Lack of contractors slows lead removal from Flint and other Michigan homes

Capital News Service

LANSING — Since receiving $24.8 million from Medicaid to remove lead from contaminated homes almost a year ago, the Department of Health and Human Services has abated only 23 homes of lead in Flint.

Another 47 Flint homes are undergoing cleanup. So far, $660,200 of those Medicaid funds have been spent in Flint and another $730,500  spent elsewhere, state officials said.

It can take a long time to remove lead from a house—close to three to five months—but before  removal can happen, contractors need to be available. And there just aren’t enough.

“It’s the biggest impediment to spending those dollars,” said Tina Reynolds, the health policy director of the Michigan Environmental Council. “Lead risk assessors and contractors are in short supply. It’s related to us only having so much money to hire them so there was only a small pool of people willing to do the work.”

Michigan is the first state to receive Medicaid funding for lead removal. Some of it can be spent in communities other than Flint, which received nationwide attention for lead contamination in its drinking water.

To fully take advantage of that money and combat the shortage, the health agency has hired someone to help increase the number of lead contractors. The new workforce development coordinator is entrusted with finding those that could become lead contractors.

“His role is to really get out into communities, starting in Flint, and looking at who’s available in the community to take the training that may have a little bit of construction knowledge,” said Carin Speidel, the Lead Safe Home Program manager. “It’s going to be a big undertaking because it’s not an overnight process.”

The reasons for the shortage date back to the recession in 2008, when many contractors couldn’t find work and began finding jobs elsewhere.

“The industry is maxed out in terms of its capacity,” Speidel said. “It’s a nationwide issue.”

Lead-removal services include paint, walls and water lines. Reynolds says there is a disconnect between the program and eligible residents. They may not know about program, or they don’t want to do the paperwork. Sometimes there’s a language barrier as well.

Toeducate people about the program and the dangers of lead in general, the state is taking steps to reduce confusion.

“So people are now going door to door to encourage people to get tested,” she said.

So far, 190 eligible people have enrolled in the Medicaid program. One hundred and fifty of them have had tests conducted on their homes.

While most of this money would go to Flint, there’s $6 million available for consortiums and local health departments that could providet services outside of Genesee County, including West Michigan.

It’s a welcome source of money, said Paul Haan, the executive director of the Healthy Homes Coalition of West Michigan, but there are problems with getting it to people after his coalition receives it.

People are used to a lot of restrictions when it comes to getting federal housing funds from the U.S. Department of Housing and Urban Development, Haan said. There isn’t a lot of confidence the funds will be easily accessible. But Medicaid money is much easier to get.

Haan’s coalition oversees some of the hardest-hit places for lead poisoning like Kent County, which found more than 6 percent of its children under age 6 testing positive for lead poisoning in 2016. The Healthy Homes Coalition has applied for $1.5 million from the Medicaid fund.

Health and Human Services received six applications from consortiums for the abatement money and will announce its awards in late Novemberd.

 Muskegon County, which has also applied for funds, struggles with even finding the opportunity to tell people about the services.

“A lot of the time, they will not let folks in their house to even provide education,” said public health education supervisor Jill Keast, of Muskegon County. “They may not want you to see their living conditions, or they may worried about (Immigration and Customs Enforcement) and deportation.”

Muskegon County also has one of the highest lea -levels in children under the age of 6, at 4.3 percent. Keast says she likes it that more money is coming into the state, but says it’s still not enough.

“Flint should be a priority., We understand that and I do appreciate they need the funding right now,” she said. “However, it’s not helping our communities. Putting all your resources toward Flint doesn’t eliminate the issue of lead in other areas.”

Proposed bill would prevent creation of rules more strict than federal regulations

Capital News Service

LANSING – Some Republican  lawmakers want to prevent state departments from creating rules that are tougher than federal regulations.

They’re backing a bill that would allow only the Legislature to do that unless there are exceptional circumstances. The bill, introduced by Rep. Triston Cole, R-Mancelona, would encompass rules that would regulate sectors as diverse as business, the environment and manufacturing.

“This is a good bill with a good purpose,” said Jason Geer, the director of energy and environmental policy for the Michigan Chamber of Commerce. “It will help ensure Michigan is not overregulated.”

It’s the third time in six years that the legislation has been pushed. And opponents fear this time there may be enough political will to pass ith.

The Michigan Environmental Council questioned why lawmakers would want to take away the governor’s power and put it in the hands of the federal government.

“Why should we demote the governor and his ability to protect Michigan?” said James Clift, the policy director for the council.

Clift said the bill would give the decision-making power to the Trump administration. He said this would directly impact quality of life in Michigan, especially  considering the federal government’s lowering of its own regulations.

Supporters of the bill say that’s good because it will require state departments to show  there really is a need for a rule that is more strict than federal regulations.

Geer said the bill would prevent state departments from doing whatever they want.

”It’s not an outright ban,” he said. “Anytime they feel the need to exceed federal standards, it just requires them to explain it and demonstrate a need for it.”

But critics fear the bill will force the state to be reactive instead of proactive.

“The level of convincing that will be needed to exceed the federal standards is a very high bar,” said Charlotte Jameson, director of government affairs at the Michigan League of Conservation Voters. “That means there will only be rules in times of crisis.”

Geer said many of the rules in Michigan that exceed federal standards relate to environmental laws, and the bill shines a light on that.

He said it would force state departments to prove why they are necessary. That would help businesses because they wouldn’t have to meet standards significantly higher than the federal level, he said.

The Michigan League of Conservation Voters says the standards set by the federal government are a minimum requirement all states must be at or above.

“We feel the federal standards are a floor, not a ceiling,” Jameson said. “The rules don’t account for unique states.”

The Michigan Environmental Council agrees, Clift said.

Officials at both environmental groups say their biggest concerns relate to the Great Lakes.

“Michigan is the Great Lakes State,” Clift said. “This would undermine the ‘Pure Michigan’ campaign because we wouldn’t be able to create stricter rules to protect the lakes.”

Stricter rules are needed to protect the lakes, Jameson said.

“The Great Lakes need forward-thinking protection,” she said. “We need flexibility to go beyond federal standards.”

This is not the first time a similar bill has been proposed. Gov. Rick Snyder vetoed one in 2011. And in 2016 one cleared the House but never made it out of the Senate.

Sen. Jim Stamas, R-Midland, said he thinks the bill will pass in the Senate this year. He sits on the Oversight Committee that approved he bill, and he supports it.

“It does present some challenges, but the bill has great intentions,” Stamas said. “This is a positive discussion to have.”

One challenge could be protection of wetlands, Stamas said. Michigan is one of only two states that administers the federal wetland program. There is a lot of support for keeping wetlands under state control, he said.

Clift said he is concerned the governor may sign the bill this time because Snyder has not made a statement in opposition to it.

The governor isn’t saying. He’ll evaluate the final version if and when it reaches his desk, said Tanya Baker, the deputry press secretary in the executive office of the governor.

Clean Water Action members and Plainfield Township residents gathered at the Capitol on Oct. 10 to oppose the bill and highlight contaminated drinking water in that Kent County community.

That contamination was caused by Wolverine Worldwide, a footwear manufacturer.

Sean McBrearty, the campaign organizer of Clean Water Action, said the bill threatens public health because the Department of Environmental Quality would be unable to more strictly regulate contamination in drinking water.

Sen. Peter MacGregor, R-Rockford and who represents Plainfield Township, issued a statement saying the bill was not created in response to water contamination there.

“This bill was not introduced or approved by the Senate Committee on Oversight in response to the current situation, nor can it be retroactively applied to the ongoing issue in Plainfield Township,”  MacGregor said.

The bill passed 57-50 in the House in May. It was reported from the Senate Oversight Committee on Oct. 5. It’s unclear when the Senate will take a vote on the bill.

MacGregor has asked the Senate to pause the bill, according to McBrearty. MacGregor could not be reached for comment.

State set to renew groundwater rule for toxic chemical

Capital News Service

LANSING — Michigan’s emergency rules on how much of a particular hazardous chemical can be left in groundwater are set to expire Oct. 27, and that could create an environmental problem in the state.

To address the concern, the Department of Environmental Quality (DEQ) is proposing  a new rule with a limit of 7.2 parts per billion for 1,4-dioxane, which is responsible for a high-profile groundwater contamination west of Ann Arbor at the site of Gelman Sciences. The company used the chemical to manufacture medical filters.

If a new rule is not approved before the expiration, the limit will revert to 85 parts per billion, the level it was before the emergency rules went into effect in 2016, said Mitch Adelman, section manager for the remediation and redevelopment division of the DEQ.

The department is working with those responsible for the contamination to assure that human health and the environment are protected using the new, lower limit for contamination, Adelman said.

But Gelman Sciences isn’t the only site where the chemical has led to groundwater  contamination. The West KL Avenue Landfill in Oshtemo Township and the Metamora Landfill in Metamora Township have been contaminated by 1,4-dioxane as well, Adelman said, resulting in groundwater contamination.

The proposed new rules would continue the emergency rules that are set to expire and are before the Legislature’s Joint Committee on Administrative Rules.

Rep. Steven Johnson, R-Wayland, chair of that committee, said they will likely be approved.

“They’ll go into place about a week before the other ones expire,” he said.

The Michigan Environmental Council agrees with the proposed limits.

“It’s needed a lower number for years,” said James Clift, the policy director for the council.

The 1,4-dioxane rule is being considered separately so that standards do not revert to 2002 values that were in place before the 2016 emergency rules were implemented.

The 1,4-dioxane solvent is a clear liquid chemical that easily dissolves in water, and is considered likely carcinogenic to people, according to the Environmental Protection Agency. Long-term exposure can also cause kidney and liver damage, according to the DEQ.  

It’s used mainly when making other chemicals and can be found in paint strippers, glues and pesticides.

Although it can also be found in some makeup, lotions, detergents, bath products and shampoos, the amount found in these products is not likely to be harmful, even if used every day, according to the DEQ.

The DEQ’s proposed change on 1,4-dioxane may be the first of a series of revisions to clean up criteria for up to hundreds of other chemicals.  

The DEQ has been updating the toxicological, physical and chemical data for over 300 hazardous substances to help set new cleanup criteria, Adelman said.

He said there are more than 9,000 contaminated sites across Michigan.

That more extensive overhaul has met with various levels of opposition.

Although the Michigan Environmental Council supports an update, Clift said he believes the proposed rules fail to provide for new science as it emerges.

“We want the cleanup processes to use the best available science,” Clift said. “Unfortunately, this doesn’t provide a way to adjust the rules with the development of new science.”

That is a safety concern, he said.

“They’re supposed to regulate any substance that could cause injury,” Clift said. “The inability to update the rules without going through the time-consuming rulemaking process every time leaves them powerless to regulate new chemicals.”

The Michigan Petroleum Association said it worries the rules are too strict and will become a bigger hindrance than a help.

The association’s members have cleaned up more than 2,000 underground sites, said Mark Griffin, the industry group’s president. “All of that is in jeopardy of coming to a standstill.”

He said contaminated sites are currently cleaned to a level that won’t harm anyone; he believes the new criteria require a level for cleanup of contaminated sites that is unreachable.

“Our concern with the new rules is getting sites cleaned up and closed,” Griffin said. “We’d hate to lose all that progress.”

The Michigan Environmental Council said it’s been too long since the rules were revised.

The Michigan Chamber of Commerce said its members acknowledge the rules for cleaning up contaminated sites need to be updated.

“It’s improved from where it started, and it’s a step in the right direction,” said Jason Geer, the chamber’s director of energy and environmental policy. “Our members all recognize that it needed to be fixed.”

State agencies unite to reduce mental illness in jails

Capital News Service

LANSING — Up to 64 percent of county jail inmates in Michigan have some form of mental illness.

And while lawmakers discuss ways to reduce that number, law enforcement officers have put their own solutions to the test.

“Police chiefs are saying, ‘We’re spending tons of time with individuals with severe mental illness in the community and then we’re bringing them to jail,’” said Ross Buitendorp, a board member of the Mental Health Diversion Council.

Jails have become mental health hospitals, said Blaine Koops, the executive director of the Michigan Sheriffs’ Association.

Koops estimates between 45 and 65 percent of county jail inmates receive some form of psychotropic medication for mental illness, and 90 to 95 percent have some type of substance abuse problems.

Jails are not the best places to treat people with mental illness, Buitendorp said, so agencies are working together to identify and treat those who need help.

Law enforcement agencies are tackling the problem by increasing use of a decades-old program called Crisis Intervention Team (CIT) training, Buitendorp said. The 40-hour class trains officers to better identify people with mental illness, and intervene in a smarter way.

A CIT-trained officer can recognize symptoms that someone who is suicidal, bipolar or schizophrenic might show during times of stress.

“What the officer does is look at the behavior of the person in front of them, and run it against the symptoms they’ve been trained in,” said Rafael Diaz, a lieutenant with the Kalamazoo Public Safety Department. “So when they see these things, they can separate the conduct driven by a mental health crisis as opposed to criminal conduct.”

The goal after recognizing those symptoms is slowing things down. Officers have time on their side, Diaz said.

“They’re going to try to open lines of communication using a set of skills called ‘active listening,’” Diaz said.

Active listening is an effort to hear what the person is saying. That can take time because many mentally ill patients have thought-process problems. But a successful attempt can calm the individuals instead of further agitating them.

In addition to keeping people with mental illness out of jail, CIT training also emphasizes diverting patients already behind bars to a mental care facility. Officials without such training are much less likely to move a person with a mental health crisis to an appropriate facility.

While Michigan doesn’t keep track of the reduced number of injuries during these interactions, other cities like Memphis, Tennessee, where CIT training has been in wider use, show the training works, Diaz said.

So Michigan agencies are doing more of it. The Community Mental Health Board of Clinton, Ingham and Eaton Counties reports 95 cases of the method used in the last year. lt expects to have 160 officers trained before 2018.

Buitendorp is also the director of substance abuse at Network180, a community health agency in Kent County that has helped train 80 officers.

“The police departments and the emergency departments are our biggest fans and our biggest partners,” Buitendorp said, “because we all serve the same clients.”

The American Civil Liberties Union of Michigan says the increased training is a great first step to addressing larger issues like mass incarceration of undeserving individuals.

“Recognizing that mental health issues are at the base of a lot of these criminal charges is so important,” said Shelli Weisenberg, ACLU’s political director. “Putting the resources for the training, creating those collaborations even though we don’t have resources in place, it’s a fabulous first start.”

The money comes from grants distributed by the federal government and the jail-diversion committee, donations from organizations like the National Alliance for Mental Illness and increased commitments from police agencies willing to send officers to be trained.

For example, Oakland County has a mental crisis center, called Common Ground, designed for people needing immediate mental help. It’s an important stop for many police officers who need to drop off a mentally ill person, said Jeff Kapuscinski, the director of business development at the agency.

“We think that the programs and services we provide for people in those situations are not only more appropriate for the care they might need at that moment, but it’s also less costly for taxpayers than sending them to jail,” Kapuscinski said.

Kapuscinski says Common Ground is one of only a handful of agencies of its kind in the country. The agency diverted 431 people from jail in 2015, saving Oakland County more than $5 million.

The savings represent progress, Kapuscinski said, but it’s not more than money is necessary. A lack of material resources, like available beds in hospitals, is a serious problem for mentally ill patients.

“Frequently, it’s been our experience that folks experiencing mental health issues or a mental health crisis are lower in terms of the priority of being served in an emergency department,” Kapuscinski said. “That’s when emergency department boarding becomes an issue.”

Both Koops and Kapuscinski agree it’s not uncommon for inmates to wait weeks for an open spot.

“The number-one issue up here is not training, it’s the availability of bed space for mental health patients,” said Cheboygan County Sheriff Dale Clarmont. “We had a violent offender with mental issues a little while ago who waited three days before we got a bed for him.”

AuSable Valley Community Mental Health, which covers Iosco, Ogemaw and Oscoda counties, averages three to four such individuals a year. Northern Lakes Community Mental Health, which covers six counties in the northwest part of the Lower Peninsula, diverted 30 people people from jail.

Clarmont requires that all of his officers receive training every 24 months, but those training sessions are less in-depth than some that are hosted further south.

“We can train them for the very short term,” he said. “But we are not mental health officials. To be frank, we don’t have the medication or facilities.”

Despite the mountain of barriers many sheriffs and community health officials have begun to climb, other public figures involved in the conversation are on the move. In July, 2017 the MiLegislature created the House C.A.R.E.S. task force made up of 14 lawmakers. The group is charged with addressing the growing issue of mental health, and that includes mental health reform in the criminal justice system.

“We’ve identified through the first meetings of the task force, perhaps we can do a better job of communication when someone enters the corrections area,” said Rep. Dave Pagel, R-Berrien Springs, a member of the task force. “We have to find the best way to care for these folks.”

For Koops, of the Sheriffs’ Association, the pivot toward more help for the mentally ill is a welcome first step toward solving an old problem.

“From a personal perspective, I’ve been doing this for 42 years,” he said. “And this is the first time in 42 years I’ve actually seen some coalitions come together to see this issue and want to work and make it better.”

Proposed bills could undo parental education requirement for immunization waivers

By Kaley Fech
Capital News Service

LANSING — Parents who don’t want to vaccinate their kids could skip an education session designed to teach them a the benefits of vaccines and the risks of disease, under legislation proposed by two Republican lawmakers.

A 2014 rule requires parents to first learn about vaccines from a county health department to get an immunization waiver, , according to the Department of Health and Human Services. The rule was put in place by a joint committee of the House and Senate, not the entire Legislature.

Michigan allows immunization waivers for medical, religious and philosophical reasons. Medical waivers are completed by a physician.The education requirement pertains only to parents claiming religious and philosophical reasons.

Michigan had the sixth-highest waiver rate for kindergarteners in the country in 2014-15, according to the state health agency. The state moved to 11th place after the educational requirement was put in place.

“Over the past two years, we’ve seen a 33 percent decrease in waivers,” said Bob Swanson, director of the Health and Human Services division of immunizations.

Rep. Tom Barrett, R-Potterville, and Rep. Jeff Noble, R-Plymouth, introduced bills earleir this year to undo the education requirements.

One of the problems with the administrative rule is it contradicts state law, Barrett testified at at House Education Reform Committee.

“Michigan law grants parents the right to waive any and all vaccines for their children for medical, philosophical or religious reasons,” he said. “That law remains on the books today.”

The Department of Health and Human Services opposes the bills.

“From a public health standpoint, vaccines are very important,” Swanson said.

Supporters of the repeal say the issue is about parental rights

“We support the right for parents to choose if their kids are vaccinated,” said Beth Bechtel, a volunteer with Michigan for Vaccine Choice. “As a group, we are not for or against vaccines. We simply believe parents should be able to choose.”

Noble testified that parents and not government should be encouraged to make wise decisions.

State health authorities note that the education requirement does not take away a parent’s rights.

“The education informs parents of the benefits of being vaccinated and the risks of diseases, but afterward they still have the right to choose to sign a waiver,” Swanson said.

Another criticism by opponents is that the requirement was approved by the Joint Committee on Administrative Rule instead of the entire Legislature.

“If the Department of Health and Human Services wanted to change the rules, they should have written up bills,” Bechtel said.

Five vaccines are required for kindergarten school entry, according to the state health agency. That includes vaccines for chickenpox; polio; measles, mumps and rubella; diphtheria, tetanus and pertussis; and hepatitis B.

Some parents are opposed to only certain vaccines due to religious or philosophical beliefs, Bechtel said. The most common one is for chickenpox.

Only about 3 percent of children in the United States are completely unvaccinated, according to officials.

Swanson said ending the education requirement would make waiver rates go back up and increase the risk of disease.

“The more people who are susceptible, the higher the risk for outbreak,” he said.

As of June 30, Houghton County had the highest waiver rate at 13.5 percent. Luce County had the lowest at 0.6 percent, according to Health and Human Services.

When 90 to 95 percent of a community is protected, it is almost impossible for vaccine- preventable diseases to spread, according to health officials administering the state’s “I vaccinate” campaign. As that number decreases, the risk of outbreak increases.  

“A number of preventable disease outbreaks have occurred in Michigan as well as other spots in the U.S. due to low vaccination rates,” said Angela Minicuci, the communications director for the department.

A current example is a hepatitis A outbreak among adults in Southeast Michigan, Swanson said.

“We haven’t seen it in a lot of kids because they’ve been vaccinated,” he said. “But most adults were never vaccinated against the virus, making them susceptible.”

State health authorities say as many people as possible should be vaccinated to protect those who cannot be vaccinated, such as pregnant women, babies, the elderly and ones who cannot be vaccinated for medical reasons.

“Vaccines are the best protection against diseases,” Swanson said.

The bills are in the House Committee on Education Reform.

State expected to catch Zika mosquitoes in nets and it did

Capital News Service

Lansing — While Michigan health officials had a plan for combating the Asian tiger mosquito, it was untested.

At least, until mid-August when they caught a few in Wayne County.

Now that the mosquitoes, known for carrying the Zika virus, have been found in Michigan,  health departments are taking more measures to fight their arrival.

“We’re probably going to be ramping up surveillance as well as monitoring Ohio and Indiana,” said Meghan Swain, executive director of the Michigan Association for Local Public Health, a nonprofit lobbyist for local health departments.

After the mosquito was found, an increased surveillance of the area in Wayne County was done twice in search for more.

“We’re in some ways, more prepared for this because of the funding we had at the beginning of the year,” said Erik Foster, a medical entomologist with the Department of Health and Human Services. “We had more preparation and understanding of the mosquito as a vector.”

The Wayne County Health Department spotted the mosquito in one of the traps put up every week in Livonia. They were breeding near a business location on I-96 in a shipment of containers, Foster said.

“They did a nice job,” said Eden Wells, the chief medical executive with the Department of Health and Human Services. “They have responded very well and I was very impressed with the way leadership of the Wayne County Health Department and the city of Livonia partnered with our state health folks to address this.”

Officials were on high alert after receiving notice a month earlier that the same species of mosquito was found in Toledo, Ohio—just across the border from Michigan.

“We weren’t that desperate, because everybody understood that Zika was going to be a problem and started preparing about two years ago,” Wells said.

This doesn’t mean the disease itself hasn’t shown up in Michigan. In 2016, there were 67 reported cases of Zika imported by people into the state.

The Zika virus, a disease that causes birth defects in children, entered the national spotlight after travelers to the 2014 World Cup in Brazil were warned about the outbreak. While they don’t travel very far on their own, they tend to make big hops in containers holding tires, Foster said.

While the Asian tiger mosquito isn’t in Kent County, mosquitoes that carry the West Nile virus are — and that’s prompting officials there to take similar measures. A warning was put out mid-September concerning five new cases of the disease.

“The reason we think that warning is important is because people need to know that West Nile is very present in the community,” said Steve Kelso, the marketing and communications manager for the Kent County Health Department. “People need to know this is active and need to be careful and take precautions.”

The tests Kent County does for mosquitoes that can carry West Nile are similar to the tests that counties use for Asian tiger. The Centers for Disease Control and Prevention (CDC) has partnered with 25 county health departments to set up traps to attract mosquitoes.

“We fully anticipated that we would need to be ready for when Zika showed up in the state a while ago,” Wells said.

That meant educating travelers about potential diseases and ways to avoid getting sick, while using a system in Michigan that she calls “enhanced surveillance” to look out for cases of the mosquitoes.

The health department has also identified airports and shipping ports where the disease could come in, increasing the number of tests for mosquitoes and making more efforts to remove places where breeding takes place.

Now that the species is here, the Department of Health and Human Services has been talking with the CDC about controlling and eliminating the species.

“These mosquitoes love standing water,” Wells said. “It’s important to try to control these mosquito pools to get rid of anything that might incite them.”

Sewer and drainage areas are popular places where water accumulates. Because a lot of Michigan’s industry is built around cars, Wells worries about old tire yards, which are considered an active surveillance site.

There is a connection between the Livonia spotting and tire pits, said Edward Walker, a Michigan State University entomologist.

“It is associated with the pile of tires that is accumulating in Livonia,” Walker said. “It’s not surprising to me because the tire trade is so common in Michigan, as well as the moderating of temperatures.”

As of 2015, the Department of Environmental Quality estimated more than 275,000 tons of tires were recycled or repurposed in Michigan..

About the same amount will be collected this year, said Aaron Hiday, an environmental quality analyst.

Scrap tire recyclers must treat them for mosquitoes,  Hiday said. “Some set traps while others will spray a type of pesticide or cut holes in the tires.”

Many scientists are calling the growing trend of tropical viruses further north a result of climate change.

“We’re seeing the same trend with allergens and an increase in pollen count,” said Katie Parrish, the communications officer with the Michigan Environmental Council. “We’re seeing this as an indicator that climate change is real and we’re seeing those manifestations in our everyday life.”

With the warming of summer months, a shrinking of winter months and increased precipitation, Walker says we should see an increase in mosquito-borne illnesses as time goes on.

“We’re going to have to have the public and political will to intercept the problem before it gets worse.”

Reviving addicts doesn’t cure them, sheriffs say

Capital News Service

LANSING — Drugs save the lives of some of Michigan’s opioid addicts, but they can’t solve the epidemic sweeping the state and nation.

Most Michigan police are equipped to revive people from an opioid overdose with the drug Narcan. But experts say it hasn’t done anything to help curb the addiction crisis. In fact, it may even falsely reassure addicts that they can continue their risky behavior.

“The dispensing of Narcan has nothing to do with getting anybody better,” said Ingham County Sheriff Scott Wriggelsworth. “It just saves their life. And we’ve had multiple instances where three or four hours later, we’re going back on the same person and administering Narcan again.”

Narcan, a nasal spray that restores breathing to patients overdosed on opioids or heroin, has been key to saving lives. For instance, the Washtenaw County Sheriff’s Office says it has saved  more than 100 people  this year. Ingham County sheriff officials say they’ve administered it more than 150 times this year.

Statewide figures show the number of deaths due to opioid and heroin has risen, from 99 in 1999 to 1,689 deaths in 2016.

Coupled with the increase in deaths is an increase in use and in questions about a limit on how many times Narcan should be used. Middletown, Ohio, spent $2 million responding to overdoses, prompting a member of its city council to propose a cap on how often someone can be given Narcan.

It’s not a popular solution in Michigan.

“We don’t get to say no, never mind, you’ve had 10 or eight chances and are capped for the night and we’re not coming,” Wriggelsworth said.

Some heroin and opioid addicts carry around their own Narcan in case they overdose by accident—or on purpose.

“They’re called Lazarus parties,” Wriggelsworth said, “where they take heroin to the tune of almost dying and then they have Narcan there to bring their buddies back.”

Narcan may save lives, but it’s not a solution to addiction, said Chad Brummett, director of Clinical Research with the Department of Anesthesiology at the University of Michigan.

Some experts disagree that proposed legislation that would limit how often someone can be revived with Narcan is the best solution.

“I frankly don’t understand the rationale behind this,” Brummett said. “I think the people proposing that legislation would be better off to focus on things like increasing access to care, addiction treatment, because this is a disease, it’s not a choice.”

Narcan is donated to law enforcement by community health agencies. A kit with two nasal spray units, a face shield used when giving cardiopulmonary respiration, gloves and information on addiction treatment costs $75. The kits are paid for with funds to the agencies provided by block grants from the federal government to the state Department of Health and Human Services.

Another drug also used to combat addiction is Vivitrol.

The  Department of Corrections recently began using it to block the desire to take opiates, while giving users little feel of euphoria if they relapse.

“We don’t have extensive knowledge of Vivitrol and its impact on prisons because it’s so new,” Anita Lloyd, the agency’s communications director, wrote in an email. “But if this medication can be used to treat addiction, and can be successfully managed as part of a larger treatment program—without a safety risk to staff or inmates—that’s a good thing.”

An injection of Vivitrol costs $1,000, requires 14 days of being clean ahead of time and is taken once a month.

Meanwhile, experts are predicting a long road ahead before the opiate crisis gets better.

“While prescribing of opioids has started to decrease, our prescribing still so far outpaces what is reasonable,” Brummett said. “Some are predicting it’ll get worse until 2020 or 2021.”

And it’s no longer just prescribed painkillers, he said. Heroin use has risen, while use of newer synthetic drugs like fentanyl and carfentanil, which are said to be 10,000 times stronger than morphine, have also increased.

Moves by some of the 10 regional health networks that assist law enforcement by donating Narcan are beginning to think of how further to assist addicts.

“We understood from the very beginning, as part of the training we provide, that officers not only use the medicine to revive, but provide information as well,” said Achilles Malta,a  substance abuse expert with the Southwest Michigan Behavioral Health, “either to family members of the individual or the individual themselves.”

Beyond making education more available, Malta wants overdosed patients to have someone there to help them as soon as they are revived, while also letting family know about other resources in the community.

Reading, writing, arithmetic and saving lives, Michigan schools to teach CPR

Capital News Service

LANSING – This year, in addition to math, science and history, students will also be learning how to save lives.

It is the first year that Michigan schools must teach students to perform cardiopulmonary resuscitation and use automated external defibrillators. The law now mandates that between seventh and 12th grade, students must learn how to perform CPR to graduate from high school.

“This legislation brought Michigan in line with more than half of the country by ensuring all Michigan students learn the life-saving skill of CPR before graduation,” said Sen. Tonya Schuitmaker, R-Lawton, the primary sponsor of the bill.

Thirty-seven states now require CPR training as a graduation requirement, according to the American Heart Association.

Barb and Bill Rafaill, Albion residents, say they believe so much in the law that they donated CPR kits to schools in both Calhoun and Oceana counties to support it.

“I know lives can be saved,” Barb Rafaill said. “It’s just a matter of education.”

The survival rate after cardiac arrests that occur outside of a hospital is just 11 percent, often because bystanders do not know how to help, according to the American Heart Association. The agency’s hope is that the law will increase the number of people who can perform CPR and intervene in emergencies.  

“Approximately 70 percent of out-of-hospital cardiac arrests occur in residences, so this requirement will help put people with knowledge of CPR in the places where it’s most likely to happen,” said Cindy Bouma, the association’s communications director for western Michigan.

“If you increase the amount of people who are trained and capable of performing CPR, you increase the likelihood that a bystander will be able to intervene until emergency responders arrive,” Schuitmaker said.

Under the law, students will receive hands-only training, meaning they will learn chest compressions. They won’t be required to perform mouth-to-mouth, according to the association. Hands-only CPR can be taught in as little as 30 minutes, depending on class size, Bouma said.

Students will also learn how to use an automated external defibrillator. That is a device that delivers an electric shock to the heart through the chest and can potentially allow a normal heart rhythm to restart after a cardiac arrest, according to the association.

Schools may use teachers or certified CPR instructors to teach the classes. Teachers do not have to be certified to teach CPR, but if schools want students to get a certification they must be taught by certified instructors. Teachers would need training, but schools can take advantage of volunteers such as paramedics and firefighters who have already been properly trained.

“I think it’s a great idea,” said Shawn Walbecq, the kindergarten through 12th grade principal for Suttons Bay Area Public Schools. “The more people that know the techniques,  the better.”

Walbecq said he plans to use local services for teaching CPR in his schools.

“We’re a small community,” he said. “Local paramedics have kids who go to school here, and we have their support.”

The Michigan Education Association says the law is a good idea, but that schools should receive government funding to change curriculum and implement the training, said David Crim, a communications consultant for the union.  

The American Heart Association sells and lends kits to help teach the technique or they can get them from local paramedics or firefighters, Bouma said.

Barb Rafaill said she and her husband wanted to do something to bring more attention to the new law, and they encourage others to help the schools in their communities.

“It’s a wonderful idea that young people are being educated in CPR,” Barb Rafaill said. “We wanted to make a difference so schools didn’t have to buy them.”

The American Heart Association expects the training to greatly increase the number of people able to perform CPR.

“We estimate the program will add 100,000 newly trained people every year,” Bouma said. “In five or 10 years, think of how many people there will be who can perform CPR.”

Midwives must be licensed under new law


Capital News Service

LANSING — Michigan midwife associations were pleased when Gov. Rick Snyder signed new midwife licensing legislation into law at the beginning of the year.

Midwives are trained to assist women in childbirth. They help with delivery as well as provide prenatal and postpartum care. Michigan has 31 certified professional midwives currently registered with the state, according to the North American Registry of Midwives.

To further protect the safety of mothers, some midwifery advocates lobbied for such a licensing law for nearly six years, according to Stacia Proefrock, president of the Michigan Midwives Association and a certified professional midwife at Trillium Midwifery in Ypsilanti. Continue reading

Some Michigan fish safe for pregnant women, sometimes


Capital News Service

LANSING — Michigan health professionals still want pregnant women to eat fish in safe amounts, despite local fish advisories throughout the state.

Fish provide nutrients, like omega-3 oils, that are important to fetal brain development, Jennifer Eisner, public information officer for the Department of Health and Human Services, said. But some of the state’s water bodies are contaminated with toxins like mercury that could harm a growing fetus, she said.

“We do want pregnant women to eat locally caught fish,” Eisner said. “But we want them to check our guidelines to find out how often it’s safe to eat them.”

The department develops Eat Safe Fish guidelines that  provide information on the health effects of chemicals in fish by geographic area. The guidelines apply to all Michiganders, but offer specific recommendations for pregnant women, children and those with chronic illnesses. Continue reading