Tag Archives: Michigan Department of Health and Human Services

COVID-19 testing of agricultural and food processing employees ordered by state health department

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Testing for COVID-19 of all migrant agriculture workers has been mandated by the state health department. (Supplied)

By WKTV Staff

ken@wktv.org

Michigan Department of Health and Human Services this week issued an emergency order requiring COVID-19 testing for agricultural and food processing employees.

The order, according to an Aug. 4 statement from the state, “makes Michigan a national leader in COVID-19 safety protections for agricultural and migrant workers, building on Executive Orders from Gov. Gretchen Whitmer requiring workplace safety measures in meat and poultry processing plans and safe housing for COVID positive migrant workers.”

Go here for the complete emergency order.

“The men and women who work in our fields and food processing plants are at particular risk for COVID-19, and they need and deserve protection,” Robert Gordon, MDHHS director, said in supplied material. “Today’s order will help to reduce the spread of COVID in communities across Michigan and reduce the pandemic’s disparate impact on Latinos.”

In recent weeks, there have been 11 identified outbreaks in farms and food processing plants in Michigan, according to the state. In addition, Latinos are 5 percent of Michigan’s population but represent 11 percent of COVID cases in which the individual’s ethnicity is identified.

“The department will work with employers and housing operators to ensure timely reporting of testing data and access to PPE so that together we can prevent further viral spread,” Gordon said.

The order makes several requirements for migrant housing camp operators to provide COVID-19 testing, including testing of all new residents with 48 hours of arrival, with separate housing for newly arriving residents for 14 days and a second test 10 to 14 days after arrival.

In addition, employers of migrant or seasonal workers, meat, poultry and egg processing facilities and greenhouses with over 20 employees on-site at a time to are ordered to provide COVID-19 testing.

“Ensuring the health and safety of Michigan’s essential food and agriculture workers is paramount to keeping our food supply chain moving,” Gary McDowell, director of the Michigan Department of Agriculture and Rural Development, said in supplied material. “These workers are our frontline staff who are a vital part of bringing our food from farm to plate.”

Employers and housing operators have several options for completing the required testing, including requesting state assistance. And the MDHHS also released a guidance document for employers providing step-by-step information on how employers can complete testing and highlighting resources like grant funding and insurance coverage through Medicaid that can provide financial support for testing.

COVID positive and exposed residents would be required to isolate or quarantine until meeting the return-to-work criteria from the Centers for Disease Control and Prevention. MDHHS will be partnering with Community Action Agencies in impacted communities in order to provide food, housing, and economic support for workers who lose income due to testing.

“It is critical that we keep our workers and their families across the food and agriculture industry safe and healthy,” John Cakmakci, president of UFCW Local 951, said in supplied material. “I applaud Directors Gordon and McDowell for their efforts to protect the people of Michigan and our economy.”

County’s mental health services being cut as state distances itself from funding shortfall problem

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By K.D. Norris

ken@wktv.org

 

As local health officials statewide seek to work with state officials to deal with funding shortfalls linked to state reimbursement for low income patients, Kent County’s community mental health provider, Network180, has begun belt tightening.

 

Having already made internal staffing reductions in reaction to a funding shortfall, Network180 executive director Scott Gilman said official notification began this week to its local partners that will have their funding reduced or eliminated — but that may be only the beginning of the local belt-tightening, he said.

 

“Even with the cuts, and we are currently looking at about $778K, we still have a $7 million deficit,” Gilman said to WKTV, adding that despite the funding deficit Network180 will be doing what it can to secure cash to make payments to providers. “We have to be really careful … We are the public safety net.”

 

(For more information on the issue, see previous WKTV stories on the announcement of the problem and more details of the problem.)

 

Meanwhile, the Michigan Department of Health and Human Services (MDHHS) maintains its existing funding contract with the local Lakeshore Regional Entity, through which state funds flow to the local Network180, is sound and needs no adjustment.

 

“Rates paid in Kent County have been certified as actuarially sound for the state by an independent actuary, Milliman (USA Inc.),” Bob Wheaton, MDHHS public information officer, said to WKTV. “MDHHS pays Lakeshore Regional Entity a monthly payment for each Medicaid and Healthy Michigan Plan eligible individual in their geographic region; those payments vary according to the number of people eligible in a given month. … As stated above, rates have been certified as actuarially sound, so there are no current plans to adjust the rates.”

 

The Lakeshore Regional Entity manages a contract with MDHHS to provide services to Kent, Allegan, Lake, Mason, Muskegon, Oceana, and Ottawa counties.

 

Combined, Network180 and a spectrum of independent groups provide support to persons with developmental disabilities, mental and behavioral health problems including addiction and substance use, and the family members who access services for those needing mental health assistance.

 

Scott Gilman, CEO of Network180. (WKTV)

While the Lakeshore Regional Entity and other state mental health networks have been under financial strain for several reasons in recent years, the basic cause of the current funding shortfall, according to Gilman, is the difference in state funding between two Medicaid programs: the older, established Disabled, Aged and Blind (DAB) program and Michigan’s newer Healthy Michigan. Healthy Michigan provides $24 per person versus the $270 received from DAB, according to Gilman. That has lead to a $9.7 million shortfall for Network180.

 

“The issue is that thousands and thousands of people have transitioned, that makes the rate we are paid not longer valid,” Gilman said to WKTV.

 

Wheaton, with MDHHS, has slightly different numbers as to the funding differential — $271.13 and $39.05 — and also says the number of people who have transitioned between DAB and Healthy Michigan is not the source of the local provider problems.

 

“It is not correct that Healthy Michigan Plan beneficiaries are mostly people who used to receive DAB benefits,” Wheaton said. “Former DAB beneficiaries make up a small percentage of the 669,000 Healthy Michigan Plan enrollees.”

 

Wheaton was unable to give the specific number of people who transitioned from DAB. He did go into more detail on the state’s contract with the Lakeshore Regional Entity and other similar entities across the state.

 

“Lakeshore Regional Entity is responsible for providing all medically necessary specialty behavioral health services to Medicaid and Healthy Michigan Plan eligible individuals in their geographic region,” Wheaton said. “The contract between MDHHS is a shared risk contract between the Department and Lakeshore Regional Entity. An increase or decrease in the number of individuals eligible for Medicaid or Healthy Michigan is part of the risk component of the contract; additional numbers of eligible results in higher payments and reducing numbers of eligible results in reduced payments.

 

“The contract between MDHHS and Lakeshore Regional Entity is a shared risk contract. Lakeshore is solely responsible for the first five percent of costs above their revenue. The next five percent of costs above revenue are split equally with MDHHS and Lakeshore Regional Entity both responsible for 2.5%. Any costs exceeding 10 percent of revenue would be borne solely by MDHHS.”

 

But, Gilman points out, a big part of the current funding problem is that the Lakeshore Regional Entity has exhausted its reserves not only due to the DAB-Healthy Michigan issue but to a separate but recent state funding shortfall for autism-related services.

 

“The Department (MDHHS) and the legislature recognized the problem and fixed it for fiscal year 2018, but it resulted in a loss of savings last year fiscal (2017) of approximately $6 million,” Gilman said. “So the savings was depleted and then with the DAB issue on top of that the savings for the Lakeshore Regional Entity is depleted completely. The projection for the LRE is (that DAB-Healthy Michigan issue will cost) $10 million.”

 

The appropriateness of the current contract, and differences in opinions on the revenue shortfall, may well be the crux of the matter as discussions continue between local healthcare providers and state officials.

 

An independent study — funded by Lakeshore Regional Entity and eight of the state’s other nine Prepaid Inpatient Health Plans (PIHPs) — by the Grand Rapids based Rehmann Group estimated a $97 million state-wide revenue shortfall, and a $7.8 million loss for the Lakeshore Regional Entity.

 

West Michigan Partnership for Children to launch Oct. 1

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Foster care in Michigan is often difficult to navigate and measuring outcomes is complicated. West Michigan Partnership for Children (WMPC) is the result of direct, intentional change in how child welfare services are delivered throughout Kent County. Representatives from Kent County, Michigan Department of Health & Human Services, Network180, the 17th Circuit Court and local child welfare agencies (including Bethany Christian Services, Catholic Charities West Michigan, D.A. Blodgett/St. John’s, Samaritas, and Wellspring Lutheran Services) are partnering to create WMPC in an effort to drive improved outcomes for children in the foster care system.

 

Kent County is the only county in Michigan with such a pilot, which officially launches on Oct. 1. Several other counties have expressed interest in the program. WMPC will pilot a performance-based contract, utilizing a case rate that incentivizes permanency while allowing for flexibility and creativity in funds. Staff will use software that allows for predictive analytics to project successful outcomes and flag cases that are at risk.

 

Kent County Interim Administrator/Controller Wayman Britt believes successful outcomes can be achieved through public/private collaborations between child and family focused agencies, school districts, foundations, business leaders and County staff who put the needs of displaced and vulnerable children first. “These agencies have been working together on improving these systems and outcomes for children for several years though the Kent County Families and Children Coordinating Council (KCFCCC),” said Britt. “Kent County is an innovator and leader in the State of Michigan as it relates to quality, outcome driven programs and services for children in the foster care and child protection systems. Forming West Michigan Partnership for Children is the most logical next step.”

 

Oversight will include a Child Welfare Advisory Committee made of judiciary members and court administration, community members, and representatives of County Administration. The committee will be tasked to do the following:

 

Review performance data of the Kent County Department of Health and Human Service (DHHS) Office for child protection investigations outcomes and in-home child welfare services, and WMPC for out-of- home child welfare services.

 

Provide constructive feedback to the KCFCCC, WMPC, and the Michigan Department of Health and Human Services related to performance trends and community support in order to improve outcomes.