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Governmental Affairs Update
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February  2017 

 Government Affairs Update

 Legislation (action since previous report)


Senate Bill 35 – Reintroduction of legislation to regulate charitable gaming millionaire parties.  Passed by the Senate on February 9, 34 – 3.  Referred to the House Regulatory Reform Committee.

SB35 
SB35 Analysis

 
Senate Bills 36 and 38 – Legislation to allow inclusion of fingerprint/photograph of a person with special health care needs in the Automated Fingerprint Identification System and statewide network of photos upon request of parent or guardian.  Passed by the Senate on February 9, 37 – 0.  Referred to the House Judiciary Committee.

SB36
SB36 & SB38 Analysis
SB38

 
House Bill 4001 – Legislation to phase out Michigan’s personal income tax.  House Republicans have begun to advance bills that would phase out the state’s personal income tax over a period of 40 years beginning January 1, 2018.  HB 4001 was reported from the House Tax Policy Committee on Wednesday, despite strong reservations from Governor Snyder and a cool reaction from the state Senate.  It’s estimated that if enacted as written HB 4001 would reduce state revenue by $680 million in FYH 2018, $1.12 billion in FY 2019, and $400 million more in each successive year.  As written the bill does not create alternative sources of revenue to the phased-out income tax.

HB4001 Legislative Analysis

 

House Bills 4170, 4171, 4173 and 4174 – Legislation to create a Physician Scope of Treatment form and modify other sections of law, including orders to Do Not Resuscitate and guardians’ ability to execute POST forms under the Estates and Protected Individuals Code, accordingly.  All four bills were referred to the House Health Policy Committee.

HB4170
HB4171
HB4173
HB4174
 

House Bill 4225 – Legislation to add children in residential foster care who require any level of mental health treatment in the list of priority populations for community mental health service providers.  Introduced by Representative Kosowski, referred to the House Health Policy Committee.

HB4225
 
 

Fiscal Year 2018 Budget

Governor Snyder released his budget proposal for Fiscal Year 2018 on February 8.  The Governor’s proposal is largely a continuation budget of the current year but does include some proposed spending increases of note (further detail below).
 
Legislative budget committees have now begun their schedules of department presentations, fiscal agency overviews and public testimony.  Hearings will continue through March, with a goal of having subcommittees report out their recommendations before the legislative spring recess (March 31 through April 18).
 
The House DHHS Appropriations Subcommittee will hear public testimony on Monday, February 27, beginning at 9:00 a.m.  The subcommittee has allocated specific blocks of time for various topic areas (link to hearing notice below).  The Senate DHHS Appropriations Subcommittee has also scheduled public hearings that will include opportunity for public testimony (Medicaid, Tuesday, February 28 at 2:30; behavioral health, Thursday, March 2, at 2:30).  Time and location of these hearings frequently change, so please stay in contact with The Arc Michigan if you plan to attend.

Click here for a link to the House DHHS Appropriations Subcommittee public testimony hearing

 
Below are links to the House Fiscal Agency review of the Governor’s proposal and a similar review prepared by the Senate Fiscal Agency.  The Department of Health & Human Services budget is addressed on pages 34 – 37 of the House document, and on pages 20-21 of the Senate document

FY2017-18 Preliminary review of Executive Budget Recommendation

Overview of Governor Snyder's FY2017-18 Budget



As previously noted, the Governor’s proposal is largely a continuation budget of the current year, particularly in the area of health and human services. 
 
His proposal does assume continuation of, and provides full funding of, both traditional Medicaid and the Healthy Michigan Plan.  In his presentation to the Legislature, he noted that if and when federal changes to Medicaid and/or the ACA occur, the budget would need to be reopened but that he doesn’t expect to impact FY 2018 in any case.
 
The Governor recommends $14.2 million General Fund ($45 million total) in new funding to support direct care workers in the community mental health system.  This increase would provide an hourly increase of approximately $.50 per hour.  Advocates for the increase acknowledge this proposal as an important first step but urge that the increase be $1.00 per hour each year for the next three years to meaningfully affect recruitment and retention of direct care workers.

 
The Governor also recommends $4.8 million General Fund ($7.2 million total) to add 72 acute care staff at four state psychiatric facilities and recommends construction of a new replacement facility for the Caro Center; estimated project cost is $115 million, to be financed by the State Building Authority.
 
The Governor recommends an increase of $6 million for the MI Choice/Home and Community Based Waiver.
 
In boilerplate language, the Governor’s proposal acknowledges the ongoing work of the Section 298 Stakeholder Workgroup but provides no further direction, except that the workgroup’s efforts must continue to build on the values of person centered planning with the expectation of high quality and consistent care statewide.  Other boilerplate sections require that a CHMSP provide at least 30 days’ notice before reducing, terminating or suspending services (section 942); require MDHHS to work with PIHPs and others to include any state and federal wage and compensation increases that directly impact staff providing Medicaid-funded community living supports, personal care services, respite services, skill-building services and other similar supports and services in their rate-setting processes (section 920); and require MDHHS to work with community mental health service programs to determine and reallocate funds  when there may be local funding shortfalls and surpluses (section 940).

 
 

Other
 
This week the House Republican caucus released its 2017-2018 Action Plan.  The document presents 5 broad themes (Governing Courageously; Partnering with Local Communities; Thriving Through Freedom; Valuing Our Culture of Life; and Training The Next Generation) encompassing 24 policy areas, but includes few specific initiatives or announcements of pending legislation.  The document prioritizes “Lifting up the mentally ill and their families”, specifically in the context of preventing incarceration, but does not offer details.

http://gophouse.org/best-way-forward/

 
Governor Snyder has called for a special election to replace Representative Brian Banks (1st district/Detroit).  The primary election to fill that vacancy will be on August 8 and the general election will be on November 7.  Rep. Banks resigned his seat earlier this month.  Rep. Banks’ committee assignments have been replaced as follows:  Rep. Tim Greimel assuming minority vice chair status of the House Insurance Committee: Rep. Abdullah Hammoud assigned to the House Insurance Committee; Rep. Jeremy Moss assigned to the Joint Committee on Administrative Rules; and Rep. Terry Sabo assigned to the House Transportation & Infrastructure Committee.
 
State Senator Mike Nofs has replaced State Senator Goeff Hansen on the Senate Appropriations Subcommittee for the Department of Health & Human Services.
 
Governor Snyder has announced Dick Posthumus as his new Chief of Staff.  Mr. Posthumus had been serving as the Governor’s Director of Legislative Affairs; he will be succeeded in that position by Darin Ackerman.
 
The Michigan Department of Health & Human Services has announced that it is seeking public input on draft financing models for improved coordination of Medicaid physical and behavioral health services (the section 298 discussion).  Input will be accepted until February 28 and can be provided through an online survey available at:

Public Input survey on draft financing models for improved coordination of Medicaid physical and mental health services


A public forum to gather comments is scheduled for February 24 from 9 a.m. to noon at the East Lansing Hannah Community Center.  A final report, including possible revised financing model proposals, will be submitted to the Legislature on March 15.
 

For Immediate Release
February 17, 2017
Contact:
Sarah Bal
916-390-1860
 
 
 

The Arc Responds to House Republican Leadership Plans to Repeal the Affordable Care Act and Decimate the Medicaid Program 

Washington, DC - The Arc released the following statement following the release of the House Republicans’ new plan to repeal and replace the Affordable Care Act:
 
“Politicians are being very cavalier with peoples’ lives as they attempt to pay for the repeal of the Affordable Care Act by slashing Medicaid funding for states. Regardless of how this is packaged, it doesn’t change the reality that this proposal will have a dire impact on people with intellectual and developmental disabilities who rely on Medicaid and the Affordable Care Act for their health care, community supports, and as a way to live independently in their communities.

“This proposal suggests paying for the ACA repeal by changing the way Medicaid is funded. Giving states a choice between per capita caps and block grants would be devastating for people with disabilities and would also negatively impact already cash-strapped states. The talking points sugar coat it, but the reality is simple – less money would be available despite the fact the needs of people who rely on Medicaid have not decreased. Inevitably, what we will see is a decline in services for those reliant on Medicaid as the financial burden is passed on to states.

“A per capita cap is a financing tool that would result in significant cuts to Medicaid. As it works today, Federal Medicaid funding is based on the actual costs of providing services to Medicaid beneficiaries. Currently, as costs go up or numbers of people needing services increase, funding grows as well. A per capita cap or block grant would limit the Federal government’s payment to states with a preset formula that does not take into consideration growth in cost or need. The bottom line is that people will lose vital benefits and services that support their basic human right to a life in the community. That is a fact that elected officials need to understand and it is exactly why they must oppose this proposal.

“It is morally reprehensible to use Medicaid to pay for the repeal of the ACA. People who have serious health conditions and disabilities require more than the bare bones coverage being proposed. For those reliant on Medicaid, the ability to access appropriate quality care could mean the difference between life and death.  There is too much at stake for us to stand by while politicians show complete disregard for the needs of low income constituents with disabilities, adults, older Americans, and children.  We oppose the plan on the table and will work with Members of Congress to find a solution that actually takes into consideration the needs of people with intellectual and developmental disabilities,” said Peter Berns, CEO of the The Arc. 

The Republican plan leaves many questions unanswered. It is not addressed whether insurance companies will be able to return to insurance policies that discriminate against people with disabilities and/or pre-existing conditions.  It does not address whether insurance companies will be able to cap health care services or use health status to increase premiums.  It does not address whether the critical health care services such as rehabilitative and habilitative devices and services, prescription drugs, mental health services, maternity coverage, and others will be available in the health plans. These protections, and many other critical provisions in the ACA, helped people with disabilities gain access to affordable and comprehensive health insurance. The meager solutions in the Republican plan that rely on high risk pools and limited tax credits are insufficient to help people with disabilities meet their healthcare needs

The Arc advocates for and serves people with intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 650 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

 
 
 
The Arc of the US, 1825 K Street NW, Suite 1200, Washington, DC 20006, United States
 

Urge Your Senator to Oppose H.J. Res. 57 and Protect the Rights of Students with Disabilities!

Contact your Senator today, and urge them to oppose H.J. Res. 57. This resolution will overturn the regulation finalized by the Department of Education on November 29, 2016 that implements the Every Student Succeeds Act's (ESSA's) core requirement that schools be held accountable for the performance of all students, including those with disabilities. The regulation has strengthened the EESA through school accountability and state plans.

ESSA, passed in 2015 with bi-partisan support, also includes provisions "ensur[ing] that vital information is provided to educators, families, students, and communities through annual statewide assessments that measure students' progress toward high academic standards that will prepare them to succeed in college and careers." (www.ed.gov/essa) This final regulation includes students with disabilities, whose civil rights entitling them to equal access to a meaningful education are also in jeopardy under H.J. Res 57.

On February 7, 2017, the House of Representatives passed the bill that will overturn the ESSA accountability regulation. The bill has since been received by the Senate, which will vote soon. 

Contact your Senator and urge them to oppose H.J. Res. 57. Help protect the rights of students with disabilities!

Call the U.S. Capitol Switchboard at (202) 224-3121 or click here to find your Senator’s phone and email.

"With this bill, we reaffirm that fundamentally American ideal—that every child, regardless of race, income, background, the zip code where they live, deserves the chance to make of their lives what they will."
— Former President Barack Obama on the ESSA

Urgent Presidents' Day Recess Alert - Congress Prepares to Dismantle Medicaid and the Affordable Care Act (ACA) 

 

BREAKING NEWS - The House of Representatives is expected to introduce a bill to cut Medicaid and the ACA on February 27 and to begin committee work immediately. 

Congress will be on its Presidents' Day recess next week.  We've got lots of ways to help you make this time count!  Below is our advocates' "To Do" list for the week of Feb 19-25. 
  1. Attend Town Hall Meetings. Check out this great new resource listing all scheduled town hall meetings across the country. If your Senator(s) or Representative has any scheduled next week, please attend and bring your staff, volunteers, friends, and family. Here are questions to ask your Members of Congress about the Affordable Care Act (ACA) and Medicaid.
     
  2. Share our Latest Action Alert with Your Networks. Take Action to Prevent Gutting of The ACA and Medicaid includes separate fact sheets and talking points. Please share widely since Congress may vote on an ACA repeal measure as soon as the week after the President's Day recess!
     
  3. Participate in our "#WeActWednesday" Social Media Campaign. The Arc has been sharing advocacy updates and resources on our Facebook and Twitter. Please share, like, and retweet on Wednesday!
     
  4. Share Peter Berns' Huffington Post Article - Why You Should Care About Looming Medicaid Cuts - with your family, friends, and coworkers. This article published on February 14 breaks the issue down for the general public and advocates alike. Please share far and wide.
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