Thursday, March 22, 2012

Special Guest Blogger: Healthy! Capital Counties Could Mean Change for the Better in Health and Healthcare

This week, I have asked one of our key senior staff at Ingham County to be a guest blogger. The Ingham County Health Department is one of the best public health agencies in the country (and I would argue the absolute best!). Their mission is to protect and promote the health of Ingham County residents. They do this through programs to prevent and control communicable diseases, programs to protect citizens from environmental hazards and several efforts and programs to link county residents to an organized system of health care. The Department also conducts research to document the health status and health problems of the community and works with the community to develop strategies to improve health and well-being. In my ten years on the Board of Commissioners, we have had two unbelievable Health Department Directors - Bruce Bragg and Dean Sienko. With Dr. Sienko's retirement, the Board promoted one of deputies to the Director position. Dr. Renee Canady has been aggressive and effective and is putting her stamp on the Health Department. I am confident that the Health Department and public health in Ingham County is in good hands for many years to come! I asked her to blog this week, and her submission is below.
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As with any community, there are many health needs and concerns in our region; access to health care, tobacco policy, the obesity epidemic, substance abuse, mental health and maternal and child health are just a few. But how to we determine which concern is a priority and how we should address it. Well, there is such an endeavor underway in the Capital area region!

Through an effort known as “Healthy! Capital Counties”, area hospitals and local health departments have initiated a comprehensive Community Health Assessment in order to better understand the health status of our community, prioritize health issues and design strategies to improve our health. . Although in Mid Michigan, stakeholders in Clinton, Eaton and Ingham counties have a history of working together on community health assessments and then using what they learn to create health improvement plans, such an effort has not occurred in long time, as a matter of fact the last health assessment took place in the mid-1990’s. A new, comprehensive health assessment is underway in the three counties that could have a big impact on how we tackle public health issues. . .

The timing was right for such a comprehensive Community Health Assessment. To understand why this health assessment is occurring now and why it is different, you need to try a little alphabet soup: PPACA and PHAB.

The first driver of our CHA is the Patient Protection and Affordable Care Act (PPACA) also called Health Reform. PPACA has created an incentive for non-profit hospitals to participate in community health assessments. Non-profit hospitals have always been required by the IRS to donate some of their resources to promote health and access to health care in their communities. But now PPACA requires them to use community health assessments and community health improvement plans to determine at least in part how those resources are allocated, and to report on what they are doing about the health needs identified. Hospitals are encouraged to collaborate with local health departments and other groups in this work. Honestly, this is always the way we have done things in Mid Michigan, but PPACA has created new energy for this activity.

The second driver of our CHA is the Public Health Accreditation Board (PHAB). Local health departments are accredited by their states to certify that they can indeed protect the health of the public. Now accreditation is being offered at the national level by PHAB. National accreditation will bring prestige to a local health department and its community, which may be an advantage in future federal and foundation funding opportunities. To receive national accreditation, local health departments must have completed—you guessed it—a recent community health assessment, health improvement plan, and a strategic plan. Again, that’s always been how we do things in Mid Michigan, but PHAB has given us a really good reason to do it again, now.

This health assessment has created a nice and friendly website. There are a huge number of community organizations and individuals participating in the http://www.blogger.com/img/blank.gifhttp://www.blogger.com/img/blank.gifhttp://www.blogger.com/img/blank.gifhttp://www.blogger.com/img/blank.gifhttp://www.blogger.com/img/blank.gifAdvisorhttp://www.blogger.com/img/blank.gify http://www.blogger.com/img/blank.gifCommittee. The hospital and health department participants are: http://www.blogger.com/img/blank.gif

McLaren Greater Lansing
Sparrow Health System
Hayes Green Beach Memorial Hospital
Eaton Rapids Medical Center
Barry-Eaton District Health Department
Ingham County Health Department
Mid-Michigan District Health Department

As its first task, the HCC team is finishing up an analysis of data on health outcomes that are affected by social issues, economic and environmental factors that influence health; and on health behaviors, mental health and the quality of health care. We have also just completed a series of community discussions (focus groups) to learn about the concerns and ideas of community members in regards to these health topics, especially those who might have unique perspectives and experiences.

After the data are collected, a series of We are also planning a series of community meetings is this summer to present information on what we have learned. These meetings will allow community members can react to the information, help us prioritize the concerns that were identified and brainstorm new ideas for addressing them. This is where a health assessment gets really fun and creative! We’ve seen a lot of good come from dialogues like this in the past, whether it is new funding for access to health care, community gardens or new programs for youth. Your participation is key, so watch the Healthy! Capital Communities website for the date of a meeting near you.

Thursday, March 15, 2012

Road Commission, St Vincent and Living Wage, LCC Community Strategic Forums, Campaign Update

Happy Ideas of March (is that a happy occasion?). Sorry once again for not blogging last week. No excuses...I just forgot. But don't fret! I will report today on the actions of the last two weeks.

Road Commission came up once again. I am sure readers would be surprised if it didn't. Not much new this time. We considered a resolution setting public hearings on the transfer of powers, duties and functions of the Road Commission to the Board of Commissioners. Although we have had much testimony already, state law requires two public hearings before we can take any action. In committee, Jim Dravenstatt-Moceri (the Chair of the Road Commission Board) presented a resolution passed by the Road Commission Board (4-0-1) that would have the county take over the HR, Finance, and IT functions from the Road Commission. I thought this was a well written resolution and showed a call for cooperation from the Road Commission. After hearing that information, we considered and passed the resolution setting hearings for the public to comment on the idea of transferring powers. The hearings will be March 27th and April 10th before the Board of Commissioners at 6:30 p.m. in the Board of Commissioners’ Room at the Ingham County Courthouse in Mason. This passed County Services unanimously. It passed the full Board of Commissioners 14-2. Commissioner Todd Tennis said he was being consistent in opposing the takeover and voted no. Commissioner Dale Copedge joined him in opposing the resolution.

The really controversial resolution was a request from St. Vincent Catholic Charities for a permanent waiver of the requirements of the Ingham County Living Wage Policy. In Ingham County, living wage is defined as an hourly wage rate which is equivalent to 125% of the U.S. Department of Health and Human Services poverty threshold for a family of four, based on 2,000 hours worked annually. For 2012, the living wage rate is $14.42/hour. Twenty percent (20%) of the hourly rate paid by the employer may be reduced if a comprehensive health care benefits package is provided. Vendors contracting with the County primarily to perform services are required to pay their employees a living wage if (1) the total expenditure of the contract or the total value of all contracts the vendor has with the County exceeds $50,000 in a twelve-month calendar, and (2) The vendor employs five or more employees. Non-profit human services agencies may request a waiver of the provisions of the policy if it
believes that the application of the policy would cause economic harm to the agency in a fashion that would result in the harm created by application of the policy outweighing the benefits of applying the policy.

In 2003, 2004, and again in 2008, the county agreed to requests from St. Vincent for a waiver from the policy provided that adequate yearly progress was being made toward paying its employees a living wage. The 2008 waiver expired on December 31, 2011. St. Vincent again came before the committee requesting an exemption. I asked them several questions. I reminded them that they were supportive of the Living Wage policy and asked us to pass it several years ago. [Note: St Vincent has since responded that they support the living wage concept and are committed to paying a fair and just wage.] They then came in for an exemption and said that they would work towards paying their employees a living wage. [The following is added at the request of St. Vincent] They said that they currently pay staff on this contract at least $10 per hour plus they receive benefits and a pension plan. The discussed that if they were to pay staff under this contract at a higher rate to meet the living wage requirements, they would have to shift all wages in the agency to adjust for this change as they use a system that is just across the board. They stated that doing this would impact their funding as they would have to lay off staff to afford the pay increase and provide fewer services to fewer numbers of clients. They said that the living wage requirement is not a fair market rate and if they were to adjust all the salaries they would probably lose funding due to not being able to meet contractual requirements and outcomes, etc. They stated that this will not only cause the refugee services program to suffer or ultimately shut down, it would also impact all programs within the agency in a negative way.

While I am still very disappointed that they are a charitable organization yet their employees may need public assistance if they are not making the living wage, I don't want to see the Refugee Program shuttered (which would affect 400-500 clients per year). As such, I proposed an amendment that would change the permanent exemption to a three-year exemption so they have to again come to the County Commission and tell us what progress has been made. That amendment passed on a 3-2 vote in committee, then the resolution was passed on to the Board floor.

Before the Board meeting, I had an opportunity to talk to the employees. They said that St. Vincent is not making much progress. They asked us to reduce the exemption time to one year so that they can work with St Vincent to get closer to the living wage. If they can work together, then the employees will join St Vincent in coming to the County Commission next year to discuss progress. I indicated support for this idea and, on the Board floor, proposed and passed an amendment to reduce the exemption to one year. On the Board floor, several Commissioners indicated disappointment in St Vincent for not meeting the goal that was committed to several times. It was stated that taxpayer dollars are being used to pay employees wages so low that they need to use other governmental services such as the Ingham Health Plan. The final resolution which granted a one-year waiver passed. I think the vote was 11-5 or so. Commissioners Vickers, Dougan, and Grebner opposed this because they thought that there should be a permanent exemption. Commissioner Tennis and one or two others (my apologies...I can't remember and don't have my notes) opposed it because they don't think there should be an exemption at all.

[Note: I met with St. Vincent at their request a few weeks after this blog was posted. They told me that their wages are not “so low” and they meet or exceed market value. They gave me their information from their perspective. They said that the employees that are unionized are not eligible for the living wage, and they said that these employees are not part of the discussions with the county. They said that they pay fair and just wages and conduct market analysis studies each year to assure that they are paying within the market value of all positions. They also said that they work with union staff who are exempt under this living wage requirement to negotiate wages per the union contract. I can't say that I agree with them on all counts, but they were very interested in discussing this issue and having Commissioners understand their perspective. I appreciate that. I told them that this will be reviewed again next year, and highly encouraged them to meet with the union and Commissioners so that another controversial debate doesn't happen in committee next year. I am encouraged by their comments.]

In other community news, Lansing Community College is holding community strategic forums. They want to hear from involved community members about how the college can better serve our community. They want to know what our community needs and what role should the college play. Here is the schedule of the upcoming forums:

I attended the first one on Monday, March 12 and was very impressed. They are really trying to hear what the community wants, needs, and expects from the college. I have also heard good things from the Tuesday, March 13th event. The third event happened this evening.

Here is information about future forums:

Friday, March 16 8-9:30 am LCC West Campus Auditorium
5708 Cornerstone Drive, Lansing

Tuesday, March 20 6:30-8 pm Eaton Rapids Public Schools, 912 S Greyhound,
Eaton Rapids

Thursday, March 22 8-9:30 am LCC University Center, rooms 203-204
210 W Shiawassee, Lansing

Thursday, March 22 7-8:30 pm LCC West Campus, rooms M119-M120
5708 Cornerstone Drive, Lansing

Monday, March 26 4:30-6 pm LCC Livingston County Center at Parker Campus, Room 201, 402 Wright Rd, Howell

Tuesday, March 27 4:30-6 pm LCC Clinton County Center, Room 172, 1013 S US 27, St. Johns

Thursday, March 29 4:30-6 pm LCC East, Room 112, 2827 Eyde Parkway, East Lansing

Please RSVP to Adrienne Jenkins at (517) 483-1415 or jenkina6@email.lcc.edu

Campaign Update: I had a GREAT fundraiser on Wednesday. Thanks to Jim McGurkin for hosting and opening up his wonderful house. We raised a lot of money, and the checks are still coming in from those who couldn't make it. I continue to attend meetings and talk to constituents at events, and am enjoying getting out in the great weather. Anyone who is looking to help out will have opportunities, apparently earlier than expected due to the awesome weather. Please sign up to volunteer or contribute at www.andyschor.com. Thanks again to everyone who is helping or supportive!

Thursday, March 1, 2012

Meijer and Free Publications, 911 Service Plan Update

Welcome to the Schor Report. Sorry for skipping a week last week. I had a death in the family and didn't have time to find a guest blogger. This week, I will try to cover the action for the last two weeks.

The County Services committee then the full Board of Commissioner took up a resolution calling on Meijer stores to continue to have City Pulse and other free magazines available in their store lobbies. Meijer's corporate offices recently decided to discontinue this service, and the City Pulse is calling on them to reverse this decision. The discussion on the Board floor was two-fold: (1) is this county business, and (2) is it a good business decision for Meijer. Commissioner Randy Schafer argued that is up to Meijer to decide what to do with their own business, and what makes business sense and what doesn't. He argued that it isn't county business. Commissioner Dianne Holman agreed, saying that she likes getting the paper there, but up to Meijer to decide. Commissioner Vickers argued that the County in the past has told people to go online (apparently he was referring to the Fair Board) and this should be no different.

Commissioner Deb Nolan pointed out that the Ingham County Commission weighs in on community issues all the time. She pointed out that others have weighed in favorable to the opinions of the Pulse, including the Lansing City Council. She said that there are 3,000 City Pulse publications picked up at Meijer locations weekly and Meijer is an important avenue to get this information out to citizens. She also pointed out that this is county business because public notices and Land Bank notices and other governmental information is in the Pulse and needs to get to residents. Commissioner Rebecca Baher-Cook also pointed out that this resolution is county business because the county shares tax foreclosures and RFP's and other county business. This must be available in places where people get public information. The elderly and others may not be in places where the City Pulse and other free publications are located, but they do go to the grocery store. She argued that this is an important resolution because the County is letting Meijer know that this is a disservice to residents. Commissioner Todd Tennis pointed out that we are not mandating anything, but encouraging Meijer to continue to allow free periodicals at their places of business.

Commissioner Schafer said that the main distribution is in Lansing and East Lansing, and the Pulse doesn't reach large portion of the rest of the county so this is just an urban issue. I responded to that saying that Meijer is in Lansing and East Lansing where the population centers are, but is also in Mason. And, I added that the Leslie paper and Stockbridge paper and other papers are free to residents and could also be carried at Meijer for the out-county residents that shop there. I pointed out that this is county business because we are acting on behalf of our constituents. I re-iterated that this is not an ordinance or mandate, but that this this is county business because the information is important to our constituents and Meijer needs to know the views of the community. The final resolution passed on a 10 - 5 vote, with the 4 Republicans and Commissioner Holman voting no and one Commissioner absent.

We also passed a resolution updating the Ingham County 911 Service Plan. The resolution updated the service plan from 1987. In includes areas services, how they all work, technical considerations, public and private agencies services by the network, etc. We had to pull this and vote on it separately from the items on the consent agenda because of state law requirements.

The final action on the Board floor involved appointments. A motion was made to make appointments to the Fair Board. We had interviewed people in the County Services Committee, but had not made a decision. The Democratic Caucus Chair moved to appoint two individuals, but apparently this information did not make it to the Republican Caucus in time. Some objected to being left out of the deliberations and decisions. Others wanted different members recommended. A motion was made to refer this back to committee for a recommendation and that motion passed 11-4. I supported the motion to send the resolution back to committee. After working in the Legislature for Democrats in the minority, I know what it is like to be kept out of the deliberations. The minority party cannot pass legislation or set the agenda, but they should at least be able to be part of the deliberation. When working in the State Senate and State House, there were plenty of times that the Republicans shut us out completely and that was frustrating when the Democrats represent Michigan residents also. As such, I agreed that the Republicans should be part of the deliberation even if the final decision may or may not be changed.

In County Services, we also heard that the Hawk Island snow park is now open. It was opened for 20 hours of service two weeks ago (Saturday for 8 hours and Sunday for 8 hours) and last weekend it was open all weekend. They are making snow at night when it is cold. With the unseasonable warm weather, it is hard to keep the snow made and not melting, but our staff is working on it. We also had a brief discussion about the Road Commission, and Chair Holman said that there will be an item on the next agenda. She said that she expected the mandatory public hearings to happen in late March or early April and expected discussions to commence soon when the Controller starts to bring recommendations.

In the Human Services Committee, we had an excellent presentation from the Greater Lansing Food Bank. I can't list everything they said, but they are definitely doing greater work for our community. They estimate 71,540 people in Ingham, Eaton, and Clinton counties don't know where their next meal is coming from. 1.3 million pounds of food was distributed to the Ingham County Food Bank network pantries from 2010 to 2011. Beginning July 1, 2012, the Greater Lansing Food Bank and the Mid-Michigan Food Bank will become one food bank. This will create efficiencies in the system. We had a great discussion about how we can get the word out. The Food Bank people mentioned the Lansing State Journal editorial and said that many people responded to that. I also mentioned that we need to keep pushing out the 2-1-1 phone number. People can call this if they have extra food they want to donate, or for any other social safety net needs. This prevents every different agency from havinghttp://www.blogger.com/img/blank.gif to market their own contact information. If you need to know if there are community services to fit your needs, call 2-1-1!

On the campaign front, things continue to be very busy. I have gained a few more endorsements in the last few weeks that I will roll out soon. Some big ones! And the first fundraiser of 2012 is set and ready to go. We have new Host Committee members being added every day. If you haven't already heard about it, block off March 14th from 5:30 to 7:30 and come join us at the home of Jim McClurken and Sergei Kvitko. All the details can be found on my website at .

Thanks for all the sympathy notes, and for all the well wishes for the commission stuff and the campaign!