Michigan Gov. Gretchen Whitmer’s health budget is heavy on prevention

Gov. Gretchen Whitmer’s $27.1 billion health budget borrows a page from a doctor’s playbook on preventative care: invest in health now in hopes of saving money in the long run.

Whitmer’s proposed budget increases funding for the Michigan Department of Health and Human Services by 2.4 percent, focusing on babies at risk, addressing everyday barriers to better health, helping troubled parents and fixing dental problems before children head to kindergarten.

“The quality of medical care is less important to a person’s health outcome than their social determinants,” Robert Gordon, director of the Michigan Department of Health and Human Services, told Bridge Magazine on Thursday.

“If we can better enable families to get what they need when it comes to food and housing, we're not going to only improve their economic outcomes, we’re also going to improve their health outcomes,” he said.

Public health officials and advocates for Michigan’s lowest-income residents have long preached access to healthy foods, stable housing and reliable transportation are critical not only to individual well-being but also to the health and vitality of the larger community.

“This is the way public health is going in general,” said Gilda Jacobs, president and CEO of the Michigan League for Public Policy, which advocates for Michigan’s underserved populations.

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• Gretchen Whitmer wants to bring back scaled-down Pure Michigan campaign

“You can’t just fix one thing…. And that’s why I believe this was put into the budget, so they can start to address all of the kinds of things that impact a person and their health but, more importantly, their well-being and their ability to thrive and do well.” 

Among the highlights of the budget:

Supporting new babies

A new, $37.5 program called Healthy Moms, Healthy Babies to lower the state’s infant mortality rate, which at 6.8 infant deaths for every 1,000 live births is above the national rate of 5.8, according to the state.

The differences are more acute when viewed by race. For every white baby that died his or her first birthday in 2017, there were nearly three times that many (2.8) black, non-Hispanic babies who died, according to the state.

The money would send more visiting nurses into the homes of high-risk mothers and vulnerable families.

It also would extend postpartum Medicaid benefits to new mothers from 60 days to 12 months and expand family planning from mothers up to 200 percent of the federal poverty level. (Eligibility now ends at 138 percent of the federal poverty limit, or about $17,236 for a single mother.) 

“I’m all in to explore ways in which we can correct” high rates of infant and maternal mortality especially among women of color, said Senate Majority Leader Shirkey, R-Clarklake, said last week. “I’m very anxious to roll my sleeves up and get into that solution.”

Still, Shirkey noted, “the devil is in the details.”

Tackling social determinants

The budget also would set aside $11.7 million for programs in public assistance and community health offices to better identify “social determinants of health” –  issues such as homelessness or lack of transportation that can contribute to poor health.

While details are being formed, the hope is to develop systems to make it easier for staffers in agencies to see what services clients are receiving and identify and close service gaps.

Supporting stressed families

Another $8.6 million would allow Michigan to invest in programs that support families in stress - providing mental health care, for example —  in hopes of keeping them intact and preventing children from entering foster care. That could reduce costs for keeping children in state care and it produces better outcomes for the youth.

Some of the funds are available under the federal Family First Prevention Services Act, according to the budget.

Better intel on opioids

Whitmer’s budget also sets aside $12.3 million to address the ongoing opioids epidemic.

Among other things, money would boost efforts that give health officials more real-time intelligence on drug activity to help deploy prevention and treatment efforts.  Money also would support training for community providers and criminal justice diversion grants.

Early dental care 

The budget also seeks $2 million for an Oral Health Assessment program that would help screen public school children entering kindergarten. 

As Bridge has reported, a proposed change in state law would require parents to make sure their children have at least a basic dental screening before they head to school.