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

2. ©2016 RWC Advocacy 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

3. ©2016 RWC Advocacy 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 148 elected members 110 House 38 Senate

4. ©2016 RWC Advocacy Year- round (full time) Legislature 27 – 10 Republican super-majority in Senate (1 vacancy) 63 – 46 Republican majority in House (1 vacancy) Two year session schedule 98 th Legislature (2015-2016) will end on December 31, 2016

5. ©2016 RWC Advocacy Year- round (full time) Legislature In 2013-2014 session, 3271 bills introduced 854 signed into law In 2015-2016 session, 2793 bills introduced as of June 10, 2016 449 signed into law as of June 13, 2016

6. ©2016 RWC Advocacy www.michigan.gov www.michigan.gov/lara www.michigan.gov/dhhs www.michigan.gov/difs www.michiganlegislature.org

7. ©2016 RWC Advocacy 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!

8. ©2016 RWC Advocacy Current Issues * FY 2017 State Budget (HB 5294) Full Funding for Healthy Michigan Plan Full implementation of Healthy Kids Dental New funding for adult dental services Reduced funding for Health and Wellness Commission (20% - $5.5 million) Language (“boilerplate”) on integration of physical and mental health (section 298) * current June 15, 2016

9. ©2016 RWC Advocacy FY 2017 State Budget continued Funding and language to support spend down ($3 million; sections 941, 1012) Language supporting enhanced wages for direct caregivers (section 920) Language requiring workgroup on recruitment and retention of direct caregivers, including impact of state minimum wage (section 1008) Language requiring 90 days’ notice before rebasing formula to PIHP or CMHSP (section 1004)

10. ©2016 RWC Advocacy FY 2017 State Budget continued Language requiring minimum 30 days’ notice before reduction/termination/suspension of CMHSP services (section 942) Language protecting access to certain medications (section 1875) Language encouraging PIHPs to reduce administrative cost and promote conflict free care management (section 1008)

11. ©2016 RWC Advocacy FY 2016-2017 State Budget (Senate Bill 801) $1.1 million to support Special Education Reform Task Recommendations $625,000 – MI Integrated Behavior and Learning Support Initiatives $500,000 – emergency seclusion and restraints training

12. ©2016 RWC Advocacy Current Issues * Flint $114 million for current year in HB 5295 $10.1 million for current year in SB 801 Other supplemental funding appropriated earlier this year Medicaid waiver for eligible Flint children Appointments to Child Lead Poisoning Elimination Board (Executive Order 2016-09) * current June 15, 2016

13. ©2016 RWC Advocacy Current Issues * Seclusion and Restraint – Bicameral, bipartisan. House Bills 5409 – 5418: House Education Committee Senate Bills 835 – 838: Senate Education Committee Expulsion/Suspension/Modification of “Zero Tolerance” House Bills 5618 – 5621, 5693- 5695: Senate Judiciary Committee * current June 15, 2016

14. ©2016 RWC Advocacy Current Issues * Regulation of “millionaire parties” Senate Bill 187, House Bill 4293: House floor Licensure and regulation of ABA practitioners Senate Bills 1015, 1016: Senate Regulatory Reform Committee Crime of abuse of person with developmental disability House Bills 5728, 5729: House Criminal Justice Committee * current June 15, 2016

15. ©2016 RWC Advocacy 2016 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

16. ©2016 RWC Advocacy 2016 Elections 110 State House seats to be filled 69 incumbents seeking reelection 35% of incumbents face primary challengers Democrats must gain 9 seats to achieve majority 14 US Congressional seats to be filled 9 Republicans, 5 Democrats 2 incumbents not seeking reelection

17. ©2016 RWC Advocacy 2016 Elections Potentially impacted by: National race? Flint? Anti-incumbent sentiment?

18. ©2016 RWC Advocacy 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

19. ©2016 RWC Advocacy General Advocacy Tips TIP #1 PARTICIPATE!

20. ©2016 RWC Advocacy THANK YOU!