However, successful programs begin in the community, with locally-specific resources, nuanced to suit the area's specific problems.

The 40-minute film, Beyond Homeless documents one effective, heart-warming solution.

Tuesday, April 21, 2026     2:30 p.m.

AGENDA

Presentation regarding The State of Homelessness in Michigan

https://www.reuters.com/business/healthcare-pharmaceuticals/trump-announces-new-leadership-cdc-nominates-erica-schwartz-director-2026-04-16/

Trump nominates former deputy surgeon general as CDC director
By Yasmeen Abutaleb and Julie Steenhuysen - April 16, 2026

Summary

• Position has been open since Susan Monarez was fired last year
• Schwartz has been praised by former public health officials
• Nominated healthcare executive Sean Slovenski as deputy director

WASHINGTON, April 16 (Reuters) - U.S. ​President Donald Trump said on Thursday he would nominate Erica Schwartz, who had served as deputy surgeon general during the ‌COVID-19 pandemic, to become director of the Centers for Disease Control and Prevention following multiple leadership shakeups at the health agency.

Schwartz, who served during Trump's first term, was involved in the federal COVID response, helping to coordinate national preparedness and public health efforts.

The nomination represents a far more traditional pick for the ​embattled health agency, as the White House seeks to focus on more popular issues such as lowering drug prices and ​food safety, rather than Health Secretary Robert F. Kennedy Jr.'s controversial vaccine policies with Republicans bracing for a ⁠difficult November midterm election. At a pair of congressional hearings on Thursday, Kennedy largely avoided questions about vaccines.

Trump, in a post on Truth ​Social, also said he was naming healthcare executive Sean Slovenski as CDC deputy director and chief operating officer, Texas Health Commissioner Jen Shuford ​as CDC deputy director and chief medical officer and FDA official Sara Brenner as senior counselor for public health to Kennedy.

The nominations come after a Massachusetts judge blocked key parts of Kennedy's effort to reshape U.S. vaccine policy, including a move to reduce the number of shots routinely recommended for children, and his overhaul of ​a CDC advisory committee on inoculations.

If approved, Schwartz would lead the Atlanta-based agency, which tracks and responds to domestic and foreign threats ​to public health. The CDC director traditionally has the final say on U.S. vaccine policy.

She would report to Kennedy, who has long questioned the safety of vaccines, ‌contrary ⁠to established science.

Trump fired CDC Director Susan Monarez last August over her objections to vaccine policy changes planned by Kennedy. Her position was filled by two acting directors: Health and Human Services Deputy Secretary Jim O'Neill, who was succeeded in February by Jay Bhattacharya, the director of the U.S. National Institutes of Health.

MORE TRADITIONAL CANDIDATES

Schwartz, who does not have a widely publicized position on vaccines, has been praised by former public health ​officials who have been critical ​of Kennedy's vaccine policies.

Demetre Daskalakis, ⁠former CDC director of the National Center for Immunization and Respiratory Diseases who resigned after Monarez's firing, said Schwartz showed "good leadership" during the COVID response and has a "proven track record... notably with pandemic preparedness."

Polls have ​shown most voters disapprove of Kennedy's moves to overhaul the childhood vaccination schedule.

The White House has ​pushed for more ⁠traditional candidates for top agency roles after Kennedy handpicked a slate of controversial political appointees who have undermined trust in vaccines, according to sources familiar with the discussions.

Close Kennedy ally and vaccine injury lawyer Aaron Siri was critical of the nomination.

"Her long track record of directly issuing rights-crushing civilian ⁠and military ​vaccine mandates, including mandating injection of smallpox, anthrax, and flu vaccines into U.S. ​Forces, and disciplining those that refused, reflects she lacks the basic ethics and morals to lead the CDC," Siri said. "This agency does not need another cheerleader for industry."

Enter Michigan's stifling MDHHS regulatory regime called Certificate of Need (CON), often considered for repeal as detailed in this MHF blog.

Federal mandates for CON no longer exist, and federal ASC reforms have helped somewhat. However, state legislators need to step up for affordable options to truly meet market demand and thrive.

Top health industry news source Beckers Health nails it in this interview.

https://www.beckersasc.com/leadership/its-antitrust-we-all-know-it-the-case-for-killing-certificate-of-need/

‘It’s antitrust. We all know it’: The case for killing certificate-of-need

Patsy Newitt

If Janet Carlson could change one thing about the regulatory landscape for ASCs, it would be to abolish certificate-of-need laws immediately.

To Ms. Carlson, a veteran ASC leader who recently founded her own ASC consulting company, Vertex Surgical Solutions, CON is a market protection scheme, one that hospital systems have spent decades and enormous lobbying dollars keeping in place.

With courts pausing repeal efforts in some markets, others raising cost thresholds or carving out ASC exemptions, CON policy is increasingly influencing expansion strategy, competition and patient access nationwide.

Ms. Carlson joined Becker’s to discuss how CON laws function as a bureaucratic wall that keeps affordable surgical care out of reach, particularly in rural communities, while preserving hospital dominance over outpatient volume.

Editor’s note: This interview was edited lightly for clarity and length.

Question: If you could change one policy or regulatory rule to accelerate the shift to ASCs, what would it be?

Janet Carlson: We really need to get rid of certificate-of-need everywhere. It’s antitrust. We all know it. Let’s call it what it is. It was intended for hospital settings, not for ASCs. All it’s doing is keeping control in the hands of very few, in states that are still clinging to it with their cold, dead hands. It’s bureaucracy for the sake of bureaucracy. It’s not there to help patients or providers. It’s just a barrier to entry — and honestly, you could argue it’s prohibiting patient access. With all the problems we have in healthcare access in America, especially in rural areas, and with so many clinicians retiring early because the grind isn’t worth it — CON is a barrier to affordable, accessible, reproducible surgical outcomes for patients throughout the United States.

I’ve maintained that to this day. In a CON state with a two-room limit, you end up with all these small, single-service-line ASCs competing against each other for staff — when if you had a multispecialty ASC, you could combine all of that talent under one roof and do more collectively. You’ve created a false market for competition, and it becomes a negative feedback loop.

Q: Can you talk about the strategies health systems use to leverage CON laws to maintain market power?
JC: They lobby hard, and they give big dollars at the state and federal level, because they want to remain in the driver’s seat. It’s an antiquated way of thinking. The horses are already out of the stable. You can’t put the toothpaste back in the tube. ASCs are not trying to replicate hospitals — we’re just trying to be the best at what we do and take care of people.

This is a health care story because Michigan Medicine is twice the size of the political indoctrination operation University by all measures.  Michigan Medicine is the largest health care system in Michigan, based on over $5 billion in reported net patient revenue:

https://www.michigandaily.com/news/news-briefs/university-president-elect-kent-syverud-steps-down-due-to-cancer-diagnosis/

University President-elect Kent Syverud steps down due to cancer diagnosis
By THE MICHIGAN DAILY NEWS STAFF - April 15, 2026

University of Michigan President-elect Kent Syverud announced Wednesday morning that he will no longer take up the position due to a recent brain cancer diagnosis. Syverud’s term was set to begin May 11.

The information was first released in an email to the campus community, which included a letter from Syverud. In the letter, Syverud wrote that he is currently receiving treatment from Michigan Medicine.

“Last week, I wasn’t feeling well, and I sought care at Crouse Hospital in Syracuse,” Syverud wrote. “After further evaluation, I traveled to the University of Michigan to receive additional assessment from their specialists. I want to be straightforward with you: I have been diagnosed with a form of brain cancer.”

While Syverud will not be taking up the presidency, he will still take up a position as a member of the Law School faculty and adviser to the University’s Board of Regents. In his letter, Syverud thanked the Board and the University community.

“While my diagnosis and treatment will prevent me from serving as the 16th President of the University of Michigan, I am deeply moved by the generosity of the Regents, who have invited me to continue contributing as a professor in the Law School and as a special advisor to the Board,” Syverud wrote. “My wife Ruth and I look forward with great anticipation to rejoining this remarkable community.”

In a video message, Board Chair Mark Bernstein (D) said interim University President Domenico Grasso will continue his tenure until a new president is elected.

“Domenico Grasso will continue to serve as president until the next president begins their service, and the Board plans to reengage a search process as soon as possible,” Bernstein said. “We’ll share details about this in the coming days. We have no doubt that outstanding candidates will seek an opportunity to lead our great university.”

https://www.justice.gov/opa/pr/justice-department-reveals-biden-administrations-weaponization-federal-law-against-pro-life

https://www.justice.gov/opa/media/1436006/dl

Justice Department Reveals the Biden Administration’s Weaponization of Federal Law Against Pro-Life Americans
For Immediate Release - Tuesday, April 14, 2026
DoJ Office of Public Affairs

DOJ Weaponization Working Group Report Outlines Corrective Action Taken to Restore the Public’s Confidence in Lawful Treatment of All Americans

• The Biden DOJ closely collaborated with pro-abortion groups to track pro-life activists’ First Amendment activity. Pro-abortion groups—especially the National Abortion Federation, Planned Parenthood, and Feminist Majority Foundation—capitalized on their relationship with the Biden DOJ to gain internal information and push targets for enforcement. These groups compiled evidence and dossiers that ultimately gave rise to search warrants and charges. The Biden DOJ affirmatively asked pro-abortion groups about pro-life individuals’ travel and constitutionally protected advocacy. The Biden DOJ and career attorneys monitored pro-life activists for years before charging them.
• The Biden DOJ’s prosecutors engaged in inappropriate conduct and comments. Prosecutors knowingly withheld evidence that defense counsel requested to prepare an affirmative defense, tried to screen out jurors based on religion, and authorized aggressive arrest tactics instead of allowing pro-life defendants to self-surrender.
• The Biden DOJ helped a pro-abortion group secure funding. The lead prosecutor on each FACE Act prosecution served as a reference on the National Abortion Federation’s application for a private grant. We found no record of ethics approval for the attorney to take an interest in the financial outcome of a party having business before the Biden DOJ.
• The Biden DOJ pursued significantly harsher sentences for pro-life defendants than violent pro-abortion defendants. The Biden DOJ requested an average sentence of 26.8 months for pro-life defendants, compared to 12.3 months for pro-abortion defendants.
• The Biden DOJ violated the rights of Americans through its biased enforcement of the FACE Act. Though the Act was supposed to protect both pro-choice and pro-life facilities, the Biden DOJ provided extensive support to abortion clinics, while ignoring and downplaying vandalism and attacks against pregnancy resource centers.

• On January 23, 2025, President Trump issued full and unconditional pardons to many of the pro-life Christians unfairly targeted by the Biden DOJ.
• DOJ has settled civil cases to address the injustices and took personnel action against those responsible.
• DOJ leadership has dismissed, with prejudice, three civil lawsuits against pro-life activists: United States v. Connolly, No. 2:24-cv-04467 (E.D. Penn.); United States v. Zastrow, et al., No. 2:24-cv-00576 (M.D. Fla.); United States v. Citizens for a Pro-Life Society, et al., No. 1:24-cv-00893 (N.D. Ohio).
• The Trump DOJ issued a directive that, moving forward, DOJ prosecutors may only bring abortion-related civil actions and prosecutions under the FACE Act in extraordinary circumstances or in cases presenting significant aggravating factors.
• To prepare this report, DOJ reviewed approximately 700,000 internal records. Acting Attorney General Blanche has approved a limited waiver of privileged information to provide the public the opportunity to review the underlying materials.

https://hoodline.com/2026/04/michigan-bosses-claim-blue-cross-turned-billing-blunders-into-cash-cow/

https://dockets.justia.com/docket/michigan/miwdce/1%3A2026cv00895/119939

Michigan Bosses Claim Blue Cross Turned Billing Blunders Into Cash Cow
By Keith O'Donnell - April 14, 2026

Several Michigan employers, including Wesco Inc., the Frankenmuth Bavarian Inn and Opus Packaging Group, say Blue Cross Blue Shield of Michigan found a way to turn claims-processing mistakes into a money-maker. In federal court filings, the companies accuse the insurer of keeping a slice of recoveries generated by errors, invoice adjustments and later reconciliations instead of fully crediting their health plans. Their lawyers point to a thick trail of contracts and monthly invoices they say map out the transfers they now want refunded.

What the suits say

According to Crain's Detroit, the complaints brought by Wesco, the Frankenmuth Bavarian Inn and Opus Packaging attach exhibits that include an Administrative Services Contract schedule and a "Wesco ASC Refund Summary." The reporting notes that the plaintiffs point to an internal "Shared Savings" ledger and a run of monthly invoices that allegedly track disputed refunds and fee calculations they say tilted in favor of Blue Cross rather than the employer plan sponsors. Those allegations sit at the heart of the ERISA-based claims driving the lawsuits.

How plaintiffs say the money flowed

The employers’ theory lines up with issues the Sixth Circuit tackled in its Tiara Yachts decision, summarized on Justia, where judges held that employers could plausibly allege Blue Cross Blue Shield of Michigan acted as an ERISA fiduciary when it overpaid claims and then recouped funds through a shared-savings program. The appellate court explained that administrators who exercise control over plan assets can face equitable remedies if they profit from the recovery process, a legal path the Michigan plaintiffs are now trying to follow. Their complaints highlight what they call "flip logic" and shared-savings invoices as the key mechanics of how the money allegedly moved.

Blue Cross's court strategy

Blue Cross has pushed back hard. It has filed motions to dismiss asking judges to throw out the claims as mere contract disputes or as time-barred, according to the federal docket on Justia. Those filings also show the case has already bounced between districts and that both sides have loaded the record with exhibits and briefing. For now, the fight is parked at the pleading stage while the courts decide whether the ERISA theories are strong enough to move into discovery.

Why the case matters

Legal observers say the outcome could influence how self-insured employers challenge the bookkeeping and recovery practices of their claims administrators. Analysts at Holland & Knight note that the Sixth Circuit’s Tiara Yachts ruling opened the door for arguments that administrators who control plan funds are acting as ERISA fiduciaries. If courts allow the employers’ claims in this case to proceed on that theory, the plaintiffs could seek recovery and disgorgement of plan assets, and other plan sponsors may be encouraged to bring similar suits.

What to watch next

For now, both sides are still trading motions and exhibits while judges decide whether the complaints can survive early dismissal. Varnum LLP, the firm that handled Tiara Yachts, has flagged the Michigan litigation as a case that could claw back plan assets and trigger tougher scrutiny of administrators’ accounting practices. The next milestones will play out on the docket as the courts rule on the motions, potentially open the door to discovery and, if the case survives, set up appeals down the line.

https://www.beckerspayer.com/payer/aca/states-ranked-by-catastrophic-plan-enrollment-growth-in-2026/

https://www.kff.org/affordable-care-act/state-indicator/marketplace-plan-selections-by-metal-level-2/

States ranked by catastrophic plan enrollment growth in 2026
By Jakob Emerson - Friday, April 10th, 2026

Montana saw the largest increase in catastrophic plan enrollment from 2025 to 2026, while Pennsylvania saw the largest decrease, according to CMS data analyzed by KFF.

Catastrophic plan enrollment grew nearly 25% nationally, from 54,000 to almost 68,000, even as total ACA enrollment fell 5% to 23.1 million in 2026.

States ranked by catastrophic plan enrollment growth in 2026

Montana
2026: 3,238
2025: 296
Change: +994%

Delaware
2026: 1,123
2025: 177
Change: +534%

South Dakota
2026: 1,672
2025: 290
Change: +477%

Michigan
2026: 8,045
2025: 1,657
Change: +386%

Oklahoma
2026: 1,127
2025: 261
Change: +332%

New Hampshire
2026: 1,343
2025: 355
Change: +278%

Arizona
2026: 737
2025: 235
Change: +214%

Iowa
2026: 184
2025: 84
Change: +119%

Kentucky
2026: 999
2025: 464
Change: +115%

North Dakota
2026: 791
2025: 373
Change: +112%

Massachusetts
2026: 889
2025: 432
Change: +106%

Go to the hyperlinks for more states' data

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/04/13/mdhhs-encourages-residents-to-get-tested-during-sti-awareness-week

MDHHS encourages residents to get tested during STI Awareness Week
By Laina Stebbins - April 13, 2026

Cases of symptomatic, infectious syphilis increased 50% over last decade

LANSING, Mich. – As part of Sexually Transmitted Infections (STIs) Awareness Week, April 12-18, the Michigan Department of Health and Human Services (MDHHS) reminds residents to advocate for their sexual health and get tested for STIs regularly. Syphilis is a key focus this year, and MDHHS is emphasizing the importance of awareness, early detection and timely treatment.

“Syphilis is preventable and treatable,” said Dr. Natasha Bagdasarian, chief medical executive. “Regular testing, open conversations with partners and providers, and timely treatment are critical to protecting your health and preventing serious complications. Taking these steps is essential to reversing current trends and safeguarding the health of our communities.”

In Michigan, preliminary 2025 data show that rates of symptomatic and infectious syphilis have increased 50% over the past 10 years. If left untreated, syphilis can affect one’s organs and nervous system, and increase the risk of acquiring other STIs, including HIV. While most syphilis cases occur among gay and bisexual men, the proportion of syphilis cases among straight men and women has risen rapidly.

There also has been an increase in syphilis among pregnant women, leading to a rise in congenital syphilis. Congenital syphilis occurs when the infection passes to babies during pregnancy. If left untreated, this can lead to serious health complications for the baby, including death. There were 58 congenital syphilis cases reported in 2024, which was the highest total number of cases in Michigan in more than 30 years.

Syphilis testing and treatment are available at little to no cost through local health departments and other providers. MDHHS encourages residents to get tested for syphilis regularly if they are sexually active. To prevent cases of congenital syphilis, pregnant women should seek early prenatal care with recommended syphilis screening in the first and third trimesters to help ensure timely treatment and partner notification when diagnosed.

In addition, doxycycline post-exposure prophylaxis (doxy PEP) is an emerging prevention strategy that may reduce the chances of acquiring syphilis among some individuals when taken within 24 hours and no longer than 72 hours after a potential exposure. Doxy PEP should be considered in consultation with a health care provider as part of a comprehensive sexual health care approach. For more information visit Michigan.gov/doxyPEP.

More information about syphilis testing, treatment, prevention resources and partner services are available by visiting the MDHHS Stop Syphilis website. Information and resources on other STIs can be found at Michigan.gov/HIVSTI.

U.S. water utilities are starting to curtail fluorosilicic acid additions and lower fluoride levels in water.  This situation will be aggravated as we get to the high water consumption periods of summer.  The fluorosilicic acid will also crimp solar panel output in China, which will affect RPS electricity generation here as well:

https://apnews.com/article/fluoride-teeth-decay-dentist-iran-israel-cavities-cc1127d5278674498fe580be9f88a243

https://www.epa.gov/system/files/documents/2023-03/Fluorosilicic%20Acid%20Supply%20Chain%20Profile.pdf

Iran war has some US water utilities facing a fluoride shortage
By Devi Shastri - April 13, 2026

It’s not just gas prices: Some U.S. water utilities are reporting the Middle East war is disrupting their ability to maintain recommended fluoride levels in the drinking water.

Over the past few weeks, a few water utilities have said their supply had been disrupted, according to the Association of Metropolitan Water Agencies. Fluoride is used in water systems as a public health measure to prevent tooth decay.

Here’s what to know.

What’s driving the fluoride shortage?

Israel is one of the world’s top exporters of fluorosilicic acid, according to the U.S. Environmental Protection Agency. EPA data also shows the U.S. is among the world’s top five importers of the product.

At least one Israeli supplier has been facing workforce challenges because many employees have been called into active military service, said Dan Hartnett, chief policy officer for the Association of Metropolitan Water Agencies.

“That has led to decreased production, and supply shortages for the U.S. market,” he said.

Not every water system is affected

The number of water utilities affected so far is small, but the shortage is affecting hundreds of thousands of people. As the conflict continues, “there will likely be additional stressors placed on the supply chain, leading to shortages in additional communities,” Hartnett said.

The country’s eighth largest water and wastewater utility, WSSC Water in Maryland, is among those facing a shortage. On April 7, utility officials said they were lowering the level of fluoride in the water to 0.4 milligrams per liter, down from the recommended 0.7 milligrams per liter.

Chuck Brown, spokesperson for the utility serving 1.9 million customers, said officials did not know how long the shortage would last, “but we feel confident that we’ll be able to stretch that out for a couple more months.”

In Pennsylvania, the borough of Lititz told its water customers it had to halt fluoridation for a couple weeks last month because of supply issues.

What dentists say you should do

Water utilities add fluoride voluntarily to improve communities’ oral health, so lower levels have no effect on drinking water safety.

A few months’ drop in fluoride levels is probably not a cause for concern for most people, said Dr. Scott Tomar, an American Dental Association community water fluoridation expert.

Research from places that stopped fluoridating their water — Calgary, Canada; Juneau, Alaska; and Israel — has found that lower levels can have an impact over the span of years.

“Based on the best available information we have, below about 0.5 milligrams per liter, you’re probably not going to see effective preventive exposure,” he said.

Tomar said younger children would be the first to experience tooth decay, because the fluoride strengthens enamel as their teeth are developing and once they’ve grown in.

He recommends people in shortage areas brush twice a day with a fluoride toothpaste and keep up with their routine dental appointments. If people are concerned they aren’t getting enough fluoride, they should talk to their dentist before taking a fluoride supplement or other treatment.

What else should I know about fluoride in the water?

Research shows water fluoridation is beneficial even when it is also available through toothpaste and other means. Nearly two-thirds of the U.S. population gets fluoridated drinking water, according to CDC data.

The addition of low levels of fluoride to drinking water was long considered one of the greatest public health achievements of the last century. The American Dental Association credits it with reducing tooth decay by more than 25% in children and adults.

However, misinformation about fluoride’s safety has proliferated. Last year, Utah became the first state to ban public water fluoridation. And Health Secretary Robert F. Kennedy Jr. has repeatedly sown doubt about its safety and restricted the use of fluoride for dental health.

“The levels we use in the United States is perfectly safe,” Tomar said. “Despite a lot of the misinformation, there are no adverse health effects associated with the levels we use in our drinking water.”

___

https://mfcannon.substack.com/p/cap-health-care-proposal-regulation

https://www.americanprogress.org/article/a-patients-bill-of-rights-to-lower-health-care-costs/

CAP Health Care Proposal: Regulation Hasn’t Delivered Affordability, So Let’s Try Regulation
To make health care more affordable and universal, we need a different approach.
Michael F. Cannon - April 10, 2026

• Tightening price controls on health insurance premiums by lowering the threshold for individual-market premium increases that regulators may reject, and imposing “rate review” regulation on employer plans as well.
• Indirect, Medicare-based price controls on hospitals in highly concentrated markets, that limit prices to three times what Medicare sets.
• Additional indirect price controls on hospitals whose prices exceed the statewide median, that prohibit price increases greater than the rate of general inflation plus one percentage point.
• Tightening indirect regulation of insurer profits, by limiting administrative expenses to a percentage of industry-average premiums (rather a figure that individual insurers can manipulate) for purposes of “medical loss ratio” (MLR) regulation.
• Imposing indirect regulation of insurer profits on self-funded employer plans. (MLR again.)
• Prohibiting integration, specifically banning health insurance companies from owning “providers, pharmacies, and PBMs,” to prevent insurers from maximizing government subsidies by acquiring downstream providers and then overcharging themselves.
• Additional indirect regulation of insurer profits, where regulators determine whether provider-subsidiaries are overcharging parent insurers, and count the excess against administrative expenses rather than claims.
• Prohibiting prior authorization for “routine, emergency, and essential care” and requiring insurers to obtain permission from a government agency before denying any other claim.