Legislative Update: Firearm Safety, Reproductive Rights, ELCRA, Budget, Scope of Practice

The Michigan Legislature has remained busy over the last several weeks, passing significant reforms including firearm safety legislation, repeal of the 1931 criminal abortion ban, expansion of the Elliott-Larsen Civil Rights Act (ELCRA), the repeal of Michigan’s right to work law, and several other notable issues. The MSMS Government Relations team has also continued advocacy efforts to reduce unnecessary administrative burdens, fight back on scope of practice overreach, and find new ways for our practices to utilize the state budget to benefit patients.

Firearm Safety Bills Clear House and Senate Committees

In wake of the recent mass shooting at Michigan State University, the Michigan House and Senate moved quickly by introducing legislation to protect Michigan communities from gun violence. After much debate in committee and on the floor, the House and Senate have begun the process of moving their bill packages through their respective chambers. The bills in question are House Bills 4138 4148 and Senate Bills 7686. Brian Stork, MD, current member of the MSMS Board of Directors and finance chair, testified on behalf of MSMS in both the House and Senate in support of the legislation. The bills will accomplish the following:

  • Require universal background checks for the purchase of all firearms (currently only required for pistols)
  • Require safe storage of firearms and provide penalties for storing or leaving a firearm where it may be accessed by minors
  • Enact the “Extreme Risk Protection Order Act,” which allows a spouse/former spouse, family member, significant other, law enforcement officer, or mental health professional to file a summons and complaint against a defendant who poses a significant risk of personal injury to themselves or others by possessing a firearm
    • The court will issue an extreme risk protection order if determined by the preponderance of evidence that the defendant poses a significant risk of personal injury to themselves or others by possessing a firearm
    • An individual restrained under the extreme risk protection order act may file a motion to modify or rescind the order and must prove by the preponderance of evidence that the restrained individual does not pose a threat to themself or others by possessing a firearm
  • Enact sentencing guidelines for making a false statement in support of an extreme risk protection order
  • Exempt firearm safety devices from sales and use tax

Pertinent MSMS policy on gun safety can be found here

Senate Votes to Repeal 1931 Criminal Abortion Ban

The Senate successfully passed House Bill 4006, which repeals the section of Michigan law that subjects anyone who administers an abortion to a felony, and House Bill 4032, which amends the state’s Code of Criminal Procedure. The Senate also successfully passed Senate Bill 2, 37, 39, and 93, which collectively repeal several sections of the 1931 abortion law that prescribe penalties for administering abortions and abortion drugs. The Senate bills successfully passed along party lines and now reside in the House Judiciary Committee, while House Bills 4006 and 4032 head to the Governor’s desk for signature.

ELCRA Expansion Passes House

Legislation expanding the Elliott-Larsen Civil Rights Act to include protections from discrimination based on sexual orientation and gender identity quickly moved through the House and Senate with bi-partisan support before being signed into law by Governor Gretchen Whitmer on March 16, 2023. Senate Bill 4, now Public Act 6 of 2023, prohibits discrimination in employment, public accommodations and public services, educational facilities, and housing and real estate based on sexual orientation and gender identity or expression.

Budget

Thanks to continued aggressive advocacy by MSMS, the Governor’s recommendation retained $65 million in new funding for increased Primary Care Medicaid reimbursement rates, and also included several other major Medicaid reimbursement increases. To support MSMS in this ongoing effort, you can make a donation to MDPAC. We need your help to ensure we reach important legislative decision-makers throughout this budget process.

The proposed executive recommendation for 2024 includes an additional $130 million in enhanced reimbursement rates for Medicaid and the Healthy Michigan program. The increases include:

  • $121 million to increase Medicaid rates for professional services, laboratory services, traumatic brain injury, as well as other programs. 
  • $4 million to increase the age limit Children’s Special Health Care Services (CSHCS) from 21 to 26 years old.
  • $5 million to provide homeless Medicaid enrollees with a safe setting or short-term transitional services to recover and continue receiving additional care post-hospitalization.
  • Full funding for the Hospital QAAP program.
  • Full funding for the Rural and Obstetrical stabilization pools.
  • Enhanced funding for local public health departments – $30 million.

MSMS is also seeking support for a $30 million MSMS-led initiative to provide staffing recruitment and retention grants for independent physician practices with a demonstrable need for assistance. In a recent survey of MSMS members, more than 85% of respondents stated their practice is experiencing understaffing issues. Under the proposal, funds will be administered by the Michigan State Medical Society and allocated to physician-owned practices in the acute, post-acute, and behavioral health care space.

Scope of Practice

MSMS Government Relations expects legislation expanding the scope of practice for nurse practitioners to be introduced soon by Senator Jeff Irwin of Ann Arbor. MSMS and the MiACCT coalition will continue opposing this legislation, and MSMS is currently working to introduce legislation requiring NPs to practice as part of a physician-led care team. 

The MSMS-proposed physician-led care team bill will require advanced practice registered nurses (APRNs) and physician assistants (PAs) to practice as part of a physician-led patient care team, assuming specific responsibilities within the scope of their usual professional activities. The legislation also requires APRNs and PAs to maintain appropriate collaboration and consultation, as provided under a written practice agreement, with a patient care team physician. Under the proposed legislation, practice agreements must include:

  • A process for communication, availability, and decision-making when providing medical treatment to a patient. The process must utilize the knowledge and skills of the APRN/PA and patient care team physician based on their education, training, and experience.
  • The duties and responsibilities of the APRN/PA and patient care team physician.
  • A provision for appropriate physician input in complex clinical cases and patient emergencies and for referrals.
  • A clear statement describing the controlled substance prescriptive practices of the APRN/PA, including the controlled substances the APRN/PA is or is not authorized to prescribe.

MSMS is excited about the start to the 2023 legislative session, but needs your continued help to grow its influence and ensure the voice of medicine is heard loud and clear in Lansing. Please make your donation to MDPAC here.