Updates About Public Health

Recent controversies surrounding Michigan’s state-run youth psychiatric services, including lawsuits, patient escapes, and allegations of inadequate care, have prompted the initiation of an audit by the Office of the Auditor General (OAG). Specifically, the Office of Recipient Rights (ORR), responsible for safeguarding the rights of mental health service recipients, is under review.

Sen. Michael Webber (R – Rochester Hills) and colleagues requested the audit last year amidst concerns about management practices at facilities like the Hawthorn Center in Northville. Complaints of substandard care, including allegations of physical abuse and poor living conditions, have underscored the need for transparency and accountability in state-operated psychiatric hospitals. The audit, expected to take approximately six months, aims to identify systemic issues and promote improvements in patient care and oversight protocols. Despite some scrutiny over its handling of the situation, MDHHS asserts that it is fully supportive of transparency efforts.

As investigations unfold, necessary reforms are anticipated to ensure the well-being of vulnerable youth under state care.

Senate Democrats introduced the Michigan “Momnibus” package, comprising 10 bills aimed at addressing birthing inequities in the state. Led by the MI State of Birth Justice coalition, the legislation focuses on enhancing accountability for maternal health care providers and creating equity in birthing practices. Here are the key bills from the package:

SB 818 (Sen. Erica Geiss): Requires MDHHS to include published studies and reports on biased or unjust perinatal care and mandates health facilities to report maternal deaths. This bill also codifies the maternal mortality review team.

SB 819 (Sen. Erica Geiss): Requires the Michigan Department of Civil Rights to receive reports of obstetric racism and violence, utilizing patient-reported experiences. MDCR must provide a report to relevant health committees and agencies.

SB 820 (Sen. Mary Cavanagh): Mandates stabilization of laboring patients before termination of care and ensures hospitals allow patients to be accompanied by a partner, spouse, or doula. Hospitals must provide proof of policy to LARA.

SB 821 (Sen. Mary Cavanagh): Requires medical malpractice insurers to provide DHHS with information regarding perinatal care services policies.

SB 822 (Sen. Sarah Anthony): Allows individuals to detail life-sustaining treatment preferences if pregnant when an advance directive becomes effective.

SB 823 (Sen. Stephanie Chang): Amends the Elliott-Larsen Civil Rights Act to include pregnancy or lactation status in the definition of “sex” and protect against discrimination.

SB 824 (Sen. Sylvia Santana): Requires a non-punitive plan of safe care when an infant is substance exposed.

SB 825 (Sen. Sarah Anthony): Adds licensed midwives to the state’s essential health provider loan repayment program.

SB 826 (Sen. Stephanie Chang): Establishes a scholarship program for low-income residents working toward certification as a doula.

SB 827 (Sen. Sylvia Santana): Mandates private payer reimbursement for licensed midwives.

These bills have been referred to the Senate Committee on Housing and Human Services for consideration. Additionally, Rep. Laurie Pohutsky is collaborating on legislation to license freestanding birth centers in Michigan.

In the recent Medicaid health plan rebid by Michigan’s Department of Health and Human Services, significant changes have reshaped coverage across the state’s ten regions. Blue Cross Blue Shield of Michigan emerged as the primary beneficiary, expanding its territory across various regions. The rebid, a key part of Governor Whitmer’s 2024-2025 fiscal year budget recommendation, will prioritize equitable, person-centered care for the nearly two million Medicaid beneficiaries. Additionally, revisions to the payment structure include withholding a greater percentage of funds to incentivize improved health outcomes and address social determinants of health.

The rebid resulted in a redistribution of territories among nine health plans, with Blue Cross Blue Shield of Michigan gaining ground in several regions. Notably, McLaren emerged as the sole plan in nine of the ten regions, while Blue Cross now has a presence in seven regions, marking significant shifts in coverage landscape.

At this time, the contracts are not yet secured in place. The new contracts are scheduled to come into effect on October 1 of this year.