1. MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Key Initiatives and Collaborations June 6, 2007 Jan Christensen Senior Deputy Director Health Policy Regulation & Professions Administration

2. Key initiatives center around making health care affordable and accessible in Michigan. These include a range of programs from primary health care to long term care initiatives to the health care workforce in our state.

3. Governor Granholm’s Plan Making Health Care affordable and Accessible in Michigan –Step 1…The Michigan First Healthcare Plan –Step 2…Advancing Health Information Technology –Step 3…Promoting Healthy Lifestyles

4. Michigan First Healthcare Plan Goals: –Protect and expand health care coverage –Reduce trend in health care cost growth –Improve business competitiveness –Meet goals without increasing state spending

5. Michigan First Healthcare Plan Targets All Uninsured Under 200% FPL – 550,000, 50% of Uninsured Uninsured parents and childless adults - Individuals with adequate access to insurance or government programs will be excluded Over 200% FPL – 550,000 Insurance Pool. Improved access to affordable insurance for small businesses – No subsidy

6. Michigan First Health Care Plan Benefits Benefit package will include: –Preventive and primary care –Hospital care –Emergency room care –Mental health services –Prescription drugs Includes annual benefit limits

7. Cost Sharing Anticipate monthly premiums below $200 Enrollees below 100 % of poverty subject to co-pays Enrollees between 100% and 200% of poverty level will participate through premium payments and co payments on a sliding scale not to exceed 5% of income

8. Michigan First Healthcare Plan “The Exchange” Select managed care plans to offer new affordable health insurance products for individuals and small businesses Assure that the plans selected offer products that comply with state set benefit guidelines, healthy lifestyle in values and other value purchasing requirements Responsible for enrollment function Administer Michigan First Premium subsidies for eligible enrollees Collect any voluntary employer contributions Work with small employers to sponsor insurance available through the Exchange for their employees

9. Cost Effectiveness Require managed care plans to be a delivery mechanism Plans will compete for enrollees on benefit design, provider network, quality, access and price Value based purchasing principles embedded in benefit design and plan requirements Healthy lifestyle Initiatives

10. Financing Amendment to existing Adult Benefit Waiver – no entitlement Financing builds on mechanisms already approved in that waiver State match to come from funds already spent by the State of Michigan on health care for the uninsured

11. Status Have met with numerous stakeholders to solicit input and help with design Ongoing negotiations with the Center for Medicare and Medicaid Services (CMS) Developing concrete implementation plans

12. Governor Granholm’s Plan Making Health Care affordable and Accessible in Michigan –Step 1…The Michigan First Healthcare Plan –Step 2…Advancing Health Information Technology –Step 3…Promoting Healthy Lifestyles

13. “ In Michigan, we will help our health care industry stop depending on your memory and their paper records as databanks. We are going to use technology to vastly improve the system.” - Governor Granholm, 2006 State of the State Address Advancing the Use of Health Information Technology

14. MiHIN Background From stakeholder feedback, Governor created the MiHIN –Began April 2006 on a 180-day mission to create a roadmap for Michigan –Joint effort of MDCH and MDIT –Over 200 Michigan stakeholders volunteered their time

15. MiHIN Mission MiHIN will articulate a path to develop a health information network connecting health care communities across the State of Michigan, with an infrastructure and governance model for long- term sustainability through public-private partnership.

16. MiHIN Organization Chart

17. With support and assistance by the Michigan Department of Community Health and the Michigan Department of Information Technology Conduit to Care: Michigan’s e-Health Initiative December 2006 The MiHIN Conduit to Care Report was released on December 11, 2006 An electronic copy can be found at the following website: www.michigan.gov/mihin

18. Governor Granholm’s Plan Making Health Care affordable and Accessible in Michigan –Step 1…The Michigan First Healthcare Plan –Step 2…Advancing Health Information Technology –Step 3…Promoting Healthy Lifestyles

19. Promoting Healthy Lifestyles Governor Granholm’s plan: Promote healthy lifestyles as a means to improving health outcomes and lowering costs –Develop public-private partnerships to foster a culture of physical activity, prevention and wellness –Extend Michigan Surgeon General’s Michigan Steps Up initiative

20. Michigan will need to fill more than 100,000 professional and technical health care jobs over the next decade –Major shortages will be for nurses, occupational therapists, physical therapists, pharmacists, radiographers, laboratory technicians, diagnostic sonographers, EMTs, and health information technicians Supply of health care professionals has major implications for quality of care MDCH Workforce Development

21. Chief Nurse Executive appointed by Governor Granholm –Provides leadership, expertise and coordination in nursing workforce development –Developed a strategic plan to address the nursing shortage: The Nursing Agenda for Michigan – Actions to Avert a Crisis –www.michigan.gov/mdch/ocne

22. MDCH Workforce Development MI Opportunity Partnership awarded $30 million for accelerated training for nursing, nurse faculty and other health professions –36 grants were awarded –More than 1,200 individuals are completing nursing education –Local partnerships have been formed between nursing schools, hospitals and regional skills alliances

23. MICHIGAN NURSING CORPS Another collaboration between MDCH and MDLEG Funding proposed in 2008 state budget Currently $0, “placeholder” status Funding depends on ability to increase state revenue for 2008

24. Michigan Nursing Corps Three year initiative Prepare 300 Masters Degree faculty in 12 month Accelerated Program Prepare 200 clinical nursing faculty utilizing a certificate program and a uniform statewide curriculum. Prepare 20 new doctoral faculty Recruit 200 displaced workers to Accelerated Second Degree nursing education programs.

25. How will the program work? –Nurses who qualify will be provided with one year of salary replacement and tuition to complete the masters program –Two years for doctoral students –In return, they sign contracts to teach in a MI nursing education program How will the program be funded? –Funds will come from the Governor’s new revenue proposal –The cost will be $45 million over 3 years. –This will produce 3,000 RN’s Critical Shortage: Nursing Faculty