STATE LEGISLATION/REGULATION
MICNP LEGISLATIVE UPDATE

 


October 2020
 


Click HERE for the weekly MIRS Legislative Report.  

Senate Moves Behavioral Health-Related Bills

The full Senate passed SB 826, Sen. Curt VanderWall’s bill that would add nurse practitioners, certified nurse specialists and physician assistants to the definition of “mental health professional” in the Mental Health Code, unanimously last week. The bill brings the Mental Health Code in line with the Public Health Code by creating clarity for the many Michigan communities and healthcare facilities desperate to find well-qualified mental health providers. In addition to updating definitions, the bill includes critical services provided in most healthcare and psychiatric care settings including temporary restraint and 24-hour emergency hold for residents in crises.  The bill has been sent over to the House where it was referred to the House Health Policy Committee for consideration.

In the Senate Health and Human Services Committee last week, votes were taken on several behavioral health bills, including legislation to standardize the credentialing for community mental health services across the state and legislation to require the Michigan Department of Health and Human Services (MDHHS) to report patient deaths that occur within 48 hours of discharge from a psychiatric hospital or unit. 

HB 5178, introduced by Rep. Hank Vaupel, would amend the mental health code to require the MDHHS to establish a uniform community mental health (CMH) services credentialing program for state department or agency use.  A state department or agency that provided, either directly or through a contract, CMH health services to Michigan residents would have to comply with the credentialing program and use the provider information profile maintained by the MDHHS.  On and after the date the credentialing program was certified by the MDHHS Director, the state department or agency subject to the provision would have to ensure that all of the forms, processes and contracts it used that related to providing CMH services complied with the credentialing program.  The credentialing and re-credentialing process would have to be conducted and documented for nurse practitioners and other behavioral health providers.  HB 5178 is now on the Senate floor for consideration.

SB 813 also made its way to the Senate floor last week.  The bill, introduced by Sen. Jim Ananich, would require the MDHHS to investigate all deaths reported by a psychiatric hospital or psychiatric unit that were the result of suicide or where the cause of death was reported as unknown.  Specifically, it would require a report provided by the MDHHS to include, if known, causes of death of mental health care recipients where death occurred within 48 hours of discharge and require the report to include information indicating whether or not the MDHHS had initiated or was in the process of an investigation and, if known, the findings of the investigation.  SB 813 is now on the Senate floor for consideration.


September 2020 

Click HERE for the weekly MIRS Legislative Report.  

Budget:
The state’s revenues were revised recently from the previous estimates set in May during an unusual August Consensus Revenue Estimating Conference that was held earlier this week.  Officials increased the revenues for the 2020-2021 fiscal year due to the boost Michigan saw from federal assistance in unemployment and CARES Act dollars that were underestimated earlier this year. This brings the $3.1 billion budget hole previously predicted down to looking more like a $926 million loss.  
The amount of lost revenue for the new fiscal year starting on October 1 is now being forecasted at $2.4 billion as opposed to $3.1 billion, but this is with federal dollars appearing to dry up.  It is also important to note that the predictions do not include the $600 million Flint Water Crisis payout since those details have not yet been finalized.   Additionally, concerns of a COVID-19 second wave, closed businesses and hundreds of thousands of people out of work still have lawmakers concerned.

Legislation:
SB 826 Mental Health Code Revisions (MICNP Supports)
The intent of the legislation is to address access issues and update the Mental Health Code (MHC) by including PAs, NPs and CNSs in the definition of “mental health code professional”, authorize those licensed health providers to initiate safety restraints, and authorize him/her to issue/sign initial certification (first cert) for a temporary emergency hold and transfer to a psychiatric facility.  The bill was reported out of the Senate Health Policy Committee on 6/23/20 and is now before the full Senate. The Mental Health Task Force is in the process of composing and sending letters to the Senate Majority Leader and the Senate Majority Floor Leader asking for a floor vote on SB 826 as soon as possible. 

HBs 5412-5416 Coverage for Telemedicine (MICNP Supports):  SIGNED INTO LAW
The new law specifies that beginning on October 1, 2020, telemedicine services will be covered under the medical assistance program and the Healthy Michigan Program.

Read more HERE. 


 August 2020 


Click HERE for the weekly MIRS Legislative Report.  

VOTE on August 4!
With August 4th quickly approaching, it is so important to please remember to vote! The 2020 presidential election is critical to Michigan’s healthcare future. In addition to choosing the next president of the United States, voters across the state will decide political contests that impact the legislative and regulatory environments faced by health care providers and the patients they serve, including one U.S. Senate seat, two Michigan Supreme Court seats and all seats in both the U.S. House of Representatives and the Michigan House of Representatives. Based on the political makeup of legislative districts, the results of the primary election often determine who will take office in January.

Due to the ongoing coronavirus pandemic, the Michigan Secretary of State has reported a huge influx in mail-in voting.  If you’re still hanging onto your mail-in ballot, you will need to find a local dropbox to submit on timeClick here to find contact and location information for your local clerk’s office. You are encouraged to contact your clerk’s office directly to determine if a drop box option is available.

Ballots can be tracked online here after they’ve been dropped off or returned by mail.

If you haven’t done so already, you can still vote in the state’s primary election on Aug. 4 at the polls. Polls will be open from 7 a.m. to 8 p.m. Sample ballots are also available online. Those who would like to ensure they are properly registered or need to verify their precinct number may click on “Your Voter Information” and type in the requested information. The November 2018 passage of the state constitutional amendment, Promote the Vote Ballot Proposal, allows citizens to register to vote up to and on Election Day at their local clerk’s office.  Please be sure to do your part and cast your ballot!


 July 2020 


Click HERE 
for the weekly MIRS Legislative Report.  

Healthcare Bills Move Forward Prior to Summer Recess

The Michigan Legislature addressed multiple healthcare-related bills during the week of June 22, as both chambers prepared for a shortened 2020 summer break.  Here are a few of interest:

Senator Curtis Hertel Jr. (D-East Lansing) introduced a package of bills to create a new certificate of immunization for 12th grade students.  The bills would also direct the Michigan Department of Health and Human Services to reference the immunizations recommended by the CDC Advisory Committee on Immunization Practices when revising the state's immunization certificate. Current state law requires students to provide proof of vaccinations before entering kindergarten and seventh grade and for entering a school for the first time. SBs 979, 980 and 981 would further protect Michigan’s colleges and universities from outbreaks of preventable diseases.  The bills were referred to the Senate Health Policy and Human Services Committee.

Letter to the Governor on I Vaccinate Campaign Funding

Governor Gretchen Whitmer has officially signed into law the telehealth package of legislation recently passed by the Legislature.  HBs 5412-5416 would expand opportunities for providers to receive Medicaid reimbursement for telehealth services.

The Senate reported SB 956 to the House of Representatives for consideration.  SB 956, introduced by Senator Pete Lucido (R-Shelby Township), would prohibit the admittance of COVID-positive patients to nursing homes and would develop regional facilities for those patients.  SB 956 now awaits a hearing from the House Health Policy Committee.

Meanwhile, in response to heightened criticism-particularly from Republicans- that the administration’s decision to put recovering COVID-19 patients into nursing homes to relieve stress on hospitals spread the virus among older patients, Governor Whitmer announced the creation of a nursing home task force.  The task force will have until August 31 to recommend how COVID-19 patients should be treated at these facilities in case of a second wave of COVID-19 cases.

The Michigan Nursing Homes COVID-19 Preparedness Task Force will include one Democrat and one Republican each from the House and the Senate, to be chosen by the governor.  Outside of the Department of Health and Human Services and Licensing and Regulatory Affairs officials, the task force will have 13 people with “personal or professional interest” in nursing home residents or its workers. Governor Whitmer charged the task force with coordinating across state government and industry stakeholders to ensure a broad range of input, analyzing data on the COVID-19 threat to nursing homes and making recommendations on how to improve data quality; making data analysis publicly available in readable format; and making periodic reports to the governor on its findings and recommendations.


 June 2020 


Click HERE for the weekly MIRS Legislative Report.  

Senate Bill 826 Update 

The Senate Health and Human Services Committee voted and passed Senate Bill 826 out of committee on June 19. The bill now goes before the full Senate for consideration. We encourage you to contact your Senators and ask them to support SB 826 when the bill is up for a vote on the Senate floor.

Senate Bill 826 was introduced to update the Mental Health Code by including Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs) and Physician Assistants (PAs) as Mental Health Professionals. The bill is sponsored by the Senate Health & Human Services (HHS) Committee Chair Curt VanderWall (R-Ludington).

 
Recent Executive Action
·      May 22nd-Reopening of two northern regions (includes Upper Peninsula & Traverse City).
·      Small group gatherings of no more than 10 people.
·      May 26th-Shopping at retail stores and visiting motor vehicle showrooms by appointment allowed.
·      May 29th-Elective medical & dental procedures and veterinary care for pets may resume statewide.
·      Stay at Home order extended until June 12th.
·      State of Emergency extended until June 19th
·      Expansion of providers that can order COVID-19 tests and the creation of a new category of community testing sites.
 
Budget Update
The near shutdown of the state has upended Michigan’s economy.
·      Over $1.3 million residents have filed for unemployment.
·      22.7% unemployment rate.
·      Legislative leadership asking for guidance from the administration on current fiscal year budget reduction recommendations-Budget Director and Governor waiting for and calling on Congress to aid state in addressing COVID-19 shortfalls.
·      Health & Human Services Budget risks the most reductions according to Senate Majority Leader Mike Shirkey.  Senate has been taking that posture that no legislation is moving unless it is COVID related.
 
SB 826, Sen. VanderWall’s bill to update the mental health code, is likely up for a hearing on Thursday, June 4th.  Dr. Umeika Stephens will be testifying on behalf of MICNP.
 
HBs 5412-5416-Coverage for Telemedicine (MICNP Supports)
The bills would specify that beginning October 1, 2020, telemedicine services would be covered under the medical assistance program and the Healthy Michigan Program.
Hearing took place in Senate Health Policy on 5/27.  The legislation has wide support from the healthcare community.
 
SB 899-Limited Liability Legislation (MICNP Supports)
The bill would expand provisions concerning the immunity of certain persons and facilities from civil or criminal liability during a state of disaster and extends this immunity to acts performed during a state of emergency.
Stalled currently in the House Judiciary Committee.  
 
SB 879-Emergency Prescription Coverage (MICNP Supports)
The bill would require that insurers allow early and emergency refills of prescription during the COVID-19 State of Emergency. 
The legislation was up in Senate Health Policy on 5/19.  Concern was expressed about how this legislation could put additional stress on the drug supply chain and exacerbate drug shortages and patient access to certain necessary medications.  The Michigan Association of Health Plans is working with the sponsor in order to help address these concerns.
 
Coming soon-Immunization Legislation
Five-bill package spearheaded by Sen. Curtis Hertel.  The bills would require 12th grade reporting on vaccinations.  It also requires the Department to adopt ACIP recommendations.
 

 May 2020 


Click HERE for the weekly MIRS Legislative Report.  

MICNP supports rescinding and revising EO 2020-17.  Read more HERE. 


 April 2020 

Click HERE for the weekly MIRS Legislative Report.  

Executive Order Suspends Scope of Practice Laws
The Governor issued an executive order (EO) on Sunday, March 29th that will make available more people to treat those infected with COVID-19 as the number of those ill has begun to strain the capacity of some hospitals.  Read more HERE.


March 2020

Click HERE for the weekly MIRS Legislative Report.  

UPDATE: HB 4042, Nursing Licensure Compact
Thank you to all the nurse practitioners across the state that reached out to their Senator asking them to support HB 4042. We know everyone operated in doing so with a short window of opportunity, and we very much appreciate your assistance. It was a big win for Senator Shirkey to discharge the compact bill out of the Senate Committee.  The legislature recessed, late Tuesday evening, until Wednesday, March 25. We will keep you posted as new developments occur.

Senate Bill 826 to Strengthen Mental Health Access in Michigan.  Read more HERE.  


February 2020

Click HERE for the weekly MIRS Legislative Report.  

State of the State Address Included a Significant Focus on Healthcare:
 
On January 29, Governor Gretchen Whitmer presented her strategic goals for the upcoming year during her second State of the State address.  She highlighted the importance of maternal health and the need to remove health disparities to improve the quality and safety of care for all Michigan mothers and babies.
 
Approximately 90 women die each year in Michigan during pregnancy, at delivery or within a year of giving birth; 44% of those deaths are considered preventable.
 
Gov. Whitmer announced plans to extend postpartum Medicaid benefits for a full year for mothers, increase access to treatment for substance use and mental health services for mothers and expand access to home visiting programs.  She also called on Michigan’s medical and nursing schools to incorporate implicit bias training into their curricula in order to ensure health equity for all moms and babies.
 
Other healthcare priorities that Gov. Whitmer addressed include codifying the Affordable Care Act (ACA) in state law, supporting behavioral health initiatives and the examination of prescription drug prices in the private market.  Gov. Whitmer called on lawmakers to bring ACA protections into state law in case the federal courts choose to repeal it.  She talked about a plan by Reps. Padma Kuppa (D-Troy), Jon Hoadley (D-Kalamazoo) and Matt Koleszar (D-Plymouth Twp.) to protect people with pre-existing conditions and prevent insurance companies from discrimination (HBs 5430-5432). 
 
She would also like to prohibit annual caps or lifetime dollar limits and require equitable coverage for mental health and substance use disorder treatment.  The Governor said she would seek to enshrine several healthcare services as essential health benefits, such as ambulatory services and hospitalizations, access to birth control, lab services, preventative wellness services and prescription drugs.
 
During the speech, Gov. Whitmer announced the creation of a legislative bipartisan Prescription Drug Taskforce that will look at prescription drug prices in the private market.The task force would include five appointed members made up of Republicans and Democrats from both chambers of the Legislature. Its charge will be to examine the problem of high-cost drugs and the impact they have had on patients and health care providers. The task force will be expected to develop recommendations on how to bring prescription costs down by August 15.  Additionally, the task force will develop transparency standards to disclose how drug companies pay for the research, manufacturing and marketing of prescription drugs. The appointed members of Gov. Whitmer's task force will also be asked to consider policies that could require pharmaceutical companies to explain their rationale for price increases above a “to be determined” threshold.

January 2020

SB 340 (VanderWall):  Remote Pharmacy License.  Allow remote pharmacies under certain circumstances.  This bill was sent to the Governor on 1/14/20
 
HB 4217 (Bellino): Requires physician or other licensee who writes prescriptions to electronically transmit to pharmacy under certain circumstances. On 1/8/2020, it was REFERRED TO COMMITTEE ON HEALTH POLICY AND HUMAN SERVICES.
 
HBs 4978 & 4979 (Brann & Johnson):  Prescription Drug Importation Programs.  Received hearing in House Health Policy in December.  This bill is AARP driven. It is not expected for these bills to come up again in 2020.
 
Bills to Revise the CON process in Michigan-SBs 669 (VanderWall); 670 (VanderWall); 671 (Theis); 672 (VanderWall); 673 (VanderWall); 675 (Zorn); 674 (MacDonald)
This package received a “testimony only” hearing before break and again this week.  The plan is to take action on these bills sometime this year.
Mental Health Revisions Update
We are exploring having Rep. Ben Frederick sponsor the draft language. 
Health Can’t Wait
SB 612 is expected to be considered by the Senate Health Policy Committee on January 30th. No vote will be taken.

Governor Signs Budget Supplemental Restoring $573M Governor Gretchen Whitmer signed a budget supplemental bill on December 20, restoring funding to schools, local governments, hospitals and more for the 2020 Fiscal Year, which began October 1. The supplemental budget was a compromise reached with Republican legislative leaders that restores about $573.5 million of her nearly 1 billion in vetoes from last year.

The deal that was reached between Governor Whitmer, Speaker Lee Chatfield and Senate Majority Leader Mike Shirkey requires the Governor to give the Legislature a 30-day notice if the State Administrative Board (SAB) is looking to move money around within departments. A new provision was also included to allow the Legislature to veto SAB transfers, much like executive orders. In addition, lawmakers are now required to send her a budget by July 1, after the House and Senate sat on their budget bills through this past summer and did not put them on her desk until the end of September.

The supplemental spending will deliver $4 million for the Michigan Department of Corrections (DOC) to upgrade its tethers monitoring felons, another $19.5 million towards cleaning up drinking water and $10.5 million to triple the number of literacy coaches. The $35 million that was slated for per-pupil increases for charter school students was also restored.

Concerning healthcare funding, the hospital community will be receiving a restoration of the Rural Access Pool, the Obstetrics Stabilization Fund and a significant Medicaid outpatient rate increase for critical access hospitals (CAHs). Funding for the Autism Navigator Program was also restored as well as funding for senior-related services, including the Alzheimer’s Association dementia program and $500,000 in Senior Citizen Center grants, available to organizations statewide. $15.9 million was restored for rate increases for pediatric psychiatric diagnostic services as well as neonatal provider reimbursements. Lawmakers have stated they plan to work on additional supplemental budgets this year.