Michigan Council for Maternal and Child Health Friday Notes

February 13, 2015
In this issue
House and Senate Committees Approve Executive Order to Cut Budget
Health Endowment Fund Discussed at Senate Committee
House and Senate Committees Approve Executive Order To Cut Budget
The House and Senate Appropriations Committees voted Thursday to approve the governor's executive order that would resolve part of the $330 million deficit in the General Fund.

EO 2015-5, which will reduce spending in the current fiscal year by $102.9 million, was given final approval, mostly along party lines, in the House Appropriations Committee by a 19-10 vote, and 13-4 in the Senate Appropriations Committee.

The cuts in the executive order include $5 million from Graduate Medical Education, which had a $51.1 million General Fund contribution. The vast majority of the General Fund savings will come from shifting funds, forgoing certain payments deemed unnecessary, anticipating lapses in funds enacted for the year but expected to go unspent and anticipating reduced caseloads in the traditional Medicaid program. The biggest shift comes with community colleges, where Governor Rick Snyder decided to end all General Fund support, replacing it with School Aid Fund money. That is part of one of the supplemental bills, separate from the executive order.

In addition to the executive order, the House panel also reported two negative supplemental appropriations bills, one for departments and agencies (HB 4112) and for K-12 public schools, higher education and community colleges (HB 4110).

Those bills provide an additional spending reduction in the current year budget of $419.7 million, bringing the total reductions to $522.6 million. Although the shortfall in the General Fund is only $330 million, officials said reductions went beyond the actual shortfall to provide additional support for the 2015-16 budget.

Governor's 2015-16 Recommendations Presented
Governor Snyder outlined the administration's FY 2015-16 budget recommendation to the House and Senate Appropriations Committees on Wednesday. The entire spending plan totals nearly $54 billion.

The budget outlined fiscal proposals for the Department of Community Health and the Department of Human Services separately, though by the time the budget is finally enacted, which is expected to be in June, the two departments will be combined into the single Department of Health and Human Services. Combined the two departments will account for more than $23 billion in spending -- out of a total $54 billion budget in 2015-16 - but as proposed, DCH will have a total budget of nearly $19 billion.

The School Aid Fund will total $12.7 billion, and with federal funding the total spending on schools will top $14 billion. Education spending in the budget, for K-12 and the state's universities and community colleges, will account for some 30 percent of the total, the administration said.

MCMCH joined health advocates in praising the Governor's proposal to expand the Healthy Kids Dental program to Wayne, Oakland and Kent counties in the budget. The budget also adds another $11.6 million, of that $4 million is in general funds, for the state's programs to help children with autism and autism spectrum disorder. A proposed $5 million, $1.9 million in general funds, will be added to help move children with mental health issues out of in-patient psychiatric care to community mental health settings.

The DCH budget likely faces the largest opposition, as Governor Snyder is proposing to end the current system of supporting GME through the General Fund. Instead, he is proposing an assessment against hospitals to finance the program. The GME program is considered important to help new physicians create practices in Michigan.

Sen. James Marleau (R-Lake Orion), chair of the Senate Appropriations Community Health Subcommittee, said he strongly supports the GME program and pledged an in-depth review of the governor's proposal to overhaul how it is funded.

"If the GME is not there, they have an opportunity to go to the other 49 states to take up their residency and go on and start a practice," he said. "I am very concerned about that."

Appropriations Subcommittees will begin reviewing the executive recommendations next week. MCMCH is actively analyzing the line items in the proposed budget to develop our budget advocacy strategy and will update members as the budget process moves forward.

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Health Endowment Fund Discussed at Senate Committee
The Senate Appropriations Community Health Subcommittee heard a presentation on the Michigan Health Endowment Fund this week, discussing the fund's goals and still-developing operations.

The fund was created when Blue Cross Blue Shield of Michigan was reorganized in 2013 as a mutual company. BCBSM will contribute $1.5 billion over 18 years to the fund, and the fund itself has to use that to create a basic financial corpus of $750 million (along with issuing grants). Rob Fowler, chair of the fund's board, said that means the fund will be the fourth largest foundation in the state.

The fund is required to have a focus on children and older state residents, along with other health issues, Fowler said, and within that framework, the fund's board has established eight areas for focus:
1) Access to prenatal care and reduction of infant mortality rates.
2) Health services for foster and adopted children.
3) Access to healthy food
4) Wellness programs and fitness programs
5) Access to mental health services.
6) Technology enhancements
7) Health-related transportation needs
8) Foodborne illness prevention.

The fund awarded a total of $38.15 million in grant awards in its first year of operation.

But the fund's board and leaders are now looking at how they should focus their grants in 2015 and beyond. To a question from Sen. Mike Shirkey (R-Clarklake) on that issue, Fowler said the organization would prefer to spend money in a way that could help improve health outcomes and mean the state has to spend less of its own money.

Sen. Curtis Hertel Jr. (D-East Lansing) asked why some of the focus areas cited, including infant mortality and others, had not yet been addressed via the grants awarded. Fowler replied that moving forward different areas would receive funding but that they were simply starting the process of working to create positive health changes.

Hillegonds Named Fund CEO
At a brief meeting on Monday, the Health Endowment Fund board unanimously selected former House Speaker Paul Hillegonds as the first CEO of the fund. He's slated to start March 16.

Hillegonds said he will retain his post as chair of the Regional Transit Authority in Southeast Michigan as well as his seat on the Kresge Foundation board as he takes on this new task. He was most recently senior vice president at DTE Energy, where he retired last year.

Hillegonds served as minority leader, co-speaker and then speaker before leaving the House after the 1995-96 term. He was first elected to the House in 1978.

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Contributors to this Issue
Gongwer News Service
HealthDay
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Quick Links . . .

SCHA-MI Advocacy Day: March 17
Are you a youth or adult that supports school-based, school-linked, and school wellness health centers and programs in Michigan? Come to the Capitol and have your voice be heard!
Join the School-Community Health Alliance of Michigan on March 17, 2015 in the Mackinac Room of the House Office Building in Lansing for annual SCHA-MI Advocacy Day. Make the legislative process come alive and join us from 9am - 3pm for legislative visits and crucial policy updates for the field. Youth, parents/guardians and Health Center Professionals are encouraged to attend. Online registration available here.

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Save the Date: MASN Conference May 7-8
The Michigan Association of School Nurses' annual conference, Effective Leadership in Emerging School Health, will be held May 7-8 at the Kellogg Center in East Lansing. Topics include: leadership in nursing, anaphylaxis and Michigan schools, legislative leadership and human trafficking.

Online Registration available March 1, 2015 at www.michiganschoolnurses.org. Overnight room reservations available online: kelloggcenter.com or call (800) 875-5090. Use code: MSN042215
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Job Posting: CHAP Project Director
The Greater Flint Health Coalition is seeking an experienced Project Director to lead the implementation and operation of a new program, the Genesee County Children's Healthcare Access Program (CHAP). A description of the position and application procedure is posted here.
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MCH Navigator Self-Assessment Available
This resource is designed to help students and professionals use the Maternal and Child (MCH) Leadership Competencies. The competencies represent a set of skills desirable for practice that professionals may want to possess as they work to protect and improve the health of MCH populations. The self-assessment can help students and professionals determine their level of knowledge and skill with respect to each of the domains that comprise the MCH competencies, and can serve as a starting point for identifying professional development needs and developing training plans.
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