Brenda Fink

Thanks! thad not seen the official policy but heard that Medicaid hact done this.

Fyi, likely you all already have seen this . . . I’m just on the MSA policy listserve so get whatever goes out . . . so am just forwarding to be sure you have this! Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 517-335-8863 Fax: ade 335-8697

Chris is aware what is being worked on and what is being described below re: the weekly reports is what we have been talking about. This is not duplicative, but the outcome of the earlier non-Flint specific discussions. Sent from my iPad

© exactly! Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 517-335-8863 Fax: 517-335-8697 finkb@mnic! GOV

No worries, Brenda, he is likely quite aware- E Sent from my iPhone

ttalkhed with Kathy S last week on this very topic, they are on it!

Per the email | just sent, | think he needs to also talk with his own staff—Kathy Stiffler and Jackie Propkop in particular to help understand all that is going on with this reporting issue, as well as the various other related isses that are part of the total package. Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 xxxEND_PAGE:dhhs02_b0227_0774_0778_1 000775 517-335-8863 Fax: 517-335-8697 [email protected]

Dobynes (DHHS) <[email protected]>; Peeler, Nancy (DHHS) <[email protected]>; Travis, Rashmi (DHHS) <[email protected]>; Hamilton, Kimberly (DHHS) <Hamiltonk@ michivan.gav>; Kwasnik, Monica (DHHS) <iwasnikM @imichivan.gov>; Prokop, Jackie (DHHS) <[email protected]>; LaPres, Marie (DHHS) <[email protected]>; Dilernia, Lisa (DHHS) <filerniai@ michigan.gow>; Diebolt, Pamela J. (DHHS) <DiehaltP @michigan.gov>; Said, Manal (DHHS) <[email protected]>; Barnett, Lonnie D. (DHHS) <Barnett,@ michigan.goyv>; McCandless, Karla K. (DHHS) Barron, Brad (DHHS) <BarronB@ michigan.zav>; Hambleton, Matthew (DHHS) Linn, Cindy (DHHS) <[email protected]>; Slawinski, Heather (DHHS) <Siawinskil @michigan.gov>; Stanbury, Martha (DHHS) <stanburyin @ michizan.gov>

Sounds good to me. . thanks, everyone Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 517- 335-8863 -8697

i neeyo 4 of kids = 6 welevated BLL As per our discussion just now, in 2014, 913 kids age 6 -17 were tested in Genesee and 6 had a BLL =>5. (This includes Flint and is whole year, not april-Dec) For Flint alone in 2014,428 were tested and 5 had BLL =>5 in 2014. (i.e. 5 of the 6 elevated lived in flint) For 2015 through November, 1,197 were tested in Genesee and 10 were elevated. For flint alone in 2015, 765 were tested and 8 were elevated. | hope this helps. Martha Stanbury, MSPH Division of Environmental Health Michigan Department of Health and Human Services PO Box 30195, Lansing, MI 48909 517-335-8364 urynui@michiggn gov xxxEND_PAGE:dhhs03_b0471_1715_1716_2

Sharing, FYL Update fram last Friday.

Forwarding, FYL

Good afternoon, everyone - as part of the MDHHS Action plan regarding Flint water, we wanted to share with you the attached Provider letter, with several resource documents that accomnanied the letter. The letter was distributed by email to local Physicians on Gctober 30", by the Genesee County Health Department. For our colleagues in Medicaid, could we please ask your assistance in sharing the Provider letter and resources with your contacts at the Medicaid Heaith Plans that currently or will be working in Flint and Genesee County, and the surrounding areas? in turn, it would he helpful if the clans could share these with their enrolled providers. We want te assure that the materials reach any providers who may be seeing Flint families and their children. These materials are also available at the following website: www michigan. gov/flintwater Many thanks for any assistance you can give with distributing these materials, Please share any questions you have, or you receive, with Rashrni and 1 Nancy << File: >> << File: >> << File: >> << File: HealthyDiet_504857_7.pdf >> xxxEND_PAGE:dhhs03_b0612_2056_2058_2 002058 EH re >> FZ Hie 2005+00221_Ledead-iint Biynier >> xxxEND_PAGE:dhhs03_b0612_2056_2058_3

associated discussion in Flint Importance: High A couple of quick comments related to this .. . direct chatting is better, touch base tomorrow when we meet? Call this afternoon if you have time and/or think you need info sooner than tomorrow. Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 517-335-8863 Fax: 517-335-8697 f Ye

Importance: High Hi Nancy, This is a new FiOA recuiest frorn Edwards. Please respond to the HOA email address below and cony Paula Anderson. Brenda said to feel free to give her a call, and it can be outside of work hours. Thanks. DUE: 11-5-15

Hi Nancy, This is a new FIGA request from Edwards. Please respond to the FIOA email address below and copy Paula Anderson. Brenda said to feel free to give her a call, and it can be outside of work hours. Thanks. DUE: 11-5-15

fsent your ernail to Trudy and Robin - we will get back to you ASAP...

Comments, see below.

Rashmi and | talked this morning, and I’m following up with the three of you. To get everyone on the same page, we all know about the Flint lead/water situation and that this dept,DEQ, Guv’s office and legislature are involved in addressing this. Relative to our divisions’ role in this $425k of new funding is now being sent to GLHD to add nurses to address the case management side of this for a number of months going forward (this is one-time, not ongoing). GLHD has other expenses related to the “child” part of this that the new money does not address (either because it’s not able to be used for some other things and/or expenses incurred before 10/15 which is when this new money became available.) Mikelle is asking Rashmi if the MCH Block can pick up some of these additional costs. Here’s what Rashmi and | discussed and where we need input from the three of you: Li Carrie, did GLHD have lead as one of their FY 15 LMCH categories? Do they have it identified for FY16? If so, how much? The new $425k can be used starting on 10/15 and going forward. It’s designated for CM. There may be lead testing that is needed for kids for whom there is no third party reimbursement (although this should not be a large number, given most of MI’s children are covered by Medicaid, if not by some other source). We are thinking that lead testing could be used as a part of what a nurse CM does with this new money---but ONLY for kids with no other funding source. Rashmi would confirm this piece about the testing w/Mikelle so GLHD has this flexibility (but they are going to have to understand it CANNOT be for kids that they must bill for). We would expect them to be able to show us documentation that this is only who they used it for. Testing is written in - see attached contract language. For expenses incurred during the end of FY15 that related to this situation. I’m assuming, but this is a question primarily for Lucie and Carrie, that if they did identify lead as a category in their 15 plan, that we could be very flexible with them as they submit their final costs to expand use of LMCH to cover costs related to this incident to whatever degree necessary (to the limit of whatever their allocation is and for which they would have the appropriate documentation). This would work, wouldn’t it? If they did NOT have lead as a category, given the circumstances, I’m thinking they could still amend their budget and costs submitted for the final quarter to accommodate this—and maybe we’d have to have some notes here in case we’re audited that would describe this local emergency situation and why we agreed they could do this?? Nancy, | can’t remember—did we give them directly any other funding in FY15 for lead? | know they got some of the benefit of funding that we centralized to the other county that applied for it, but that wouldn’t be available to them for this scenario. Yes, however, it is directed to prevention. Karen is working with them on redefining this to focus on low in come, pregnant women, even if they don’t have an elevated blood lead level. Prevent the baby from ever becoming lead exposed. This would leave the two week period of Oct 1 to Oct 15. Rashmi and | are thinking we could use Block carryover for this. She would ask Mike V to send us documentation as to what those expenses are to support whatever total amount he thinks he should have. Comments? Carrie, l’d suggest putting this item in the first part of your updated carryover plan, with the amount TBD at this point. Rashmi needs to call Mark V and explain whatever we agree on here related to this, early next week. Please provide your comments asap. Thanks!! Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 517-335-8863 xxxEND_PAGE:dhhs02_b0212_0627_0629_2 000629 xxxEND_PAGE:dhhs02_b0212_0627_0629_3

More about the Dykerna thing

Importance: High This is what | arm talking about -

Sharing FYI - the $850,000 is to be split between CLPPP for case management and Healthy Homes for EBL investigations. Next step for us is decisions about how to put the case management services into place, which Sue Moran has already scheduled a meeting to discuss. I'll be calling in for that meeting - feels good to know we can do more to contribute to something good happening for families in Flint. Sent from my iPad Begin forwarded message:

Draft, v2 is attached. i drafted this using the talking points and press releases, In order to have a consistent message. Looking forward to your input!

We need to see the memo. Can you please send that around? Anges

I'll just add that once we send this memo out, all the HV providers will be asking us to clarify this very point—are the HV pg women and babies eligible for these filters? I’m guessing given our IM priority and the fact that we’re about to release an updated IM reduction plan for the next 3 years, that having to tell Flint that these moms aren’t eligible is something we’d want to at least think through carefully. Minimally we’d need some guidance from you all as to how to word clarifying they are not eligible. Brenda Fink, A.C.S.W. Director, Division of Family and Community Health Michigan Department of Health and Human Services 109 W. Michigan Ave. Lansing, MI 48933 517-335-8863 Fax: 517-335-8697