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MCMCH LOGO       Michigan Council for Maternal and Child Health
                 Friday Notes

Friday Notes is intended to share current information, resources and notices.

If you have information or announcements that you would like to have included in the next issue, forward them to MCMCH.

                         May 13, 2011
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In this issue
State Budget Update
HHS Works on 'Dual Eligibles'
Providers: President's Plan Needs Work

STATE BUDGET UPDATE   

Work on the state budget continued this week on both sides of the Capitol and both sides of the fiscal equation with the Senate passing a version of Governor Snyder's "tax plan" on the revenue side and the House addressing the Senate-passed versions of the spending proposal. 

With a reduction in the Earned Income Tax Credit, a tiered pension tax, elimination of almost all business tax credits and a replacement of the Michigan Business Tax with a flat 6% corporate tax headed to the Governor for his signature, the only remaining piece of the revenue equation for the '11-'12 fiscal year is the Revenue Estimating Conference scheduled for Monday, May 16.  The conference will be an update of the state's current revenue and tax collections and it is strongly anticipated that it will be favorable with as much as $500 million more in expected revenues than previous estimates.  If those dollars will be incorporated into the current '11-'12 budget proposals remains to be seen.

We are also anxiously awaiting the next move on the state budget.  With an omnibus budget bill passed by the House and rejected in the Senate and individual department bills passed in the Senate and now rejected in the House, the normal conference committee process of negotiating differences on individual department budgets is unclear to say the least.

MCMCH Advocacy
What is clear is that we need to continue educating all legislators on the importance of maternal and child health issues in the state budget.  It is time for your advocacy with your own legislators on the items most in jeopardy:

Healthy Michigan Fund
We are defending the current year funding for five maternal and child health-related lines with in the Healthy Michigan Fund: Pregnancy Prevention, Teen Pregnancy Prevention, Michigan Model for Health, Michigan Care Improvement Registry (MCIR), and Michigan Outpatient Maternity Services (MOMS).  Click here for talking points on these issues and please include specific, local examples if possible.  Most importantly, please talk about the importance of prevention.

Graduate Medical Education
GME funding is in real jeopardy with a 40% cut proposed in the Executive recommendation.  The House agreed with that cut and the Senate took it even further and simply eliminated all GME funding.  GME programs have a profound effect on access to health care for vulnerable populations and are
essential for preserving health care jobs and many advocacy partners are working on this issue, but we need to add the unique maternal and child health perspective.
It is important that legislators understand what GME and what it is not: GME funding helps teaching hospitals offset the costs of operating medical residency programs for physicians who have completed medical school training and who provide significant patient care to vulnerable populations in hospitals and clinics. GME is not tuition funding. 
Please speak to the GME cut from your own perspective about the access and workforce issues it will exacerbate in Michigan.

Local Public Health
The local public health essential services line which provides so much of the base support for local pubic health departments is slated for cuts again.  A 5% cut of $1.7 million was proposed in the Executive recommendation and was agreed to in the Senate but the House doubled that amount to $3.4 million or 10%.  It is critical to convey to legislators that combining this cut with county revenue sharing cuts and cuts to individual program lines (like pregnancy prevention) means that local public health departments are in real danger of not being able to provide statutorily-required services.  It is also imperative to convey the increased demand for services during tough economic times.  Please speak to not only your program at local public health but the breadth of the services provided.

Medicaid Rates
No cuts to Medicaid rates are currently proposed by the Governor or in either chamber's version of the DCH budget.  It is important that the newly proposed 1% tax on insurance claims is introduced and enacted quickly however as the agreement with the administration and legislators is if the tax doe snot pass that cuts to Medicaid rates would be necessary to make up the almost $300 million hole in the DCH budget.


Please pick those items most relevant to you and your expertise in maternal and child health and contact your own legislators and those who represent your work location as well.  Click here for the links to to find your state representative or state senator.

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HHS offers new tools to help states lower Medicaid costs, provide better care

The U.S. Department of Health and Human Services (HHS) announced this week a series of initiatives to work with states to save money and better coordinate care for the 9 million Americans enrolled in both Medicare and Medicaid. The new initiatives include better access to Medicare data and better coordination of health care between Medicare and Medicaid. The initiatives will be led by the new Federal Coordinated Health Care Office (the Medicare-Medicaid Coordination Office), which was created by the Affordable Care Act to help make the two programs work together more effectively to improve patient care and lower costs.

"Medicaid costs are largely driven by the complex medical needs of low-income seniors and people with disabilities who are eligible for both Medicare and Medicaid. We know that by working together, we can provide better, more coordinated care while lowering health care costs and saving money for states," said Centers for Medicare & Medicaid Services (CMS) Administrator Donald M. Berwick, M.D.

"Medicare and Medicaid spends $300 billion each year to care for people enrolled in both programs. Better coordinated care for this vulnerable population could yield savings and improve care and coverage in Medicaid."


Currently, 60-percent of Medicare-Medicaid enrollees, "dual eligibles," have multiple chronic conditions and 43-percent have at least one mental or cognitive impairment. While only 15-percent of Medicaid enrollees are also Medicare beneficiaries, Medicare-Medicaid enrollees represented 39-percent of Medicaid spending in 2007. Medicaid spent about $120 billion on this group - about twice as much as Medicaid spent on the 29 million children it covered. The Medicaid spending per Medicare-Medicaid enrollee was $15,459 in 2007, over six times higher than the comparable cost of a non-disabled adult Medicaid-only enrollee ($2,541).
 

The Medicare-Medicaid Coordination Office on Wednesday launched the Alignment Initiative, an effort to more effectively integrate benefits under the two programs. Read more here.

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President's Plan for Health Care Quality Dealt Setback
Associated Press 

President Barack Obama's main idea for getting quality health care at less cost was in jeopardy Wednesday after key medical providers called his administration's initial blueprint so complex it's unworkable.

 

Just over a month ago, top officials released long-awaited draft regulations for "accountable care organizations," networks of doctors and hospitals that would collaborate to keep Medicare patients healthier and share in the savings with taxpayers. Obama's health care overhaul law envisioned quickly setting up hundreds of such networks around the county to lead a bottom-up reform of America's bloated health care system.

 

But in an unusual rebuke, an umbrella group representing premier organizations such as the Mayo Clinic wrote the administration Wednesday saying that more than 90 percent of its members would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed. Read the full article here. 

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Contributors to this Issue
AHIP HI-Wire
Associated Press
HealthDay
Wiener Associates
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Quick Links . . .


Children First Article Looks at Governor's Dashboard Indicators
Jack Kresnak of Michigan's Children has a new article in his Children First series: Taking His Eyes Off the Dashboard? It reflects on Jack's experience hearing the Governor's education address, the Governor's Dashboard indicators, and how the budget proposals passed by the House and Senate disinvest in key Dashboard areas.
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Family Fun Run at the Capitol this Saturday 

Join us for a morning of family fun on May 14 and help support Michigan's non-profits at the Heart of Michigan Run, held on Michigan Avenue and along the River Walk, followed by the Heart of Michigan Farmers Market at the finish in front of the Capitol. Sign up at heartofmichiganrun.com. Your participation in this event will support the Healthy Kids, Healthy Michigan Coalition and the Children's Trust Fund.
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Vitamin D May Prevent Serious Respiratory Disease in Newborns
Vitamin D supplements for pregnant women may help prevent a respiratory disease called RSV that can lead to pneumonia and other potentially life-threatening illnesses in newborns, Dutch researchers report.

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New Resources Available from the Michigan Birth Defects Registry
The MBDR's Annual Report "Monitoring Infants and Children with Special Health Needs: Birth Defects Prevalence and mortality in Michigan, 1992-2006" is now available online.  This report provides more detailed analyses of heart defects reported in the section A Closer Look: Congenital Heart Defects, in addition to descriptive analyses of NTDs, OFCs and Down syndrome.
In addition, the MBDR's revised rules and regulations have been approved, effective April 1.
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Physical Disabilities Add Challenge To Pregnancy
Physical disabilities add a whole new challenge to pregnancy. And while the vast majority of women with disabling conditions appear to have healthy babies, specialists say far too little is known about mothers' risks of complications, their special needs and barriers to good care, the Associated Press reported this week.
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Study in South Korea Finds Higher Rate of Autism
A study in South Korea suggests about 1 in 38 children have traits of autism, higher than a previous U.S. estimate of 1 in 100. By casting a wider net and looking closely at mainstream children, the researchers expected to find a higher rate of autism characteristics. But they were surprised at how high the rate was. They don't think South Korea has more children with autism than the United States, but instead that autism often goes undiagnosed in many nations.

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Fever During Pregnancy, Diabetes and Obesity May Raise Autism Risk
Having the flu during pregnancy isn't associated with a heightened risk of autism or developmental delay in children, although having a fever during pregnancy might be. And giving birth by Cesarean section isn't associated with autism in offspring, but having diabetes or high blood pressure or being obese while pregnant seems to be. Those are the findings of several new studies that sought to uncover what factors during pregnancy may have an impact on the risk of autism in children. The research was presented Wednesday during a press conference at the International Meeting for Autism Research (IMFAR) in San Diego.
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Order your 2011-12 Watch Me Grow Calendars!  This 24-month calendar highlights a different program each month - offering both program information and contact information. Activities and tips for parents are also offered throughout the calendar providing information on health, safety, nutrition, and parenting. The best part is that these calendars are $1 each.  Visit the website for complete information and order form.

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The Michigan Council for Maternal and Child Healthblur image MCMCH is made up of
member organizations who share a commitment to the health of
Michigan's women, children and families.
To learn more go to http://www.mcmch.org or email info@mcmch.org.

             Amy Zaagman - Executive Director - azaagman@mcmch.org
     Jennifer Gorchow - Communications Manager - jgorchow@mcmch.org 
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