The Mental Health Association in Michigan

is the only statewide, non-governmental agency concerned with the broad spectrum of mental illness across all age groups.

April 1, 2020

Letter from Lansing – March

Welcome to the March 2020 edition of MHAM’s monthly newsletter that provides you with public policy updates and other information that impacts the behavioral health care of you and those you love.

“An abnormal reaction to an abnormal situation is normal behavior.” Victor Frankl

A Note from the President & CEO

Covid
Covid

Everyone’s attention, as it should be, is on the coronavirus pandemic. We hope you are safe and well. The Mental Health Association in Michigan cares about our mental health and the mental health of those you love. As the state of Michigan and its citizens navigate the challenges of COVID-19 or “coronavirus” by closing schools, restaurants and all “non-essential” businesses, limiting the number of individuals who can congregate and by reporting the increasing numbers of individuals who are testing positive for the virus and how many are dying, anxiety among Michiganders is growing. This anxiety is understandable, particularly when there does not seem to be an endpoint. MHAM wants to let you know that you are not alone.

Paying attention to your mental health during the coronavirus crisis is as important as paying attention to your physical health. It is normal to feel afraid and anxious, especially when faced with a situation that has many “unknowns”. It is important for you to be patient with yourself and others during this time. One of the most vital things you can do for yourself is limit the amount of time you listen to the news reports about the pandemic. Get only the information that you need and then turn it off. Unfortunately, there is little that we can do to impact the devastation that we see and hear about on the news. We can, however, focus on the positive aspects of our lives in the “here and now.” If we are not struggling with the coronavirus or another illness, then we are safe in the present moment. There are times that it may be necessary to take one moment at a time.

Another way of coping with traumatic events is to help others. If you want another way to alleviate your stress and your anxiety, you may wish to consider volunteering to help your fellow Michiganders. Here is a link to Governor Whitmer’s website: https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98811—,00.html
The state of Michigan is looking for medical volunteers, public health volunteers, community volunteers, donations, volunteers to help older adults and to aid with older adults, and for individuals to donate blood.

Policy Updates Related to Coronavirus

Even though the Michigan Legislature has cancelled most, if not all, of its committee meetings through the months of March and April, there has been several Executive Orders that have been issued by Governor Gretchen Whitmer in response to the state of emergency that has been declared in Michigan.


On March 25, 2020, Governor Gretchen Whitmer issued an Executive Order 20-25 that applies to the “temporary enhancements to operational capacity, flexibility, and efficiency of pharmacies” that is designed to provide flexibility to pharmacists in light of the COVID-19 pandemic. The only possible concern relative to this Executive Order is this section which states:
5. Pharmacists may substitute a therapeutically equivalent medication for a medication subject to critical shortages without the authorization of a prescriber. The pharmacist must inform the patient of any such substitution. The pharmacist must inform the prescriber within a reasonable period of time of any prescriptions or refills dispensed under this section. A prescriber must not incur any criminal or civil liability or licensing disciplinary action as the result of a pharmacist filling or refilling a prescription under this section.

MHAM is paying close attention to this Executive Order due to concerns that it could negatively impact persons with psychiatric conditions whose medications may not be easily interchangeable.

MHAM and other disability rights advocacy groups are also monitoring concerns about a letter that Henry Ford Health System sent to its patients and their families about medical treatment and how the system will determine “who” gets lifesaving treatment for COVID-19 and who does not. The following statement was released by an advocacy organization called Detroit Disability Power in response to the letter by Henry Ford Health System:

No Healthcare discrimination DDP Press Release
Updated: 6 hours ago
HEALTH CARE SYSTEMS MUST NOT DISCRIMINATE AGAINST PEOPLE WITH DISABILITIES AND CHRONIC ILLNESS DURING PANDEMIC

March. 27th, 2020
For More Information Contact:
Dessa Cosma, Executive Director
231-631-4469
Dessa@DetroitDisabilityPower.org

Detroit, Michigan — Disabled and chronically ill residents are outraged by the release of a confirmed Henry Ford Health System letter outlining protocol for rationing care under scarce medical resources and prioritizing “Patients who have the best chance of getting better.” This vagueness and ambiguity are unacceptable. Such guidance does a disservice to decision making as well as human dignity. Due to a history of ableism in medicine, public policy, and American culture at large, perceived notions of ‘quality of life’ are biased and problematic, often minimizing the value of the vulnerable. We cannot let ‘quality of life’ serve as a pretext for denying treatment, especially vital treatment, to people with disabilities and chronic illness.

According to the Allocation of Scarce Medical Resources and Services During Public Health Emergencies in Michigan, it is unacceptable to consider social characteristics such as disability when making allocation decisions. Categorizing people into social characteristics can be used as pretext for favoritism, discrimination, and reduced access for marginalized groups. Hospital systems around the country are grappling to figure out how to administer scarce resources, creating a patchwork of policies that mean a person with a disability or chronic illness may receive a different level of care from one hospital to another. Therefore, hospital systems, City and State government, must clarify policies and commit to non-discrimination of disabled and chronically ill Michiganders.


Earlier this week advocates in Washington filed a complaint with DHHS and the Office of Civil Rights about illegal disability discrimination in treatment rationing protocols being developed in response to the COVID-19 pandemic there. We agree that this kind of health care rationing violates federal disability rights laws, including the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act (Section 504) and Section 1557 of the Affordable Care Act (ACA). Medical triage forces hard decisions. However, disability activists have fought for decades to secure equal access and civil rights when mainstream America did not think we deserved them. As a country, we cannot, even in this crisis, abandon this progress.

According to Roger Severino, the director of the U.S. Department of Health and Human Services’ civil rights office, “Persons with disabilities should not be put at the end of the line for health services based on stereotypes or discrimination, especially during emergencies. Our civil rights laws protect the equal dignity of every human being from ruthless utilitarianism.” We agree, and therefore we call on Henry Ford Health System, and all other local healthcare systems, to clarify their policies and we call on our City & State Government to confirm that they will not tolerate discrimination against disabled and chronically ill people as critical care is rationed during this pandemic.

Detroit Disability Power’s mission is to leverage and build the organizing power of the disability community to ensure the full inclusion of people with disabilities in Metro Detroit. Public Policy Initiatives by MHAM – Dr. Mark Reinstein, Public Policy Consultant

Amidst the coronavirus crisis, MHAM recently introduced six bills in the Michigan House of Representatives. This month’s Letter from Lansing will talk about House Bill 5615.

HB 5615
Michigan has a major problem regulating psychiatric hospitals and assuring the quality of care within them. Most of these hospitals are private, or community based. Years ago, the private and community psychiatric hospital beds were licensed and monitored by the assigned state department that included primary public responsibility for mental health. Today those responsibilities belong to the state’s Licensing and Regulatory Affairs department (LARA). Unfortunately, under LARA’s watch, many Michiganders are being put at great risk due to a lack of enforcement.

Channel 7 News (Detroit) recently obtained under the Michigan Freedom of Information Act (FOIA) some 151 death reports from LARA on people who were in or just released from psychiatric hospitals. MHAM has sent its own FOIA request. That is an alarming number of deaths for such a period. And according to Channel 7, only one or two deaths have ever been investigated by LARA. We were recently able to review the report of such an “investigation” on a death in a Warren hospital, and that report was highly inadequate.

Beyond the question of fatalities, we’ve been able to review a wealth of material on negative occurrences in some private and community psych hospitals over the past three years. We’re talking about multiple rapes, assaults, injuries, and potential overmedications, as well as a lack of effective recipient rights policies and procedures. Yet, to the best of our knowledge, when complaints about these incidents are made to LARA, it never finds that anything was done wrong by the facility or its staff.
This shameful situation must stop, and the priority for action is clear: Get the licensing and oversight of these hospitals back into the hands of mental health clinical experts within the Department of Health and Human Services (DHHS). We are pleased to report that Rep. Phil Green (R-Millington) has introduced HB 5615 to do this.

The bill also requires minimum elements and timeframes for hospitals (and in some cases Community Mental Health) to report deaths to DHHS, and for DHHS to subsequently report to the Legislature. HB 5615 also gives the state Office of Recipient Rights the authority to oversee rights protection in private and community psych hospitals.

The bill has been referred to the House Health Policy Committee, chaired by Rep. Hank Vaupel (R-Handy Township). Because of the coronavirus situation, it could be several months before legislative non-budget committees can start meeting again.

{NOTE: Senator Jim Ananich (D-Flint) has introduced a separate bill related to this. It would not change licensing responsibility but calls on DHHS to provide hospital death reporting to the Legislature, and to investigate hospital deaths that were by suicide or occurred in seclusion. The bill introduced in the House is more comprehensive, thorough, and protective of vulnerable individuals.}

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