MPCA strives to be leaders on the cutting edge of health care policy at both the state and federal levels. Whether it’s legislative or regulatory issues, from big picture ideas to minute details, MPCA actively evaluates the health care environment to bring “need to know” information on new and upcoming policy developments to ensure Michigan Health Centers have the knowledge they need to thrive now, and in the future. Each year, MPCA identifies policy priorities that will improve the ability of Health Centers to provide quality, affordable health care services to all in need and we work closely with our members to promote the importance of grassroots advocacy in shaping the issues affecting Health Centers every day. Through our work with policymakers and elected officials, MPCA advocates for policies that assure all Michigan residents have access to quality, affordable primary and preventive health care within their communities.
MPCA's Policy Priorities are developed with input from our membership to highlight community-based solutions to current state-level issues facing Michigan Health Centers. Below are MPCA's 2017 Policy Priorities.
The opioid abuse crisis has reached an all-time high with more people dying from drug overdoses in 2014 than any year on record and more than six out of ten of those overdose deaths involving an opioid. Currently, there are inadequate resources dedicated to addressing the crisis, and Michigan must take steps to address it at both the state and community level.
Without access to comprehensive and coordinated mental health and primary care services, the opioid epidemic will continue. In 2015, Governor Snyder formed the Michigan Prescription Drug & Opioid Abuse Task Force to recommend action in areas related to prevention, treatement, regulation, policy and outcomes, and enforcement. The Task Force strongly recommended bolstering access to care and evidence-based treatment modalities, including Medication Assisted Treatment (MAT). MAT combines medications, counseling, and behavioral health treatment to prevent and treat substance use disorders. Implementing these recommendations will require coordinated efforts among lawmakers, communities, primary care and behavioral health networks, and safety-net organizations.
Federally Qualified Health Centers (FQHCs) are uniquely positioned to pilot solutions in providing substance use disorder care in a community-based, culturally appropriate, and trauma-informed manner in the primary care setting. Considering 77 of Michigan's 83 counties have some form of a federally-designated Mental Health Professional Shortage Area, MAT will be difficult to offer to patients in underserved areas without state support to develop infrastructure and program incentives. Michigan's FQHCs already improve access to care in more than 260 medically underserved communities, making them key partners in curbing the opioid epidemic. Given this statewide footprint, Michigan FQHCs should be included in pilot programs that fund MAT services in the primary care setting.
As part of the Fiscal Year 2018 budget, MPCA recommends the state include funding specifically for Michigan Health Centers to implement pilot programs increasing access to MAT services in the primary care setting.
Training the Next Generation of Providers in the Healthcare Safety Net: Increasing Residency Opportunities in Michigan’s Federally Qualified Health Centers
Medicaid Graduate Medical Education (GME) is a vital public resource partially funded by Michigan taxpayers to help recruit, train, and retain providers in Michigan. However, programs currently receiving funding are not accountable for addressing the State’s workforce needs.
Training the next generation of primary care physicians is critical to meeting Michigan's health care needs. Today, one in six Michigan adults reports not having a personal doctor and by 2020, our state is projected to be short 4,400 primary care doctors. In fact, right now Michigan would need an additional 233 primary care doctors to adequately provide services to the more than 2 million people who currently do not have access to care. In light of this, funding for Graduate Medical Education program must be tied to future workforce demands. Annually, Michigan taxpayers help support more than $160 million in GME programs, but only $21 million (13 percent) of that funding went to primary care training. Despite this public investment in training primary care physicians, 81 of Michigan's 83 counties have some form of a federally designated Health Professional Shortage Area in primary care.
Health Centers must be codified into state law as the pipeline for state medical schools and GME programs to place primary care residents in underserved areas. Research suggest that physicians tend to practice where they train, making it all the more important that the next generation of providers train in medically underserved areas. The state has acknowledged the need for more training opportunities for primary care physicians in underserved areas, as evidenced by the creation of the MiDocs residency program consortium. In Michigan, there is no greater network of primary care providers focusing on population health and disease management in underserved areas than Health Centers, so by coordinating with the MiDocs consortium, Health Centers can help our state more responsibly use its Medicaid GME funding and place primary care physicians where they are needed most.
As part of the Fiscal Year 2018 budget, MPCA recommends the state formally identifies Michigan's Health Centers in the MiDocs Consortium boilerplate language as the pipeline for state medical schools and Graduate Medicaid Education programs to place primary care residents in underserved areas.