PUBLIC HEALTH ADMINISTRATIVE OFFICERS FORUM
The Michigan Association for Public Health-Lansing, Michigan
March 13, 2014 - MPHI, Okemos
MEMBER
Kristin Tekiele
Brent Helm
Shelby Perrin
Lisa Smith
Gail Brink
LaTasha Thompson
Jim Rahoi
Mike Ernst
Dodie Putney
Patricia Romero
Melissa Bowerman
Christine Lundquist
John Jacobs
Hilary DeHate
Kathy Meyers
Health Department
Calhoun County
Lapeer County
Shiawasee County
Barry Eaton DHD
Kent County
Jackson County
Marquette County
Lenawee County
Benzie-Leelanau
Ottawa County
Mid-Michigan DHD
Chippewa County
Ingham County
Livingston County
Saginaw County
MEMBER
Jennifer Brassow
Heather Law
Christine Lopez
Isaiah Maton
Rachel Shymkiw
Kate Beer
Lynn Woelffer
Jere Pugh
Shelley Wittaniemi
Joel Strasz
Patrick DeTine
Joy Haynes-Hawkins
Bev Richards
Tammy Layman
Frank Smith
Health Department
Washtenaw County
Monroe County
DHD#10
Genesee County
Oakland County
Western UP
Delta-Menominee DHD
Grand Traverse HD
Ottawa County
Bay County
Macomb County
Genesee County
Dickinson-Iron
Kalamazoo County
Guests: Tammy Stevens, Steve Ireland, Jessica Kupraszewicz, Mikelle Robinson, Craig Boyce,
Brad Barron– MDCH
Call to Order: The meeting was called to order by the Forum Chair, Joy Haynes-Hawkins at
10:00AM
Consent Agenda: No Additions
Review of February 13, 2014 Meeting Minutes: Motion was made by Brent Helmand supported
by Jennifer Brassow to defer the minutes to the next meeting as the minutes were not emailed
to the listserv. Motion passed.
Treasurer’s Report: John Jacobs emailed the report to the listserv
Correspondence/Officer Report: Board of Directors Meeting- Joy Haynes-Hawkins
a) Board of Directors meeting – notes sent via email. Biggest conversation point about
low-risk food service legislation, what is in category of low risk? Remote festivals –
travel expenses for low risk is high. Definition of what is low risk resulted in a lot of
discussion. Recommended language by MALEHA - revision of language needs to be
completed.
b) Medicaid Policy with Plan First and B&C – Enrollment ends 3/31/14 and billing
coverage ends 06/30/14. There is no automatic enrollment into Healthy Michigan
Plans for BCCCP.
Malph Report - Meghan Swain not present
State Department Reports
Mikelle Robinson, MDCH
 Melanie Brim has resigned, this was mentioned at the last meeting – there are no
updates at this point. Have not appointed an acting position or filled the position.
Melanie working until the end of March. Reception information is out. Was posted to
MALPH
 Document sent on BCCCP changes due to ACA and Healthy MI Plan. Bit complicated. If a
woman is eligible for the Healthy MI Plan, will not be eligible for B&C program.
Flowchart and other info available. Questions to Paulette Vallaire
 Budget process still continuing. Health & wellness allocation not finalized yet. Expecting
level funding. Currently working on block grant application. In system by end of month.
 Feds – funds have been increased, not sure how much MI will be receiving.
(Preventative block grant funding)
 Public Health Administration Strategic plan has been completed and sent out to
program areas. File will be sent to Joy for distribution
 Director sent out health innovation grant application in January – has been finalized for
first round. For each grant that falls under PHA what programs and people will be
assigned to work with them.
Champ/Billing- Craig Boyce, MDCH

Going fairly well on billing side. No major issues. MIHP – coordinator training is MidMarch and at the end of the month. Craig will be speaking about issues related to
secondary claims. Billers may want to attend the meeting if assistance is needed
regarding client with secondary insurance.
Medicaid Policy - Brad Barron, MDCH

Focus is on the Healthy MI Plan. This week or next week some sort of announcement on
some official date. Moving along. Eligibility determinations testing. Positive outcomes.
Medicaid Full Cost Report – Steve Ireland, Tammy Stevens, Jessica Kupraszewicz - MDCH


2010 sent out. 3 appeals one for 2009 and two for 2010. Finalized and out the door soon
2011 initial settlements, all completed, in review or sent out. 6 remaining that would
have revisions to include encounter data. Highly encourage to review encounter data,
not 100% sure on this data. Documented responses back in order to move forward.
Differences – email or call with discrepancies on initial settlements, nothing formal is
required. Put request in to get claim data. Pull MHP encounter data by Medicaid ID.

2011 – 99211 claim issue adjustments and MHP encounter data. Have to submit a
revision to remove the 99211 encounters which will change the cost per encounter rate.
Need to include MHP encounter data before finals can be issued.

Settlement System in testing now to get it approved. Starting to go forward with 2012.
Expect 2012 to be worked on before April and hopefully initials completed by June.

Interim quarterly payments – will be basic – based on last completed settlement –
divided by 4. This will be the interim payment going forward. As newer report is settled,
quarterly payment will be adjusted. Target date is October. By using the most recent
settlement to do an interim payment, will result in approximately 90% of the next years
value as long as program is consistent from year to year. Smaller facilities that have a
big year, and interim based on that may have issue the next year with a possible
overpayment. Mayrequest reduced payments.

Healthy MI Plan – submitted a revised cost report that includes Healthy MI information.
Policy bulletin February 25th gives benefit plan that identifies Healthy MI population.
Coding issues – working on this. Determination of Health Plan Members vs Medicaid
Members will need to be determined for cost reporting purposes. Health plans will get
different reimbursement as well. Population will need to be identified. Need to check
eligibility at every visit to determine what encounters will be at 100% rate.

Encourage to look at ICD10. Business to Business is up for batch processing of samples.
Will identify issues need to address. Craig is able to forward information on ICD10.
Committee Reports:

Governance Committee–Rachel Shymkiw - Joy will forward Rachel’s contact
information to the committee

Education – Lisa Smith – Met briefly, any ideas to Lisa

Premier Public Health Conference – no update
Old Business:
 Full Cost reimbursemento Department response to MALPH BOC regarding
o Concerned about interim payments, concerned about cash flow issues. Letter
focused on timeliness of getting payments out. The written response board
received back was same as update Steve Ireland presented at today’s meeting.
Local HDs doing revised report due to 99211 code change. Joy will send letter to
listserv

New representative for the Governance Committee – identified

Talking point for the MALPH executive board regarding quarterly payments to LHD’s in a
mechanism similar to FQHC payments

Jennifer brought up last month about 99211 code and not many responses. Code issue
and scope of practice issue separately. Discussion held on 99211 billing with a nurse and
not receiving reimbursement as nurse is diagnosing as well. Clinics with a NP diagnosis
and signing off on chart and nurse providing service is acceptable. Brad recommends reopening issue on 99201 to have nurse allowed to perform. Unique nature of public
health. Joy removing cost report 99211 issues and looking at scope of practice for letter.
Including immunization counseling codes as well.
New Business:
 Providing advance financial information prior to their Accreditation visit? How many
Health Departments have had this request? How was that information used by MDCH?
Financial data was requested from some health departments. Genesee County Billing
data has been asked for. Statistical analysis was completed. Didn’t weigh against them.
Analysis was completed that provided data on the cost to provide service. Impact on
public and what it cost to serve the population. Saginaw – Asked for seven years of
specific financial information, overwhelming at first. County has info and was available.
Resources given. Report produced on financial and program data and reports were
appreciated.

MOMS, PlanFirst!, BCCCP and Presumptive Eligibility updates – no extension of waiver,
will end June 30th. All beneficiaries will receive letter to notify of changes. Plan Firstis not
a comprehensive health plan. Some of the population will be eligible for expansion,
others eligible for marketplace. MOMS will remain - different funding source. ABW –
eligible for Healthy MI Plan, automatically transferred.

MSA 12-66 Payments to Physicians – a Local Health Department provider cannot get
payment distribution as settlements in cost based reimbursement. Doctors have
received several checks and L 13-55 says have to give money to provider. Health
Departments are exempt and money has to be returned to Health Plan.

Implementation of the Healthy Michigan insurance - possible effects on health
departments and school based clinics - seen as medical home, no exception for health
departments.
o
Christine Lundquist has asked for answers on how this will work. As third party
insurance is billed, running into problems with third parties not paying for
immunizations as want person to go through federal system, denied as not
medical home and need prior authorization, finding situations, never heard of
person, can’t give authorization as doctor’s never seen, left with “what do we
do with them”, write off service or try to get service with dr. joe as you put his
name down. That’s with imms, what about other programs, FP, etc.
o
Under ACA have to pick medical home. Medical home has to provide basic
services, immunizations is a basic service. Primary care is not LHD focus -it’s
prevention. Primary care at school centers is for a small subset of the
population. MSA Bulletin – Craig getting number, References RHC and FQHC but
not LHDs. If could be covered under exception, all prior authorizations would
not be required.
Adjournment was moved by Brent Helm and supported by Jennifer Brassow at 11:50am
Next meeting is Thursday, April 17, 2014 at 10AM. The meeting will be held at MPHI, Okemos
Respectfully submitted: Christine Lopez, Secretary