Nancy Ridley

Importance: High See attachments Human Services cluding ary attachments, is intended for the use of ine above named recipient(s} and may contain . Any unauthorized review, use é, of distribution o ich and/or privileged sshy prohibited, tf you are ipie tthe sender by reply e-mail and rec of the orginal message.” xxxEND_PAGE:dhhs02_b0081_0300_0300_1

The Detroit News — October 12, 2015, By Gary Heinlein Lansing —The Snyder administration is battling a surge in overdose deaths in Michigan linked to the abuse of pain and anxiety medications — an issue experts say was previously almost invisible to the public outside the families dealing with it. Later this month, a committee headed by Lt. Gov. Brian Calley will make recommendations for addressing Michigan’s part in what the U.S. Department of Health and Human Services calls America’s “unprecedented drug overdose epidemic.” Prescription drug and opioid addiction has led to a fivefold increase in drug deaths in Michigan since 1999, a trend that Calley said leaders “must come together to reverse ... before more Michiganders are hurt.” “We are losing kids in schools. People are losing their jobs because of these drugs,” said Cass County District Judge Susan Dobrich, who sees the problem daily in her courtroom. “It’s shocking how many prescriptions there are out there and it’s scary there are so many people on the roads, driving on painkillers.” Prescription abuse is a “huge problem” made worse, and harder to counteract, because the drugs are legal, said Dobrich, president of the Michigan Association of Treatment Court Professionals. ‘o see charts and pictures associated with this article. Opioid analgesics or painkillers accounted for 1,001 or nearly 20 percent of the 5,062 Michigan deaths caused by “unintentional drug poisonings” between 2009 and 2013, according to state statistics. The state’s health department has said overdose deaths linked to opioids were increasing at a faster rate than for illegal drugs such as heroin — also on the rise — and cocaine. A state report also noted that another class of medications called benzodiazepines — prescribed for anxiety — accounted for about 9 percent of deaths. xxxEND_PAGE:dhhs02_b0006_0079_0092_01 000080 The Michigan Automated Prescription System, which tracks controlled drugs, hints at why this is happening: 20.8 million controlled substance prescriptions and 1.4 billion pills were in circulation in 2013 alone, the equivalent of 139 pills for every state resident. Still, Gov. Rick Snyder’s decision to raise the issue and create a task force in his January State of the State address surprised many lawmakers and pundits. Experts say the problem had been largely invisible to residents not directly affected by addicted family members or friends. Opioids are powerful painkillers that can lead to the use of highly addictive and dangerous illegal substances, especially heroin, Snyder said. They include drugs such as fentanyl, codeine and hydrocodone, or brand names such as OxyContin, Demerol and Vicodin. Waterford resident Jeannie Richards, whose son died of a heroin overdose in 2011 after he first got hooked on painkillers, recalled an earlier state task force that seven or eight years ago “came together and they did nothing.” She said she hopes this effort will be more productive because the problem is bigger now. “I’m very optimistic,” said Richards, who has formed a group called Bryan’s Hope to push for policy changes in honor of her son. Richards said drug addictions have been shrouded in secrecy for too long because of the stigma that goes with them. “We go to great lengths to keep it secret when, in fact, we need to bring it out to get victims help,” she said. Mirrors national trend The pattern of prescription abuse in Michigan mirrors a national trend. According to a recent U.S. Department of Health and Human Services report, the proportion of overdose deaths attributed to opioid painkillers doubled from 30 percent to 60 percent between 1999 and 2010. Opioid overdoses caused 16,651 deaths in 2010 alone, the report said. “The abuse of opioid analgesics results in over $72 billion in medical costs alone each year,” the federal agency said. “This is comparable to costs related to other chronic diseases such as asthma and HIV.” A Michigan Prescription Drug and Opioid Abuse Task Force hearing in August brought an outpouring of testimony from professionals dealing with the fallout and anguished witnesses to sons, daughters, nieces and nephews destroyed by drug abuse. Lansing resident Anne Kesler described how a nephew was introduced to the anxiety drug Xanax by a girlfriend at 16 and developed an affinity for prescription medications. The results were three trips through rehabilitation clinics, three wrecked cars and one nonfatal overdose. His growing addiction was aided by a 30-day prescription for Vicodin following a wisdom tooth extraction and a prescription for OxyContin following an appendectomy when he was 18, she said. By the time his parents and family realized what was happening, Kesler said, “he was like a train that was out of control. He’d go to doctors and say, ‘I’ve got this or I’ve got that’ and get a prescription. He was taking anything he could get his hands on — Xanax, OxyContin.” He died at 24 in April from a mixture of fentanyl and heroin that he obtained on the streets, she said. It’s a powerful blend experts say is becoming alarmingly common in overdose fatalities. “| would say, first of all, the doctors have to take some responsibility,” Kesler said. “Kids are getting this stuff ... as young as 12.” xxxEND_PAGE:dhhs02_b0006_0079_0092_02 000081 Pills for every malady Robert Gerds, administrator of the Oakland County Medical Examiner’s Office, said opiate abuse is an outgrowth of an industry that produces pills to cure every malady and sells them endlessly on television. Hydrocodone, an opiate painkiller that is used in drugs such as Vicodin, is the most prescribed drug in Michigan, comprising nearly a third of all prescriptions, according to state records. “We make it very convenient to die of a prescription overdose,” said Patty Roland, manager of operations for the Macomb County Medical Examiner’s Office. More than 75 percent of those who died of opiates had valid prescriptions and didn’t mix the drugs with heroin or cocaine, according to a 2014 state report that analyzed prescriptions and death records. “The majority had legitimate prescriptions ... their deaths were accidental, and many didn’t realize how much they were taking,” said Dr. Su Min Oh, one of the report’s authors. Statewide, prescription drug-related deaths skyrocketed during the late 2000s, but leveled in the past few years as heroin deaths increased. Many medical professionals suggest that tightened restrictions on opiates forced users to turn to street drugs. Heroin has less “quality control” than prescription opiates, leading to more overdose deaths, Gerds said. so shambers often fizzy t “The doctors have gotten smarter about tracking prescriptions. Law enforcement has gotten more aggressive, so it’s harder to find these prescription drugs on the street,” said Kyle Rambo, executive director of Catholic Social Services of the Upper Peninsula. “It’s gotten more expensive. Folks who are addicts are turning to the low-cost, what’s available alternative, and that is heroin.” Rambo’s Marquette-based agency last year treated about 400 people for substance abuse, a number that has remained consistent for years. In the past, the agency may have treated users for meth addictions. Now they are abusing prescription drugs, and Rambo said many users are simply prone to abusing drugs. “It’s been on the increase for years,” said Bob Mellin, deputy director of clinical operations for Great Lakes Recovery Centers, an Ishpeming-based treatment facility. “The danger with opiates is that you never know if your brain has a neurological pathway that is prone to addiction unless you are prescribed a painkiller. You can have no history of abuse, but it’s like your brain gets hijacked and you’re off to the races.” bites /www Detroit Free Press — October 12, 2015, By Robin Erb Under the steady gaze of a watercolor giraffe and tissue paper butterflies, a Flint pediatrician and mother of two last month forced the state of Michigan to snap to attention. xxxEND_PAGE:dhhs02_b0006_0079_0092_03 000082 But the probability that Flint’s water is poisoning its children with lead — after months of assurances from both city and state officials that the water is safe — was far from easy. It required 2, 38, to sidestep bureaucracy. It meant awkward conversations and putting her hospital — city-owned Hurley Medical Center — smack-dab in a political minefield. And it meant checking her data “a zillion times,” she said, then second-guessing herself to the point of being physically ill when a state spokesman questioned her credibility. Just hours after state officials acknowledged her data, Hanna-Attisha felt equal parts exhausted and vindicated — at one moment laughing at congratulatory e-mails and comments from colleagues (“Maybe they'll give you a lead key to the city,” one had quipped), at another reciting sobering statistics about the life-long damage from lead poisoning: irreversible brain damage, development delays, speech problems, a boosted risk for behavioral issues, serious chronic conditions, to name a few. & Aon Flint’s water troables “It has been such a physiologic response,” she said of her look at the numbers and the state’s reaction. She sat in her office, where children’s artwork hangs haphazardly on the walls. A pink-lettered sign on her door — “This is my fight song,” it reads — @ E y é ts. “At times | want to cry and then I’m so happy,” she said. But then Hanna-Attisha, a pediatrician for many of Flint’s poorest families whose training and experience has focused on environmental toxins and health disparities, shook her head. achiliven husher in 2 Puet ZIP codes? “But then I’m tearful because how could this have happened in 2015 when all these regulations are in place (to ensure clean water)? For a population that has every burden in the world already, this is the last thing they needed,” she said. In retrospect, Hanna-Attisha served as the canary in the coal mine in this latest public health crisis — the doctor who spotted a problem and wouldn’t let it go until others paid attention, said Dr. Eden Wells, the state’s chief medical executive. nid howe predicted Flint's “She was a doc on the front lines who knows to pick up the phone ... rattle some cages and say ‘Hey, come here, we’ve got a problem,’ ” Wells said. It began over a dinner party with high school friends Aug. 26. Among Hanna-Attisha’s guests was a friend who played piano at her wedding and also is a water-quality expert. The conversation turned to the issue of the drinking water. “Have you looked at kids’ blood-lead levels?” the friend asked. Hanna-Attisha was not only intrigued, but also perfectly positioned for such a data dive. xxxEND_PAGE:dhhs02_b0006_0079_0092_04 000083 She heads the pediatric residents program at Hurley and is a pediatrics and human development professor at the Michigan State University College of Human Medicine. She sits on the Michigan Chapter of the American Academy of Pediatrics, too. In short, she lives as much on the research side of medicine as she does the clinical side. So she knew that routinely drawn blood-lead level data existed for thousands of Flint-area children, especially those on Medicaid or who live in high-risk areas for lead exposure. The following week, she turned to the Genesee County Health Department for its blood-lead level data. She was disappointed. Test results are kept in individual patient files and could not be easily analyzed, Genesee County health officer Mark Valacak told Hanna-Attisha. Undaunted, she asked the state for its analysis of the same blood-level data for Flint. In the meantime, local and state officials were facing mounting pressure from residents who had already complained that the water smelled and tasted funny. In mid-September, a Virginia Tech researcher and lead expert, Marc Edwards, concluded from his testing of Flint water that it was 19 times more corrosive than Detroit water. And even though repeated testing at Flint’s water treatment plant had detected no lead and testing in homes had registered lead at acceptable levels, according to the state, Edwards wrote on his website, «#: :, that his own test results suggested an undeniable presence of lead in water drawn from Flint homes. While she waited for state data, Hanna-Attisha began sorting through Hurley’s own records — a total of 1,746 test results from Flint children to compare against 1,640 results from elsewhere in Genesee County. The results were sobering: The number of Flint children with elevated blood-lead levels — 5 micrograms per deciliter or more — jumped from 2.1% in the 20 months prior to Sept. 15, 2013, to 4% between Jan. 1 and Sept. 15 this year. In certain ZIP codes, the change was even more troubling, she said — jumping from 2.5% of the children tested to 6.3%. The change correlated roughly to the timing of the city’s switch from using Detroit water to water that would be temporarily drawn from the Flint River. She and her research assistant kept rechecking the numbers — often late into the evening. One night, “her baby is crying and I’m like ‘Can you run that p-value one more time?’ ” she said, chuckling. By the time Hanna-Attisha went to Hurley’s CEO, Melany Gavulic, public panic was high. Community organizations were handing out filters and bottled water. Community leaders blamed a state-appointed emergency manager for changing water systems. It’s an election year, too, for the city. It was a “politically messy situation,” Hanna-Attisha told her boss. Gavulic was clear, Hanna-Attisha said: Kids’ health comes first. On Sept. 24, Hanna-Attisha went public with her results. The response from the state, she said, was startling. Her research was dismissed and her comments called “unfortunate.” Brad Wurfel, spokesman for the Michigan Department of Environmental Quality, repeated a familiar refrain: Repeated testing indicated the water tested within acceptable levels. xxxEND_PAGE:dhhs02_b0006_0079_0092_05 000084 Hanna-Attisha said she crawled into bed that night, physically ill. “We checked our data a bazillion times ... but when you hear (the state’s dismissal) on national news, how can you not doubt yourself?” she said. She wasn’t the only one surprised. Valacak, the Genesee County health executive, said he “took offense ... in part because | know how dedicated she is and | know the quality of her character.” That Monday, Valacak e-mailed state health officials. Among his questions: Why would the state’s analysis include non- Flint residents? On Tuesday, he pushed again for an answer. On Wednesday: “Any update?” He got no answers, he said: “It was frustrating.” At the same time, Hanna-Attisha had stepped up conversations with Wells, who had taken her post as the state’s chief medical executive in May. The two women knew of each other and had even stood together earlier this year to promote immunizations. Wells, who leads the preventive medicine residency program at the University of Michigan’s School of Public Health, said she’d heard media reports about Flint’s water. She balanced those against water-quality tests indicating the water was safe. Moreover, a look at county-wide data didn’t trigger any alarms. Now, she was alarmed by a closer look at Hanna-Attisha’s findings. In several conversations, Wells and Hanna-Attisha compared the pediatrician’s analysis against that of the state epidemiologists. Among the differences: The state’s number included kids from outside Flint — those who wouldn’t normally drink Flint water. Some had Flint addresses but lived outside city limits. As September drew to a close, state health epidemiologists reanalyzed their data, eventually confirming Hanna-Attisha’s results. Wells saw a yellow Post-it note from her staff on her keyboard when she walked in at 7:30 a.m. Oct. 1. Her own data analysts had confirmed Hanna-Attisha’s findings. She walked down the hallway to find Nick Lyon, director of the Michigan Department of Health and Human Services. They’d have to let the public know — and fast, the two decided. That same day, Valacak and Genesee County commissioners declared a public health emergency. Commission Chairman Jamie Curtis said he’d simply had enough. Hanna-Attisha’s data couldn’t be ignored, no matter what state authorities said water testing indicated. “In six years | don’t want 5- and 6-year-olds going to school with lead poisoning,” he said. Valacak said he got a call the next day — Friday, shortly before the state news conference. Hanna-Attisha’s numbers had been confirmed, he was told. At 1:30 p.m. Oct. 2, Flint Mayor Dayne Walling joined state officials — environmental, health and public relations — at the microphone in front of a packed room of reporters. “We understand many have lost confidence in the drinking water. We need to build that back. We need to do that more,” Dan Wyant, of the Michigan Department of Environmental Quality, said in front of a line of cameras. Reporters tapped away on keyboards. Outside were protesters. Quietly in the back of the room stood Hanna-Attisha. She leaned over to Brad Wurfel, the state spokesman who a week earlier had called her work “unfortunate” in a time of “near hysteria.” 6 xxxEND_PAGE:dhhs02_b0006_0079_0092_06 000085 “You called me irresponsible,” Hanna-Attisha recalled saying to him. Wurfel said he was sorry. “| had the opportunity to apologize ... | was grateful for the opportunity to do it,” Wurfel told the Free Press later. “I will be the first to say, | came ona little strong on this because | believed the numbers we had in the moment.” Hanna-Attisha, whom Gavulic called “definitely one of our superstars” even before her recent spotlight, said she and other researchers aren’t done. They want to specifically map blood-lead levels throughout the city’s neighborhoods, and they want to test for blood levels in cord blood from Flint’s newest babies. Exhausting? Yes. Ready to stop? Never, she said: “Because this is what matters. This is what we do ... This is why we’re ‘ininw frecu com/stery/news/local Dispatch Times — October 12, 2015 Despite the complaints, city officials had said state tests showed the water met federal safety guidelines. The lightbulb finally lit up over the city’s collective head last week when Hurley Medical Center released a study that showed that lead was found in the blood of children at unnaturally high levels, especially in certain zip codes. A statement from a spokesperson in the article said: “We believe protecting public health is paramount and safe, clean, accessible drinking water is essential”. Now, locals and citizens are asking Environmental Protection Agency to reconnect their city to Detroit’s water system again. Because of the huge outcry, Flint City Administrator Natasha Henderson said she’s working to make it right. In July, a spokesman for the state’s Department of Environmental Quality, Brad Wurfel, recommended home tests but added: “Anyone who is concerned about lead in the drinking water in Flint can relax”. “As evidenced by the ongoing poisoning of the children of Flint, it’s time for the EPA to take immediate action to provide us with a safe water source”, LeeAnne Walters, a Flint parent and member of the Water You Fighting For group, said Thursday. The decision, estimated to save about $4 million annually, was made previous year while a state emergency manager was shepherding Flint through a financial crisis. About 30 protesters chanted “Flint lives matter”, and a few wore hazmat suits, as they stood outside the midday news conference in Flint to voice their displeasure with the new plan for Flint’s water. Under the Safe Drinking Water Act, the EPA is empowered to stop “imminent and substantial endangerment to human health” such as the elevated lead levels in Flint’s drinking water. It includes free water filters for people’s homes, a fast-track fix to reduce lead in the system and more testing. A General Motors plant stopped using the water, saying it was rusting its parts. For now, the NRDC reports, residents are take caution when drinking tap water. Flint City mayor Dwayne Walling advised everyone to use only county- approved taps and filters and flush cold water for five minutes first before drinking it. Soon after the switch was made, residents began to complain about the taste, smell, and appearance of their water. The toxic effects of lead on virtually every system in the body, and particularly on the developing brains of young children, are well documented. xxxEND_PAGE:dhhs02_b0006_0079_0092_07 000086 Filters will be distributed at the University of Michigan-Flint for Flint homes affected by high levels of lead in their water. And in addition to repairing what went wrong — or defending the state’s actions and oversight — the governor needs to be up front with the public about what he finds. Children, drinking tap water polluted by lead. That’s when the city, ina dispute with Detroit, quit buying its water and instead signed on with a new system that will draw water from Lake Huron. WMUK - October 12, 2015, by Jake Neher (MPRN-Lansing) State lawmakers hope to act quickly this week to help resolve Flint’s water problems. Gov. Rick Snyder is asking the Legislature to approve about $10 million to address the city’s water contamination crisis. A number of top Republican lawmakers say they’re on board with the governor’s request. said state House Speaker Kevin Cotter (R-ML Pleasant}. State Senate Majority Leader Arian Meekhof (R-West Olive) says he expects to take action on the issue this week, but said late last week that the specifics of where the money will came from stil needed to be worked out. The chair of the House Appropriations Committee says he intends to hold a carnmittes vate on the funding this week. said state Rep. Al Pschotka (R-Stevensville}. Some lawmakers say the state bears at least some responsibility far the crisis because an emergency manager oversaw Flint's decision to switch water sources, Cotter says they shauld approve the money regarciless of the state’s role in the crisis. None of the lawmakers offered a specific source frarn which they preferred to take the money as of late last week. But Cotter said the state’s “rainy day fund” is ari option. Pscholka says he doesn’t think lawmekers need to dip into the state’s savings. He says he'd rather see it come from sources such as the state's Drinking Water Revolving Fund or state agency budgets such as the Michigan Department of Environmental Quality or the Michigan Department of Health and Human Services, He said it could aise be a cormbination of those sources. Gov, Rick Snyder apeoints West Olive resident to Developmental Disabilities Council Holland Sentinel — October 9, 2015 xxxEND_PAGE:dhhs02_b0006_0079_0092_08 000087 Holland, Mich. - Gov. Rick Snyder, R-Michigan, recently announced the appointment of Steve Johnson, of West Olive, to the Developmental Disabilities Council. The 21-member council, housed within the Michigan Department of Health and Human Services, advocates for people with disabilities on a statewide level. “The varied backgrounds and experiences of these individuals will be a tremendous asset to the council and Michiganders, and | look forward to their contributions moving forward,” Snyder said in a news release. Appointments are not subject to the advice and consent of the Senate. For more information, visit michigar.goy/sryder . https /www holla glcom/s ZOLS1OOS/NEWS foi Bll would reopen Maxey, Lansing State Journal — October 12, 2015, By Justin A. Hinkley State Rep says close advocates ‘comparing bananas and pickles' in savings math LANSING — A Republican lawmaker is trying to build bipartisan support to reopen the W.J. Maxey Boys Training School, taking on members of his own party who finally closed the juvenile justice facility after years of trying. mil from state # , R-Troy, would add a little over $7 million back into the state budget to reopen the Whitmore Lake facility and bring back the t. He’s gained support from six Democrats and one fellow Republican but is looking for more cosponsors in both the House and Senate to save what he called an effective and efficient facility that offered a much-needed balance to private agencies. “We need to take into consideration that we have an outlet that’s been closed, so the stream of juvenile offenders needs to find a new home,” Howrylak said Friday. “It’s not just the people who were there last week and six months ago, it’s those people that now don’t have that option.” After several failed attempts in the past, the Maxey closure was inserted in the 2016 state budget that took effect Oct. 1. Proponents of the closure — Rockford Republican state Sen. Peter MacGregor chief among them — pointed to the hundreds of dollars in additional daily cost at Maxey compared to both private facilities and the state’s remaining two juvenile justice facilities, the in Escanaba and the in Grayling. ‘, state Rep. Earl Poleski, R-Jackson, called it a difficult but simply economic decision. On its face, the math is pretty simple: The Legislature gave Maxey $10.3 million last year to run a full-fledged facility and only $2.8 million this year to care for the transferred youth and shut down the 90-acre property. That’s $7.5 million saved a But Howrylak, an accountant, said that’s “comparing bananas and pickles.” 19 DHHHS workers laid off in Maxey closure There are other costs in other parts of the state budget that aren’t factored into that math, including millions of dollars in bond debt on the facility that still has to be repaid and the fact that some private facilities receive School Aid Fund dollars to run charter schools, he said. xxxEND_PAGE:dhhs02_b0006_0079_0092_09 000088 And, Howrylak said, there’s the benefit column: Maxey costs more because it does more, offering intensive, on-site mental health services. Mental health and judges groups and state employee unions said Maxey cared for kids who’d been unsuccessful at other facilities. “f you want the private facilities to offer such treatment, or even if you want Shawono or Bay Pines to offer it, you’re going to have to put more money into it,” Howrylak said. “When you put all the numbers together and you take into consideration all the intangibles, at best it’s a wash.” The Department of Health & Human Services does «: for behavioral health services for juvenile justice, and the language closing Maxey also required contracts with private agencies be amended to say mental health services must be offered. Officials from private facilities they’re ready and capable of handling the Maxey youth. A DHHS spokesman said last week that all of Maxey’s youth were successfully transferred to the remaining two state facilities and to independent living facilities, halfway houses and private facilities in Michigan. But Midland County probate Judge Dorene Allen said Maxey “gave an option to courts that we otherwise are not going to have. “My feeling was that it was a cost that was necessary to support the rehabilitation of youth,” she said Friday. “And that’s really what this was all about, getting these kids back on their feet so they’re not part of the adult system.” Maxey hit all of its treatment goals last year, DHH 4 to lawmakers. State Rep. Mike Callton, R-Nashville, a cosponsor on Howrylak’s bill and chairman of the : said the mental health services are “an important conversation to have,” but he said he also signed on to the bill because he’d seen the negative economic impacts of prison closures in his district. “It’s devastating when a big employer like that leaves a community,” he said. Lansing Democrat Andy Schor, another cosponsor, said the Maxey closure was one of the reasons he voted against the current budget. He conceded Howrylak’s bill faced “a tough path, no doubt,” but he thought it stood a chance. “It was part of a budget, and a lot of compromises go into that,” Schor said. “Perhaps if you take this out of a budget deal and you have it stand on its own, the support will not be there to shut it down and defund it. It’s worth taking a shot.” igarn’s new guidelines for tre i ng onlate addict MLive — October 7, 2015, By Sue Thoms GRAND RAPIDS, MI — In the battle against drug addictions, Michigan can claim a first — it is the first to create detailed statewide guidelines for treating people addicted to heroin and other opiates. The guidelines draw on research showing when and how to use 12-step programs, behavioral therapy and medication, such as methadone, for the best chance of recovery. 10 xxxEND_PAGE:dhhs02_b0006_0079_0092_10 000089 Although there always have been rules regarding medications and counseling for substance abuse treatment under Medicaid, the guidelines provide far more detailed information about what works, said Lisa Miller, state opioid treatment authority. "This really takes it to the next level," she said. "Never before have we had guidelines that defined mild, moderate and severe levels of addiction and then applied medication and behavioral therapy that research has shown to be most effective for that level of addiction." One of the major goals is to provide consistency statewide, said Dr. Corey Waller, a Grand Rapids addiction medicine specialist and the director of the Center for Integrative Medicine at Spectrum Health. He served on the Medication- Assisted Treatment work group led by Miller and is the lead author of the guidelines. The report is avallakie online, An excerpt from the 68-page report, Medication Assisted Treatment Guidelines for Opioid Use Disorders, created for the Michigan Department of Health and Human Services. “If we don't create a known, consistent approach, we are going to have counties that are haves and have-nots," he said. He has made a mission of promoting the guidelines around the state, speaking to treatment agencies, town hall meetings, conferences and law enforcement officials. Although they are targeted toward the doctors and therapists who provide treatment, Miller said the guidelines can help clients and family members understand the disease of addiction and the science behind the treatment. "| think certain people have a gift for taking complex concepts and making them easy for the general public to understand," she said. "And Dr. Waller has that gift. He has written the document in such a way that it is understandable. The concepts and the reasoning behind the thoughts are very clear." The guidelines were announced in September 2014 and promoted to care providers. A revision is in the works, with specific information for law enforcement and for the treatment of adolescents and pregnant women. Eventually, the guidelines will be incorporated into contracts for treatment programs with state funding. The document aims to give providers the latest information on using medications for opiate addiction — methadone and buprenorphine, a newer drug manufactured as Suboxone, Zubsolv and Bunavail. "Things have really changed in the field of medication-assisted treatment," Miller said. "Any medical field worth its salt is learning from research and applying that research. This is what the guidelines are designed to do." Holland Sentinel — October 9, 2015, By Amy Biolchini Fewer teens in Michigan and in the Holland area are getting pregnant, statistics show. It’s a trend that health educators take pride in — but note that it’s more than good programming that has made a difference. 11 xxxEND_PAGE:dhhs02_b0006_0079_0092_11 000090 Michigan has seen a 40 percent drop in teen births over the past two decades, according to recently released data from the Michigan League for Public Policy. In 2013, the annual teen birth rate in Michigan was 24 of every 1,000 births — lower than the national average (27 per 1,000), but still much higher than other developed countries. “We still have too many babies born to teen moms — an average of almost 9,000 annually over the last three years — and that’s 9,000 babies who are more likely to live in poverty, struggle academically and suffer from health issues," said Alicia Guevara Warren, Kids Count in Michigan Project Director at the MLPP, in a statement. Of the 532 babies born in Holland from 2011 to 2013, 9.96 percent (53 babies) were born to teen mothers — and eight babies were born to teens who were already mothers. That’s a decrease from 2004-2006, when 13 percent of all babies born in Holland were to teen mothers. Rates of teen pregnancies have declined, but the rates of repeat teen pregnancies are continuing to increase, said Heather Alberda, a certified sexuality educator with the Ottawa County Department of Public Health. Though the Michigan League for Public Policy reports Holland has fewer babies born to teens who are already mothers, in Ottawa County that’s not the case. In 2011, there were 24 teen moms who became pregnant again — a figure that’s grown to 37 repeat teen moms in 2013, Alberda said. Alberda said part of the reason there’s fewer pregnancies is because teens are making better choices. In 2013, 40 percent of Ottawa County teens said they had engaged in some kind of sexual activity by the time they had graduated

enile justice center to layoff 25 workers Detroit Free Press — October 7, 2015, By Christina Hall Macomb County is planning about 25 layoffs at its juvenile justice center as the number of youth in the detention and residential treatment center has declined -- a trend that officials there said is occurring across the region and state as youth are placed in less-restrictive services. The announcement today came a day after a bi-partisan group of legislators from metro Detroit introduced a package of bills in Lansing that would raise the age when a juvenile is considered an adult in the criminal justice system from 17 to 18 years old. Michigan is one of nine states that automatically prosecutes 17-year-olds as adults, according to a release from Michigan United. The bills would allow youth to be transferred to the adult system on a case-by-case basis, state Rep. Peter Lucido, R-Shelby Township, said in a news release from the Michigan Council on Crime and Delinquency. oY Res OUE af attorney in ial desth suit Part of the legislative package would create a financial incentive for counties to use community-based programs over expensive residential facilities. Macomb County Deputy Executive Mark Deldin said the county’s 140-bed juvenile justice center — renovated a decade ago for $29 million -- has fewer than 40 youth. It is staffed for 120 youth, he said, including those from neighboring St. Clair County, which closed its underused juvenile detention facility two years ago. Now, about 25 case managers and youth specialists will be laid off in the next four to six weeks because of declining occupancy, Deldin said, calling the layoffs an “uncomfortable and unpleasant task” but one that is a “fiduciary responsibility.” xxxEND_PAGE:dhhs02_b0005_0060_0078_01 000061 The positions remain in next year’s budget and workers could be called back if there is an influx in youth. But that may not occur, in part, because juvenile court filings also are down, said Nicole Faulds, juvenile court director. Juvenile Justice Center Director Rhonda Westphal said there is an effort to reinvent the center through more training for staff, hiring a treatment manager and having more evidence-based curriculum and programs that better cater to the needs of the youth, perhaps drawing more youth to the center instead of programs elsewhere. She said the reduction in youth started about five years ago. Jad death bovourt. He was naked, fntime, no one aided “Some variables that directly impact, vary from community, is a growing trend in juvenile justice using the least restrictive services for kids,” Westphal said. Faulds said detention and residential treatment are a “last resort for a public safety issue,” adding that once youth are in detention they often don’t finish high school and end up in the adult criminal justice system. Westphal said of the state’s 19 county court-operated facilities, they have 50% or less youth in the detention or treatment facility, a trend that she said is a national one. On Monday, the 190-bed Wayne County Juvenile Detention Facility had 97 youths, said Lloyd Jackson, communications and community outreach director for the county's Department of Health, Veterans and Community Wellness. He said 21 temporary non-union positions were eliminated and 10-full time union employees were laid off at the center during Wayne County Executive Warren Evans’ restructuring process. Jackson said the decline in the number of youth at the center is attributed to diversion and youth assistance programs and in-home care facilities. Westphal told Macomb County commissioners that Oakland County Children’s Village, which offers detention, residential treatment and shelter care services, had less than 47% capacity a couple of months ago. According to the Michigan Council on Crime and Delinquency, there has been a movement in the last decade or so in the juvenile justice field to treat youth closer to home and in less-restrictive environments. The community-based programs cost less, reduce re-offending and incidents of violent youth crime, and improve youth and family well-being, experts say. In addition, the number of arrests of juveniles ages 10-16 have been dropping steadily in Michigan from 2008 to 2013, when there were 13,265 arrests. That total accounted for a very small portion of the 260,000 total arrests reported in the state that year, according to Michigan’s Statewide Juvenile Arrest Analysis Report released in June. It stated most of the juvenile crimes were for larcenies. The number of 17-year-olds arrested were 8,514 in 2013, according to the report. The statewide youth offender reform bills were introduced this week because of a growing concern of the treatment of youth in Michigan’s adult prison system, according to releases announcing the proposals. More than 20,000 youth under 18 have been sentenced as adults in Michigan during the past decade, with most convicted for nonviolent offenses and with no prior juvenile record, according to releases. The proposed changes, which follow recommendations from a recent report by the Michigan Council on Crime and Delinquency, would permit 17-year-olds to be processed in juvenile courts; prohibit youth under 18 from being sent to adult jails, and eliminate certain offenses that automatically trigger adult prosecution, such as running away from a juvenile facility, according to the council. xxxEND_PAGE:dhhs02_b0005_0060_0078_02 000062 The bills also would require public monitoring and oversight of youth under the jurisdiction of the Michigan Department of Corrections who entered for an offense committed prior to turning 18; ensure age-appropriate programming and outdoor exercise for youth under 21 in administration segregation in prison, and establish a family advisory board within the state Department of Corrections. “Seventy-percent of all 17-year-olds in Michigan’s criminal justice system come from only 10 counties,” said Kristen Staley, associate director of the Michigan Council on Crime and Delinquency, in a news release. “Of those 10, all have strong juvenile justice services like diversion, community-based programs and mentoring that are better equipped to provide the age-appropriate rehabilitation we know yields better outcomes for our youth and our communities. But, until we raise the age of juvenile court jurisdiction, these children will never have access to these great services.” OG rmullion lewsuit about Mac ab jak Earlier this month, W.J. Maxey Boys Training School, a state juvenile justice facility just outside Whitmore Lake that housed many youth from metro Detroit, closed for budgetary reasons. The start of state government’s 2016 budget year Oct. 1 marked the controversial end of the boys training school, shuttering three state-run juvenile justice facilities and upending 65 state employee jobs. The Michigan Department of Health & Human Services has scrambled over the past several months to find new placement for juveniles and employees after the Legislature — over the objection of state employee unions and mental health groups — finally made good on years of trying to close the 60-bed facility for offenders ages 12 to 21. All of the 48 youth have been successfully placed, Department of Health & Human Services spokesman Bob Wheaton said in an e-mail to the Lansing State Journal. Official calls clasing of Whitmore Lake facility ‘a shame’ 9 & 10 News — October 8, 2015 WHITMORE LAKE, Mich. (AP) - The supervisor of a township in Livingston County says it's "a shame" that the state closed a juvenile justice facility in a nearby community west of Detroit. Three state-f run juvenile justice facilities, including W.J. Maxey Boys Training School in Whitmore Lake, were shuttered reports that the Department of Health and Human Services has been working over the past several months to find new placement for juveniles and 65 state employees who were affected by the decision. Green Oak Township Supervisor Mark St. Charles says it's too bad the Maxey kids were "uprooted" but they've been reassigned to different facilities. Maxey was a 60-bed facility that housed offenders ages 12 to 21. Information from: Livingston Daily Press & Argus, xxxEND_PAGE:dhhs02_b0005_0060_0078_03 000063 Snyder announces Si2-million plan to fix Detroit Free Press — October 8, 2015, by John Wisely Gov. Rick Snyder said today that he has a plan to come up with the $12 million needed to reconnect Flint to the Detroit water system to address elevated lead levels. Snyder said he will ask the Legislature for $6 million. The C.S. Mott Foundation, a Flint-based nonprofit founded by auto pioneer Charles Stewart Mott, has pledged another $4 million, and the City of Flint will provide the additional $2 million

cases at Detroit hosnital itical feac ge ls fed ed by the AMfordable e “ORta s children who experis Stete fo announce Flint water action nian Friday ef Kettering MLive — October 1, 2015, By Ron Fonger FLINT, MI — Local, state and federal officials are set to announce a plan for addressing concerns with igae in: Fire's drinking water at a news conference Friday, Oct. 2. An advisory from the Michigan Department of Environmental Quality said leaders will announce the plan at 1:30 p.m. at Kettering University. documented by researchers from Virginia Tech university and a study by a Hurley Medical Center doctor that showed the number of children in the city with elevated blood levels nearly doubled after the city started using the Flint River as its water source in 2014. Brad Wurfel, director of communications for the DEQ, said Thursday, Oct. 1, that Sav, Bick Snyder cannot attend the news conference. Snyder said earlier this week that he expected state officials to announce plans to deal with the lead in water issue by Friday, saying, “There are probably some things that weren't as fully understood when that switch was made." The state oversees water quality in Flint, and state-appointed emergency managers were running city government when decisions were made not to negotiate a short-term agreement to continue buying Lake Huron water from Detroit and to instead use the river as a water source. xxxEND_PAGE:dhhs02_b0004_0035_0059_01 000036 Although the city is not currently in violation of the Safe Drinking Water Act, bacteria, the level of total trihalomethanes and lead have been problems in the water system since then. Among those scheduled to attend the news conference are Mayor Dayne Walling; Harvey Hollins, director of the state Office of Urban Initiatives; Dan Wyant, director of the Michigan DEQ; Nick Lyon, director of the Michigan Department of Health and Human Services; and Dr. Eden Wells, chief medical executive of the state Department of Health and Human Services, the news release said. Wurfel would not discuss the plan in advance of the news conference, but officials in local, state and the federal government have called for a variety of actions in recent weeks. Among them: Funding for home water fituys, additional testing of city water and reconnection of Flint to the Detroit water system. "We're looking forward to coming to Flint. We recognize lead is a concern in the city," Wurfel said. f2015/iisstate will announce flint wate. ors take action to fix Flirt Detroit Free Press — October 1, 2015, 5, tilonn | ray LANSING — The Michigan Legislature is beginning to take notice of the ongoing controversy surrounding Flint’s water system, which has been plagued by problems with discoloration and foul smells since the city disconnected from the Detroit water system and began pulling its water supply from the Flint River. The state Senate approved a supplemental appropriations bill that included a $100 placeholder while the state looks for a solution to the water issue. “We want to make sure we have an accurate number. We didn’t want to put too much in or not enough,” said state Sen. Jim Ananich, D-Flint. “We want to get an accurate understanding of what it’s going to cost to get us the help that we need.” The appropriation comes on the heels of Gov. Rick Snyder telling reporters on Wednesday that he’ll have some more answers on the state’s role in fixing Flint’s water problems by the end of the week. The state Departments of Environmental Quality and Health and Human Services is scheduled to hold a news conference at 1:30 p.m. in Flint Friday to discuss a comprehensive plan to deal with Flint's controversial water system. It also occurred as the Genesee County Board of Commissioners and Health Department to Flint residents on Thursday, telling them to refrain from drinking the city water unless it was filtered through a certified filtration device or had been tested and showed that it doesn't contain elevated lead levels. "Since no safe level (of lead) has been identified, it is in everyone’s interest to reduce exposure to lead as much as possible," the emergency advisory stated. Jamie Curtis, chairman of the commissioners, said they had little enics: Curtis said he had asked the state last week for a response after a Hurley Medical Center pediatrician 3 the city began pulling water from the Flint River. But instead of hearing from the state, he read in the Free Press Wednesday that Gov. Rick Snyder publicly acknowledged that Flint's water supply "appears" to have problems. That, Curtis said, was in conflict with assurances from state officials earlier this year that the water was safe. xxxEND_PAGE:dhhs02_b0004_0035_0059_02 000037 “It wasn’t our fight,” Curtis said of the decision to change water systems in 2014 and to temporarily pull water from the Flint River. “I (couldn’t) care less who’s at fault ... but now we need to deal with this health issue. In six years | don’t want 5- and 6-year-olds going to school with lead poisoning.” s achon coming on Fhint’s water woes An anonymous benefactor and the state have begun distributing water filters to Flint residents in recent weeks after the Hurley doctor spotted what she said are increasing lead levels in Flint children. The state has spent $4.2 million already this year, said Snyder spokeswoman Sara Wurfel, including $2 million from the distressed communities grant program for water infrastructure work and some help with bonding that helped save the city another $2.2 million. “We’ve been actively working that issue for a significant period of time and providing additional resources recently,” Snyder said. “| would expect us to have more to talk about by the end of the week, and how we’re partnering with Flint and the federal government on this.” Lead-poisoned Flint buls will pay price for water switch In 2014, cit ace with the f:% rt saying that water costs were too high. They opted instead to pull from the Karegnondi Water Authority, which is building a system to supply Genesee County with water pulled from Lake Huron. In the long run, this will mean lower water costs, officials have said, adding that water from the Detroit system will cost $1.5 million more a month than the city is paying now. But until the new system comes online in 2016, Flint is temporarily pulling water from the Flint River. Since it made the switch, residents have complained that the water smells, is discolored and makes them sick. And the } recently found that the number of Flint children with elevated blood-lead levels — 5 micrograms per deciliter or more — jumped from 2.1% in the 20 months prior to Sept. 15, 2013, to 4.0% between Jan. 1 and Sept. 15 this year. In certain ZIP codes, the change was even more troubling, she said — jumping from 2.5% of the children tested to 6.3%. Ananich said filters need to be made available to affected residents, especially vulnerable citizens like children and senior citizens, and the corrosion in the water system pipes needs to be addressed. “And | think we need to move to a new water source, potentially going back to Detroit,” he said. “Filters can do a lot of good, corrosion control can do some good. But a new water source has to happen and it has to happen soon.” In addition to the action at the state level, the Flint-based Coalition for Clean Water, the American Civil Liberties Union of Michigan, and the Natural Resources Defense Council has petitioned the U.S. Environmental Protection Agency to take emergency action to ensure that Flint has safe drinking water. The petition urges the EPA to reconnect Flint to the Detroit water system and provide safe water to city residents until that can happen. “Flint city officials, state-appointed emergency managers and the Michigan Department of Environmental Quality have all failed monumentally in their duty to provide the people of Flint with clean, safe drinking water. Now that the truth is revealed, further action is imperative,” said Kary L. Moss, ACLU of Michigan executive director, in a statement. In addition to the money for the Flint water issue, the appropriations bill approved by the Senate also included a $7.7- million settlement of a lawsuit filed by a Flint woman whose car was hit by a Michigan State Police trooper who was pursuing a driver who refused to stop for a seat-belt violation. ‘in the July 3, 2014, crash and another passenger, Jacqueline Nichols, 64, of Flint, was killed. Trooper Timothy Fagin received undisclosed discipline after the crash and remains a state trooper xxxEND_PAGE:dhhs02_b0004_0035_0059_03 000038 Michigan Radio — October 1, 2015, By Mark Brush Yesterday, Gov. Rick Snyder admitted that the decision to switch the city of Flint's water supply from Detroit's system over to the Flint River was not well planned. “In terms of a mistake, what | would say is, is there are probably things that were not as fully understood as when that switch was made,” Snyder said. At the direction of the state-appointed emergency manager, the city made the switch in April 2014, and problems with the drinking water started soon after. People complained of brown water. There were boil-water advisories after the water was found to have E. coli contamination, and the drinking water also had unsafe levels of a chlorine byproduct (total trinalomethanes). Fast forward almost a year and a half, and now we learn some residents in the city are being exposed to unsafe levels of lead in their drinking water. How could one of Michigan’s major cities be facing this problem? Marc Edwards, a civil engineering professor from Virginia Tech University and a nationally renowned expert on water treatment, has put the blame squarely on the agency in charge of overseeing the safety of Flint’s drinking water, the Michigan Department of Environmental Quality. Listen io our conversation with Edwards ners: Edwards day in which he writes: Given MDEC(’s insistence that there is absolutely nothing wrong with Hint water, we have created a timeline that illustrates how MDEQ’s mistakes and deception created the Hint water crisis in the first place. In his timeline, Edwards says the state failed to require that the city have a corrosion-control program in place when the city switched over to Flint River water. Edwards says current estimates are that Flint has about 15,000 drinking water service lines made of lead. “What we discovered to our shock was that they switched to a new water source that was obviously very corrosive, meaning it would eat up the lead pipe and iron pipe and essentially put the metals into the water, without controlling the corrosion,” Edwards says. “And this is a horrible idea in a city full of lead plumbing and lead pipe like Flint.” Edwards says current estimates are that Flint has about 15,000 drinking water service lines made of lead. How dangerous metals can get into drinking water When water flows through copper and lead pipes, it can take up some of the metal and make the water unsafe. To control for this problem, the Environmental Protection Agency has what’s called a “lead and copper rule." xxxEND_PAGE:dhhs02_b0004_0035_0059_04 000039 The purpose of the rule is listed in this “ Protect public health by minimizing lead (Pb} and copper (Cu} levels in drinking water, primarily by reducing water corrosivity. Pb and Cu enter drinking water mainly from corrosion of Pb and Cu containing plumbing materials. To keep these metals from leaching into drinking water, municipal treatment plants can change the water chemistry to lower the water’s ability to corrode these pipes. It’s called “corrosion control,” and Edwards says the Michigan Department of Environmental Quality covered up the fact that Flint had no corrosion control program in place. “Before you switch to a new water source, six months to a year ahead of time, you are supposed to do laboratory experiments to determine the corrosivity of the water,” says Edwards. “And the chemistry — the pH, the alkalinity, and the phosphate that you need to make sure that the lead stays on the pipes and out of the water.” Edwards contends that the new water system had to have a “corrosion control” plan in place so that “you’re not doing an uncontrolled human experiment on a city’s population.” : 371, a state MDEQ official, Stephen Busch, responded to a request

e | rar will h Soseteiers gays Detroit Free Press e_Septerber 3 30, 2015, oO Robin Erb The salmonella that is believed to have sickened 14 patients at Henry Ford Hospital last week is the "relatively rare" strain called Salmonella Isangi, according to the state health department. It's a strain so rare, state officials have asked the U.S. Centers for Disease Control & Prevention for more information about it, said Jim Collins, director of the communicable diseases division of the Michigan Department of Health and Human Services. Though there are no other clusters currently reported in the state or even elsewhere in the U.S., "it's got a name, so it's not unheard of," he said. Though other types of salmonella are not uncommon, Salmonella Isangi has been reported just four times in the past five years in Michigan, he added. Still, what that means is still unclear. Henry Ford Hospital officials are investigating the outbreak, but have released few other details including whether a source has been identified. Collins said hospital officials reported the cases, as mandated, to the state and are currently working with state health officials to identify the cause. "They're looking at what procedures these people received, where they stayed at the hospital, and who their health care workers were while they were there," Collins said. xxxEND_PAGE:dhhs02_b0003_0020_0034_01 000021 While experts say salmonella is most often food-borne, Henry Ford officials say they don't believe this outbreak is food- related. h Syatem fo ianld SELGM cancer center Seven patients remained in the hospital today and had been isolated as a precaution, a statement said. The hospital did not disclose the condition of the other seven and Collins said details weren't immediately available. No new patients were identified this week, according to the hospital statement. "Salmonella is not typically life-threatening and, in most cases, goes away in less than a week, even if untreated," the Henry Ford statement said. Michigan, d nhatie over igspections, raw milk Various strains of salmonella are estimated to cause 1 million illnesses throughout the U.S. each year, resulting in 19,000 hospitalizations and 380 deaths, according to the U.S. Centers for Disease Control & Prevention. The infections are usually traced to raw or undercooked meat, poultry, eggs or egg products, according * £ . People also can get infected by touching contaminated surfaces or even pets, then putting their fingers in their mouths. Symptoms of infection include nausea, vomiting, abdominal cramps, diarrhea, fever, chills, headache and bloody stool. counties FOX — September 30, 2015, By Jacob Burbrink alized following 20710 oil sollin Calhoun, The Michigan Department of Health and Human Services (MDHHS) has finalized a public health assessment connected to the July 2010 oil spill in Calhoun and Kalamazoo counties. A news release from MDHHS said the public health assessment evaluated the levels of oil-related chemicals in the air following the oil spill. The assessment concluded residents are not expected to experience long-term harm to their health from breathing chemicals released into the air from the spilled oil. People who breathed oil-related chemicals in the air from the time of the spill to August 18, 2010, reported temporary health effects including: headaches, nausea, respiratory discomfort, and eye irritation. The release said by August 18, 2010, concentrations of oil-related chemicals in the air had fallen below human health screening levels that protect the public, including vulnerable populations such as children, the elderly, and those with preexisting illnesses. Also in the assessment, MDHHS said air monitoring near cleanup sites in 2011 and 2012 did not find oil-related chemicals in the air at concentrations exceeding the human health screening levels. People can read the Public Health Assessment online on the MiH or at the following locations: e = Marshall District Library, located at 124 W. Green St. in Marshall e = Willard Library, located at 7 W. Van Buren St. in Battle Creek e Galesburg Memorial Library, located at 188 E. Michigan Ave. in Galesburg 2 xxxEND_PAGE:dhhs02_b0003_0020_0034_02 000022 ed-followinge-2010-oif soilin- WZZM — September 30, 2015 LANSING, Mich. (WZZM) -- Residents affected by the 2010 Enbridge oil spill can now breathe easy, at least according to the latest study from the Michigan Department of Health and Human Services. The public health assessment concluded that residents who breathed in chemicals released into the air by the oil spill are not expected to experience long-term harm to their health. In July 2010, when residents breathed in oil-related chemicals, they reported headaches, nausea, respiratory problems, and eye irritation. A month later, concentrations of oil-related chemicals in the air had fallen to below human health screen levels. The last air monitoring in 2012 found there were no chemicals in the air that would be harmful to humans. The study concluded that residents did not breath in oil-related chemicals long enough or at high enough levels to cause long-term health effects. «. It's also available at the If you would like to read a copy of the public health assessment, libraries in Marshall, Battle Creek and Galesburg. Problems unlikely from breathing <alarnezoo River oll spill chemicals in 2070 WNDU - September 30, 2015 LANSING, Mich. State officials say people living near the site of an oil spill that fouled the Kalamazoo River in July 2010 probably won't have long-term health problems from breathing chemicals released into the air. In an analysis released Wednesday, the Michigan Department of Health and Human Services says some residents who inhaled oil-related chemicals after the spill reported symptoms including headaches, nausea, breathing discomfort and eye irritation. But the department says air monitoring in the next two years found no oil-related chemicals at dangerous concentrations. It says people did not breathe such chemicals long enough or at levels high enough to have long-term effects. The department says its analysis doesn't apply to people who worked on cleanup of 843,000 gallons of oil from a ruptured Enbridge Inc. pipeline in Calhoun County. o Carnpbell Unregulated orescribing authority wrong move The Detroit News — October 1, 2015, By Fred Campbell, President, Michigan Society of Anesthesiologists 3 xxxEND_PAGE:dhhs02_b0003_0020_0034_03 000023 At the beginning of the summer, Gov. Rick Snyder announced the formation of a “Prescription Drug and Opioid Abuse Task Force.” It was an important move and perhaps an even more important acknowledgment — Michigan is facing a prescription drug abuse crisis. According to the Michigan Department of Health and Human Services, a record 1,533 people lost their lives to a drug overdose in Michigan in 2013 — with prescription pain killers resulting in more deaths than any other drug. Now U.S. Attorney Barbara McQuade and law enforcement have weighed in, publicly calling out Michigan as a “drug pipeline” with pushers illegally pumping highly addictive prescription pain killers across the Midwest. The Detroit News hit the nail on the head last week when it urged law enforcement to work with health care providers to limit prescriptions of these highly addictive opioids (Re: The Sept. 24 editorial, “? buses”), Unfortunately, lawmakers in Lansing are poised to pass a new bill that could make this crisis much worse. Senate Bill 320 would for the first time give full prescribing authority to 3,000 certified registered nurse anesthetists, without requiring any additional training. What’s more, it would remove all physician oversight of opioid prescription by nurse anesthetists. The Department of Health and Human Services recently reported that between 2009 and 2012, 36 percent of fatal drug overdose victims had obtained prescriptions from five or more prescribers in the year before their deaths. The more prescribers, and the less oversight, the worse the problem. Adding 3,000 new prescribers overnight will only drive those numbers higher and exacerbate Michigan’s opioid abuse crisis. Gov. Snyder and Lt. Gov. Brian Calley are taking important steps to combat Michigan’s prescription drug abuse crisis. And law enforcement is fighting back. But just when policymakers, physicians, and drug treatment experts are picking up steam in their battle to address opioid abuse, Senate Bill 320 would make it worse. We strongly urge lawmakers reject this dangerous legislation. sionals learn about traum You Daily Globe — October 1, 2015, By Tom Stankard The Michigan Department of Health and Human Services teamed with Western Michigan University to create a trauma- informed system of care for children and their families in child welfare. According to the MDHHS, trauma is the emotional response to an event, or series of events, that threatens or causes harm. Dr. James Henry Child Trauma Assessment Center Director at WMU said the effects of trauma can interfere with normal development and can have lasting adverse effects on children. xxxEND_PAGE:dhhs02_b0003_0020_0034_04 000024 To educate and inform welfare professionals about traumatic stress, Henry spoke Monday about building trauma resilience case plans for children and families. Then, on Tuesday, Henry emphasized the importance of identifying and addressing secondary traumatic stress within child welfare professionals. Approximately 40 professionals attended the training session Tuesday to watch and participate in a session. Henry divided people into four groups according to how they deal with secondary traumatic stress. There was a physical, social, emotional and cognitive group. Henry said most people were in the physical group. Henry said the point of the exercise was to show how secondary traumatic stress affects the workplace. People returned to their seats and Henry gave a keynote presentation. To begin, Henry said the first step to addressing the problem is to "name it and contain it."

packyare The Associated Press — September 29, 2015, By Ricardo Alonso-Zaldivar WASHINGTON (AP) — Medicare paid $30 million for ambulance rides for which no record exists that patients got medical care at their destination, the place where they were picked up or other critical information. The mystery ambulance rides are part of a bigger problem with Medicare payments for transporting patients, according to a federal audit being released Tuesday. The Department of Health and Human Services' inspector general's office also found that some urban ambulance services got paid for an average distance of more than 100 miles per ride. That contrasts with a national average of just 10 miles for urban ambulance rides. Four major metro areas seemed to be breeding grounds for ambulance schemes. Philadelphia, Los Angeles, New York and Houston accounted for about half of the questionable rides and payments. Medicare has barred new ambulance companies from joining the program in Houston and Philadelphia, and the report recommends a similar approach in certain other places. Across the country, 1 in 5 ambulance companies had at least some questionable billings. "Medicare payments for ambulance transports have increased in recent years, and investigators have uncovered a variety of fraud schemes involving ambulance suppliers," the report said. The audit involves medical claims dating to the first six months of 2012, but the inspector general's office said it believes the findings reflect continuing weaknesses in Medicare's efforts against fraud. A Medicare spokesman says the agency has taken action since the auditors privately shared their findings last year. Investigators went to great lengths to try to explain the $30 million in mystery ambulance rides. The report said they did not count any cases in which the patient died within a day of being transported by ambulance. On the chance that some billers might have incorrectly reported pickup and drop-off locations, auditors checked if the patient might have gotten care related to their ambulance ride at another location. They scrutinized Medicare's xxxEND_PAGE:dhhs02_b0002_0012_0019_1 000013 inpatient, outpatient, nursing home, hospice, and physician claims databases. To account for tardy bills, they kept watch for a whole year. In the end, they were stumped. "The transports may not have occurred," the report said. For 46 ambulance companies, there was no record that patients got medical services in more than 9 out of 10 of the rides they billed for. Medicare has a longstanding problem with ambulance fraud, investigators said. Over the past decade or so the total cost of ambulance rides has risen sharply. Medicare's Part B, which covers outpatient care, paid $5.8 billion for ambulance rides in 2012, almost double the amount paid in 2003. The audit scrutinized 7.3 million ambulance rides in the first half of 2012. In addition to the mystery transports, investigators found that Medicare paid $24 million for ambulance rides that didn't meet program requirements for payment. In its formal response, Medicare said it has developed a comprehensive strategy to combat ambulance fraud and abuse. A spokesman said separately that Medicare is now requiring prior approval for repeat non-emergency ambulance rides in New Jersey, Pennsylvania and South Carolina. Next year that requirement will be extended to Delaware, Maryland, North Carolina, Virginia and West Virginia, plus Washington, D.C. Medicare is also considering barring new ambulance companies from joining the program in fraud-prone areas. Fraud costs the health care system tens of billions of dollars a year. Medicare is especially vulnerable because Congress requires the program to pay claims promptly in most cases. That has given rise to the frustrating condition that law enforcement officials call "pay and chase." The inspector general recommended that Medicare use its existing legal authority to require more documentation from ambulance companies and to give its billing contractors additional options to hold off paying claims that don't seem to meet basic requirements. pep: Cadillac News — September 29, 2015, By Rick Charmoli You might be shocked to know that Michigan ranks second only behind Nevada in human trafficking. If that doesn’t shock you, maybe this will: The government estimates that in West Michigan alone, there are 2,400 minors for sale at any given time, mostly on the Internet. For those who don’t know, human trafficking is a form of modern-day slavery. Victims of human trafficking are subjected to force, fraud or coercion for the purpose of commercial sex or forced labor. They are young children, teenagers, men and women. Trafficking in persons occurs throughout the world, including in the United States and Michigan. Michigan Attorney General Bill Schuette is aware of the problem. According to the AG’s office, human trafficking is not a choice. A person cannot consent to become enslaved. Victims want to escape but cannot. Human trafficking is not smuggling. Smuggling is transportation; trafficking is exploitation. Representatives of the attorney general also explained that human trafficking does not require that a victim be moved over state or international borders. It is a $32 billion global industry. 2 xxxEND_PAGE:dhhs02_b0002_0012_0019_2 000014 Luther Lovell said Michigan has seen human trafficking increase dramatically over the past few years. Although Lovell is the Mecosta/Osceola Michigan Department of Health and Human Services director, he also is a member of the Northern Michigan Coalition to End Human Trafficking and simply a concerned citizen. Lovell said that two years ago, Michigan ranked 15th in the nation in human trafficking and jumped 10 spots to fifth in 2014. He added that although the attorney general’s office is saying there are 2,400 minors for sale on the Internet in West Michigan, it is hard to really know exactly how many cases there are. With that in mind, Lovell said the coalition decided to organize an event to raise awareness of human trafficking. The two-day Northern Michigan Human Trafficking Awareness Summit is scheduled for Oct. 23 and 24 and will be held at the Cherry Grove Event Center. “What we wanted to do, whether we have one or 100 cases, we want the community to be prepared as muchas possible — people don’t know it exists,” Lovell said. “We aren’t going to be looking at solutions, but we do want to make the community aware.” Lovell said the first day of the summit is intended for the general public while the second day aims to rally the local faith- based community. October’s event won't be the first time human trafficking has been the subject of such an event. This past weekend, the Women of the Evangelical Lutheran Church in America held its annual conference in Tustin. The subject of the conference was services for prostituted, addicted and trafficked women. Vince Schumacher of the Our Sisters organization was the keynote speaker. Our Sisters is working in the Grand Rapids area to create a way to help prostituted and addicted women escape “the life.” Barbara Hazlett is the anti-human trafficking chairwoman for the North/West Michigan Synod of the Evangelical Lutheran Church in America and helped to organize last weekend’s event. She said the anti-human trafficking theme has been ongoing since July 2014. Living in Northern Michigan, and Tustin in particular, Hazlett said she believes a lot of people are like ostriches with their heads in the sand about human trafficking, and most people in the area probably think it is something that happens in Detroit or Grand Rapids but not here. Hazlett said thanks to groups such as Our Sisters and even the local Cadillac Area Ministerial Association, the word is starting to get out there, but more work needs to be done. “It is sad we are not aware of it,” she said. “Awareness and communication are the two things we need to promote so people know exactly what is happening.” For more information about the upcoming summit in Cadillac, go to nmicoalitiontoendht.com. Detroit Free Press — September 29, 2015, By Paul Egan LANSING — Michigan Gov. Rick Snyder said Tuesday the drinking water situation in Flint is a serious issue and he expects the state to come forward with "action steps" by early next week. 3 xxxEND_PAGE:dhhs02_b0002_0012_0019_3 000015 Snyder did not answer directly when asked if he thinks the drinking water in Flint is contributing to elevated lead levels in children there. But he told reporters "a large team of people" in state government is working hard on the Flint drinking water issue. “During the course of the week or early next week we hopefully will be coming out with more public action steps," some of which are already under way, and others to be implemented, Snyder said. wh law writ large mn B water crisis "I take it as a serious issue; the Flint water situation," Snyder said in Lansing. "Lead is a serious issue, so again, we're spending a lot of time and effort looking at this and trying to partner with the people in Flint on that issue." Flint's drinking water has had odor and taste problems since the city, awaiting a hook-up to Lake Huron water expected next year, stopped getting its supply from the Detroit water department in 2014 and switched to the Flint River. Lead-poisonod Flint kuls ell pay price for water s Senate Minority Leader Jim Ananich, D-Flint, has urged Snyder to help Flint return to the Detroit water system, which also has Lake Huron as its source. Mona Hanna-Attisha, a researcher at Flint's Hurley Medical Center, analyzed blood-lead level information collected as part of a routine screening process, and found that the percentage of Flint children with elevated blood-lead levels has increased significantly since the city started pumping water from the Flint River in April 2014. In some ZIP codes — those considered most at-risk — the percentage of kids affected by lead has doubled. The Michigan Department of Health and Human Services said the increase was "seasonal and not related to the water supply." But a * i; found that the numbers that provide the basis for a chart the state released Thursday, indicating seasonal changes, support the Hurley data. The Hurley data shows that percentage of kids under 5 with elevated lead-blood levels increased from 2.1% before the water supply switch to 4% after, across the city. In high-risk ZIP codes, the percentage of affected kids was larger, from 2.5% before the switch to 6.3% after. The state's data, which includes a larger sample size of children under 16, show that before the switch to Flint River water, 2.37% of Flint kids had elevated blood-lead levels; after the switch, it was 3.21%, a significant increase not just because it's a reversal of the trend, but because it shows that a much larger percentage of Flint kids were lead-poisoned than in the previous year. fe-acterrcorn lint-water/73033400/ Rito swwow freep /envder-3 Water Online — September 29, 2015, By Sara Jerome In some ways, the tap water problems that have plagued Flint, MI, for over a year seem to become worse with each new revelation. xxxEND_PAGE:dhhs02_b0002_0012_0019_4 000016 “(The city’s] ongoing water woes are now associated with an immediate and irreversible danger — possible lead poisoning of some of the city’s children,” the Detroit Free Press repartee, citing an assessment of blood test results by a Hurley Children’s Hospital pediatrician. “Some doctors urged Flint to stop using the Flint River for water after finding high levels of lead in the blood of children, an extraordinary health warning in an ongoing controversy over the city's water supply,” the Associated Press renartec. Mona Hanna-Attisha of Michigan State University’s College of Human Medicine explained the implications of the findings. “| was hoping not to find anything, but what we found ... is concerning," she said, per the Free Press. “This is not something you mess around with. Our population already has so many issues from poverty, from unemployment, from violence.” Flint has faced water challenges, including E. coli and high trihalomethane levels, since it stopped using Detroit's water supply over a year ago and became responsible for its own treatment processes. After the switch to Flint River water, residents began reporting “skin rashes and their hair falling out, likely caused by the chlorine used to kill the E. coli," Michigan Radio ragarted. Experts employed by the state had a different take on Flint River water. Brad Wurfel, spokesman at the Department of Environmental Quality, said, per the Associated Press: "Flint's drinking water is safe in that it's meeting state and federal standards. The system has an aging portion that needs to be addressed. They haven't had meaningful maintenance for four decades or more." Department of Health and Human Services Spokeswoman Geralyn Lasher said of the findings, per to the AP: "Our experts want a better sense of how they got there. The data that we have is a much larger set of data. We're not seeing what those numbers look like.” Tests by Virginia Tech researchers indicated that nearly 17 percent of Flint samples showed 15 ppb of lead or more. The EPA says that “if lead concentrations exceed an action level of 15 ppb...in more than 10 percent of customer taps sampled, the system must undertake a number of additional actions to control corrosion.” For additional stories, visit Water Online’s Source Water Cantemination Solutions Center. ap bite Aan, Michigan Radio — September 28, 2015, Ryan Grimes Last year, Flint ended five decades of service from the Detroit Water and Sewerage Department. The city’s going to take its water from a new pipeline from Lake Huron, but that won’t be ready until sometime next year. In the meantime, Flint decided that rather than continuing to pay for Detroit water, it would get its drinking water from the Flint River. Almost immediately after making that change, residents began complaining about the way their drinking water looked, smelled and tasted. There were issues with the chemicals used to treat the river water. And now a stuay Herfontied by Bediatrician Dr. Mona Hanna: Attisha of the Hurley Medical Center has ? j 4 since the switch to the Flint River water. xxxEND_PAGE:dhhs02_b0002_0012_0019_5 000017 Hanna-Attisha says she looked at the blood lead levels of Flint residents from before and after the switch, and noticed that the percentage of children with elevated blood lead levels just about doubled. “Pre-switch percent of children with elevated blood (lead) levels was 2.1%, and then after the switch it was 4%,” she says. She adds that the data for children in the rest of Genessee County, which is sticking with Detroit water until the new pipeline is ready, showed no statistical change in blood lead levels. Even more troubling, Hanna-Attisha says that state and national data showed blood lead levels in children dropping consistently year over year before the switch due to, “great public health efforts and education efforts and lead abatement efforts.” “Whenever you see that percentage staying the same or that percentage increasing, that is a red flag,” she says. There has been some concern surrounding Flint’s infrastructure and how it affects the quality of the water, but Hanna- Attisha says that’s not the key factor here. “Infrastructure has a role, but this infrastructure hasn’t changed. It was old then, it is old now, but these levels have increased. So what’s changed is... the water,” she says. She explains that the Flint River water is more corrosive than the water from Lake Huron, so it is aging Flint’s existing water infrastructure and causing the leaching of lead from these pipes. According to Hanna-Attisha, “mountains and mountains of research” show that lead poisoning is linked with decreased IQ, behavioral issues, ADHD-like symptoms, and higher rates of violent offenses and incarcerations. “It’s just one of the absolute worst things that you could do for the life course of a child,” Hanna-Attisha says. The State Department of Health and Human Services, the Department of Environmental Quality and the Governor's office have downplayed and in some cases attempted to discredit Hanna-Attisha’s findings, but she isn’t swayed. “| think it’s fascinating, because if you look at their data, it pretty much shows the exact same thing. Every year there was a decrease in the total percentage of kids with elevated blood lead levels, and then the year after the switch it jumped up.” she says. “You can’t fight the numbers, the numbers are there, everything is consistent.” Hanna-Attisha advises that children, formula-fed infants and pregnant mothers in the area avoid tap water. As for everyone else, she suggests running the water for five or so minutes before using it and only using cold water for cooking. Here's a: + for those trying to get a better understanding of the complicated water issues in Flint. he ings MLive — September 28, 2015, By Sue Thoms GRAND RAPIDS, MI - The Kent County Health Department is offering shingles vaccines at minimal cost to adults who don't have insurance that covers them. xxxEND_PAGE:dhhs02_b0002_0012_0019_6 000018 Two hundred doses of the vaccine were provided to the county from the Michigan Department of Health and Human Services. Although the Zostavax vaccine typically costs $197 at the health department, the vaccines will be provided to people 60 and older for the cost of the vaccine's administrative fee — while supplies last. The fee, based on a sliding scale, tops out at $23. Shingles is a virus that causes a painful skin rash that can last two to four weeks and can cause nerve pain that lasts for months. It is caused by the varicella zoster virus — the same one that causes chickenpox. It lies dormant in the body and can cause shingles years later. Anyone who recovered from chickenpox is at risk, but the risk increases with age, according to the Centers for Disease Control. "The CDC recommends people 60 years of age or older should get a shingles vaccine," said Adam London, administrative health officer for Kent County. "Studies show that almost every American 40 years of age and up had chickenpox at some point, even if they don't remember getting it. Because the varicella-zoster virus lays dormant in your system, you can develop shingles without any warning signs." The shingles vaccine is not recommended for the following: © Those who experienced a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine. * Those with weakened immune systems because of HIV/AIDS, or who have been treated with drugs that affect the immune system (i.e. steroids, radiation or chemotherapy) ¢ Anyone who has been diagnosed with cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma. ¢ Women who are or might be pregnant. Vaccines are available by appointment at the health department's four clinics. Those interested can call 616.632.7200 for information. Qetober is "ime te think salmon Midland Daily News — September 28, 2015, By Steve Griffin Michigan salmon fans can get in on both ends of the state’s program in October: visiting a facility where eggs and milt are taken to produce the next generation of coho and Chinook salmon, and/or buying surplus salmon to eat. (Granted, it’s what happens between those extremes, when salmon should fill harbors and rivers, and anglers’ coolers and memories, that’s seemed flaky this summer and early fall — fishing generally regarded as poor.) Salmon typically swim upstream as far as they can before settling in to spawn; the DNR installs weirs, temporary barriers, to create such an upstream limit at which to collect fish and their eggs. Eggs go to hatcheries, and fish to market. This fall, three weirs will offer school groups and individuals tours of egg-taking facilities: on the Boardman River in downtown Traverse City, the Little Manistee in Manistee County, and the Platte near Honor in Benzie County. Both Chinook and coho are collected on the Boardman, Chinook on the Little Manistee, and coho on the Platte. 7 xxxEND_PAGE:dhhs02_b0002_0012_0019_7 000019 It’s worth noting that all three of those northern Michigan locations are splendid places to visit in autumn. Interpreters from the DNR’s Carl T. Johnson Hunt and Fish Center at Cadillac will explain how salmon, weirs and fish ladders, egg collection and fish hatcheries, and invasive species all interact in the complex Great Lakes fisheries and ecosystem. The DNR says its tour programs tie in components of history, ecology, biology and stewardship. Boardman River Weir tours are expected to run through mid-October, at various times on Fridays, Saturdays and Sundays and, for groups, by appointment. The Platte River facility plans its tours during egg-taking for October 14-16 and October 19-20, with more tours on Saturdays and Sundays. The Little Manistee weir plans to take eggs October 5-9, with public tours each day; the schedule could vary based on fish readiness, so it’s best to call and confirm on the weir hotline at 231-775-9727, ext. 6072. I'd double-check with the Platte (231-325-4611) and Boardman (231-922-5280) facilities, too. Fall’s a great time for a drive, but why chance disappointment? To schedule a tour at any of the locations, visit and click on the facility under the “School Group Programs” section. Weirs send eggs to hatcheries — and some of the weir-harvested egg providers to market for public sale. American- Canadian Fisheries, the contractor harvesting salmon for the DNR, pays the agency a flat per-pound rate, then directs salmon products into human and pet food, and bait and caviar markets. (The Michigan Department of Health and Human Services does recommend caution when eating certain ITE and sizes of fish from Michigan lakes and streams; check out the Eat Safe Fish Guide available online at miuchigar & or by contacting MDHHS at 1-800-648-6942.) Michigan retailers selling salmon harvested at DNR weirs include: Andy’s Tackle Box, Brethren; AuSable River Store, Oscoda; Hank and Sons, Brethren; Lixie’s Fish Market, East Tawas; R&J Resort, Brethren; Tippy Dam Campground, Wellston; and Wellman’s Bait & Tackle, Oscoda. Any of them, like any of the weirs, could be a good destination for an early-fall road trip. ; xxxEND_PAGE:dhhs02_b0002_0012_0019_8

sue to Wy Click On Detroit — September 25, 2015 Health officials say woman died due to complications from virus OAKLAND COUNTY, Mich. - The Michigan Department of Health and Human Services has confirmed an 81-year-old woman from Oakland County died due to complications from West Nile Virus (WNV), the Oakland County Health Division announced Friday morning. She is the first human WNV-related death in Oakland County since 2003 and the first this year in Michigan. "This is a tragic reminder of how severe West Nile Virus can be, especially for adults over 50 who are at greater risk for severe illness," said George Miller, director of Oakland County Department of Health and Human Services. “We strongly encourage residents to protect themselves and family members from mosquitoes, even as we enter the fall season." Quick Clicks Qakland County confirms 2 human cas ist human cases of West Nile Vir onfirrned in Michigan Crow in Oakland County tests positive for West Nile Virus Mosaultoes in Wayne County test positive for West Nile Virus © OF West Nile Virus Oakland County health officials announced last week it received laboratory confirmation from the Michigan Department of Health and Human Services of two human cases of West Nile Virus (WNV) in the county. "All residents are strongly urged to follow prevention tips to protect themselves from WNYV, especially those who are 50 and older who are more susceptible to severe symptoms,” said Kathy Forzley OCHD manager/health officer. "Most people infected with WNV do not have any symptoms, but for those who do become sick, the disease can be serious, even fatal." So far this year, two mosquito pools, a crow and a blood donor have also tested positive for WNV. Earlier this month, Michigan health officials identified the state's first confirmed human cases of West Nile Virus for 2015 in Macomb, Monroe, and Ottawa counties. Other cases were confirmed in Wayne County, but are not considered human cases. 1 xxxEND_PAGE:dhhs02_b0001_0001_0011_01 000002 Follow these tips to prevent WNV: ¢ Use insect repellent. The Centers for Disease Control and Prevention recommends the use of insect repellents containing active ingredients registered with the U.S. Environmental Protection Agency. Always follow manufacturer’s directions carefully. ¢ Be careful using repellant on the hands of children because repellents may irritate their eyes and mouths. ¢ Wear protective clothing such as long-sleeved shirts and pants. * Limit outdoor activity from dusk to dawn when mosquitoes are most active. ¢ Avoid areas where mosquitoes may be present such as shaded and wooded areas. * Maintain window and door screens to keep mosquitoes out of buildings. ¢ Get rid of mosquito breeding sites by emptying standing water that collects in birdbaths, boats, buckets, tires, unused pools, roof gutters and other containers. yeh couniy-wrman cies-due-twast-nile- : 8 ; ob crc ities WKAR -— September 23, 2015, 5, By S Scott t Pohl Yesterday, the public policy organization r: held a forum called “Raising the Voices of Caregivers from the Foster Care System” to discuss how to improve the system. Current State speaks with Michele Corey, vice president of programs at Michigan’s Children, and state There are more than 13,000 children and caregivers in Michigan’s foster care system. Yesterday, the public policy organization Michigan’s Children held a forum called “Raising the Voices of Caregivers from the Foster Care System” at the state capitol. Parents, lawmakers and others got together to work on improving the system. Our next guests were there and will help us learn about the challenges being faced by the state in the months and years to come. Current State guest host Sue Carter speaks with Michele Corey, vice president of programs with Michigan’s Children, and Rep. Jim Runestad (R-White Lake). ‘foster-rare-edyvocat htto//wkar.ore ‘post, ~vated ipad found in more Flint kids alter water switch, MLive — September 24, 2015, By Ron Fonger FLINT, MI -- More Flint infants and children are being found with elevated levels of lead in their blood since the city switched to using the Flint River as its water source, according to a new study by a Hurley Medical Center doctor. The data show that the percentage of Flint infants and children with above average lead levels has nearly doubled citywide, and has nearly tripled among children in "high risk" areas of lead exposure, according to the study. The research was based on blood samples from more than 1,700 children living in the city, and underscores Flint's struggles with water quality since switching from Lake Huron water in April 2014. Results of the study were delivered to Flint Mayor Dayne Walling and City Administrator Natasha Henderson this week. The study includes a recommendation that the city end its use of the Flint River as its drinking water source "as soon as possible." xxxEND_PAGE:dhhs02_b0001_0001_0011_02 000003 Among its key findings and recommendations: The percentage of children 5 years old and younger with more than 5 micrograms per deciliter of lead in their blood increased from 2.1 percent while Flint purchased Lake Huron water from the city of Detroit to 4 percent after the switch to the Flint River. The report also recommends that infant formula not be mixed with Flint tap water, that pregnant mothers not use city water, and that lead-clearing filters be distributed here. Areas of Flint with the highest lead levels, according to testing by Virginia Tech University, also showed the most drastic increases in elevated lead levels in children, rising from 2.5 percent to 6.3 percent. The study recommends the city declare a health advisory that could trigger additional resources from the federal government. Findings from the study are expected to be discussed at a news conference scheduled for 3 p.m. today, Sept. 24, at Hurley. In addition to lead researcher Dr. Mona Hanna-Attisha, representatives of the Greater Flint Health Coalition, Mott Children's Health Center, Hamilton Community Health Network and Genesee County Medical Society are also expected to speak about their concerns about the safety of Flint water. The data from Flint children reveals an alarming increase in lead poisoning, said Hanna-Attish, director of Hurley's pediatric residency program and an assistant professor in the Department of Pediatrics & Human Development at Michigan State University's College of Human Medicine. The study used a database, built from blood tests collected from about 150 doctors and health care providers. It compares the lead levels in the blood of children from Jan. 1, 2013, until Sept. 15, 2013, to levels in samples collected

Call: Gillian Mohney of ABC News; 212/456-7211 Looking for a confirmation that there is a woman in Flint diagnosed with legionnaires disease Nancy Ridley Senior Executive Management Assistant External Relations & Communications Michigan Department of Health & Human Services Phone: 517/241-2112 Fax # 517/335-5468 RidleyN@ michigan. gov xxxEND_PAGE:dhhs02_b1257_4725_4727_3