Spring 2009 | Vol 7#2
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2008-2009 MPCA Board of Directors Executive Committee
Jaeson Fournier, DC, MPH, President
Deputy Health Officer, Ingham County Health Department, Lansing, MI
Chris Shea, President-Elect
Executive Director, Cherry Street Health Services, Grand Rapids, MI
Linda Shively, MPA, HCA, Secretary
Executive Director, Baldwin Family Health Care, Baldwin, MI
Michelle Styma, Treasurer
Executive Director, Thunder Bay Community Health Service, Inc., Hillman, MI
Laura Piascik, Health Center Board Member Committee Chair
Center for Family Health, Jackson, MI
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Upcoming MPCA Events
MPCA Health Center Board Member Workshop
May 15-16, 2009
Comfort Inn & Suites
Mt. Pleasant, MI
Online registration
Pesticide Education & Reporting: What Outreach Workers Need to Know
May 19, 2009
Grand Rapids
Community College
Grand Rapids, MI
Online registration
Screening, Identifying, Treating & Reporting Environmental & Occupational Health Risks (FREE Webinar)
May 20, 2009, 12-1pm
Online registration
Third Annual Tri-State Finance Workshop
May 28-29, 2009
Ann Arbor Marriott Ypsilanti
at Eagle Crest
Ypsilanti, MI
Online registration
Annual MPCA Clinical Conference: A Conference
for Health Center Staff
May 28-29, 2009
Kellogg Hotel &
Conference Center
East Lansing, MI
MPCA Workforce Summit
June 4-5, 2009
Sheraton Detroit Novi
Novi, MI
Michigan Oral Health Conference
June 11-12, 2009
Kellogg Hotel &
Conference Center
East Lansing, MI
Online registration
National Health Center Week
August 9-15, 2009
2009 MPCA Annual Conference
September 27-29, 2009
Amway Grand Plaza
Grand Rapids, MI
Click here for additional MPCA events, including committee, network, and workgroup conference calls and meetings.
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For up-to-date information about H1N1 and links to reliable sources of information like the Centers for Disease Control & Prevention and the Michigan Department of Community Health, click here.
Support Michigan’s Health Centers! Click here to sign up as a Health Center ADVOCATE today. Health Center Advocates receive e-mails about advocacy efforts, state and federal legislation affecting Health Centers, and Calls to Action to communicate with elected officials.
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by Kim E. Sibilsky, Executive Director, Michigan Primary Care Association
Awhile back, when Dick Bohrer was still at the Bureau of Primary Health Care, he referenced the intention of President Bush to double the number of Community Health Centers and number of people served, as Health Centers being “in the spotlight like being in the headlights.” That is very much the sense of our current great luck in receiving $2.0 billion nationally through economic stimulus. Health Centers are receiving wave after wave of stimulus funding for operations and capital needs, but the turn around time for applications is very short and the “transparency” and need to perform successfully very great.
This is our time to show how the system is designed to get the job done. Health Centers work under many pressures, in underserved communities, serving any and all comers. But Health Centers also have many resources available that other private providers don’t. Please do not be shy in asking for what you need to succeed in this current environment. PCAs' only reason for being is to help you meet your mission and serve your communities. Let us know what technical assistance you need, what consultants you want made available, what data will help you. If you need writers, let us know. Or architects or engineers. If we don’t have the resources at hand, we’ll find ways to make them available to you. JUST LET US KNOW.
Transparency is a burden, but it is also an opportunity. This is our chance to show what we can do and how we can be a true asset to our State, our communities, and patients. Let us help you meet these challenges in the spirit of the mission and for the people we serve.
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 by Douglas M. Paterson, MPA, Director of State Policy, Michigan Primary Care Association
Tuesday May 5, 2009, was a dark day for the people of Michigan. The auto industry's decline and the job losses that have resulted became reality in the ability of our State government to provide for the common good. Like any entity, we have to live within our means, but our means continue to deteriorate.
On May 5, we continued to disinvest in our people. Services to Medicaid beneficiaries were cut, as were vital public health programs that save Michigan money over the long run. We are turning down 75 cents in federal funding because we can’t come up with the 25 cents needed for match. This is a vicious spiral. Those federal revenues we forgo create jobs and generate taxes. Most of that money in one way or another goes into people’s pockets, which then generates both income and sales tax revenue. When we forgo the federal revenue, we also forgo the tax revenue it generates for our state.
While many individuals complain about government and the associated perception of waste, it is untenable to believe government can be perfect. While perhaps imperfect, government is still the ONLY institution we have at our disposal to provide for the COLLECTIVE good on all our behalf. Having been a State of Michigan employee for most of my career and having watched government during the last seven years of budget deficits, I truly believe that much of the waste and inefficiency that can be reasonably cut has been realized. I will not argue that more can’t be done, but government efficiency and cuts will NOT get us where we want to be.
I think we need to quit dwelling on the negative. If we expect things to get worse and continually dwell on that fact, then we will get what we expect. I believe it is time to dwell on the positive. We can and want to be a state that is vital and growing once again. I believe in the theory that “you move toward what you focus upon”. We need to begin to collectively focus on a vision for what we want our government to do for us. If that vision includes quality health care for everyone, quality schools, safe and vibrant neighborhoods, safety net services for people who need our collective support, and children who are protected from harm from their parents or caregivers, then we need to insist on investment, NOT disinvestment in these things. We need to stop the downward vicious spiral that we have created in continuing to insist on more cuts. We ALL need to pull together and contribute to that investment.
Like a family, we have to decide if we are going to continue to cut away at essentials or if we are going to begin looking at how we can generate more money to support our vision. The first thing we must insist upon is that our elected officials review all the money that we currently forgo collecting in taxes right now. As of 2008, State government put laws in place that provide tax relief to institutions and individuals to the tune of $37 billion while we collect $26 billion in taxes. This is $37 billion that is essentially lost. We forgo more money than we collect. I argue that some of these exceptions SHOULD be continued. However, many have been in place for years to give special advantage to powerful groups and institutions; they have not been reviewed since passage and should get careful reconsideration. In fact, since 2005, over 26 bills or proposals have either been made by the Governor or passed by at least one that would generate $614 million in additional revenue available to the state. Each week, more tax credit bills are passed that forgoes income to the state.
In addition, we must re-examine our tax structure. We need a new tax structure that leaves room for growth as our economy grows, more equitably spreads the tax burden among individuals, and broadens the tax basis. We must insist that our elected officials consider a graduated income tax similar to what the majority of states in our country do, and once again revisit taxes on services which make up 60% of our economy in Michigan. This would broaden the tax base and assure it is built with capacity to expand rather than contract as the service industry continues to grow while goods continue to decline.
Finally, none of us should be exempt from sharing the burden. As a retired State of Michigan employee, I currently am not taxed by the state on my state pension. This is a loophole I would be glad to forgo if everyone else, based on income and ability to pay, helped as well. I also like a beer once in awhile and would be glad to contribute another nickel for each beer I buy if I thought that might protect an abused child, assure someone has access to health care, provided help to someone mentally ill, or fixed one of those darn potholes. In fact, maybe I would have two beers.
So do me a favor - while you are sharing time with friends, family, co-workers, and colleagues, have this discussion. Share a vision for what kind of state we want, and ask each one if they would be willing to share in that investment. Then vote for policymakers who are willing to lead us there. Together we CAN create Michigan’s future through investment in the collective good, NOT disinvestment!!! We must stop this vicious spiral.
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 To kick off each new year, Michigan Primary Care Association(MPCA) members have the opportunity to educate their State Legislators and Members of Congress about the quality, affordable, accessible primary and preventive health care that Community Health Centers provide constituents.
In February, MPCA held its annual Legislative Forum during which Michigan Health Center staff and board members met one-on-one with their State Senators and Representatives in Lansing to discuss MPCA’s 2009 legislative priorities, which are outlined in MPCA’s new plan for ensuring all Michigan residents have access to health care:
- Developing Michigan’s health care workforce
- Providing health coverage for all Michigan residents
- Securing direct state funding of Community Health Centers
- Implementing the Patient Centered Medical Home model in Michigan
As policy makers consider policies aimed at expanding health coverage, it is equally important to maintain and strengthen the system already in place through which the uninsured receive medical care, namely Community Health Centers. MPCA’s Access to Health Care for All of Michigan is designed to expand the system of care beyond medical care to improve the health status of patients and communities, put patients in the center of the health and human services equation, and create access to what people need when they need it regardless of the time of day or day of the week.
 During the Legislative Forum, MPCA presented Senator Tom George (R-Portage) with the Champion for the Underserved Award. As chair of the Senate Health Policy Committee, Senator George was a key player last year in legislative activity aimed at ensuring access to and affordability in the individual health care market. “MPCA was proud to name Senator George the 2009 Champion for the Underserved, and we look forward to working with him this year to promote and protect care for the vulnerable populations in our state,” said Doug Paterson, MPCA Director of State Policy. Click here to watch a short video of the awards presentation.
Following the Legislative Forum, MPCA members headed to Washington, DC, in March to meet with their Members of Congress at the National Association of Community Health Centers’ 34th Policy & Issues Forum. “Michigan is fortunate to have so many Members of Congress who are key players in health care policy and the impending health care reform, and who value the role of Community Health Centers as local providers of quality health care for America’s medically underserved,” said Kim Sibilsky, MPCA Executive Director. “They understand that Health Centers are a vital part of the solution to this nation’s health care crisis because they provide access to affordable, quality primary and preventive care for 18 million Americans today and stand ready to expand their services to the increasing number of our neighbors who find themselves in need of a health care home.”
 A highlight of the Policy & Issues Forum was the presentation of distinguished community health care champion, defender, and superhero awards, which are given to only select Members of Congress who have done outstanding work on behalf of low-income, uninsured, and medically underserved Americans. This year, Senators Debbie Stabenow (D-MI) and Carl Levin (D-MI; pictured at left with MPCA Board Chair Jaeson Fournier), and Representatives John Dingell (D-15), Fred Upton (R-6), Vernon Ehlers (R-3), and Dave Camp (R-4) were among the distinguished award winners. MPCA congratulates and thanks them for their commitment to preserve, strengthen, and expand access to health care through Community Health Centers in Michigan and across the nation.
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 The number of people across the country struggling without access to basic health care during these tough economic times has skyrocketed from 56 million to 60 million over the last two years. This is according to a new report, Primary Care Access: an Essential Building Block of HealthReform, released in March by the National Association for Community Health Centers.
Michigan has been hit especially hard by the recession, with its current unemployment rate of 12.6% the highest in the nation and its uninsured population estimated at over 1 million. Many other residents of rural and urban communities across the state are underinsured due to a host of factors that include loss of employer-sponsored health insurance, a worsening shortage of primary care doctors, and a growing scarcity of providers willing to treat the uninsured or publicly insured.
Now, more than ever, Community Health Centers are serving as the health care home for an increasing number of people who find themselves suddenly uninsured or underinsured. Community Health Centers are local, non-profit, community-owned providers of high-quality, affordable, comprehensive primary and preventive health care whose doors are open to everyone in the community—young and old, rich and poor, insured and uninsured. Patients are charged for services on a sliding-fee scale that is based on family size and income.
Michigan Community Health Centers are rising to the challenge of meeting escalating need by expanding services and establishing new sites. This is being made possible in part by funding from the American Recovery and Reinvestment Act (ARRA) to help more patients access health care. In Michigan, Community Health Centers have received approximately $11.2 million from the ARRA to address increased demand for health care from the uninsured and underinsured (see Federal Government Shows Trust in Community Health Centers with Granting of Federal Funds below).
Keeping pace with escalating demand is a tremendous challenge for safety net providers, even for Community Health Centers with their proven record of success in narrowing health disparities, providing health care in a cost-effective way, and providing significant returns on taxpayer investments – but it has rarely, if ever, been as challenging as it is today.
Studies show that uninsured individuals with access to regular preventive care at a Community Health Center they call home are less likely than those without access to a Community Health Center to be taken to the emergency room or hospitalized, less likely to have an unmet medical need, less likely to have postponed or delayed seeking needed care, more likely to have had a general medical visit, and more likely to receive preventive screenings.
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These are exciting times! As Congress and the Obama Administration lead the charge in overhauling the American health care system, confidence in Community Health Centers as a key partner in reform is mounting. This is evidenced by the recent investment in the Health Centers program through the Children’s Health Insurance Program Reauthorization Act, the American Recovery and Reinvestment Act, and fiscal year 2009 Omnibus appropriations. Michigan Community Health Centers are tremendously grateful for this trust and investment, and stand ready to demonstrate significant returns on investment. Already, Michigan Community Health Centers can reasonably be credited with saving the State of Michigan over $42 million in 2007 based on findings from a study conducted by the Institute for Health Care Studies at Michigan State University. These savings are likely attributed to prevention, chronic disease management, reduced pharmaceutical costs, and reduced emergency room utilization.
 In February, Congress passed and President Obama signed the Children’s Health Insurance Program Reauthorization Act (CHIPRA) to expand health coverage to an additional 4 million low-income, uninsured children by 2013. As a result, Michigan will receive approximately $203 million in new funds next year to cover additional eligible children through the successful MIChild and Healthy Kids programs. Michigan Health Centers deeply appreciate provisions in this legislation that will enable them to expand and improve care for CHIP beneficiaries in our state while ensuring adequate financial stability for Health Centers.
Also in February, the American Recovery and Reinvestment Act (ARRA) became law, providing $2 billion in funding to Community Health Centers over the next two years. Of that, $1.5 billion is for infrastructure funding (facility construction and renovation, equipment, and health information technology investment) and $500 million is for Health Center operations. Ingham County Health Department (Lansing) and Western Wayne Family Health Centers (Inskter) were among the 126 Health Centers across the nation to receive New Access Point funding through ARRA. Both Health Centers will receive $1.3 million over the next two years to help ensure 13,890 more Michigan residents have access to quality, comprehensive primary and preventive health care.
ARRA also provided additional funding for the state’s AmeriCorps Program to allow current grantee organizations to add 76 AmeriCorps members to help Michigan residents access adequate health care and housing, tutor students, and much more. MPCA’s AmeriCorps Program has submitted a competitive application for this funding and is anticipating to hear the results in early May. Currently, the MPCA AmeriCorps program consists of 14 members in seven Michigan Community Health Centers. “This is a great opportunity to help individuals and families impacted by the current economic crisis. The MPCA AmeriCorps program is committed to supporting our member outreach efforts to help all Michigan residents have convenient and affordable access to quality health care,” said John Taylor, MPCA AmeriCorps Program Director.
HRSA released an additional $340 million in ARRA funding to Community Health Centers through Increased Demand for Services (IDS) grants. All Michigan Community Health Centers submitted applications for and received this one-time, 2-year funding to support increased services at existing sites. This will enable Michigan Community Health Centers to care for an additional 53,000 patients in our state, including over 27,000 uninsured patients, and support approximately 152 jobs.
And let’s not forget fiscal year 2009 Omnibus appropriations, which President Obama signed into law in March. Included is a $125 million increase for Health Centers over last year’s budget, of which a historic $56 million is for base grant adjustments for existing Health Centers. This puts total funding for the Community Health Center program at $2.190 billion to provide an additional 470,000 uninsured Americans with access to Community Health Centers. The appropriations also include $190,000 for Hamilton Community Health Network (Flint) facilities and equipment; $476,000 for Community Health and Social Services (CHASS) Center, Inc. (Detroit) to construct a new Health Center; and $143,000 for St. Mary’s Health Care (Grand Rapids) to launch an electronic medical records initiative.
While Congress hasn’t approved the fiscal year 2010 budget yet, MPCA would like to thank Senator Debbie Stabenow (D-MI) for once again co-authoring the Health Centers “Dear Colleague” letter with Senator Kit Bond (R-MO). This letter asks Senators to sign the letter to support a $412 million increase for the Health Centers program in fiscal year 2010, which will include $66 million in base grant adjustments. Thank you also to Senator Carl Levin (D-MI) for already signing the Senate letter, and to U.S. Representatives Mark Schauer (D-7), Pete Hoekstra (R-2), Vernon Ehlers (R-3), Dale Kildee (D-5), Bart Stupak (D-1), Gary Peters (D-9), and John Conyers (D-14) for signing the House’s companion letter. This funding level was already reauthorized by Congress when it passed the Health Centers Reauthorization Act of 2008. |
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Two Michigan Community Health Center board members were recently recognized by the National Association of Community Health Centers (NACHC) for their advocacy efforts. Henry Hatter (picutred above left), board member at Hamilton Community Health Network (Flint), was named NACHC’s February Advocate of the Month. “The ultimate CHC supporter, Mr. Hatter has grassroots advocacy down to a science and often leads the charge to participate in Health Center events, including National Health Center Week, local Health Center initiatives, and local, state, and federal legislative visits. In March, Thunder Bay Community Health Service Board Chair, Mike Wurtsmith (pictured above right with Marc Wetherhorn of NACHC), was inducted into NACHC’s Grassroots Hall of Fame. “Mike is a strong supporter of TBCHS and Community Health Centers across the nation. He is very committed to ensuring access to health care for our communities and every community across America. We are fortunate to have him represent us all!” said Michelle Styma, TBCHS Executive Director. MPCA extends its appreciation to Henry and Mike for their persistent advocacy efforts on behalf of Michigan CHCs and encourages other CHC supporters to register as health care defenders on the NACHC and MPCA web sites, and to contact their elected officials when called upon via action alerts - every voice truly does count!
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In an effort to make more people aware of the quality, comprehensive, affordable primary and preventive care that Michigan Community Health Centers provide, MPCA has been increasing its online presence over the past few months. With the addition of a blog, a Facebook Page, and a Twitter account, MPCA is spreading the word about Health Centers far and wide. Click here to access the blog and sign up to receive RSS feeds. Click here to join the MPCA Facebook group. Click here to follow MPCA on Twitter. Please take advantage of the interactive and viral nature of these social networking tools – the more you use them and share what you read with others, the more people will know about Community Health Centers. We don’t want to be the best kept secret!
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Fully integrating behavioral health care into the primary care model has been a challenge for Community Health Centers across the country as health care financing, policy, and delivery systems have historically separated primary health care from specialty behavioral and substance abuse services. However, providers increasingly recognize that bringing these clinical services together increases access, quality, and cost-effectiveness of all levels of care.
According to a recent Institute of Medicine publication, Primary Care: America’s Health in a New Era, it is estimated that 10-40% of primary care patients have a diagnosable mental disorder and approximately 40-50% exhibit significant psychological distress. By addressing a population’s behavioral and substance abuse treatment needs, studies have shown measurable improvement in the process of care and clinical outcomes, and an increase in value and overall cost savings.
To assist Michigan Community Health Centers in integrating behavioral and primary health care, MPCA, the Washtenaw Community Health Organization, the Michigan Department of Community Health, and the Michigan Association of Community Mental Health Boards supported a behavioral health “learning community” pilot in 2008. Initially, three Michigan Community Health Centers (CHCs) and six Community Mental Health agencies participated in the Michigan Integrated Health Learning Community (MIHLC). Teams from Health Centers and Community Mental Health agencies are currently being enrolled for participation in MIHLC this year, with the next meeting scheduled for June 9. Throughout the year, participants will take part in face-to-face meetings, conference calls, and individual team meetings. Collaboration continues to help integrate the cultures of both behavioral health and primary care providers, as well as provide technical assistance related to integration of treatment plans, health records, and negotiating reimbursement for behavioral health services.
 MPCA is also expanding the collaborative approach to improve organizational capacity at Michigan CHCs by integrating mental health services for children and adolescents into their primary care settings. This is being funded through a $50,000 grant from the Ethel and James Flinn Foundation. One out of every five children suffers from some form of emotional disorder and one out of every 10 has a serious emotional illness. In the United States, about six million children are affected by emotional disorders every year. According to the department of Health and Human Services, childhood is an important time to prevent mental disorders and promote healthy development, because many adult mental disorders have related antecedent problems in childhood. Thus, it is logical to try to intervene early in many children’s lives. |
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MPCA and Community Health & Social Services (CHASS) Center, Inc. are among 75 nonprofits in 28 states, the District of Columba, and South Africa to receive 2009 first quarter grants from The Kresge Foundation. The metropolitan Detroit-based foundation focuses its grant making in six fields of interest: health, the environment, community development, arts and culture, education, and human services. MPCA will receive $200,000 to assess and support capital development projects in Community Health Centers throughout Michigan. CHASS will receive $1 million to support the development of a new facility in Southwest Detroit. |
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