https://www.michigan.gov/whitmer/news/press-releases/2026/06/22/whitmer-announces-acting-mdhhs-director-staff-promotions

Gov. Whitmer Announces Acting MDHHS Director & Staff Promotions
FOR IMMEDIATE RELEASE - June 22, 2026
Contact: press@michigan.gov

Governor thanks Director Hertel for leading MDHHS as she moves to a new chapter in her career

LANSING, Mich. — Today, Governor Gretchen Whitmer announced Amy Epkey will serve as acting director of the Michigan Department of Health and Human Services (MDHHS). The governor also announced additional promotions and hires within the executive office.

“Today, I am proud to announce several talented public servants stepping into new roles to help our administration keep delivering for the people of Michigan," said Governor Whitmer. "Amy Epkey brings decades of experience in state government and a proven record of leadership, and I am confident she will continue the important work of the Department of Health and Human Services. I also want to thank Director Hertel for her dedicated service to our state. Under her leadership, MDHHS helped Michigan navigate unprecedented challenges, expanded access to health care, strengthened behavioral health services, and improved outcomes for families across our state. I am grateful for her partnership and wish her continued success in her next chapter.”

Amy Epkey, Acting Director of MDHHS

Amy Epkey will serve as the acting director of MDHHS beginning July 1. Epkey previously held the senior deputy director position for the Financial Operations Administration at MDHHS, where she oversaw the department's budget, contracts and grants, finance and accounting, audit functions and information technology financial support services. Responsible for overseeing the department’s nearly $40 billion budget, Epkey has played a key role in negotiating with the Legislature on the passage of four bipartisan balanced budgets, developing and leading the implementation of strategic priorities, and ensuring alignment across all levels of the department.

Epkey has held numerous roles across departments in state government. She served as senior deputy director for the Michigan Department of Environment, Great Lakes and Energy (EGLE), where she oversaw the department’s annual budget, helped develop and implement EGLE’s strategic plan, coordinated its training and outreach efforts and legal services and testified before the state Legislature on priority issues, among other duties. She also worked for the Michigan Department of Agriculture and Rural Development, where she eventually served simultaneously as policy advisor to the department director and the department’s budget officer.

Epkey has a Bachelor of Business Administration from Grand Valley State University.

After leading the department since 2021, Director Hertel has announced her last day at MDHHS will be June 30. Under Director Hertel’s leadership, the department has built out the community behavioral health continuum of care and designed two state-of-the-art state psychiatric hospitals, launched the Keep Kids Safe Action Agenda and redesigned the way children’s services are delivered through the CSA teaming model, implemented substance use disorder programming which lowered the overdose death rate by 47 percent since 2021, protected residents access to Medicaid and SNAP, created scholarships and stipends to build the health care workforce, and recorded Michigan’s lowest infant mortality rate in its history in 2025.

Karen Kudelko, Director of Federal Affairs

Karen Kudelko will serve as director of federal affairs for Governor Whitmer, leading the administration's engagement with federal agencies, Congress, and key national stakeholders. She previously served as senior deputy director of federal affairs, overseeing issues including energy, environment, Great Lakes, defense, homeland security, and judiciary matters.

She was previously a communications officer on issues of children and families, science, and local giving with the David and Lucile Packard Foundation in Los Altos, California. Prior to that, she served as senior counsel and policy advisor to the late Congressman Elijah E. Cummings and the U.S. House Committee on Oversight and Government Reform, covering criminal justice, civil rights, voting rights, and immigration. Karen started her career in policy as an associate at the DC law firm Squire Patton Boggs, LLP. A Michigan native, she spent her first year as a lawyer in Michigan's Thumb area, serving survivors of domestic violence in civil matters with Lakeshore Legal Aid.

Karen holds a Juris Doctorate from Yale University and completed her undergrad at Brown University.

Kristina Pinault, Communications Senior Advisor

Kristina Pinault has been promoted to communications senior advisor. She first joined the Executive Office of the Governor in 2025 as communications research director. Before working in the governor’s office, Kristina worked at an accountability watchdog group and in the United States Senate. Kristina is a graduate of Catholic University, where she earned a Bachelor of Arts in Politics with minors in Spanish, Philosophy, Theology, and Latin American Studies.

Kylie Spagnuolo, Policy Analyst

Kylie Spagnuolo has been promoted to policy analyst. She previously served in the policy assistant and correspondence assistant roles in the Executive Office of the Governor. Before that, Kylie worked as the operations manager and then a legislative advisor for Majority Floor Leader Abraham Aiyash. She graduated from the University of Michigan with a dual degree in Political Science and International Studies.

Andrew Yaklin, Office and Correspondence Assistant

Andrew Yaklin joined the Constituent Services division as an Office and Correspondence Assistant. Before joining the Executive Office of Governor Whitmer, he served as an Organizer for the Michigan Democratic Party, a Junior Legislative Aide for State Senator Kevin Hertel, and as a contractor for the Michigan Vital Records Office. Andrew attended Grand Valley State University, working to receive a Bachelor of Science in Political Science and Government.

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/06/08/eat-safe

https://www.michigan.gov/mdhhs/safety-injury-prev/environmental-health/topics/eatsafefish/find-your-area

Michigan releases 2026 Eat Safe Fish Guides about local fish consumption
June 08, 2026

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) has released the 2026 Eat Safe Fish Guides to help Michigan residents choose fish that are best for them and their families to eat.

The Eat Safe Fish Guides provide consumption guidelines for eating locally caught fish. Guidelines are based on levels of chemicals found in the portions of fish people eat, typically the filets. Test results from the MDHHS Bureau of Laboratories are used to determine what can be safe for people to eat over the long term.

“There are many health benefits to eating fish and the Eat Safe Fish Guides provide consumption recommendations based on the levels of certain chemicals found in fish in waterbodies across the state,” said Dr. Natasha Bagdasarian, chief medical executive. “Michigan families can use these guidelines to help make healthy choices about the fish they eat.”

In total, the guides provide consumption guidelines for 696 Michigan waterbodies. This year, there were 59 guidelines that were relaxed and 65 that became more protective than previous years.

MDHHS Eat Safe Fish Guides are not laws or regulations. They provide free guidance to help people choose fish that are safe to eat and less likely to affect their health due to harmful chemicals. The Eat Safe Fish Guides use lab test results to provide specific fish and waterbody consumption guidelines in an easy-to-use format. The guidelines are set to be protective of all individuals, including children, pregnant or breastfeeding women and people with health issues including cancer and diabetes.

MDHHS also produces the Buy Safe Fish Guide to help residents choose seafood lower in mercury from local grocery stores, fish markets and restaurants. The Eat Safe Fish Guides and Buy Safe Fish Guide are available at Michigan.gov/EatSafeFish.

For more information on how to buy, eat or prepare safe fish, or to get the 2026 Eat Safe Fish Guide for your region, visit Michigan.gov/EatSafeFish and select Find Your Area or call the MDHHS Environmental Health Bureau at 800-648-6942.

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/06/01/medicare-fraud-prevention-week-highlights-need-to-combat-fraud-and-abuse

MDHHS has opened the 2027 - 2029 State Plan on Aging (SPoA) developed by their Bureau of Aging, Community Living, and Supports (Michigan's SUA, known as ACLS) for comments:

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/04/23/aging-plan

MDHHS seeks public comment on State Plan on Aging
By Lynn Sutfin - April 23, 2026

LANSING, Michigan. – The Michigan Department of Health and Human Services (MDHHS) Bureau of Aging, Community Living, and Supports (ACLS) has developed the State Plan on Aging (SPoA) for fiscal years 2027 to 2029 and is seeking public comment on the updated plan.

State Units on Aging are tasked under the Older Americans Act (OAA) with developing and administering a multiyear SPoA that provides goals and objectives related to assisting older residents, their families and caregivers. The plan serves as a blueprint outlining coordination and advocacy activities to meet the needs of older adults.

To support the development of the plan, the ACLS Bureau conducted a comprehensive needs assessment and engaged older adults, their family members and key partners through community conversations, interviews and a statewide survey.

“The role of the State Unit on Aging is key to the health, wellness and independence of Michigan residents that fall under the OAA and Older Michiganians Act,” said MDHHS Director Elizabeth Hertel. “We appreciate the voices of Michigan’s older adults, family caregivers, service providers and advocates who participated in the needs assessment and contributed to the plan development. The priorities for the next three years are designed to better enable the aging network and our partners to address the issues our older adults face.”

Guidance for content and expectations for developing the plan are established by the federal Administration for Community Living (ACL), including a required narrative and specific attachments.

The ACLS Bureau incorporated input from the needs assessment and convened a multidisciplinary workgroup of Area Agency on Aging (AAA) staff and Tribal Elder Services directors to develop the SPoA’s four goals:

• Enhance access to services for older adults and caregivers to support their health, independence and social connectedness.

• Promote collaborations and partnerships across MDHHS and other state departments, AAAs, OAA Title VI tribal grantees and other agencies and organizations.

• Enhance pathways for accessing information so older adults and their support network, including those of greatest economic need and greatest social need, are aware of resources.

• Utilize language and messaging that celebrates aging and communicates the strength and value of older adults and those who provide their care.

The draft document and the process for submitting comments can be found on the MDHHS website. Comments on the plan will be accepted through Thursday, May 21.

The finalized plan will be submitted for review and approval to the Commission on Services to the Aging at their June meeting, prior to submission to ACL.

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.

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.

No one in Michigan wants to care for mentally ill children.  Michigan is now having to place juvenile mental health cases in other states, as far away as Hawaii:

https://bridgemi.com/michigan-health-watch/michigan-kids-in-mental-health-crisis-sent-out-of-state-as-facilities-close/

• Michigan has nearly doubled its out-of-state youth mental health placements over the past decade. Costs have similarly surged
• The pandemic accelerated a youth mental health crisis already worsened by social media, burning out staff at treatment facilities
• Amid state policy shifts and facility closures, in-state capacity has shrunk

HOLT — Eleanor Middlin was 15 when her family sent her to a Missouri boarding school, an 11-hour drive from her mid-Michigan home. It was the worst thing that ever happened to her. It also saved her life.

“I’m alive because of it, and I will never be able to forget it,” Middlin, now 20, told Bridge Michigan.

Her experience leaving Michigan for long-term care represents an emerging trend for the state’s youth in severe mental health crises.

In the years following the COVID-19 pandemic, a growing number of teens and children are being sent hundreds or thousands of miles from home, often because the state lacks the resources to treat them here.

The Middlins are among an unknown number of families in Michigan who pay their own way to get the help they need — their experience largely invisible in state data.

But for other children placed in facilities through court order or child welfare, state reports show out-of-state placements have surged in recent years as a series of Michigan facilities closed.

As of September, 152 youth in Michigan’s direct-placement program were living in out-of-state facilities — some as far away as Hawaii and Arizona, according to a recent report from the Department of Health and Human Services.

That was up from 122 children sent out of state in 2024 and more than double the 74 children in 2023.

Forcing a child to travel for care is like “throwing them to the wolves,” said Laura Marshall of Cedar Springs, whose son was sent to a Wyoming long-term treatment facility through court order. “We had no control over where he was going.”

Families say the extreme distance makes it challenging to plan visits and some facilities further limit contact. The isolation can be detrimental to their children’s recovery and traumatizing for parents to endure.

“Horror stories” about abuse and staff misconduct dominate conversations about youth treatment facilities, adding a layer of fear for parents that their loved ones may return in a worse condition.

“You’re shipping your kid, in some cases, across the country,” Marshall said. “There really isn’t any way as a parent to be able to vet what’s really going on.”

State officials believe the rise in out-of-state placements is largely limited to court-supervised youth in the juvenile justice system, not children they directly oversee. But counties that report placement data to the state are “not required” to share that information, a spokesperson said.

“The Michigan Department of Health and Human Services believes that placement decisions for youth in foster care and those involved with the juvenile justice system must be guided by safety, stability and the best interests of each individual child to ensure they receive the care and treatment they need to thrive,” spokesperson Erin Stover wrote in an email.

The confusion is a symptom of a larger problem, lawmakers contend: A massive department overseeing a sprawling landscape of juvenile facilities that could lead to kids falling through the cracks — or needing to seek care elsewhere because state offerings are not accessible at the time.

“The liability question is really huge, because who is responsible?” State Rep. John Roth, R-Interlochen, said. “If that kid gets seriously injured in an (out-of-state facility), is it the state that they went to’s problem now?”

‘Fighting it out’ for treatment

Eleanor Middlin was hospitalized for self-harm at 12 years old.

Throughout her adolescence, Eleanor had seen therapists and received medication. But her mental health issues compounded during the pandemic, a period marked by intense isolation and “complete access” to the internet. Snapchat, Instagram and Yubo became social media vehicles toward a “path of feeling horrible” about herself.

“It was the perfect environment for me to get worse,” she said.

She developed substance-use disorders — mainly “downers” like Xanax and opioids — and eating disorders. Many of her habits were unknown to her mother, Jennifer Middlin.

“It felt shameful … even though we tried everything that we could try,” Jennifer told Bridge. “It’s sort of this secret club that no one wants to be part of and no one admits to being part of.”

Short-term stays could stabilize her daughter, Jennifer said, but Eleanor needed something more than the behavioral health centers near Holt were offering.

“We didn’t think we could keep her monitored the way she needed to be monitored,” she said. “They didn’t have recommendations that we could really sink our teeth into, so we had to find it on our own.”

The cost of out-of-state care came out-of-pocket for the Middlins — Jennifer estimates her family spent $90,000 on her daughter’s treatment. Insurance didn’t cover her daughter’s frequent therapy sessions at the boarding school. The loans and the toll on her savings to make payments were “financially devastating.”

The state also carries a significant financial cost to send its youth out-of-state for treatment — it paid more than $13 million in related costs last fiscal year, with about half coming from the state. That was up from $9.7 million the prior year.

That amounted to $392 per day of care, up from $379.

Parents and mental health advocates describe a system that consistently fails children with complex psychological disorders, where the needed treatment “doesn’t exist anywhere” in Michigan.

They point to several intersecting factors — limited in-state capacity, insurance not offering enough support and publicly-funded community mental health services not meeting the needs of families.

Emergency calls to deal with youth in crises are frequent, setting the stage for many youth to have prolonged encounters with the criminal justice system to address their needs.

Insurance companies and the public mental health system are constantly “fighting it out” to cover care, said Rachel Cuschieri-Murray, a cofounder of a local parents group called Advocates for Mental Health of MI Youth. “So it’s not being done by anyone.”

Parents are being overwhelmed, she said, both by the specific needs of their children, and by navigating a system that does not provide a roadmap for care.

A ‘perfect storm’

There were 9,200 children in Michigan’s welfare system as of December 2024, according to recent state reporting. Of those, 468 lived in institutional centers that include youth residential treatment facilities.

Several of those facilities, which house children and teens with significant emotional, behavioral or mental health challenges, have closed since the onset of the pandemic, when about 1,200 beds for child caring institutions were operating. Today, there are fewer than 400 beds available.

Dan Gowdy, the president of the Association of Accredited Child and Family Agencies and the CEO of the Grand Rapids-based Wedgewood Christian Services, describes a “perfect storm” that enabled the current capacity crisis in Michigan.

Youth mental health had been deteriorating long before COVID-19 with the proliferation of social media, he explained. The pandemic made matters worse with “extended isolation” pushing the problems out of public view.

Mounting staff turnover at child caring institutions became the norm in the early-2020s, as facilities went on “full lockdown for months at a time,” Gowdy added. Amid the “great retirement” during COVID, programs could not safely staff their facilities amid “skyrocketing” assaults.

Kathy Regan, CEO of recently-closed Vista Maria residential treatment program in Dearborn Heights, said the agency’s insurance provider for workers’ compensation stopped coverage at the end of 2025 due to the severity of staff injuries, which included broken knees and dislocated shoulders.

“I can’t keep staff safe,” Regan said in an October 2025 interview. “They’re getting their asses handed to them.”

With fewer beds and trained staff available, providers say recent state regulations also pushed agencies to deny children with severe behavioral health issues.

After the death of 16-year-old Cornelius Fredrick, whose fatal restraint at Lakeside Academy in Kalamazoo was determined to be homicide, MDHHS adopted new rules in 2022 to reduce the use of “restraints and seclusions” at state child caring facilities.

Two former staffers charged with involuntary manslaughter in Fredrick’s death were sentenced to probation and Lakeside Academy was closed.

Stover, the MDHHS spokesperson, said that use of restraints “is permitted in emergency situations to ensure the safety of youth and staff,” adding that emergency restraints were utilized 362 times in February alone.

Shifting state policies and oversight have put pressure on youth residential treatment facilities to address growing wait lists, Gowdy said, even if that means taking on children and teens whose needs are not aligned with what facilities can offer.

“You had smaller available beds, high-acuity youth concentrated in more intense environments,” Gowdy told Bridge. “That’s just simply not sustainable.”

According to the state, there are 101 active child caring institutions in Michigan. Gowdy estimates about 16 youth treatment programs have shuttered since the onset of the pandemic.

The Shawono Center in Grayling, Michigan’s only state-run residential facility for male juveniles, closed in February 2025. Vista Maria, which had been the state’s largest treatment facility for girls, shut down in December.

Ahead of Vista Maria’s closure, Regan described “a systemic crash” happening for Michigan’s youth treatment programs, but said she didn’t have the answers as to why.

Michigan has worked in recent months to increase its in-state capacity to serve youth in psychiatric crisis. Still, many children and teens are traveling to states as far as Nebraska and Utah to get help.

The path forward

Some lawmakers say that no real, substantive changes are likely to occur within the state’s youth treatment facilities this year amid elections to replace term-limited Gov. Gretchen Whitmer and other officials.

With the Whitmer administration having “just months” left in office, “I just don’t see it as something that they’re going to be willing to tackle,” state Rep. Matt Bierlein, R-Vassar, said.

Instead, he argued, a voter-approved change to legislative term limits — allowing lawmakers to serve up to 12 years in a single chamber — has led to a strong bench of Republicans and Democrats who care about the topic and have the institutional knowledge to possibly enact change.

Providers and advocates hope the state can develop more sustainable practices for its facilities in the future, and bring about more specialized bed capacity for those who need it. That includes taking a trauma-informed approach to deliver services and implementing proper public investment to train clinicians and frontline staff to care for children and teens.

Families say finding community in those who have already charted the turbulent tides of the state’s mental health care system has been a critical resource.

“The more connected you are, the more success you’re going to have in navigating the system,” said parent advocate Cuschieri-Murray.

For Eleanor Middlin, the crisis stabilization services she got in Michigan were a “life preserver” to keep her head above water when she really needed a “lifeboat” of long-term care to take her safely to shore, which her family eventually found in Missouri.

Now adjusting to life back in Holt, she hopes telling her story will remove some of the stigma that surrounds mental health issues.

“I’m not looking for everyone to understand what I went through and how that affected me,” she said. “I’m more just hoping that maybe the one person who needs it … maybe they understand it. Maybe they feel a little bit less alone about that.”

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/03/23/mdhhs-announces-new-plan-to-address-sickle-cell-disease

https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Public-Health-Genomics/HEMQIP/2026-Strategic-Plan-to-Address-Sickle-Cell-Disease-Across-the-Lifespan.pdf

1. Implement system changes that center the needs of the SCD community through collaboration.
2. Ensure access to high-quality, integrated treatment and support services statewide.
3. Provide continuous education to increase awareness of best practices, resources and information for SCD.
4. Utilize standards of care and protocols that improve patient outcomes.
5. Improve prescription of and adherence to disease-modifying therapies.
6. Use data to establish metrics that enhance health outcomes.

Michigan's current SNAP error rate is 9.53%.  Michigan is expecting a $ 320 million annual penalty.  Should the OBBBA penalties improve state SNAP error rates, there will be pressure in the U.S. Congress to apply such penalties to other federal/state partnerships such as Medicaid.  The health care community should watch this closely:

https://www.themidwesterner.news/2026/03/michigan-may-face-320-million-federal-penalty-as-snap-payment-error-rate-nears-10/

Michigan may face $320 million federal penalty as SNAP payment error rate nears 10%
'The administrative state does not govern itself. Agencies answer to the legislature and we answer to the citizens of Michigan'
By Travers Koory | March 11, 2026

Members of the Michigan House Oversight Committee raised concerns Tuesday about potential fraud, administrative errors, and weak verification procedures in the state’s food assistance program during a review of a nine-month investigation into the issue.

The hearing examined how the state administers the Supplemental Nutrition Assistance Program, which distributed $3.2 billion in benefits each year through the MI Bridges portal and Bridge Cards.

Lawmakers warned that Michigan could face a federal penalty of at least $320 million if the state fails to reduce its SNAP payment error rate, which currently sits above the federal threshold.

Michigan’s most recent SNAP payment error rate stands at 9.53%, according to figures discussed during the hearing. With the passing of the One Big Beautiful Bill last year a series of guidelines set a 6% threshold before penalties apply.

Rep. Jason Woolford, R-Howell, who chairs the subcommittee investigation, framed the hearing as part of the legislature’s duty to monitor how taxpayer dollars are spent.

“Oversight is not optional. It’s our constitutional duty,” Woolford said. “The administrative state does not govern itself. Agencies answer to the legislature and we answer to the citizens of Michigan,” he added.

“Michigan’s most recent SNAP error rate … was 9.53%, and while this represents improvement from earlier years, it still remains significantly above the 6% threshold,” Woolford said. “We will be writing the check back to the federal government for a minimum of $320 million.”

Committee Chair Rep. Jay DeBoyer, R-Clay Twp., also questioned the scale of spending involved in the program.

“We have $3.25 billion sitting in a pile,” DeBoyer said during the hearing. “And then you said to me, there’s no front-end verification.”

Much of the committee’s questioning centered on whether the state verifies applicants before issuing benefits or relies primarily on checks after enrollment.

Woolford demonstrated how the MI Bridges portal allows applications to begin with minimal verification. During the investigation, he said he attempted to apply for benefits using a real address with a false identity.

“I started applying for those benefits using Governor Whitmer’s address, so a real address with a fake name,” Woolford said. “I was able to bypass the Social Security … never getting denied benefits, and at the very end, getting registered to vote.”

Woolford questioned why the system does not require stronger identity verification before processing applications.

“Why would we spend $16 million on an upgrade to a website and not allow for someone or mandate someone to log in to use a Social Security number or an alien number when we’re handing out $3 billion?” he asked.

He argued the system relies too heavily on self-attestation, allowing applicants to provide information without immediate verification.

“Think of the things that you need to log into or show proof of who you are,” Woolford said. “But when it comes to benefits and over $3 billion we say we trust you, friend. No, that’s not how this works.”

Scott Centorino of the Foundation for Government Accountability told lawmakers that much of the program’s error rate stems not from individual fraud but from systemic weaknesses in how benefits are administered.

“You can’t get under that 6% error rate threshold if you only look at that kind of fraud,” Centorino said. “You’ve got to look at the systemic errors, and that’s what I would always call fraud by design.”

“In Michigan today … you can have unlimited assets and enroll in food stamps. There is no verification. It’s never asked,” he said.

Centorino noted that federal rules set minimum standards but allow states to implement stricter safeguards.

“There are some laws and regulations that state what must be done, what must be accepted, but that’s a floor, not a ceiling,” Centorino said. “There’s no limitation… on what can be verified.”

At the same time, he said, the state has one of the highest participation rates in the country.

“Our job is not to protect the bureaucracy. Our job is to protect the citizens of this great state,” Woolford said. “That means protecting the single mother trying to put food on the table… and the taxpayers who fund them.”

Democrats on the committee also raised questions and called for additional information from the Michigan Department of Health and Human Services, which administers SNAP.

Rep. Reggie Miller, D-Van Buren Twp., said the agency should appear before lawmakers to respond directly.

“I have many questions for MDHHS,” Miller said. “Just getting a report from them or information isn’t enough. I think we need them here to answer questions.”

DeBoyer noted that lawmakers previously requested data from the department and never received a response.

“You made a request of that information from them… about a month ago,” DeBoyer said during the hearing. “No response, not even that, ‘We’re not sending it to you.’”

During the hearing, lawmakers and witnesses discussed several potential reforms, including stronger identity verification during applications, adding photo identification to Bridge Cards, and upgrading the cards from magnetic stripes to more secure to the Europay, Mastercard, and Visa style chips that are common on most credit cards.

Michigan officials are pursuing a $16.3 million plan to transition Bridge Cards to more secure chipped cards after a surge in EBT card-skimming fraud. Reported scams involving electronic benefit cards increased from about $181,000 in replaced benefits in 2023 to nearly $885,000 in 2024, with hundreds of thousands more stolen in early 2025.

Woolford last year introduced legislation to require photos and signatures on Bridge Cards to prevent unauthorized use, arguing the measure could reduce trafficking and misuse of food stamp benefits.

Other proposals discussed during the hearing included expanding cross-checks with tax and income data and joining the SNAP National Accuracy Clearinghouse to detect duplicate participation across states.

DeBoyer emphasized that lawmakers must both protect the integrity of the program and ensure benefits reach those who genuinely need them.

“At the end of the day, we have an obligation to manage the money wisely, provide the benefits to the individuals that are certainly in need,” DeBoyer said, “but at the same time, we have to be certain that people are not taking advantage of those benefits.”

Woolford argued that improving oversight is ultimately about ensuring public programs work as intended.

“Every dollar lost to fraud is $1 stolen from a struggling family,” Woolford said. “Every dollar wasted by bureaucratic complacency is $1 taken from a taxpayer who worked hard… sometimes multiple jobs… to earn it.”

https://bridgemi.com/michigan-government/aric-nesbitt-includes-more-state-psychiatric-hospitals-in-anti-crime-agenda/

Aric Nesbitt includes more state psychiatric hospitals in anti-crime agenda
By Simon D. Schuster - March 9, 2026

• GOP gubernatorial candidate Aric Nesbitt says Michigan needs more state psychiatric hospitals
• Sheriffs and prosecutors backing Nesbitt say jails have become de facto housing for mentally ill because of bed shortage
• Michigan has fewer than 500 state psychiatric beds, a tenth of what advocates claim is needed