MDHHS Issues RFP for Peer Navigator Pilot Project

The Michigan Department for Health and Human Services (MDHHS) issued a Request for Proposal (RFP) to enhance support for pregnant and postpartum individuals facing substance use disorder. The Peer Navigator Pilot Project (PNPP) aims to place Peer Navigators in healthcare and behavioral health settings to identify, restore trust and partner with families to provide immediate access to essential services.

Peer Navigators support families through a recovery journey and facilitate connections with community resources. The RFP is open to the public and nonprofit hospitals/health systems, OBGYN offices, community health centers, community substance use treatment providers, community peer recovery coaching agencies, federally recognized tribes and Federally Qualified Health Centers.

Eligibility is exclusive to entities that are public and nonprofit. Applicants will be ranked based on priority to place one Peer Navigator in each of the focus counties/regions:

  • Ingham County
  • Kalamazoo County
  • Region 1 (Upper Peninsula)
  • Wayne County

Proposals should also include the target population of pregnant person through 12-weeks postpartum in the areas identified. As a data driven project, Peer Navigators will be responsible for all data collection throughout the pilot project, reporting outcomes utilizing the REDCaP system.

This grant will award a total of $500,000, with individual grants ranging from $60,000 to $125,000 to be implemented during a five-month period, between May 1 and Sept. 30, 2024.

Applications are due March 7, 2024, by 3 p.m. through EGrAMS. A recording of the pre-application webinar, held Jan. 31, can be found is available. The MDHHS intends to release a FAQ Feb. 7 on the EGrAMS website.

Members with questions may contact Kelsey Ostergren at the MHA.

MDHHS Release Medicaid Reimbursement Proposed Policy

The Michigan Department of Health and Human Services (MDHHS) recently released a proposed policy to establish additional Medicaid reimbursement for certain medically necessary drugs and therapeutics when provided in the inpatient hospital setting. The policy, pending approval by the Centers for Medicare & Medicaid Services, proposes to establish separate payment for drugs and therapeutics that are carved out of the diagnosis related group (DRG) in addition to providing the inpatient DRG payment. Payment would be made under Medicaid fee-for-service (FFS) for beneficiaries covered under both FFS and managed care plans with no beneficiary copayment.

The MDHHS publishes and maintains a list of applicable drugs and therapeutics. The payment rates for drug and therapeutic reimbursement are outlined in the Michigan Medicaid State Plan with these drugs and therapeutics covered as either professional claims or pharmacy claims as specified in the policy.

The provider must request prior authorization (PA) if the drug or therapeutic is purchased directly through a pharmacy, distributor or wholesaler. PA requests may be submitted either via Direct Data Entry through the Community Health Automated Medicaid Processing System or via fax.

Hospitals are encouraged to review the proposed policy and submit comments to MDHHS by March 5, 2024. Members with questions should contact Vickie Kunz at the MHA.

Three Key Takeaways from Michigan’s Social Determinants of Health Summit

The following article was written by Carlie Austin, BSN, RN, Maternal Infant Health Policy Specialist at the MHA.

In my role as Maternal Infant Health Policy Specialist at the MHA, one of my main goals has been to utilize my expertise to inspire health equity for marginalized birthing persons and their children and to build relationships that strengthen my impact and purpose. Attending the second annual Michigan Social Determinants of Health (SDOH) Summit affirmed how purposeful impact is achieved.

MHA SVP Jim Lee presented on the Health Equity Policy Panel facilitated by Dr. Renee Canady, CEO of the Michigan Public Health Institute. Lee was joined by Poppy Hernandez, Ponsella Hardaway, and Tommy Stallworth.

The event, hosted by the Michigan Department of Health & Human Services Jan. 23-25, offered a variety of informative sessions that explored key issues impacting the health and well-being of Michiganders and what solutions foster change when it comes to SDOH. Presenters covered maternal health, behavioral health, childcare, food access, housing and much more. There was also a health equity policy panel featuring my colleague Jim Lee, senior vice president of Health and Data Policy at the MHA that centered around how data and community go hand-in-hand for advancing health equity.

As a healthcare provider who also works in the policy space, I often ask myself how I can be most impactful. I left the event with three key takeaways, that I’ll now be referring to as CUE:

  1. Collaboration is critical. It is not uncommon for health equity work to feel impossible and in the maternal-infant space specifically, there are a plethora of initiatives across our state aiming to accomplish identical goals. The summit stressed the importance of becoming intentional about how we reduce siloed and duplicative efforts to ensure we’re maximizing our knowledge, resources and scope of impact.
  2. Utility of information often feels like an undervalued tool for achieving health equity. The summit addressed various ways to effectively communicate and exchange information. In addition to embracing the quantitative data, we must also seek out and listen to the lived experience of community members. During his keynote presentation, Lt. Governor Gilchrist’s said, “lack of information is deadly” – I would build upon that notion by adding that lack of utilizing information is deadly. Knowledge is powerful not only in its existence, but in the manner we use it.
  3. Earnest effort was a theme threaded throughout the summit. Every person, program and future pathway was rooted in the earnest effort to simply serve people well. Health equity efforts are founded in an earnest response to understanding what people need to achieve prosperous lives and how we justly share our resources to get them there. I appreciate the summit reemphasizing the importance of having principally similar partnerships. I loved this art of action because it aligns with who I am at my core and re-centered that, yes, my earnest effort is vital to eradicating health inequities, but being principally aligned in my pursuits will make the pathway achievable.

I truly enjoyed the summit, and look forward to attending again next year.

MHA Monday Report Jan. 22, 2024

MHA Monday Report

The Centers for Medicare & Medicaid Services (CMS) released a final rule last week intended to expedite the prior authorization process for those covered by Medicare Advantage, Medicaid and Children’s Health Insurance Program (CHIP) plans. …


Register Now for MHA Human Resources Conference

Registration is now open for the 2024 MHA Human Resources Conference, scheduled for March 5, 2024 at the ACH Hotel Marriott University Area, Lansing. Attending the conference provides human resource professionals with an opportunity …


MDHHS Issues RFP to Expand Child Adolescent Health Center Programs

The Michigan Department of Health and Human Services (MDHHS) issued a Request for Proposal (RFP) to expand Child and Adolescent Health Center programs, focusing on school-based or school-linked health services. This initiative will support …


Now Accepting Nominations for the 2024 MHA Ludwig Community Benefit Award

The MHA is accepting nominations for the 2024 Ludwig Community Benefit Award, which recognizes healthcare organizations that improve the health and well-being of their communities through collaborative health, economic or social initiatives. Benefits provided include …


OAC Provides Recommendations and Hosts Panel Discussion

The Michigan Opioid Advisory Commission (OAC) provides recommendations to the legislature about initiatives that will bolster education, prevention, treatment and services of substance use disorders and mental health conditions. The Commission aims to equip local …


SAMHSA Rural EMS Training Grant Program Pre-Application Webinar

The Substance Abuse and Mental Health Services Administration (SAMHSA) is launching a grant program to recruit and train emergency medical service (EMS) providers to rural areas. This program intends to address substance use disorder and …


Outpatient Prospective Payment System Final Rule Includes Behavioral Health Additions

The Centers for Medicare & Medicaid Services (CMS) recently finalized several policies in the 2024 Medicare fee-for-service final rules for the outpatient prospective payment system and physician fee schedule final rule. These provisions, effective …


MHA Podcast Explores Workplace Violence Resources for Michigan Hospitals

The MHA released a new episode of the MiCare Champion Cast, which features interviews each month with experts in Michigan discussing key issues that impact healthcare and the health of communities. The January 2024 episode, …


The Keckley Report

Paul KeckleyEconomic Indigestion for U.S. Healthcare is Reality: Here’s What it Means in 2024

“By the end of this week, we’ll know a lot more about the economic trajectory for U.S. healthcare in 2024: it may cause indigestion. …

So, the conclusion that can be deduced from the four events this week is this: economic indigestion in U.S. healthcare will persist this year and beyond because there is no political will nor industry appetite to fix it.  Darwinism aka ‘survival of the fittest’ is its destiny unless….???”

Paul Keckley, Jan. 15, 2024


News to Know

  • MHA-member physician residents are encouraged to save the date for GME Capitol Day, scheduled from 8:30 a.m. to 3:30 p.m. Wednesday, May 1, at the MHA Capital Advocacy Center.
  • MHA-member communications professionals are encouraged to save the date for this year’s MHA Communications Retreat, scheduled from 8:30 a.m. to 4 p.m. Tuesday, May 7, at the Henry Center for Executive Development in Lansing.

MDHHS Issues RFP to Expand Child Adolescent Health Center Programs

The Michigan Department of Health and Human Services (MDHHS) issued a Request for Proposal (RFP) to expand Child and Adolescent Health Center (CAHC) programs, focusing on school-based or school-linked health services. This initiative will support models such as CAHC and School Wellness programs, providing a secure environment for children and adolescents to learn about disease prevention and receive necessary medical care and support.

This grant will award a total of $4.46 million, with individual grants ranging from $180,000 to $330,000. It will be implemented during a four-month period, between June 1 and Sept. 30, 2024. Priority will be given to proposed sites in counties lacking an existing CAHC clinical program.

Applications are due March 12, 2024, by 3 p.m. Members wishing to apply for this RFP must initiate the registration of both the agency and users, complete a Project Director Request and submit it with the proposal. MDHHS will answer questions related to the grant application through Jan. 26, and will host a pre-application webinar Jan. 23 from 11 a.m. to 12:30 p.m. The application process is electronic through the MI E-Grants system and detailed instructions are available on the EGrAMS website.

Members with questions may contact Lauren LaPine at the MHA.

MHA Monday Report Jan. 8, 2024

MHA Monday Report

MHA Partners with AAPL for CME Courses

The MHA is pleased to partner with the American Association for Physician Leadership (AAPL) to provide a series of in-person Continuing Medical Education (CME) courses in 2024 at the MHA headquarters at 2112 University Park Drive, Okemos, MI …


The Joint Commission Revises Definition of Suicide in Sentinel Event Policy

The Joint Commission has updated the definition of suicide in its Sentinel Event Policy to include time frames with the highest risk for suicide and highlight the healthcare organization’s continued responsibility for ongoing assessment …


MDHHS Expands Medicaid Coverage to Include CHW Services and Releases Beginner Guide

The Michigan Department of Health and Human Services (MDHHS) recently announced an expansion of Medicaid coverage effective Jan. 1, 2024 to include community health worker (CHW) services. The MDHHS also issued a final policy establishing this coverage for Medicaid …


Nominations Open for Hometown Health Heroes Award

The MHA is pleased to sponsor Michigan Public Health Week, scheduled for April 10, 2024, with the theme of “Protecting, Connecting and Thriving: We Are All Public Health.” MHA members are encouraged to submit nominations …


MHA CEO Report — Vaccinations & Respiratory Illness Season

The last four years have generated tremendous awareness about vaccines, but also a large public health challenge as disinformation has exploded and anti-vaccine sentiment has emerged from the fringes to become widely embraced. This likely isn’t news to any of you, but the …


The Keckley Report

Paul KeckleyAn Open Letter to Hospital Boards of Directors: Long-Term Strategic Planning needs Your Attention

As 2023 comes to an end and prognostics for 2024 pepper Inboxes, high anxiety is understandable. The near-term environment for hospitals, especially public hospitals and not-for-profit health systems, is tepid at best: despite the November uptick in operating margins to 2% (Fitch, Syntellis), the future for hospitals is uncertain and it’s due to more than payer reimbursement, labor costs and regulatory changes. …

Hospitals are not alone in dealing with money-driven pressures that seem out of sync with lofty aims like ‘student athletes’ and ‘community benefits.’ That’s why hospitals must embrace long-term strategic planning with an outside-in frame of reference now.”

Paul Keckley, Jan. 1, 2024


MHA in the News

The MHA received media coverage over the holidays during the weeks of Dec. 18, Dec. 25 and Dec. 31. Topics covered include the healthcare workforce, the MHA Keystone Center, air ambulance services and a review …

MHA Monday Report Dec. 18, 2023

MHA Monday Report

MDHHS Expands Medicaid Coverage to Include CHW Services

The Michigan Department of Health and Human Services (MDHHS) recently announced an expansion of Medicaid coverage effective Jan. 1, 2024 to include community health worker (CHW) services. The MDHHS also issued a final policy establishing …


Hospital-based Substance Use Disorder Consultation Reimbursement Coverage

Physicians and other qualified practitioners will be reimbursed for substance use disorder (SUD) consultations in the inpatient hospital or emergency department setting effective Jan. 1, 2024. These services include assessment, evaluation, diagnosis and treatment of individuals during …


Coverage of Office-based Substance Use Treatment Services

Primary healthcare providers will be reimbursed for substance use disorder (SUD) treatments that are provided in an office-based primary care setting effective Jan. 1, 2024. This applies to providers who do not have a specialty SUD benefit services contract with a Prepaid .…


Guide and Action Plan Created to Support Health Equity Programming

As strides are made to address inequities and disparities in healthcare, governing and regulatory bodies including The Joint Commission and the Centers for Medicare & Medicaid Services have created guidelines, benchmarks and policies that evolve over time. The MHA Keystone …


Enrollment Deadline Friday for MHA Governance Affinity Group

The deadline to enroll a trustee in the new MHA Governance Affinity Group is Friday, Dec. 22. The benefits of a well-run meeting go beyond parliamentary procedure. Proper communication and facilitation skills needed to make decisions about strategic issues drive performance and .…


Hospital Vaccine Resources Available

The MHA is at the forefront of advocating for vaccination awareness and education, particularly focusing on the challenges associated with the Beyfortus (nirsevimab) monoclonal antibody for infants entering their first respiratory syncytial virus season. The association is …


Latest AHA Trustee Insights Outlines the Board’s Role in Patient Experience

The December edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), includes an article on the board’s role in patient experience. The average hospital has turned over 105% of its workforce in the last five years and national …


The Keckley Report

Paul KeckleyThe Affordable Care Act is Back on Stage: What to Expect

“In the last 2 weeks, the Affordable Care Act (ACA) has been inserted itself in Campaign 2024 by Republican aspirants for the White House …

It’s no surprise. Health costs and affordability rank behind the economy as top issues for Republican voters per the latest Kaiser Tracking Poll. And distaste with the status quo is widespread and bipartisan: per the Keckley Poll (October 2023), 70% of Americans including majorities in both parties and age-cohorts under 65 think “the system is fundamentally flawed and needs major change.” To GOP voters, the ACA is to blame. …

The ACA is back on the radar in U.S. healthcare. Stay tuned.”

Paul Keckley, Dec. 10, 2023


News to Know

  • Clarence RuckerClarence Rucker, manager, patient safety and quality, MHA Keystone Center, is featured in COLOR Magazine’s 40 Under 40 Powerlist.
  • Due to the holidays, Monday Report will not be published Dec. 25 and Jan. 1, and will resume its normal schedule Jan. 8.

 


MHA in the News

The MHA received media coverage the week of Dec. 11 related to post-secondary nurse degree programs and telehealth.

MDHHS Expands Medicaid Coverage to Include CHW Services

The Michigan Department of Health and Human Services (MDHHS) recently announced an expansion of Medicaid coverage effective Jan. 1, 2024 to include community health worker (CHW) services. The MDHHS also issued a final policy establishing this coverage for Medicaid fee-for-service and health plan enrollees.

CHWs are trained public health professionals and trusted community members who focus on addressing social determinants of health (SDOHs) while serving as links between health and social resources. A health risk and/or SDOH screening/assessment tool must be used to assess the need for CHW services. CHW services must be recommended by a licensed healthcare provider for conditions including but not limited to:

  • Diagnosis of one or more chronic health conditions including behavioral health.
  • Unmet health-related social needs.
  • Pregnancy and up to 12 months postpartum.

Individuals providing CHW services must meet certain criteria to be verified by the MDHHS designated contractor prior to Community Health Automated Medicaid Processing System enrollment for Medicaid reimbursement. CHW services must be provided face-to-face in the language of the beneficiary’s choice when available and are limited to two hours per day and 16 visits per month, for a maximum of 32 hours per month, per beneficiary. This limit may be exceeded based on medical necessity determined in collaboration with the recommending licensed provider and requires prior authorization.

Members with questions may contact Kelsey Ostergren at the MHA.

MHA Monday Report Dec. 11, 2023

MHA Monday Report

Healthcare Worker Safety Bills Signed into Law

Gov. Whitmer signed into law Dec. 6 House Bills 4520 and 4521, which increase the penalties for assaulting a healthcare worker or volunteer. Now referred to as Public Acts 271 and 272 of 2023, the …


Psychiatric Residential Treatment Facility Final Policy in Effect

The Michigan Department of Health & Human Services recent policy for Psychiatric Residential Treatment Facilities went into effect Dec. 1, 2023. Initially released for comment in May 2023, the MHA provided feedback on …


LARA Task Force on FTMPs Releases Report

In a response to the growing need for qualified healthcare professionals, the Michigan Department of Licensing and Regulatory Affairs (LARA) released a comprehensive report aimed at addressing the challenges faced by Foreign Trained Medical Professionals …


MDHHS Releases Outpatient Hospital 340B Billing Final Policy

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to modify hospital outpatient billing requirements for drugs purchased through the 340B drug pricing program. Existing policy requires 340B hospitals to …


MHA Podcast Covers the Latest on Flu Vaccines and Pediatric Respiratory Illness in Michigan

The MHA released a new episode of the MiCare Champion Cast, which features interviews each month with experts in Michigan discussing key issues that impact healthcare and the health of communities. The December 2023 episode, …


The Keckley Report

Paul KeckleyHealth System Chief Strategy Officer Roundtable Assessment: ‘The Near-Term is Tough, the Long-Term is Uncertain and the Deck is Stacked against Hospitals’

“CSOs know that hospitals are at a crossroad, particularly not-for-profit system operators accountable to the communities they serve. In the 4Q Keckley Poll, 55% agreed that “the tax exemption given not-for-profit hospitals is justified by the community benefits they provide”  but 45% thought otherwise. They concede their competitive landscape is more complicated as core demand shifts to non-hospital settings and alternative treatments and self-care become obviate traditional claims-based forecasting. They see the bigger players getting bigger: last week’s announcements of the Cigna-Humana deal and expansion of the Ascension-LifePoint relationship cases in point. And they recognize that their reputations are under assault: the rift between Modern Healthcare and the AHA over the Merritt Research ’s charity care study (see Hospital section below) is the latest stimulant for not-for-profit detractors. …”

Paul Keckley, Dec. 4, 2023


News to Know

  • The MHA welcomes ModusOne Health as a new Endorsed Business Partner and the only physician-founded and physician-run Clinical Diagnosis Improvement company that delivers robust monthly leaderboard-style reporting of provider accuracy in diagnosing patients on the conditions that most directly affect quality metrics and reimbursements.
  • Due to the holidays, Monday Report will not be published Dec. 25 and Jan. 1, and will resume its normal schedule Jan. 8.

MHA in the News

The MHA received media coverage the week of Dec. 4 on a new law signed by Gov. Whitmer that increase the penalties for assaulting a healthcare worker or volunteer, as well as stories on expanded …

MHA Podcast Covers the Latest on Flu Vaccines and Pediatric Respiratory Illness in Michigan

MI care matters

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

The December 2023 episode, released during National Influenza Vaccination Week, features Dr. Natasha Bagdasarian, MD, MPH, FIDSA, chief medical executive for the Michigan Department of Health and Human Services (MDHHS) and Dr. Matthew Denenberg, MD, pediatric emergency medicine physician at Corewell Health.

The episode explores vaccine misinformation, common misconceptions and tips for patients and providers to navigate vaccine hesitancy. Bagdasarian, who serves as a cabinet member of Gov. Whitmer, kicks off the episode with a statewide look at routine childhood immunization rates in Michigan.

“In 2017, our statewide vaccination coverage rate was almost 76% for children between the ages of 19 and 35 months,” noted Bagdasarian. “Now we’re down to about 66% in that age group for things like measles, mumps, rubella…vaccines that have been around for decades.”

Denenberg, interviewed later in the episode, shares his insight on pediatric respiratory illness from the hospital perspective, recalling the 2022 ‘tripledemic’ that led to a surge in pediatric COVID-19, flu and RSV hospitalizations.

“Last year was particularly severe…the worst I’ve seen in my 30 years,” said Denenberg. “It’s important to get vaccinations not only for the health and safety of a child, but for the community around them. As providers, we need to work with our patients and families so that they trust us, trust in the science and trust in the vaccines.”

Both Bagdasarian and Denenberg noted it’s not too late in the season to get vaccinated against the flu, COVID-19 and RSV if eligible. To find more information about the 2023-2024 flu season and ensure everyone in the family is up-to-date on routine immunizations, visit the MDHHS website. To find a vaccine nearby, visit Vaccines.gov.

The December episode is available to stream on SpotifyYouTubeApple Podcasts and SoundCloud. Questions or idea submissions for future MiCare Champion Cast episodes can be sent to Lucy Ciaramitaro at the MHA.

MiCare Champion Cast · The Latest on Flu Vaccines and Pediatric Respiratory Illness in Michigan