TRIAD by Michigan Osteopathic Association

triad WINTER 2013 VOLUME 24 ISSUE 1

THE AWARD WINNING JOURNAL OF THE MICHIGAN OSTEOPATHIC ASSOCIATION

LEGISLATIVE GUIDE

IN THIS ISSUE: • HOW A BILL BECOMES A LAW • 2012: A YEAR OF LEGISLATIVE SUCCESS • MICHIGAN SENATE & HOUSE • MEE TING & COMMUNICATING WITH ELECTED OFFICIALS TRIAD, WINTER 2013 1

We hate lawsuits. We loathe litigation. We help doctors head off claims at the pass. We track new treatments and analyze medical advances. We are the eyes in the back of your head. We make CME easy, free, and online. We do extra homework. We protect good medicine. We are your guardian angels. We are The Doctors Company. The Doctors Company is devoted to helping doctors avoid potential lawsuits. For us, this starts with patient safety. In fact, we have the largest Department of Patient Safety/Risk Management of any medical malpractice insurer. And, local physician advisory boards across the country. Why do we go this far? Because sometimes the best way to look out for the doctor is to start with the patient. The Michigan State Medical Society exclusively endorses our medical malpractice insurance program, and we are a preferred partner of the Michigan Osteopathic Association. To learn more about our program benefits, call our East Lansing office at (800) 748-0465 or visit www.thedoctors.com.

Exclusively endorsed by

www.thedoctors.com 2

TRIAD, WINTER 2013

TA B L E O F C O N T E N T S

FEATURES

BI L

2012: A Year of Legislative Success

2013: A Look Ahead at Health Care Policy

Michigan Senate & House of Representatives

Meeting with Elected Officials

Communicating with Elected Officials

How Does a Bill Become a Law?

Michigan Board of Osteopathic Medicine & Surgery

Michigan Osteopathic Political Action Committee

2013 MOPAC Contributors

DEPARTMENTS 19

Editor’s Notebook

President’s Page

Dean’s Column

Advertiser Index

TRIAD, WINTER 2013

e d i t or’s no t eboo k

dvocacy is about taking action. Effective advocacy requires you to take the initiative.

In the fall edition of TRIAD, we introduced advocacy to you and why it’s impor-

tant. This edition will give you the tools and resources needed to take action. This resource guide includes contact information for Michigan legislators, information on the Michigan Osteopathic Political Action Committee with tips on how you can get

involved, information on our licensing board, Michigan Board of Osteopathic Medicine and Surgery, and, finally, the Michigan Osteopathic Associations’ 2013 legislative agenda.

by ROBERT G.G. PICCININI, D.O., dFACN

The resources in this guide and on mi-osteopathic.org will allow you to take action to support effective health policy. This guide offers advice for communicating with policymakers, making your voice heard and ensuring your advocacy is effective and efficient. Using MOA materials and the tactics in this guide, you can make the most of your time as an advocate. Even if you have only two minutes to spare, these tried-and-true approaches will make sure you are respected and effective as a go-to source for health policy. With the help of physicians like you, we advocate for health policy and patients rights. Your voice and insight are invaluable to decision makers and legislators. They welcome your input, and it will make a difference. Without our involvement, others will shape the policy according to their own narrow interests—and make decisions without the critical information you can provide. The consequences of such ill-informed efforts, even when well-intentioned, can be devastating. The stakes are simply too high, and the potential too great, for physicians not to engage in advocacy efforts. If we don’t stand up for ourselves, nobody else will. Robert G.G. Piccinini, D.O., dFACN is TRIAD co-editor-in-chief and a member of the MOA Board of Trustees. He can be reached at rggpiccinini@gmail.com.

TRIAD, WINTER 2013

NEW ICD-10 DEADLINE:

OCT 1, 2014

2014 COMPLIANCE DEADLINE FOR ICD-10 The ICD-10 transition is coming October 1, 2014. The ICD-10 transition will change every part of how you provide care, from software upgrades, to patient registration and referrals, to clinical documentation, and billing. Work with your software vendor, clearinghouse, and billing service now to ensure you are ready when the time comes. ICD-10 is closer than it seems. CMS can help. Visit the CMS website at www.cms.gov/ICD10 for resources to get your practice ready.

Official CMS Industry Resources for the ICD-10 Transition

www.cms.gov/ICD10

TRIAD, WINTER 2013

P R E S ID E N T ’ S P A G E

REFLECTIONS ON 2012

by Edward J. Canfield, D.O.

As I write this in late December, I am astonished by the events of this year. As your President, I have been afforded a glance at several spheres of influence and have come away with a new perspective. These exposures, both locally and nationally, have provided the opportunity to advocate for physicians, our patients and our health care system. In May your Michigan Osteopathic Association’s (MOA) House of Delegates (HOD) passed many resolutions, several of which were sent to the American Osteopathic Association (AOA) HOD where some became national guidelines. I had the distinct pleasure to nominate five Michigan physicians to offices of AOA governance, four Board members and the Speaker of the AOA HOD. We have five past presidents of the AOA, who remain active in state and national advocacy. This fall, Mrs. Nancy Granowicz of Royal Oak, became the President of the Advocates of the American Osteopathic Association. Michigan is very well represented nationally. Earlier this year I met with John Bizon, M.D., President of the Michigan State Medical Society (MSMS). We discussed where our associations could mutually advocate and have decided that a regular meeting of the MOA/MSMS leadership and key staff is warranted. Interestingly, in 2013, Kenneth Elmassian, D.O., will be the first Osteopathic physician to be elected President of the MSMS. We have met with the leadership of the Michigan Academy of Physician Assistants (MAPA) and will schedule a meeting with the Michigan Nurses Association (MNA). Certainly there are differing issues between our organizations and, at times, they are divisive, but there are many issues in common where we must — and will — work together. With the Supreme Court decision to uphold the Patient Protection and Affordable Care Act (PPACA), and the reelection of President Barack Obama, we now know the program will be implemented and can focus on that task. Medicaid reform in our state has also been an issue. I testified at a Michigan Senate committee hearing related to reimbursement of physicians. At least for now primary care physicians will be reimbursed at Medicare rates for certain codes. I met with the Directors of the Michigan Department of Community Health (MDCH), James Haveman and Michigan Medicaid, Steve Finton, to present our concerns and recommend solutions to improve the Medicaid program. Although there was not complete agreement, our ideas were voiced and we have been invited to continue the dialogue. The plague of the Sustainable Growth Rate (SGR) and a 26.5% automatic decrease in Medicare reimbursement makes the Medicaid issue pale comparatively. Your MOA will continue to lobby for solutions. Innumerable issues have come before the MOA Council on Government Affairs. Under the leadership of former MOA President Craig Bethune, D.O., the committee, with guidance of our lobbyist, Kevin McKinney, and the MOA team has done an outstanding job of advocating for our profession. Your MOA has sent a letter of initial support to the AOA related to the negotiations between the Accreditation Council for Graduate Medical Education and the American Association of Colleges of Osteopathic Medicine in their efforts to resolve issues related to the education of Osteopathic students, residents and fellows. Many concerns remain about this process and what it means to osteopathic medicine. Also, as your MOA representative to the Blue Cross Blue Shield of Michigan Board, I have had the opportunity to witness and participate in the company’s historic change to a non-profit mutual Insurance company in preparation for the upcoming exchanges of PPACA. There were many other issues, committee meetings and times we actually assisted individual members with problems. The world did not end just because the Mayan calendar ended on December 21, 2012, and we will look forward to the issues of 2013. We will continue to advocate, because that is what we do. Happy New Year! MOA President Edward J. Canfield, D.O. is a family physician in Sebewaing, MI. He may be reached at ejcanfield.do@gmail.com. TRIAD, WINTER 2013

A YEAR OF LEGISLATIVE SUCCESS The conclusion of the past lame duck session brought about a flurry of legislative activity, some expected, some not, some welcomed, some brought challenges. But for the most part, your Michigan Osteoapthic Association (MOA) can be proud of the number of successes in the legislative process for 2012. Below is a brief summary of the major issues that MOA was directly involved with and the status:

supervision/delegation of a physician. MOA, MSMS and MAFP were able to work with Sen. Jansen (bill sponsor) and Sen. Marleau (Senate Health Policy Committee Chair) to avoid a discharge motion of SB 481 from committee during lame duck. The issue will be reintroduced early next session. MOA will be participating in a small workgroup of key stakeholders to review this proposed scope of practice and evaluate how it addresses access to care and the safety of patients.

SCOPE of PRACTICE

MOA opposeS as introduced

Advanced Practice Registered Nurse Scope of Practice Legislation – (SB 481) would significantly expand APRN’s scope of practice and allow independent practice outside the

CRNA Scope of Practice – (SB 1309) would provide in the definition of nursing the administration of anesthesia by a RN

TRIAD, WINTER 2013

2 0 1 2 L E G I S L ATI O N

who holds a specialty certification as a nurse anesthetists. No action taken on the bill. MOA opposes. Physical Therapists Scope of Practice – (HB 4603) would allow PTs to diagnosis and practice independent of a physician’s prescription. The PTs scope bill was scheduled for action in the House Health Policy Committee the last two weeks of session but saw no further action. The bill will likely be pushed for early action in the House. MOA opposeD

STATE LICENSING BOARD MERGER The Office of Regulatory Reinvention’s (ORR) recommendation for the merger of the state licensing boards of the Michigan Board of Osteopathic Medicine and Surgery, Michigan Board of Medicine and the Michigan Board of Podiatric Medicine and Surgery received strong questioning and opposition from MOA which assisted in no action taken this session on the proposal. MOA opposeD

would clarify the definition of non-economic damages and SB 1118 addressed balance in the requirements for affidavits of merit and meritorious defense as well as closing a loophole in the statute of limitations. MOA supportED

Auto No Fault Reforms – Despite strong support from the Governor’s office, House and Senate leadership and the House insurance Committee Chair auto insurers were unable to advance bills to make changes to Michigan’s Auto No Fault system that would limit medical benefits and place draconian fee structures on providers. MOA worked with CPAN to oppose numerous bills

Medical Audits – (HBs 5908 and 5909) would limit the time frame during which insurers could perform a retro medical audit and seek recoupment of previously paid claims. The bills will be re-introduced next session. MOA supportED

ACCESS TO CARE Universal Prior Authorization Forms – (SBs 429 and 430) would require one single, electronic prior-authorization form to be used by all health-insurance companies and pharmacy benefit managers across Michigan. These two bills received strong support in the Senate but died in the House Insurance Committee. The bills will be re-introduced this session in both the house and senate with anticipation of quick action in both chambers.

SAFETY AND PREVENTION Impaired Drivers Bills – SBs 402 and 403 would limit liability to physicians for reporting or not reporting impaired drivers to the Secretary of State. MOA has worked with other physician groups and patient advocates on these bills for several years and both bills finally cleared the legislature and are now Public Acts 354 and 355 of 2012. MOA supported

MOA supportED

Michigan Medical Marijuana Act – (HB 4851) was part of a larger package of bills that attempted to correct some perceived deficiencies in the MMM Act. HB 4851 would establish and define a “bona fide” physician/patient relationship prior to a patient being able to receive a certification for use. MOA supportED

INSURANCE REFORMS Medical Liability Reforms – Despite four contentious public hearings in the Senate Insurance Committee two bills in a four bill package made it through the process and will be enrolled and sent on the Governor for his signature. SB 1115

Kelsey’s Law – SB 756 would prohibit young drivers on probation (levels 1 and 2) from using a cell phone while operating a vehicle unless of an emergency. The bill passed the House the last few hours of the last day of session and has been enrolled and sent on the Governor for his signature. Sports Concussion – SB 1122 and HB 5697 would provide guidelines and public awareness education for young athletes, coaches and parents on sports concussions and when the concussed athlete could return to play. The bills are targeted at youth and recreation sports leagues. The bills were passed and signed into law and are now Public Acts 342 and 343 of 2012. MOA supportED

TRIAD, WINTER 2013

A LOOK AHEAD AT HEALTH CARE POLICY By KEVIN MCKINNEY The 97th Legislature officially commenced on January 9, 2013. The opening session day was ceremonial in nature, with the official swearing in of newly elected members, election of legislative leadership, introductions and referral of bills to standing committees for future deliberations. Typically, session and committee work begins in earnest in late January around the time of the Governor’s State of the State Address. 2013 is expected to be another year of high energy and swift pace of legislative action given that all members of the legislature (House and Senate) and all statewide constitutional offices will be up for election in 2014 making it more desirable to move the more controversial issues earlier in the legislative session. With the highly contentious atmosphere that existed during the recent lame duck session is likely to continue during the new session and the reduction of the House Republican Majority to 59 to 51 it will certainly make it more challenging for the Governor to move his legislative priorities. Your Michigan Osteopathic Association’s (MOA) Council on Government Affairs is currently reviewing legislative issues that were not resolved during this past session, as well as other policy priorities in developing your MOA’s legislative agenda for 2013-14. The recommended MOA legislative agenda will be presented to your MOA Board of Trustees at its February meeting. However, we do know the following issues will be back during the new session and included as part of our legislative agenda.

CRNA Scope of Practice – (Previous SB 1309) would provide in the definition of nursing the administration of anesthesia by a RN who holds a specialty certification as a nurse anesthetists. MOA opposes

Physical Therapists Scope of Practice – (Previous HB 4603) would allow PTs to diagnosis and practice independent of a physician’s prescription. The PTs scope bill was put on the agenda for action in the House health Policy Committee the last two weeks of session. The bill will likely be pushed for early action in the House. MOA opposes

STATE LICENSING BOARD MERGER The Executive Office remains guarded as to its support of the administration’s far reaching review of all state licensing and regulations in the occupational code. The Office of Regulatory Reinvention’s (ORR) recommendation for the merger of the state licensing boards of the Michigan Board of Osteopathic Medicine and Surgery, Michigan Board of Medicine and the Michigan Board of Podiatric Medicine and Surgery is not likely to advance but legislation incorporating many of the recommendations in an omnibus bill is still a possibility during the new session. MOA opposes

SCOPE of PRACTICE

ACCESS TO CARE

Advanced Practice Registered Nurse Scope of Practice Legislation – (Previous SB 481) would significantly expand APRN’s scope of practice that would mirror the practice of medicine and allow independent practice outside the supervision/delegation of a physician. The bill sponsor is formalizing a smaller workgroup of key stakeholders to begin discussions and review of this proposed scope of practice and determine how it addresses access to care and the safety of patients.

Universal Prior Authorization Forms – (Previous SBs 429 and 430) would require the Insurance Commissioner to work with health insurance companies to develop one single, electronic prior-authorization form to be used by all healthinsurance companies and pharmacy benefit managers across Michigan. Despite a strong push by the MOA and other physician organizations and patient groups, the bills died in the House Insurance Committee despite repeated attempts to get the bills on the committee agenda. The bills will be

MOA opposes as introduced 10

TRIAD, WINTER 2013

2 0 13 : A loo k a he a d

2013 is expected to be another year of high energy and swift pace of legislative action given that all members of the legislature...and statewide constitutional offices will be up for election in 2014 making it more desirable to move the more controversial issues earlier in the legislative session. re-introduced this session in both the house and senate with anticipation of quick action in both chambers. MOA supports

Expedited Partner Therapy – (previous HB 5934) would provide for the department to promulgate rules that would allow for a provider to prescribe treatment for a patient’s partner for STD that is unable or unwilling to come in for testing and treatment. MOA supports

Specialty Tier legislation – Access to medicine will be under discussion to determine insurers policies of step therapies/fail first policies, high co pays and co insurance for medicine and how it impacts affordability/compliance and the physician/ patient relationship. MOA will be co hosting an access to medicine forum in February or March with the National Arthritis Foundation.

INSURANCE REFORMS Auto No Fault Reforms – Numerous bills were introduced by auto insurers, mostly in the House, which would dramatically impact providers and patients by placing limits and caps on medical benefits, place workers comp fee schedules on providers in catastrophic injury cases – all resulting in significant cost shifting to Medicaid and cutting access to care. MOA working with the collective efforts of members of the Coalition Protecting Auto No Fault were able to defeat the bills and keep them on the House floor due to lack of support despite strong support from the Governor’s office, House and Senate leadership and the House insurance Committee Chair. Auto No Fault Reform will continue to be a top priority in the Legislature. CPAN will be pushing its own reforms in the new session.

Medical Audits – (Previous HBs 5908 and 5909) would limit the time frame during which insurers could perform a retro medical audit and seek recoupment of previously paid claims. The bills will be re-introduced next session. MOA supports

SAFETY AND PREVENTION Anaphylaxis – (Previous HBs 5865 and 5866) would require school districts to have non-patient specific auto epinephrine injectors at each school building and to require school personnel to be trained to administer. Limits on civil liability are also included in the proposals. The bills will be re-introduced in the House and a workgroup set up with the various stakeholders. MOA supports

BUDGET Health Insurance Claims Assessment – (Previous SB 1359) attempts to include an adjustable rate on the assessment to address the anticipated short fall in revenue from the one percent claims assessment for the current fiscal year. A projected $129 million shortfall significantly impacts the state’s ability to match federal funds. The bill is not likely to be reintroduced but all stakeholders are meeting to discuss solutions rather than provider reimbursement cuts in early 2013. Other issues still under discussion and development include establishing a student loan repayment program, GME funding reforms, Medicaid reforms, recodification of the Public Health Code, improvements in the delivery of behavioral health and implementation of the ACA with the federal/state partnership of the health insurance exchanges. Kevin McKinney handles the MOA’s Governmental Affairs and may be reached at kevin@mckinneyandassociates.net TRIAD, WINTER 2013

MOAâ&#x20AC;&#x2122;s 114th Annual Spring Scientific Convention May 15-18, 2013 | Novi, MI.

www.mi-osteopathic.org/2013SpringConvention

NEW LOCATION: Suburban Collection Showplace, Novi, MI. 30 hours of AOA category 1-A CME anticipated Specialty credits available for AOBIM, AOBFP, AOBS, AOBOG and AOBEM (credits vary). Watch www.mi-osteopathic.org for the latest updates.

TRIAD, WINTER 2013

RESOURCE

MICHIGAN HOUSE OF REPRESENTATIVES Anderson House Office Building 124 North Capitol Avenue P.O. Box 30014 Lansing, MI 48909-7514

House Business Office

Clerkâ&#x20AC;&#x2122;s Office

Ph: 517.373.6339 BusinessOffice@house.mi.gov Capitol Building P.O. Box 30014 Lansing, MI 48909-7514

Ph: 517.373.0135 Clerk@house.mi.gov

Please note, for locations, HOB = House Office Building and CB = Capitol Building.

District Name

Party

001 Brian Banks D 002 Alberta Talabi D 003 John Olumba D 004 Rose Mary Robinson D 005 Fred Durhal D 006 Rashida Tlaib D 007 Thomas Stallworth D 008 David Nathan D 009 Harvey Santana D 010 Phil Cavanagh D 011 David Knezek D 012 Douglas Geiss D 013 Andrew Kandrevas D 014 Paul Clemente D 015 George Darany D 016 Robert Kosowski D 017 Bill LaVoy D 018 Sarah Roberts D John Walsh R 019 020 Kurt Heise R 021 Dian Slavens D 022 Harold Haugh D 023 Pat Somerville R 024 Anthony Forlini R 025 Henry Yanez D 026 Jim Townsend D 027 Ellen Lipton D 028 Jon Switalski D 029 Tim Greimel D 030 Jeff Farrington R 031 Marilyn Lane D 032 Andrea LaFontaine R 033 Ken Goike R 034 Woodrow Stanley D 035 Rudy Hobbs D

Location S0585 HOB S0586 HOB S0587 HOB S0588 HOB S0589 HOB S0685 HOB S0686 HOB S0687 HOB S0688 HOB S0689 HOB N0690 HOB N0691 HOB N0692 HOB N0693 HOB N0694 HOB N0695 HOB N0696 HOB N0697 HOB 251 CB N0699 HOB S0785 HOB S0786 HOB S0787 HOB S0788 HOB S0789 HOB N0790 HOB N0791 HOB N0792 HOB S1122 HOB N0794 HOB N0795 HOB N0796 HOB N0797 HOB N0798 HOB S1124 HOB

Phone

517-373-0154 BrianBanks@house.mi.gov 517-373-1776 AlbertaTalabi@house.mi.gov 517-373-0144 JohnOlumba@house.mi.gov 517-373-1008 RoseMaryRobinson@house.mi.gov 517-373-0844 FredDurhal@house.mi.gov 517-373-0823 RashidaTlaib@house.mi.gov 517-373-2276 ThomasStallworth@house.mi.gov 517-373-3815 DavidNathan@house.mi.gov 517-373-6990 HarveySantana@house.mi.gov 517-373-0842 PhilCavanagh@house.mi.gov 517-373-0849 DavidKnezek@house.mi.gov 517-373-0852 DouglasGeiss@house.mi.gov 517-373-0845 AndrewKandrevas@house.mi.gov 517-373-0140 PaulClemente@house.mi.gov 517-373-0847 GeorgeDarany@house.mi.gov 517-373-2576 RobertKosowski@house.mi.gov 517-373-1530 BillLaVoy@house.mi.gov 517-373-1180 SarahRoberts@house.mi.gov 517-373-3920 JohnWalsh@house.mi.gov 517-373-3816 KurtHeise@house.mi.gov 517-373-2575 DianSlavens@house.mi.gov 517-373-0854 HaroldHaugh@house.mi.gov 517-373-0855 PatSomerville@house.mi.gov 517-373-0113 AnthonyForlini@house.mi.gov 517-373-2275 HenryYanez@house.mi.gov 517-373-3818 JimTownsend@house.mi.gov 517-373-0478 EllenLipton@house.mi.gov 517-373-1772 JonSwitalski@house.mi.gov 517-373-0475 TimGreimel@house.mi.gov 517-373-7768 JeffFarrington@house.mi.gov 517-373-0159 MarilynLane@house.mi.gov 517-373-8931 AndreaLaFontaine@house.mi.gov 517-373-0820 KenGoike@house.mi.gov 517-373-8808 WoodrowStanley@house.mi.gov 517-373-1788 RudyHobbs@house.mi.gov TRIAD, WINTER 2013

District Name

Party

036 Pete Lund R Vicki Barnett D 037 038 Hugh Crawford R 039 Klint Kesto R 040 Michael McCready R 041 Martin Howrylak R Bill Rogers R 042 043 Gail Haines R Eileen Kowall R 044 045 Tom McMillin R 046 Bradford Jacobsen R Cindy Denby R 047 048 Pam Faris D Jim Ananich D 049 Charles Smiley D 050 051 Joseph Graves R Gretchen Driskell D 052 Jeff Irwin D 053 054 David Rutledge D 055 Adam Zemke D 056 Dale Zorn R Nancy Jenkins R 057 058 Kenneth Kurtz R 059 Matt Lori R Sean McCann D 060 061 Margaret O'Brien R 062 Kate Segal D Jase Bolger R 063 064 Earl Poleski R Mike Shirkey R 065 066 Aric Nesbitt R 067 Tom Cochran D 068 Andy Schor D 069 Sam Singh D 070 Rick Outman R 071 Theresa Abed D 072 Ken Yonker R Peter MacGregor R 073 074 Rob VerHeulen R Brandon Dillon D 075 Winnie Brinks D 076 077 Tom Hooker R 078 Dave Pagel R 079 Al Pscholka R 080 Bob Genetski R 081 Dan Lauwers R 082 Kevin Daley R Paul Muxlow R 083 084 Terry Brown D Ben Glardon R 085 Lisa Lyons R 086 Mike Callton R 087 088 Roger Victory R 089 Amanda Price R 090 Joe Haveman R Collene Lamonte D 091 092 Marcia Hovey-Wright D 093 Tom Leonard R 094 Tim Kelly R 095 Stacy Oakes D 096 Charles Brunner D 14

TRIAD, WINTER 2013

Location 374 CB S0886 HOB S0887 HOB S0888 HOB S0889 HOB N0890 HOB N0891 HOB N0892 HOB N0893 HOB N0894 HOB N0895 HOB N0896 HOB N0897 HOB N0898 HOB N0899 HOB S0985 HOB S0986 HOB S0987 HOB S0988 HOB S0989 HOB N0990 HOB N0991 HOB N0992 HOB N0993 HOB N0994 HOB N0995 HOB N0996 HOB 164 CB N0998 HOB N0999 HOB S1085 HOB S1086 HOB S1087 HOB S1088 HOB S1089 HOB N1090 HOB N1091 HOB N1092 HOB N1093 HOB N1094 HOB N1095 HOB N1096 HOB N1097 HOB N1098 HOB N1099 HOB S1185 HOB S1186 HOB S1187 HOB S1188 HOB S1189 HOB N1190 HOB N1191 HOB N1192 HOB N1193 HOB 351 CB N1195 HOB N1196 HOB N1197 HOB N1198 HOB N1199 HOB S1285 HOB

Phone

517-373-0843 PeteLund@house.mi.gov 517-373-1793 VickiBarnett@house.mi.gov 517-373-0827 HughCrawford@house.mi.gov 517-373-1799 KlintKesto@house.mi.gov 517-373-8670 MichaelMcCready@house.mi.gov 517-373-1783 MartinHowrylak@house.mi.gov 517-373-1784 BillRogers@house.mi.gov 517-373-0615 GailHaines@house.mi.gov 517-373-2616 EileenKowall@house.mi.gov 517-373-1773 TomMcMillin@house.mi.gov 517-373-1798 BradfordJacobsen@house.mi.gov 517-373-8835 CindyDenby@house.mi.gov 517-373-7557 PamFaris@house.mi.gov 517-373-7515 JimAnanich@house.mi.gov 517-373-3906 CharlesSmiley@house.mi.gov 517-373-1780 JosephGraves@house.mi.gov 517-373-0828 GretchenDriskell@house.mi.gov 517-373-2577 JeffIrwin@house.mi.gov 517-373-1771 DavidRutledge@house.mi.gov 517-373-1792 AdamZemke@house.mi.gov 517-373-2617 DaleZorn@house.mi.gov 517-373-1706 NancyJenkins@house.mi.gov 517-373-1794 KennethKurtz@house.mi.gov 517-373-0832 MattLori@house.mi.gov 517-373-1785 SeanMcCann@house.mi.gov 517-373-1774 MargaretO'Brien@house.mi.gov 517-373-0555 KateSegal@house.mi.gov 517-373-1787 JaseBolger@house.mi.gov 517-373-1795 EarlPoleski@house.mi.gov 517-373-1775 MikeShirkey@house.mi.gov 517-373-0839 AricNesbitt@house.mi.gov 517-373-1058 TomCochran@house.mi.gov 517-373-0826 AndySchor@house.mi.gov 517-373-1786 SamSingh@house.mi.gov 517-373-0834 RickOutman@house.mi.gov 517-373-0853 TheresaAbed@house.mi.gov 517-373-0840 KenYonker@house.mi.gov 517-373-0218 PeterMacGregor@house.mi.gov 517-373-8900 RobVerHeulen@house.mi.gov 517-373-2668 BrandonDillon@house.mi.gov 517-373-0822 WinnieBrinks@house.mi.gov 517-373-2277 TomHooker@house.mi.gov 517-373-1796 DavePagel@house.mi.gov 517-373-1403 AlPscholka@house.mi.gov 517-373-0836 BobGenetski@house.mi.gov 517-373-1790 DanLauwers@house.mi.gov 517-373-1800 KevinDaley@house.mi.gov 517-373-0835 PaulMuxlow@house.mi.gov 517-373-0476 TerryBrown@house.mi.gov 517-373-0841 BenGlardon@house.mi.gov 517-373-0846 LisaLyons@house.mi.gov 517-373-0857 MikeCallton@house.mi.gov 517-373-1830 RogerVictory@house.mi.gov 517-373-0838 AmandaPrice@house.mi.gov 517-373-0830 JoeHaveman@house.mi.gov 517-373-3436 ColleneLamonte@house.mi.gov 517-373-2646 MarciaHovey-Wright@house.mi.gov 517-373-1778 TomLeonard@house.mi.gov 517-373-0837 TimKelly@house.mi.gov 517-373-0152 StacyOakes@house.mi.gov 517-373-0158 CharlesBrunner@house.mi.gov

RESOURCE District Name

Party

097 Joel Johnson R Jim Stamas R 098 099 Kevin Cotter R Jon Bumstead R 100 101 Ray Franz R 102 Phil Potvin R Bruce Rendon R 103 104 Wayne Schmidt R Greg MacMaster R 105 106 Peter Pettalia R 107 Frank Foster R Ed McBroom R 108 109 John Kivela D Scott Dianda D 110

Location S1286 HOB 153 CB S1288 HOB S1289 HOB S1385 HOB S1386 HOB S1387 HOB S1388 HOB S1389 HOB S1485 HOB S1486 HOB S1487 HOB S1488 HOB S1489 HOB

Phone

517-373-8962 JoelJohnson@house.mi.gov 517-373-1791 JimStamas@house.mi.gov 517-373-1789 KevinCotter@house.mi.gov 517-373-7317 JonBumstead@house.mi.gov 517-373-0825 RayFranz@house.mi.gov 517-373-1747 PhilPotvin@house.mi.gov 517-373-3817 BruceRendon@house.mi.gov 517-373-1766 WayneSchmidt@house.mi.gov 517-373-0829 GregMacMaster@house.mi.gov 517-373-0833 PeterPettalia@house.mi.gov 517-373-2629 FrankFoster@house.mi.gov 517-373-0156 EdMcBroom@house.mi.gov 517-373-0498 JohnKivela@house.mi.gov 517-373-0850 ScottDianda@house.mi.gov

MICHIGAN STATE SENATE P.O. Box 30036 Lansing, MI 48909-7536 www.senate.michigan.gov

District Name

Party

1 Young, Coleman II D 2 Johnson, Bert D 3 Hood, Morris W III D 4 Smith, Virgil D 5 Hunter, Tupac A. D 6 Anderson, Glenn D 7 Colbeck, Patrick R 8 Hopgood, Hoon-Yung D 9 Bieda, Steven M D 10 Rocca, Tory R 11 Brandenburg, Jack R 12 Marleau, Jim R 13 Pappageorge, John R 14 Gregory, Vincent D 15 Kowall, Mike R 16 Caswell, Bruce R 17 Richardville, Randy R 18 Warren, Rebekah D 19 Nofs, Mike R 20 Schuitmaker, Tonya R 21 Proos, John R 22 Hune, Joe R 23 Whitmer, Gretchen D 24 Jones, Rick R 25 Pavlov, Phil R 26 Robertson, David B R 27 Vacant 28 Jansen, Mark R 29 Hildenbrand, Dave R 30 Meekhof, Arlan B R 31 Green, Mike R 32 Kahn, Roger R 33 Emmons, Judy K R 34 Hansen, Goeff R 35 Booher, Darwin L R 36 Moolenaar, John R 37 Walker, Howard R 38 Casperson, Tom R

Location 410 Farnum Bldg 220 Farnum Bldg 710 Farnum Bldg 510 Farnum Bldg S-9 Capitol Bldg 610 Farnum Bldg 1020 Farnum Bldg 515 Farnum Bldg 310 Farnum Bldg 205 Farnum Bldg 605 Farnum Bldg 1010 Farnum Bldg S-2 Capitol Bldg 1015 Farnum Bldg 305 Farnum Bldg 720 Farnum Bldg S-106 Capitol Bldg 415 Farnum Bldg S-132 Capitol Bldg 405 Farnum Bldg 820 Farnum Bldg 505 Farnum Bldg S-105 Capitol Bldg 915 Farnum Bldg 905 Farnum Bldg 320 Farnum Bldg 315 Farnum Bldg S-310 Capitol Bldg 920 Farnum Bldg S-8 Capitol Bldg 805 Farnum Bldg S-324 Capitol Bldg 1005 Farnum Bldg 420 Farnum Bldg 520 Farnum Bldg 715 Farnum Bldg 910 Farnum Bldg 705 Farnum Bldg

Phone 517-373-7346 517-373-7748 517-373-0990 517-373-7918 517-373-0994 517-373-1707 517-373-7350 517-373-7800 517-373-8360 517-373-7315 517-373-7670 517-373-2417 517-373-2523 517-373-7888 517-373-1758 517-373-5932 517-373-3543 517-373-2406 517-373-2426 517-373-0793 517-373-6960 517-373-2420 517-373-1734 517-373-3447 517-373-7708 517-373-1636 517-373-0142 517-373-0797 517-373-1801 517-373-6920 517-373-1777 517-373-1760 517-373-3760 517-373-1635 517-373-1725 517-373-7946 517-373-2413 517-373-7840

Email Sencyoung@senate.mi.gov Senbjohnson@senate.mi.gov Senmhood@senate.mi.gov Senvsmith@senate.mi.gov Senthunter@senate.mi.gov Senganderson@senate.mi.gov Senpcolbeck@senate.mi.gov Senhhopgood@senate.mi.gov Sensbieda@senate.mi.gov Sentrocca@senate.mi.gov Senjbrandenburg@senate.mi.gov Senjmarleau@senate.mi.gov Senjpappageorge@senate.mi.gov Senvgregory@senate.mi.gov Senmkowall@senate.mi.gov Senbcaswell@senate.mi.gov Senrrichardville@senate.mi.gov Senrwarren@senate.mi.gov Senmnofs@senate.mi.gov Sentschuitmaker@senate.mi.gov Senjproos@senate.mi.gov Senjhune@senate.mi.gov Sengwhitmer@senate.mi.gov Senrjones@senate.mi.gov Senppavlov@senate.mi.gov Sendrobertson@senate.mi.gov Senmjansen@senate.mi.gov Sendhildenbrand@senate.mi.gov Senameekhof@senate.mi.gov Senmgreen@senate.mi.gov Senrkahn@senate.mi.gov Senjemmons@senate.mi.gov Senghansen@senate.mi.gov Sendbooher@senate.mi.gov Senjmoolenaar@senate.mi.gov Senhwalker@senate.mi.gov Sentcasperson@senate.mi.gov TRIAD, WINTER 2013

MEETING

WITH ELECTED OFFICIALS Meeting With Your Legislators

Remember to follow-up with the answers. 5. Be cordial. In politics, today’s enemy is tomorrow’s Personal meetings, either to discuss a specific issue or just friend. If the Member or staff position is not in line to introduce yourself as a constituent, are the most effective with the AOA’s position, agree to disagree, but be means of political communication. Given a legislator’s busy respectful. schedule, meetings are sometimes difficult to arrange, yet they 6. If you see a Member alone, make sure you follow up are just as vital as any other extremely important professional with staff. meeting. The contact can be made with the legislator directly 7. Tell them who your allies are, if any. or through key staff aides. Unless you already know your 8. Tell them why they might be interested in your posilegislator, you should write, rather than phone, to request an tion, from a local or issue-related point of view. appointment or schedule a special event. Do not overlook the 9. Be educated on bills and efforts Members and staff opportunity to meet with a staff aide, particularly if he/she is have taken on behalf osteopathic medicine. working closely with the legislator on an issue of concern to 10. Always say please and thank you. The basic rules of you. Further, try to schedule meetings with your legislators courtesy still apply. when they are in the district or state visiting their constituents (including you). If the meeting is to discuss a specific issue, it is important to Tips for Successful Visits 1. Plan Your Visit. Decide what it is that you want to be thoroughly familiar with all aspects of the issue prior to the achieve. Determine key issues and participants. meeting. When talking to the legislator, try to be concise and 2. Make an Appointment. Write, fax, and follow up by well organized. Demonstrate a regard for his/her schedule. phone your targeted office in advance. Always use one Most of all, state your views firmly, but be attentive to the legkey staff contact for your issue. In your communicaislators’ position as well. The meeting should be an exchange tion with offices it is important to relay all contact of ideas, not a lecture. During the meeting, use of personal information, affiliations you will be representing, and anecdotes/contacts should be limited to only those that are perkey issues you would like to discuss. Be sure to comtinent to the issue being discussed. municate that you are a constituent! 3. Be Prompt and Patient. Arrive to your meeting neat, Rules for meeting with Elected on time and prepared. Members are extremely busy Officials and their Staff and often have rigorous schedules. If interruptions 1. Keep it short. occur during your meeting, please remain patient and 2. Know the other side’s arguments. flexible. 3. Know your issues. Document your position with sum4. Be Prepared. Be direct about your perspectives of legmary and supporting papers and leave them with the islative issues and provide background materials. In staff. addition to Elected Officials, staffers also maintain a 4. Promise to supply answers and documents requested. 16

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C O M M U N I C ATI O N S

hectic schedule comprised of tracking numerous bills and political developments. Explain how the legislation affects you and why you support or oppose it. 5. Be Political. Remind Members that you are a constituent and you have a vote. Legislators are elected to their office by their constituents -- that means you! Legislators want to be known for best representing their districtâ&#x20AC;&#x2122;s residents. Request commitment (but do not threaten retaliation!) 6. Be Responsive. Answer questions to the best of your knowledge. If you canâ&#x20AC;&#x2122;t answer a question, use this opportunity to tell staffers you will get them more detailed information. If more information is requested promise to send it -- and follow up. 7. Follow Up. After your meeting send a letter of thanks. Use this letter as an opportunity to review points covered, identify points of agreement, target next steps,

and provide requested information. 8. Do Not Be Intimidated. Officials are elected to work for you. Legislators and their staff want to meet with you to learn more about your views as a constituent.

After the Meeting The most important part of your meeting is that you have established a base, both as an individual and as a representative of osteopathic medicine. Name recognition will most likely earn you a future meeting and will initiate the line of communication for MOA staff with that legislator. 1. Follow up with a thank you letter and re-emphasize key points which were discussed. 2. Send a note of thanks to those staff people who helped arrange the visit or who participated in the meeting. 3. Advise the MOA of any significant items which were discussed during the visit.

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COMMUNICATING WITH ELECTED OFFICIALS Because much of a legislator’s schedule most of the communications you have will probably be written. When writing to a legislator as an advocate it is important to keep the following guidelines in mind: • Use your office letterhead when writing legislators at the request of the MOA. Personal stationary should be used if your home address is in the district of the legislator, and your office is in another district. • Address the letter correctly. • On the envelope and on the inside heading refer to the elected official as “The Honorable (Name).”

•

• •

Address the letter as follows: Members of the Michigan House of Representatives The Honorable (Name) Michigan House of Representatives P.O. Box 30014 Lansing, MI 48909-7514 Dear Congressman/woman (Name) Members of the Michigan Senate The Honorable (Name) Michigan Senate PO Box 30036 Lansing, MI 48909-7536 Dear Senator (Name)

• State the reason for writing. If extending an invitation or requesting a meeting, suggest a time and date, or several dates, for the visit. Be flexible. Indicate how much time you would like with the legislator and the purpose of the meeting. If you are scheduling a meeting, many offices set aside

TRIAD, WINTER 2013

• •

•

15, 20, or 30-minute “slots” for meetings. If you are trying to schedule a tour of your hospital or facility, try to give approximate length of time that it will take. If applicable, provide brief background information about your practice (number of patients and employees, length of time in the community, medical society positions held, etc.) Keep your comments short and to the point. Cover only one issue per letter, if you are writing to express your views. Identify the subject clearly. Use the bill number, if available, when writing about a piece of legislation and indicate which committee is dealing with the bill. If you are communicating your views about an issue, explain how the issue would affect you, your family, your patients, and the delivery of quality health care, as well as any specific impact it would have on your community or state. Be reasonable. Don’t ask the impossible. Don’t use threats. Be courteous and respectful in all communications. Ask the legislator to respond and explain his or her position on the issues. Be constructive. If a bill deals with a problem but seems to represent the wrong solution, propose constructive alternatives. Avoid form letters of stereotyped phrases and sentences that give the appearance of form letters. Communications written in your own words that reflect your own personality and cite your own expertise are more effective. Type all correspondence; handwritten letters are difficult to read and may not be understood clearly. Don’t forget to write when a legislator does something that deserves approval or thanks. A word of appreciation will create a more favorable light for the next communication.

F E AT U R E

How does a

BI L

Bill become a Law?

From the Michigan Government There are a few major steps of the legislative process that a bill must go through before it is enacted into law. Bills may be introduced in either house of the Legislature. Senate bills are filed with the Secretary of the Senate and House bills with the Clerk of the House. Upon introduction, bills are assigned a number. At the beginning of each biennial session, House bills are numbered consecutively starting with House Bill No. 4001 and Senate bills are numbered starting with Senate Bill No. 1. In both houses, joint resolutions are assigned a letter.

Title Reading Under the State Constitution, every bill must be read three times before it may be passed. The courts have held, however, that this requirement can be satisfied by reading the bill’s title. Upon introduction, the bill’s title is read a first and second time in the Senate and is read once in the House. The bill is then ordered to be printed. A bill cannot be passed or become law until it has been printed or reproduced and in the possession of each house for at least five days.

Referral to Committee Upon introduction, a bill is also referred to a standing committee in the Senate by the Majority Leader and in the House of Representatives by the Speaker of the House. All bills involving an appropriation must be referred either directly to the appropriations committee or to an appropriate standing committee and then to the appropriations committee.

Committee Review Committee members consider a bill by discussing and debating the bill. The committee may also hold public hearings on the bill.

Committee Action A standing committee may act on a bill in various ways. The committee may: • Report the bill with favorable recommendation. • Report the bill with amendments with favorable recommendation. • Report a substitute bill in place of the original bill. • Report the bill without recommendation. • Report the bill with amendments but without recommendation. • Report the bill with the recommendation that the bill be referred to another committee. • Take no action on a bill. • Vote to not report a bill out of committee. In the cases of d and e, the bill, upon being reported from committee, is tabled on the floor (temporarily removed from consideration). A majority vote of the members present and voting in the house where the bill is tabled is required to remove the bill from the table before it may be given further consideration. In both houses, a majority vote of the members serving on a committee is necessary to report a bill. If a committee fails to report a bill, a motion to discharge the committee from consideration of the bill may be offered in the house having possession of the bill. If this motion is approved by a vote of a majority TRIAD, WINTER 2013

of the members elected and serving, the bill is then placed in position on the calendar for floor action. In the House, at least a one-day prior notice of the motion to discharge must be given to the Clerk of the House.

Committee Reports

majority” of a two-thirds or three-fourths vote) or one of the following four options is exercised to delay final action on the bill: (a) the bill is returned to committee for further consideration; (b) consideration of the bill is postponed indefinitely; (c) consideration is postponed until a certain date; or (d) the bill is tabled. Following either passage or defeat of a bill, a legislator may move for reconsideration of the vote by which the bill was passed or defeated. (A motion to reconsider can be made for any question.) In the Senate, the motion for reconsideration must be made within the following two session days; in the House, the motion must be made within the next succeeding session day.

If a bill is reported from committee favorably with or without amendment or in the form of a substitute bill, the committee report is printed in the journal under the order of business entitled “Reports of Standing Committees” in the House. On being reported favorably from committee, the bill and recommended committee amendments (if any) are placed on the order of “General Orders” in the Senate. In the House, the bill and amendments are referred to the order of “Second Reading.”

No bill can become law at any regular session of the Legislature until it has been printed and reproduced and in the possession of each house for at least five days. (Constitution, Art. IV, Sec. 26.)

General Orders or Second Reading

Immediate Effect

For the purpose of considering the standing committee recommendations on a bill, the Senate resolves itself into the Committee of the Whole and the House assumes the order of Second Reading. Amendments to the bill may be offered by any member when the bill is being considered at this stage of the legislative process. In the Senate, a simple majority of members present and voting may recommend adoption of amendments to the bill and recommend a bill be advanced to Third Reading. In the House, amendments may be adopted by a majority serving, and a majority voting may advance the bill to Third Reading. In the House, a bill may be placed on Third Reading for a specified date.

No act shall take effect until the expiration of 90 days from the end of the session at which the measure was enacted. The Legislature may give immediate effect to an act by a two-thirds vote of the members elected and serving in each house. (Constitution, Art. IV, Sec. 27.)

Third Reading While there are provisions in the House Rules and the Senate Rules for reading bills unless exception is made, in practice, bills are not read in full in either chamber. In both houses, amendments must be approved by a majority vote of the members serving and the previous question maybe moved and debate cut off by a vote of a majority of the members present and voting. At the conclusion of Third Reading, the bill is either passed or defeated by a roll call vote of the majority of the members elected and serving (pursuant to the State Constitution, approval of certain measures requires a “super 20

TRIAD, WINTER 2013

Five-Day Rule

Enactment by the Legislature If a bill passes, it is sent to the other house of the Legislature where the bill follows the procedure outlined above, resulting in defeat or passage. If a bill is passed by both houses in identical form, the bill is ordered enrolled by the house in which the bill originated. Following enrollment and printing, the bill is sent to the Governor. If a bill is passed in a different form by the second house, the bill must be returned to the house of origin and one of the following occurs: a. If the amendment(s) or substitute bill of the second house is accepted in the house of origin, the bill is enrolled, printed, and sent to the Governor. It should also be noted that either house may amend an amendment made by the other to a bill or joint resolution. At any time while in possession of the bill, either house may recede from its position in whole or in part and the bill may be returned to the other house for this purpose.

F E AT U R E

If this further action is agreed to by both houses, the bill is ordered enrolled. b. If the amendment(s) or substitute proposal of the second house is rejected in the house of origin, the bill is then sent to a conference committee (a special committee composed of three legislators from each house) which attempts to compromise differences between the two versions of the bill. The conference committee can consider only issues in the bill upon which there is disagreement between the two houses. However, when the agreement arrived at by the conferees is such that it affects other parts of the bill, such as in an appropriations measure, the conferees may recommend further amendments to conform with the agreement. The conferees may also recommend corrections to any errors in the bill. The conference committee may reach a compromise approved by at least a majority of the conferees from each house, and submit a report to the house of origin. If adopted, the report and bill are transmitted to the second house. If the conference committee report is approved in the second house, the bill is then enrolled, printed, and sent to the Governor. A conference report may not be amended by either house. If the conference committee is notable to agree, or if the report is rejected by either house, a second conference committee is appointed. When a second conference has met and the two houses are still unable to agree, no further conference is in order.

Approval by Governor Upon receipt of an enrolled bill, the Governor has fourteen days to consider the bill. The Governor may: • Sign the bill, which then either becomes law at the expiration of ninety days after the Legislature adjourns sine die or on a date beyond the ninetieth day specified in the bill. If the bill has been given immediate effect by a two-thirds vote of the members elected to and serving in each house, the bill will become law after the Governor signs the bill and files it with the Secretary of State or on a day specified in the bill. • Veto the bill and return it to the house of origin with a message stating the Governor’s objections. • Choose not to sign or veto the bill. If the bill is neither signed nor vetoed, the bill becomes law fourteen days after having reached the Governor’s desk if the

Legislature is in session or in recess. If the Legislature should adjourn sine die before the end of the fourteen days, the unsigned bill does not become law. If the Legislature has adjourned by the time the bill reaches the Governor, he or she has fourteen days to consider the bill. If the Governor fails to approve the bill, it does not become law.

Legislative Veto Response If the Governor vetoes a bill while the Legislature is in session or recess, one of the following actions may occur: • The Legislature may override the veto by a two-thirds vote of the members elected to and serving in each house. The bill then becomes law. • The bill may not receive the necessary two-thirds vote and thus the attempt to override the veto will fail. • The bill may be tabled. • The bill may be re-referred to a committee.

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MICHIGAN BOARD OF OSTEOPATHIC MEDICINE & SURGERY The Michigan Board of Osteopathic practice of osteopathic medicine and surMedicine and Surgery was originally gery in the State of Michigan; provided formed with the enactment of Public for the examination, licensing and reg11ADX546 Pinkus BWThis ad 1/2 page_Layout 1:58 PM Page 1 Act 162 of 1903. Act regulated 1the12/20/11 istration of osteopathic physicians and

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surgeons; and provided for the discipline of offenders against the Act. On September 30, 1978, this authority was transferred to the Public Health Code, Public Act 368 of 1978, as amended. The practice of osteopathic medicine and surgery, as defined in the Public Health Code, means a separate, complete, and independent school of medicine and surgery, utilizing full methods of diagnosis and treatment in physical and mental health and disease, including the presentation and administration of drugs and biologicals, operative surgery, obstetrics, radiological and other electromagnetic emissions, and placing special emphasis on the interrelationship of the musculoskeletal system to other body systems. The Public Health Code mandates certain responsibilities and duties for a health professional licensing board. Underlying all duties is the responsibility of the board to promote and protect the public’s health, safety, and welfare. This responsibility is implemented by the Board by ascertaining minimal entry level competency of health practitioners and verifying continuing medical education during licensure. The Board also has the obligation to take disciplinary action against licensees who have adversely affected the public’s health, safety, and welfare. The Michigan Board of Osteopathic Medicine and Surgery consists of 11 voting members: 7 osteopathic physicians, 1 physician’s assistant, and 3 public members. As of October 1, 2012 the Board oversees 8,291 Osteopathic Doctors.

Michigan Board of Osteopathic Medicine and Surgery Members •

James A. Kilmark, PA Belleville Term Expires: 12-31-15 Professional Member

LICENSING

• • • • • • • • • •

Douglas P. Vanator, DO Olivet Term Expires: 12-31-12 Professional Member Steven A. Acker, DO Ann Arbor Term Expires: 12-31-13 Professional Member William C. Cunningham, DO Grand Rapids Term Expires: 12-31-14 Professional Member Peter T. McAndrews, III, DO Traverse City Term Expires: 12-31-14 Professional Member Charles E. Kelly, DO, Chairperson Ortonville Term Expires: 12-31-14 Professional Member Dennis W. Dobritt, DO, Vice-Chairperson Bloomfield Hills Term Expires: 12-31-14 Professional Member Susan C. Sevensma, DO Grand Rapids Term Expires: 12-31-14 Professional Member Kathleen M. Carney Brighton Term Expires: 12-31-12 Public Member Catherine L. Heise Plymouth Term Expires: 12-31-15 Public Member Barry C. Kane Grand Rapids Term Expires: 12-31-13 Public Member

• • •

E-mail: bhpinfo@michigan.gov Licensing Section - Main Number: (517) 335-0918 Mailing Address: (USPS Mail) Bureau of Health Care Services Health Professions Division PO Box 30670 Lansing, MI 48909-8170

• Delivery (Street) Address: (Overnight Services, UPS or Freight Deliveries) Bureau of Health Care Services Health Professions Division Ottawa Building 611 West Ottawa Street, 1st Floor Lansing, MI 48933

Contact the Health Professions Division • •

Website Address: www.michigan.gov/healthlicense Hours of Operation: 8 am to 5 pm Monday through Friday TRIAD, WINTER 2013

MICHIGAN OSTEOPATHIC POLITICAL ACTION COMMITTEE The Michigan Osteopathic Political Action Committee (MOPAC) fights to elect and re-elect pro-physician candidates through direct contributions, voter education and targeted political activism. As a physician, your time and resources are limited. MOPAC is the best resource for you to learn who supports the osteopathic profession and how you can help elect candidates that represents you and your patients.

MOPAC’s four giving levels – President’s Circle, Governor’s Club, Senator’s Club and Representative’s Club. By joining one of MOPAC’s annual giving levels, members support our political efforts and become part of the elite network of politically active osteopathic physicians and students around the country. They receive invitations to members-only receptions, have access to insider political information, and are recognized in numerous mediums.

What is MOPAC? The Michigan Osteopathic Political Action Committee (MOPAC), the political arm of the Michigan Osteopathic Association (MOA) and the sole political action committee representing osteopathic physicians on the state level, was established in 1981 to be the voice of the osteopathic profession in campaigns and elections. Governed by a committee made up of osteopathic physicians, MOPAC is constantly working to increase our effectiveness in elections and strengthen the clout of the physician community. MOPAC’s primary goal is to elect and re-elect pro-physician candidates. We accomplish this through MOPAC-supported candidates, providing voter information on elections, issues, and candidates, and the political activism of our members.

How is MOPAC funded? MOPAC’s political activities are funded by the voluntary contributions of MOA members above and beyond their membership dues. These contributions make it possible for MOPAC and the osteopathic profession to have significant impact in elections. Contributions at every level are vital to MOPAC’s success. Even the smallest contribution adds to the growing army of osteopathic physicians standing up for our profession. Members of MOPAC are instrumental to ensuring we have both the funds and the people to be effective in the political arena.

MOPAC Club Levels Our most politically active members are part of one of 24

TRIAD, WINTER 2013

MAKE A DIFFERENCE! As a physician, your time and resources are limited. However, your political activism is essential to help elect candidates that represents you, Michigan’s osteopathic physicians. Every physician can make a difference in how candidates and elected officials view key-physician issues, who represents them at the state capitol, and the understanding of these issues by voters within their communities. No matter how small the effort, the key is that the effort is made to protect your profession. Here are just a few ways, as a physician, you can make a difference: • Vote! The most important way to be politically active is to vote. The message of physicians is heard best when it is their collective voice at the ballot box! MAKE SURE YOU ARE REGISTERED TO VOTE in time to make your voice heard in this year’s elections! • Host or Attend a Fundraiser: Fundraisers for candidates and for MOPAC are great opportunities to be politically active, meet candidates and elected officials, and network with other politically active physicians. Events of this kind also are effective settings to discuss key physician issues with current and potential legislators. • Host a Candidate at your Facility or Practice: Most candidates do not know what a physician’s day entails or how specific legislation and regulation affect their practice. By hosting a candidate at your facility or practice, you establish a relationship with that candidate and afford them a

P O L ITI C A L A C TI O N

•

first-hand look at how the issues they vote on directly impact your ability to care for your patients. Host a Voter Registration Drive: It is amazing to think how many people in this country are not registered to vote or have not updated their voter registration information. Be proactive in ensuring your employees, colleagues and friends are properly registered. This can be done as a day in the office, or as an e-mail campaign. Write an Op-Ed: Important issues affecting physicians around the country are often complicated and mis-interpreted. Op-eds serve as an avenue for physicians to communicate a pro-physician message, clarify complicated details of specific issues and counter misinterpretations and misrepresentations often seen in an election year. Serve as a Media Spokesperson: Physicians are leaders in their communities, and the media looks to physicians for insight on important physician issues at the forefront of elections. By serving as a media spokesperson, you can be an effective voice for physicians with reporters, at press conferences and various media events. Contribute to MOPAC: MOPAC is the sole political action committee representing the osteopathic profession at the state level. Members of the MOA may contribute to MOPAC to support our efforts. We can only succeed in our goal of electing and re-electing pro-physician candidates to Congress with the involvement and support of osteopathic physicians around our state. Take a stand with your fellow D.O.s today and SUPPORT MOPAC! Get to Know Your Candidates: Before making a decision on which candidate to support, research their positions on issues, ask them where they stand, and learn about their opponents. Once you know you are supporting the prophysician candidate, offer to help the campaign in some capacity. Volunteer with a Political Campaign: Volunteering directly with a pro-physician candidate’s campaign is a great way to start the relationship between constituent and legislator

Mission: MOPAC is responsible for oversight of the collective funds donated by osteopathic physicians for use in influencing legislative activity in Lansing. The committee makes recommendations to the Board of Trustees on the recipients of PAC support for political campaigns, the appropriate levels of campaign contributions, identification of investment candidates for public office and fundraising activities. early. Candidates appreciate leaders in the community, like physicians, offering their time to help a campaign. In addition to volunteers with standard duties like making calls and distributing literature, candidates often find issue experts, finance committee members and other assets in their volunteer base. • Educate Others on Key Physician Issues: Physicians are not the only ones affected by key physician issues. Your employees, patients and family are also impacted by legislation and regulation of important helth care issues. Make sure they understand how these issues affect your practice and why they should be important to them. • Turn Out the Vote on or Before Election Day: Your vote and the votes of your employees, colleagues, friends and family are critical to electing candidates who represent you. Encourage people to vote early or by absentee ballot. Give people time to vote on Election Day. Most importantly, lead by example and making voting a priority. • Run for Office: Running for office is the highest level of political activism. If you are running for office learn more about receiving MOPAC SUPPORT. If you are interested in running, please contact MOPAC STAFF. For more information on any of these important political activities or to learn more about being politically active, contact MOPAC staff via email, phone (800) 657-1556 or learn more online a www.mi-osteopathic.org.

MOPAC Committee Anthony Ognjan, D.O., Chair Linda Adams Kurt Anderson, D.O. Paul Brown, Jr., D.O. Audrey Carrier, MSUCOM Student Khawaja H. Ikram, D.O. Shant Korkigian, D.O.

Lauren Kriger, MSUCOM Student Kevin McKinney, Consultant Member Max McKinney, D.O. Donna Moyer, D.O. William Penn, D.O. Lauren Pitters, MSUCOM Student

Lawrence Prokop, D.O. Gerald Robbins, D.O. Audrey Sanders, MSUCOM Student Shane Sergent, MSUCOM Student Louis Standiford, MSUCOM Student William Strampel, D.O. Brandon Trivax TRIAD, WINTER 2013

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Patients trust doctors. Doctors trust Kerr Russell. A successful medical practice requires more than talented physicians and a desire to heal. Let Kerr Russell provide the legal insight needed to manage and grow your practice. PRACTICE FORMATION • TAX MATTERS • PURCHASE, SALE AND LEASING OF REAL ESTATE • EMPLOYMENT CONTRACTS PRACTICE PURCHASES AND SALES • MALPRACTICE AND ALL OTHER COMMERCIAL LITIGATION • MEDICAL STAFF PRIVILEGE MATTERS STARK LAW, ANTI-KICK BACK, FRAUD AND ABUSE AND OTHER REGULATORY MATTERS • LICENSING MATTERS

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TRIAD, WINTER 2013

W W W.K E R R - RUSS E LL .CO M

Established 1874

P O L ITI C A L A C TI O N

2013 MOPAC CONTRIBUTORS AS OF OCTOBER 15, 2012

President’s Circle ($1,000-up)

Representative’s Club ($100 - $249)

Kurt Anderson, D.O. William Anderson, I, D.O. Donna DeFilippo, D.O. Khawaja Ikram, D.O. Paul LaCasse, D.O. Max McKinney, D.O. Joseph McNerney, D.O. Harris Mainster, D.O. Carol Monson, D.O. Donna Moyer, D.O. Kris Nicholoff Anthony Ognjan, D.O. Gladstone Payton, D.O. Carl Matthew Pesta, D.O. John Sealey, D.O. Susan Sevensma, D.O. William Strampel, D.O. Mary Jo Voelpel, D.O. Larry Wickless, D.O.

Robert Amsler, D.O. Archie Attarian, D.O. Alan Belkin, D.O. May-Eileen Bue-Neiderhauser, D.O. Carey Check, D.O. James Correti, D.O. Kevin Cranmer, D.O. Richard Doud, D.O. Gerald Gilroy, D.O. Jan Goldberger, D.O. Vincent Granowicz, D.O. Paul Gretkierewicz, D.O. Joseph Hunt, D.O. Julie Knas, D.O. Joseph Kozlowski, D.O. David Kraus, D.O. Eugene Laveroni, D.O. Lisa Lepain, D.O. Ronald Lutsic, D.O. Floyd Meachum, D.O. Tawfiq Nakhleh, D.O. Tolam Nguyen, D.O. Michael Popoff, D.O. Louis Putz, D.O. Craig Reynolds, D.O. Donald Rochen, D.O. Jagneswar Saha, D.O. Ernest Schillinger, D.O. Arno Schury, D.O. Alice Shanaver, D.O. Gerald Swiacki, D.O. Keith Tom, D.O. Chad Uptigrove, D.O. Norman Weber, D.O. Eugene Yen Barbara Zajdel, D.O.

Governor’s Club ($500-up) Paul Brown, Jr., D.O. Rodney Diehl, D.O. Eugene Oliveri, D.O. Lawrence Prokop, D.O. Steven Proper George Sawabini, D.O. Jeffrey Stevens, D.O. Bruce Wolf, D.O.

Senator’s Club ($250 - $499) William Bush, D.O. Kevin Florek, D.O. Mary Goldman, D.O. Lawrence Hazen, D.O. John Lemke, D.O. Carrie Lotenero, D.O. Jeffrey Ricketts, D.O. Nicholas Schoch, D.O. Kyle Thomas Douglas Vanator, D.O.

Other Generous Contributors Charles Alderdice, D.O. Teresa Buiocchi Sara Liter-Kuester, D.O. Malcolm Williamson, D.O. TRIAD, WINTER 2013

DEAN’S COLUMN

THE POWER OF INITIATIVE

by William Strampel, D.O.

“A lot of people never use their initiative because no one told them to.” — Banksy

When I think about the osteopathic profession, it occurs to me that we often restrict our advocacy to being reactive to events or plans that threaten us, anger us, or simply inconvenience us. Though playing defense is necessary to success, a good offensive is, I believe, far more powerful. The best key to maintaining the qualities we value in osteopathic medicine – for ourselves and for our patients -- is to build the future we want by seizing the present, by using the power of initiative. Every step we have taken through our history has been achieved by doers who can dream, people who damn the torpedoes and move full steam ahead. We see this in the MSU College of Osteopathic Medicine, as people stopped worrying about “being as good as” and started building positively: the first publicly supported osteopathic college, the first D.O./Ph.D. program, the first to develop international educational and research partnerships, the first to accrue substantial NIH funding for research, and the first to develop a consortium for graduate medical education. That last point is vital for our advocacy today, as we turn our attention to the national plans to combine D.O. and M.D. residencies. This feels threatening to us, because we’ve been in the catbird seat for many years, with osteopathic graduates able to take allopathic residencies, but not vice versa. With limited GME resources nationally, and still an overwhelming majority of M.D. physicians, it feels more than a bit overwhelming. But it’s also proof positive that osteopathic medicine has come of age. Look what we have done. The Consortium of Osteopathic Graduate Medical Education and Training, the precursor to our Statewide Campus System, was the first graduate medical education consortium anywhere – a product of our initiative. It was the exemplar for the development of the profession’s OPTI system. It was a model so powerful that our faculty and DMEs were called to present before Congress. Now with the expansion of COGMET to the SCS, we are one of the largest GME systems in the nation – both in terms of programs and of trainees: 41 hospitals, 216 postdoctoral programs, 47 specialties and more than 1,600 residents and interns. It is time for us to take the initiative again, continuing to build and expand our system so that we always ensure that our graduates, and graduates of other osteopathic colleges, will have a slot. It is time to make sure that what we value most about osteopathic principles and practice remains visible, active, important, verified by research, and utilized. At this nexus, Mark Cummings, Ph.D., who has ably served as our associate dean for the Statewide Campus System since 1999, has informed me that he’s postponed his retirement long enough. We’re delighted though, that he has mentored an excellent replacement: Jon Rohrer, Ph.D., D.Min., who has spent the last 12 years as the SCS associate director. Dr. Rohrer has supervised the development of educational programs, curriculum evaluation, and the use of technology in learning for SCS. Orland Battista said that “Initiative is to success what a light match is to a candle.” We are already carrying a torch, and if we forge ahead fearlessly, I have no doubt that we can continue to be a significant force for positive change in the world – for ourselves, and most importantly, for our patients. Please join us. William Strampel, D.O., is Dean of the Michigan State University College of Osteopathic Medicine. He can be reached at pat.grauer@hc.msu.edu.

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TRIAD, WINTER 2013

AD V E RTI S E R I N D E X

TRIAD Staff

Association Benefits Company..............................................32

Robert G.G. Piccinini, D.O., dFACN & Jeffrey M. Stevens, D.O., Editors-in-Chief

CMS – ICD 10........................................................................6

Kevin M. McFatridge, Managing Editor John Bodell, D.O.; Vance Powell, D.O. & William Strampel, D.O., Contributing Editors

David Leszkowitz, D.O.........................................................21

Kris T. Nicholoff, Executive Director

Health Law Partners PC..........................................................4

Lisa M. Neufer, Director of Administration Kevin M. McFatridge, Manager of Communications Cyndi Earles, Director, MOA Service Corporation Shelly M. Madden, Manager of Membership Marc A. Staley, Manager of Finance Carl Mischka, Advertising Representative Keystone Millbrook, Layout and Cover Design 2012–2013 Board of Trustees Edward J. Canfield, D.O., President Michael D. Weiss, D.O., President-Elect Kurt C. Anderson, D.O., Immediate Past President Myral R. Robbins, D.O., FAAFP, FACOFP, Secretary/Treasurer

Kerr Russell & Weber PLC...................................................26 Keystone Pharmacy..............................................................26 Michigan Beef Industry Commission....................................32 Michigan Clinic for Facial Pain, P.L.C...................................23 MSU College of Osteopathic Medicine..................................26 MSU Federal Credit Union...................................................29 Pinkus Dermatopathology Laboratory..................................22

George T. Sawabini, D.O., FACOFP, D.Ph, Past President Lawrence J. Abramson, D.O., MPH & Bruce A. Wolf, D.O., Insurance Department

Premier MRI CT...................................................................17

Gregory Harris, D.O. & Lawrence L. Prokop, D.O., Membership Department

The Doctors Company...........................................................2

Robert G.G. Piccinini, D.O., dFACN & Jeffrey Stevens, D.O., Continuing Education Department

Wachler & Associates PC.....................................................29

Leo E. Reap III & John W. Sealey, D.O., Public Affairs Department The osteopathic profession in Michigan is made up of osteopathic physicians, osteopathic hospitals and an osteopathic medical school. This TRIAD stands together to serve our patients and one another. TRIAD, the official journal of the Michigan Osteopathic Association, serves Michigan’s osteopathic community, including its osteopathic physicians, hospitals, medical school and patients. The Michigan Osteopathic Association will not accept responsibility for statements made or opinions expressed by any contributor or any article or feature published in TRIAD. The views expressed are those of the writer, and not necessarily official positions of MOA. TRIAD reserves the right to accept or reject advertising. The acceptance of an advertisement from another health institution or practitioner does not indicate an endorsement by MOA. TRIAD (ISSN 1046-4948; USPS 301-150) is published quarterly by the Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Periodical postage paid at Okemos, MI 48864 and other post offices. Subscription rate: $50 per year for non-members. All correspondence should be addressed to: Communications Department, Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Phone: 517.347.1555. Fax: 517.347.1566. Website: www.mi-osteopathic.org. Email: moa@mi-osteopathic.org. POSTMASTER: send address changes to TRIAD, 2445 Woodlake Circle, Okemos, MI 48864. 30 TRIAD, Osteopathic WINTER 2013 ©2013 Michigan Association

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BE BOLD WITH LEAN BEEF Heard the good news about lean beef? The latest research presents a new way of thinking: lean beef can be part of a solution to one of America’s greatest health challenges—eating for a healthy heart. A study published in the American Journal of Clinical Nutrition found that participants in the BOLD (Beef in an Optimal Lean Diet) study experienced a 10% decrease in LDL cholesterol from baseline when they ate lean beef daily as part of a heart-healthy diet and lifestyle containing less than 7% of calories from saturated fat.*1

Setting the Record Straight This ground-breaking clinical study substituted lean beef for white meat as part of an overall heart-healthy diet and found the improvements in LDL cholesterol seen on the beef-containing diets were just as effective as DASH (Dietary Approaches to Stop Hypertension).

MANY LEAN CUTS Lean beef is easily served with vegetables, whole grains and low-fat dairy—improving taste, satisfaction and providing essential nutrients. And many of the most popular cuts of beef—like Top Sirloin steak, Tenderloin and 95% lean Ground Beef— meet the government guidelines for lean.

TEN ESSENTIAL NUTRIENTS Packed with high-quality protein, lean beef provides a satisfying, nutrient-rich experience. A 3-ounce serving of lean beef contains 150 calories on average and is a good or excellent source of ten essential nutrients, including iron, zinc and B-vitamins.2 Scan to view the BOLD fact sheet

PART OF A HEART-HEALTHY PLAN PATIENTS WILL LOVE Lean beef can be a deliciously welcome and satisfying choice in a heart-healthy diet. Help your patients increase meal ﬂexibility by including lean beef among other heart-healthy choices on their shopping lists. Learn more about the many nutritional and heart health beneﬁts of lean beef at:

Funded by The Beef C koff

* Subjects that consumed the BOLD diet experienced a 10.1% decrease in LDL cholesterol compared to baseline. In comparison to the Healthy American Diet, subjects experienced a 4.7% decrease in LDL cholesterol on the BOLD diet. 1 Roussell MA, Hill AM, Gaugler TL, West SG, Vanden Heuvel JP, Alaupovic P, Gillies PJ, and Kris-Etherton PM. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr 2012; 95(1):9-16. 2 USDA, ARS. 2011. USDA National Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp/search/

TRIAD, WINTER 2013

The Michigan Beef Industry Commission www.mibeef.org