Elizabeth L. Weihl Partner Email weihlb@rwca.com Direct 517-374-2736 Cell 517-719-5398

Executive Governor State Departments/Agencies MI Department of Licensing & Regulatory Affairs (LARA) – all health professional, program and facility licensure MI Department of Health & Human Services (DHHS) – population health, public sector policy and financing (physical, behavioral) and Medicaid

Executive State Departments/Agencies MI Department of Insurance & Financial Services (DIFS) – regulates individuals and businesses in financial and insurance industries, including Michigan’s health insurance exchange

Legislative Year- round (full time) Legislature 99th Legislature (2017-2018) began on January 1 and will end on December 31, 2018 148 Elected members 110 House 38 Senate

Legislative 27 – 11 Republican super-majority in Senate 63 – 47 Republican majority in House (2 vacancies) * ** vacancies to be filled by special election

Legislative In 2013-2014 session, 3271 bills introduced 854 signed into law In 2015-2016 session, 3305 bills introduced 832 signed into law

www.michigan.gov www.michigan.gov/lara www.michigan.gov/dhhs www.michigan.gov/difs www.michiganlegislature.org

Current Issues State Budget for Fiscal Year 2017-2018* Integration of physical/behavioral health (sec. 298) DHHS hiring of independent facilitator for all pilots Pilot in Kent County with a willing CMHSP and all willing health plans to pilot full integration model 4 PIHPs (Wayne; Oakland; Macomb; rest of state) Up to 3 pilots on fully integrated pilots * Preliminary as of June 9, 2017

Current Issues State Budget for Fiscal Year 2017-2018* Integration of physical/behavioral health (sec. 298) Pilots to last at least 2 years Benefits and cost savings reinvested in services and supports No language establishing goal of statewide integration by 2020 Pilot evaluation done by state research university * Preliminary as of June 9, 2017

Current Issues State Budget for Fiscal Year 2017-2018* Increased funding for Healthy Michigan Plan and traditional Medicaid for state match, caseload and utilization adjustments 25-cent/hour wage increase for direct care workers, additional 25-cent increase on 6/1/18 for those earning less than $10.90/hour Medicaid common drug formulary – Open meeting requirements, 45 day public comment period * Preliminary as of June 9, 2017

Current Issues State Budget for Fiscal Year 2017-2018* 36 new staff positions at state psychiatric hospital 35 new adult services caseworkers 5% increase in Medicaid autism services fee schedule New funding for psychiatric transition unit at Hawthorn center, reduced funding for Mental Health and Wellness Commission * Preliminary as of June 9, 2017

Current Issues State Budget for Fiscal Year 2017-2018 and beyond What will happen in Washington? When and how will it affect Michigan? Medicaid Expansion/Healthy Michigan Plan? Waivers? Other state changes to Healthy Michigan Plan?

Michigan Elections Michigan’s legislative term limits are among the strictest in the nation. State House – 3 terms of 2 years each (6 years) State Senate – 2 terms of 4 years each (8 years) = 14 year lifetime limit Approved in 1992 by constitutional amendment, affecting lawmakers sworn in after January 1, 1993

Michigan Elections 110 State House seats up for election in 2016 42 true freshman legislators seated in January 2017 14 US Congressional seats up for election in 2016 2 true freshman congressmen seated in January 2017

Michigan Elections In 2018: All constitutional officers 110 State House seats (23 term limited) 38 State Senate seats (26 term limited) 14 US Congressional seats 1 U.S. Senator In a mid-term election Other Issues – Part Time Legislature? Term Limits? Legalization of Marijuana?

Successful advocacy must Include both branches of government Include both statutory and regulatory engagement Be both pro-active and reactive Be both strategic and properly timed The good news: Advocacy done right, Works!

General Advocacy Tips #2 - 8 Engage your lawmakers in district when possible Communicate via call or email, personal meetings, testimony Arrange site visits Be courteous Be timely Be confident Be coordinated Be persistent

General Advocacy Tips TIP #1 PARTICIPATE!

THANK YOU!