The House Health Policy Committee also heard testimony on bills to change lead testing requirements for children. House Bills (HBs) 4678 and 4679, introduced by Reps. John Cherry (D-Flint) and Helena Scott (D-Detroit), would require minors to be screened for lead poisoning between the ages of 9 and 12 months and the ages of 2 and 3 years old and would include this information as part of the child’s immunization record. Providers would also be expected to identify high risk factors such as the age of the child’s residence, but it is unclear how penalties would be assessed for the new requirements. The MHA has not yet taken a position on the bills but will continue to monitor any action taken.

In the Senate Health Policy and Human Services Committee, bills to allow Michigan to join the Psychology Interjurisdictional Compact were taken up again. This compact is a legal agreement among states that creates an expedited pathway to licensure for psychologists who wish to practice telepsychiatry across state lines. HBs 5488 and 5489 were introduced by Reps. Bronna Kahle (R-Adrian) and Felicia Brabec (D-Pittsfield Township), respectively, and are supported by the MHA. The bills now go to the Senate floor for a final vote and, if approved, will be sent to the governor desk for final consideration.

The Senate Health Policy and Human Services Committee also took up HB 5163, which was introduced by Rep. Angela Witwer (D-Delta Township) and would create an opt-out grant program for hospitals to establish medication-assisted treatment (MAT) for substance use disorders in their emergency departments. Hospitals provided MAT programs prior to introduction of the bill, and the MHA has already partnered with the Michigan Department of Health and Human Services to implement the first round of grants provided under this legislation. No hospitals would be required to participate in the program. HB 5163 was advanced to the Senate floor for further action.

For more information on these and other state bills related to healthcare, contact Adam Carlson at the MHA.

Michigan Legislature Addresses Multiple Healthcare Bills

February 11, 2022 Member News

The Michigan Legislature took up several bills impacting hospitals during the week Feb. 7. Some of the covered topics included legislation to expand the essential health provider loan repayment program, make changes to nonopioid directive forms, new regulation for pharmacy benefit managers (PBMs) and transparency bills for the Certificate of Need (CON) Commission.

The House Health Policy Committee reported Senate Bills (SBs) 246 and 435 to the House floor. Introduced by Sens. Curt VanderWall (R-Ludington) and Mike MacDonald (R-Macomb Township), the two bills would expand the essential health provider loan repayment program. SB 246 would raise the maximum allowable loan repayment from $200,000 to $300,000 for providers who agree to serve in a health resource shortage area for two to 10 years. SB 435 would expand the program to allow mental health professionals working in a health resource shortage area to qualify for the loan repayment program. The MHA supports both bills, which were passed in the full House and now go to the governor’s desk for signature.

The approved version of SB 435 includes an MHA-proposed amendment to extend the Physician Licensure Compact (PLC) law that was set to expire in March. The PLC is an important recruitment and retention tool for Michigan hospitals that allows physicians in good standing to more easily obtain licenses to practice medicine in multiple states. The MHA will continue to advocate for the governor to quickly sign SBs 246 and 435 into law and will keep members apprised of any action.

The House Health Policy Committee also reported to the House floor House Bill (HB) 5637, which would allow physicians to prescribe certain off-label medications to patients terminally ill with COVID-19. The bill amends the “Right to Try Act,” which is intended to give patients access to medications that are still in trial at the Food and Drug Administration for their condition or already approved to treat another diagnosis. As currently written, the medications could be prescribed only by the patient’s treating physician and the bill would not require health facilities to offer new medications or services that they do not already provide. The MHA has not taken a position on HB 5637.

The full House of Representatives approved and moved to the Senate four Certificate of Need (CON) bills that make no substantive changes to covered services. HBs 5074, 5075, 5076 and 5077 would require CON Commission reports and minutes to be posted online pursuant to certain deadlines and would require the Legislature’s Joint Legislative Committee, which oversees the CON Commission, to meet annually. The MHA does not have a position on the bills and has confirmed that the Michigan Department of Health and Human Services does not expect the bills to hinder the success of the program.

In the Senate Health Policy and Human Services Committee, members reported HB 4348, which would regulate and establish licensure for PBMs in Michigan. HB 4348 was introduced by Rep. Julie Calley (R-Portland) and is supported by the MHA to help slow the rising cost of prescription medications. The bill now moves to the Senate floor for consideration.

The Senate Health Policy and Human Services Committee also took testimony on HB 5261, an MHA-supported bill introduced by Rep. Abdullah Hammoud (D-Dearborn). HB 5261 would create specific exemptions for providers to administer opioids to a patient who has an active nonopioid directive form when the opioids are provided during a surgical operation or if the provider deems them medically necessary. No votes were taken on the bill.

Questions on state legislation related to healthcare may be directed to Adam Carlson at the MHA.

Senate Introduces Behavioral Health Funding, Including MHA Priorities

October 29, 2021November 1, 2021 Member News

State legislative action continued during the week of Oct. 25, including committee votes on bills impacting behavioral health and certificate of need.

The state Senate introduced a $350 million supplemental spending request related to behavioral health. The bill includes the MHA priority of providing $100 million to fund additional inpatient psychiatric beds and $20 million to improve behavioral health services in hospital emergency departments. The proposal also includes additional funds to attract behavioral health providers and add funding to the Essential Health Provider Loan Repayment Program that would allow psychiatrists to be added to the list of professionals eligible for loan forgiveness. The supplemental was referred to the Appropriations Committee, and the MHA encourages the Legislature to quickly pass this important funding to improve behavioral healthcare in Michigan.

On a related note, the state Senate Government Operations Committee reported Senate Bills 597 and 598 that would create new specialty integrated plans to replace the current prepaid inpatient health plans and contract with each community mental health services program to deliver physical and behavioral health services to Michigan’s Medicaid population. The MHA-supported bills were amended in committee to slow the timeline for the transition from the current system, which could now take up to eight years in the committee-approved legislation.

The House Health Policy Committee approved four Certificate of Need (CON) bills that make no substantive changes to covered services. House Bills (HBs) 5074, 5075, 5076 and 5077 would require CON Commission reports and minutes to be posted online pursuant to certain deadlines and would require annual meetings of the Legislature’s Joint Legislative Committee, which oversees CON. The committee did not make changes to the legislation from the introduced version, and the MHA has confirmed that the Michigan Department of Health and Human Services does not expect the bills to hinder the success of the program. The bills will next be considered on the House floor.

The House Health Policy Committee also took testimony on HBs 5261, 5262, 5263 and 5264, which are related to improving the availability of an MHA-supported non-opioid directive form. The package is currently being amended based on stakeholder input and will be discussed again in future committee meetings.

Members with questions on the state budget or healthcare legislation may contact Adam Carlson at the MHA.

Legislative Action Continued During the Week of Oct. 11

October 15, 2021October 26, 2021 Member News

Several pieces of legislation impacting hospitals were acted upon during the week of Oct.11. In the Senate, votes were taken on legislation to establish a grant program for emergency department-based medication assisted treatment (MAT). In the House, an MHA-supported bill on pharmacy wholesale distributors was reported from committee, and testimony was taken on an MHA-supported bill on background checks and a new package of Certificate of Need (CON) bills.

Senate Bill (SB) 579, which would establish an opt-out grant program for hospitals to establish emergency department-based MAT programs, was reported from committee and passed unanimously by the full Senate. SB 579 was introduced by Sen. Curt VanderWall (R-Ludington) and is supported by the MHA. The Senate Health Policy and Human Services Committee also approved several mental health jail diversion and transportation bills.

In the House Health Policy Committee, members voted to report the pharmacy wholesale distributors bill to the House floor. House Bill (HB) 5072 was introduced by Rep. Ryan Berman (R-Commerce Township) and is a state-level effort to exempt hospitals and other healthcare entities that are under common control from a medication distribution threshold that currently requires registration as wholesalers. The MHA supports the bill, as it would remove the requirement for additional paperwork for hospital pharmacies..

The House Health Policy Committee also took testimony on a new package of CON bills that make no substantive changes to covered services. HBs 5074, 5075, 5076 and 5077 would require CON Commission reports and minutes to be posted online in a timely fashion. The package would also require the Legislature’s Joint Legislative Committee that oversees CON activities to meet annually and review the report. The MHA has confirmed that the Michigan Department of Health and Human Services does not expect the bills to hinder the success of the program.

Another MHA-supported bill was discussed in the House Judiciary Committee. HB 5358, introduced by Rep. Graham Filler (R-Dewitt), would ensure employers have access to general information for background checks. Information like birthdates is important to ensure the identity of people in certain court-related documents and maintain efficient turnaround times for necessary background checks

Members with questions on state healthcare legislation may contact Adam Carlson at the MHA.

Healthcare Bills Progress Prior to State Legislative Summer Break

June 25, 2021October 27, 2022 Member News

The Michigan Legislature continued work on bills impacting Michigan hospitals as it goes into the final week before its summer break. Action was taken during the week of June 21 on issues regarding certified registered nurse anesthetists (CRNAs), the fiscal year (FY) 2022 budget, pharmacy benefit managers (PBMs), requirements for Canadian health professionals in Michigan and allowing certain health professionals to train nurse aides. In addition, the Michigan Department of Health and Human Services held a news conference on legislation related to treatment for opioid use disorder (OUD), and the governor signed legislation related to the Certificate of Need (CON) program.

Both the House and Senate took action on House Bill (HB) 4359, voting to support the important legislation that would modernize the scope of practice for CRNAs. The bill was introduced by Rep. Mary Whiteford (R-Casco Township) and will now go to the governor’s desk for signature. The legislation would bring Michigan in line with 42 other states and the U.S. military, all of which provide flexibility regarding physician supervision of CRNAs delivering anesthesia care. The MHA has supported HB 4359 with testimony in both chambers and will continue to advocate for the bill to be signed into law.

Representatives in the House approved House Bill (HB) 4410, which would provide for all funding for the FY 2022 budget year, aside from community colleges and higher education. HB 4410 would protect key hospital priorities, including graduate medical education, disproportionate share hospital funding, rural and obstetrics stabilization pools, critical access hospital funding and Medicaid rate increases. The bill includes new provisions that would make changes to streamline prior authorization timeframes for Medicaid health plans and boilerplate that would prohibit the use of any funds for vaccinations under a mandatory vaccination program. Due to concerns that the vaccine mandate provision could hinder state vaccination efforts, the MHA will work closely with the administration to address potential issues. HB 4410 will now be sent to the Senate for consideration.

The House Health Policy Committee reported Senate Bill (SB) 416 to the floor. The bill was introduced by Sen. Wayne Schmidt (R-Traverse City) and would ensure that Canadian health professionals who have previously taken relevant medical exams could apply for Michigan licensure. SB 416 clarifies legislation supported by the MHA during the last session that provided licensure reciprocity to Canadian health professionals who want to work in Michigan. It will now be sent to the full House for a vote.

The House Health Policy Committee also took testimony on HB 5089, which was introduced by Rep. Ann Bollin (R-Brighton Township) and would allow a registered professional nurse to train nurse aides without a permit for up to four months after the end of the COVID-19 declared state of emergency. The MHA has not taken a position on HB 5089 and no vote was held.

In the Senate Health Policy and Human Services Committee, further testimony was held on HB 4348, which would regulate and establish licensure for PBMs in Michigan. The legislation was introduced by Rep. Julie Calley (R-Portland) and is supported by the MHA to help slow the rising cost of prescription medications. No vote was held in committee on HB 4348.

A news conference was held June 23 to announce the introduction of a bill that would provide funding for a grant program for hospitals to increase access to medication assisted treatment for OUD in the emergency department (ED). The MHA Legislative Policy Panel supports the bill, which is intended to increase access to lifesaving treatment for OUD. Daniel Roper, MD, chief of emergency services and medical director of the ED at Mercy Health Saint Mary’s in Grand Rapids, represented one of 19 Michigan hospitals currently providing medications for OUD in EDs during the event, noting that the proposed bill would remove barriers for other providers to offer the treatment. The bill is expected to be introduced before the legislative summer break, and the MHA will keep members apprised of its movement.

Lastly, the governor signed SB 440 into law June 24 as Public Act 35 of 2021. SB 440 was introduced by Sen. Winnie Brinks (D-Grand Rapids) and would remove full-body PET scanner services from CON oversight.

Members with questions on these or other state legislative issues should contact Adam Carlson at the MHA.

MHA Monday Report June 14, 2021

June 14, 2021October 27, 2022 Monday Report

Combating the Novel Coronavirus (COVID-19): Weeks of June 7

The Michigan First-Dose Tracker indicates that, as of June 10, 60% of Michiganders ages 16 and over had received a COVID-19 vaccine. By June 12, more than 892,000 cases of COVID-19 had been confirmed in the state since the pandemic began; but more than 852,000 …

MHA Provides Testimony in Senate on Newly Introduced Legislation

Association Submits Comments on Medicare Post-acute Care Proposed Rules

The MHA recently submitted comments to the Centers for Medicare & Medicaid Services regarding the proposed rules to update the Medicare fee-for-service prospective payment systems for fiscal year 2022 for several post-acute care …

Community Benefit Reporting and the COVID-19 Pandemic Discussed in Webinar

The COVID-19 pandemic has had significant impacts on communities, patients and the hospitals that serve them and has severely affected hospital finances. Questions have arisen regarding how pandemic-related expenses, revenues and …

MHA and MHA Keystone Center Events Focus on Diversity, Equity and Inclusion

To act deliberately and purposefully to ensure outcomes across all patient populations are equitable, leaders should know where disparities exist, ways to prevent disparities and how to create a culture and system that reduces disparities to improve quality and …

Chief Medical Officer Debunks COVID-19 Vaccine Myths on MiCare Champion Cast

The MHA released a new episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities. …

High Reliability Leads to Safe Work Environment

Creating a highly reliable hospital requires a commitment to a just culture, continuous learning and designing care improvement. The webinar High Reliability in the Time of COVID-19, scheduled from noon to 1 p.m. EDT June 24, will review high reliability principles proven …

CyberForce|Q Offers Continuous, Collective Approach to Cybersecurity Assessments

The MHA’s newest Endorsed Business Partner, CyberForce|Q, offers a new approach to cybersecurity for healthcare organizations. CEO Eric Eder described a situation where a rural healthcare system’s CEO shared his organization’s experience …

Headline Roundup: Week of June 6 for COVID-19 in Michigan

The MHA has compiled a collection of media stories that include references to the MHA related to the last COVID-19 surge and vaccines. …

The Keckley Report

Post Pandemic, Affordability Looms as the Big Challenge in Healthcare — This Time, It’s Different

“Pre-pandemic, polls showed healthcare costs were a major concern to U.S. consumers. Post-pandemic, indications are it will re-surface as the industry’s biggest challenge, particularly affordability. But this time, consumers are likely to act differently on their concerns.”

Paul Keckley, June 8, 2021

MHA in the News

Modern Healthcare published an interview with MHA CEO Brian Peters June 7 discussing the new administrative rules requiring implicit bias training for licensure or registration of healthcare professionals in Michigan.

MHA Provides Testimony in Senate on Newly Introduced Legislation

June 11, 2021October 27, 2022 Member News

The Michigan Legislature addressed several bills impacting hospitals during the week of June 7, including legislation that would create new statewide systems of care for two time-sensitive emergency medical conditions, modernize scope of practice for certified registered nurse anesthetists (CRNAs), and remove certain positron emission tomography (PET) scanner services from the Certificate of Need (CON) program.

The Senate Health Policy and Human Services Committee took initial testimony on Senate Bill (SB) 521, introduced by Sen. John Bizon, MD (R-Battle Creek). SB 521 would direct the Michigan Department of Health and Human Services to create accreditation levels for hospitals that would indicate their ability to treat patients experiencing a stroke or ST-elevated myocardial infarction (STEMI). Alex Chebl, MD, director of the Henry Ford Stroke Center and head of the Division of Vascular Neurology at Henry Ford Health System, joined the MHA to provide testimony to the committee supporting this potentially lifesaving legislation. “It is critical all patients throughout the state have access to the best stroke care possible. SB 521 is an essential step to improving the quality of stroke care in the state of Michigan.” said Chebl.

The Senate Health Policy and Human Services Committee also addressed House Bill (HB) 4359, introduced by Rep. Mary Whiteford (R-Casco Twp.). The bill would modernize the scope of practice for CRNAs, who are currently required by the state of Michigan to be supervised by a licensed physician of any specialty when delivering anesthesia care. The MHA supports HB 4359, which would bring Michigan in line with 42 other states and the U.S. military to provide flexibility regarding the physician supervision requirement. The committee reported HB 4359 to the Senate floor, where it awaits a vote.

The full Senate voted on SB 416, which was introduced by Sen. Wayne Schmidt (R-Traverse City) and would ensure that Canadian health professionals who have previously taken relevant medical exams could apply for Michigan licensure. SB 416 is a clarification of MHA-supported legislation passed last session that provided licensure reciprocity to Canadian health professionals who want to work in Michigan. SB 416 will now be sent to the House Health Policy Committee for further action.

The House voted on SB 440, which would remove certain PET scanner services from CON oversight. SB 440 was introduced by Sen. Winnie Brinks (D-Grand Rapids) and would remove a specific technology from CON regulation that is expected to be before the CON commission June 17. The MHA opposed SB 440, which undermines the CON process that ensures high-quality, accessible, cost-effective care for Michigan patients. The House approved the legislation, which will now go to the governor’s desk for final signature.

Members with questions on any of this legislation should contact Adam Carlson at the MHA.

MHA Members Testify Before Senate Committee on CRNA Legislation

May 21, 2021October 26, 2022 Member News

The Senate’s Health and Human Services Policy Committee addressed a pair of bills relevant to hospitals during the week of May 17. The committee took testimony on House Bill (HB) 4359, which would modernize the scope of practice for certified registered nurse anesthetists (CRNAs). The committee also took up Senate Bill (SB) 440, which would remove certain positron emission tomography (PET) scanner services from Certificate of Need (CON) oversight.

Steve Barnett, president and CEO, McKenzie Health, and David Jahn, president and CEO, War Memorial Hospital, provided testimony May 20 to the committee in support of HB 4359. “This legislation will increase access to healthcare for Michigan residents. It will reduce costs for Michigan residents. It will permit CRNAs to practice to the full extent of what their license already provides for – and it will do all of this while maintaining every bit of patient safety,” said Jahn.

The MHA supports HB 4359 that, by modernizing the scope of practice for CRNAs, would allow flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources to offer safe and effective patient care. The bill, sponsored by Rep. Mary Whiteford (R-Casco Township), would also bring Michigan in line with 42 other states and the U.S. military on this issue. This change would eliminate a costly regulation while maintaining patient safety and would put into law a policy that has been allowed and proven effective during the COVID-19 pandemic. Current Michigan law requires a licensed physician of any specialty to supervise a CRNA to deliver anesthesia care.

The committee also voted to report SB 440, introduced by Sen. Winnie Brinks (D-Grand Rapids), to the Senate floor. The MHA supports Michigan’s existing CON process and is opposed to the bill that would, by removing certain full body PET scanner services from CON oversight, undermine the program that ensures high-quality, accessible, cost-effective care for patients in the state. The specific technology this bill seeks to address is expected to be before the CON Commission at its June meeting. The MHA will continue to monitor any action that is taken.

For more information on state legislation affecting healthcare, contact Adam Carlson at the MHA.