Gorilla' State Must Wrestle With, Panel Told
Gongwer News Service,
February 12, 2003
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Michigan's Medicaid program is the "900-pound gorilla" that
the state has to wrestle with as it searches out ways to solve
its budget problems, Community Health Director Janet Olszewski
told the Senate Government Operations Committee on Wednesday.
Ms. Olszewski and other officials are digesting all the ideas
generated so far by Governor Jennifer Granholm's Medicaid
summit to determine what might best control costs without
drastically affecting services, she told the panel at her
Ms. Olszewski was confirmed unanimously by the committee, as
have all members of Ms. Granholm's Cabinet, and now will go
before the entire Senate for a confirmation vote.
The hearing came on the same day that the Saginaw-based Center
for Civil Justice filed a federal lawsuit against the state
for cuts in Medicaid ordered in December by former Governor
John Engler. That cut eliminates Medicaid eligibility for
low-income parents and grandparents caring for a child that
Besides trying to handle the Department of Community Health's
share of the budget problems, Ms. Olszewski said her goals are
to foster innovation to help the state attack and reduce some
of its major health problems including obesity and lead
poisoning of children.
The appointment of Michigan's first surgeon general will be
important to promoting healthy lifestyles and reducing health
threats, she said. The surgeon general, Kimberlydawn Wisdom
will also be chiefly responsible for the public health side of
Many of the questions aimed at Ms. Olszewski also dealt with
mental health and among those, she said the state should aim
at some form of parity with health insurance coverage also
covering mental treatments. Whatever the state devises, she
said, "we should craft a Michigan solution."
She also said the state is working together with local mental
health officials in Wayne County to craft treatment plans for
the 220 patients still in the Northville Hospital, which the
state is preparing to close.
Sen. Shirley Johnson (R-Royal Oak), who sat in on the hearing,
said mental health services in the state had suffered over the
previous decade and if at all possible "I don't want to see
them touched" in the budget Ms. Granholm will release on March
But the biggest issue facing the department is finding a way
of controlling costs of the Medicaid program. In finding those
solutions, the state has to remember that people will always
seek medical care when needed, even if they are not enrolled
in Medicaid or if physicians won't treat Medicaid patients,
The basic options in controlling Medicaid costs are limited to
enrollment of recipients, the types of services offered and
the fees paid health care providers, she said. While the state
considers options it also has to factor in changes planned in
the program at the federal level, she said.
One area the state will have to look at is recovery of assets
from individuals placed in nursing homes on Medicaid. The
federal government requires recovery in cases where a patient
has unspent assets, and Michigan is one of only two or three
states not following the requirement. Eventually, Ms.
Olszewski said, the state could face financial sanctions if it
does not enact recovery programs.
However, when it enacts a recovery program the state would
likely only recover between $1 million to $2 million.