Michigan Council for Maternal and Child Health Friday Notes

February 6, 2015
In this issue
February: National Children's Dental Health Month
DCH-DHS Merger Discussed at Committee Hearing
February: National Children's Dental Health Month
February is National Children's Dental Health Month, providing a great opportunity to spread the news about children's oral health in the nation and in Michigan. The recently implemented Michigan Caries Prevention Program (MCPP) is a collaborative initiative that aims to reduce the burden of early childhood caries by working with primary care providers and dentists to develop and enhance supporting health information technologies to further integrate the medical and dental communities.

This program is led by the Altarum Institute in collaboration with the U-M School of Dentistry, Delta Dental of Michigan and the Michigan Department of Community Health. Read more from the Altarum Institute about why oral health matters in Michigan here.

Altarum Institute is seeking partners to collaborate to fully realize success of this comprehensive project. Contact Amanda DeLandsheer, Program Coordination Lead, to find out more.

Alabama Practice Serving State's Poor
This article examines a large and thriving multiple site dental practice in Alabama where 90 percent of its clients are children with Medicaid insurance. This model has drawn criticism from the dental establishment in the state but access and outcomes for Alabama's poorest kids have improved significantly in the 10 years the practice has been open.

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DCH-DHS Merger Discussed at Committee Hearing
The merger of the state departments of Community Health and Human Services will mean few short-term changes in how local offices operate, Director Nick Lyon told members of the House Families, Children and Seniors Committee at a hearing Wednesday.

Initial efforts will be developing communication between the existing offices and programs, Lyon said. "It's a matter of getting all those entities the information to work together," he said.

As Governor Rick Snyder said when he introduced the idea in his State of the State address, Lyon said the goal of the merger is to focus more on the individual. "We want to make sure the individual gets what they qualify for, but more importantly what they need to get them through what is hopefully a temporary situation," Lyon said.

He warned members, though, not to expect quick results. "This isn't, as you can imagine, an overnight or quick process," he said. "We're going to continue to make incremental progress."
With projected cuts to balance both the current year and coming year budgets, Lyon said there could be as many as 100 layoffs in addition to the vacant positions that have been eliminated.

Committee members pushed Lyon to continue efforts to get the state out from under the consent agreement in the Children's Rights federal lawsuit. Lyon said that was a priority for the current DHS and would remain one for the merged department. "Our goal is at some point to substantially meet the requirements," he said. "In the meantime, we're trying to reduce the things they're looking at." The state has already met some of the targets in the settlement, he said.

ALICE Project Reports Residents Working But Still Struggling
Also presenting at Wednesday's hearing was Scott Dzurka, President and CEO of Michigan Association of United Ways, who reported on the ALICE project (Asset, Limited, Income, Constrained, Employed). This national project demonstrates the needs of underemployed workers and their families in Michigan. More than 60 percent of all jobs in Michigan pay less than $40,000 a year and low-income jobs are projected to dominate the state's economy for the foreseeable future. The new ALICE report breaks the issue down by community for policy makers and others to understand the issue easily and comprehensively.

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Federal Policy Change Could Mean More Funding for School-Based Health
A recent federal policy reversal, long-sought by states and health care advocates, could enable schools to take a lead role in managing chronic childhood diseases and result in the hiring of many more school nurses.

The change, announced quietly and unexpectedly in December by the Centers for Medicare and Medicaid Services (CMS), will allow public schools to receive Medicaid money for health services they provide to eligible students for the first time since 1997.

Once several financing and bureaucratic hurdles are cleared, advocates believe the new policy will improve the coordination of care provided to children with conditions such as asthma, diabetes and mental illness.

The issue arose in 1997 when the Health Care Financing Administration (HCFA)-now CMS-said Medicaid would no longer pay for services provided free to the general public. For example, if a school district provided free vaccinations to all its students, that district could not bill Medicaid for immunizing Medicaid-eligible children, even though Medicaid would cover the immunization in a doctor's office or community health center. Exceptions were allowed for some children with disabilities.

Schools could work around the rule by charging non-Medicaid children for the same services, generally by billing their private insurers or, if they had no insurance, charging their families directly. But that placed a burden on the schools, which are not equipped to handle insurance billing. Also, many private insurers do not recognize schools as providers of medical care.

President George W. Bush's administration was not interested in reversing the free care policy, but advocates found the Obama administration to be more sympathetic, given its stated desire to improve the delivery of health care in communities and not just in clinics and doctors' offices.

"The goal of this new guidance is to facilitate and improve access to quality health care services and improve the health of communities," Cindy Mann, the CMS director, wrote in a December 15 letter to state Medicaid offices.

Read more about the policy change in this piece analyzing the decision and potential effects in this article provided by the Pew Charitable Trusts.

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Enrollment Begins For Medicare/Medicaid Dual Eligible Pilot Program
The Michigan Department of Community Health (MDCH) announced this week the start of enrollment for MI Health Link, Michigan's pilot project to integrate care for individuals eligible for both Medicare and Medicaid. MI Health Link will be launched in four regions of the state in two phases. Phase 1 includes the entire Upper Peninsula and eight counties in southwest Michigan, including Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph, and Van Buren. Phase 2 includes Macomb and Wayne counties.

Residents eligible for MI Health Link in Phase 1 counties will receive an introductory letter from MDCH advising them of their options for enrollment, who to contact for help, and the benefits of participating in MI Health Link. These individuals can now enroll in the program, with services beginning March 1, 2015. Passive enrollment for residents included in Phase 1 will be effective May 1, 2015. Through passive enrollment, eligible individuals will be enrolled if they did not elect to enroll or did not opt out of the program. Residents in Phase 2 will receive introductory letters in late March and can enroll in the program in April with services starting on May 1, 2015.

The Michigan Medicare/Medicaid Assistance Program (MMAP) is available to provide free un-biased options counseling through a toll free number 1-800-803-7174. MMAP local representatives understand the details of MI Health Link and can assist people in selecting a health plan which best meets their needs.

More information about MI Health Link is available at michigan.gov/mihealthlink.

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Contributors to this Issue
Altarum Institute
Gongwer News Service
HealthDay
MDCH
Pew Chartitable Trusts
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Quick Links . . .

Oral Health Mini-Grant Applications Due Feb. 16
The Michigan Oral Health Coalition's 2015 Community Mini-Grant Program is accepting applications. Support for this grant program is provided by the Michigan Oral Health Coalition, through the Oral Health 2020 Initiative of the DentaQuest Foundation. A partnership with Oral Health Kansas and Wisconsin Oral Health Coalition will develop a Midwest collaborative to formally connect local stakeholders to state and national partners. The Michigan Oral Health Coalition looks to inspire local communities to create networks of innovation, advocacy, and leadership to improve the oral health of its residents. These community networks will align data and resources, and create effective approaches to prevent and manage oral disease that can be replicated. Application Deadline: February 16, 2015 at 5 p.m. Full details available here.

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Save the Date: Connecting With Kids Through School Health Conference
June 18-19, Boyne Highlands Resort

Organized by the Michigan Coordinated School Health Association, the conference theme encompasses leadership, partnership and programming in schools to meet the needs of the whole child, ultimately ensuring academic success. This includes social-emotional and physical health. This event will bring coordinated school health teams (teachers, support staff, administrators, parents) together to ensure academic success.
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Study: Income Inequality Affects Children's Health
There is a growing disparity in the physical and mental health of rich and poor children and teens in the United States and other wealthy countries, a new study reveals. Researchers examined data gathered from nearly half a million youngsters, aged 11 to 15, in 34 countries in North America and Europe between 2002 and 2010.
The analysis showed that poorer kids living in countries with greater income inequality were more likely to be in worse health, get less exercise, have more body fat, have lower life satisfaction, and report more physical and mental health symptoms, such as irritability and headache.
The study was published Feb. 3 in The Lancet. Read more
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First Lady Announces $500M for Anti-Childhood Obesity Efforts
Michelle Obama announced on Thursday -- the fifth anniversary of her signature "Let's Move" effort -- a $500 million donation from the Robert Wood Johnson Foundation to help combat childhood obesity. Obama made the announcement at a New York City high school that she said already is serving nutritious meals. Read more
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