Notebook Page 14, April 2016

Spring has finally made its way to Lansing and with that Lawmakers are making their way out of Lansing for their two week spring break. Some budgets have moved out of their subcommittees but the Health and Human Services budget still finds itself being tweaked. Let's take a look at what happened last month in Lansing.

The House and Senate continue to work on their respective budgets for the coming fiscal year. This year the House signaled a trimming of the Health and Human Service budget which houses the programs that ACS CAN continues to support. Chairman VerHeulen said that the budget would see a reduction from the the Governor proposed for the coming fiscal year. It is unclear right now what funding will be effect in this large budget, but it is expected that both the cancer and tobacco prevention programs could be in the cross hairs. We expect to know after the legislature returns from its two week break.

The Governor signed Senate Bill 150 in March. Senate Bill would allow for patient to sync their medication for a one fill date rather than having multiple fill dates and having multiple trips to the pharmacy. ACS CAN staff worked with the legislature and interested parties to help push the legislation over the finish line. The legislation was widely supported by both the House and Senate and the Governor signed the legislation. The changes will become effective by July 2016.

More importantly Lobby Day is coming up in Michigan on April 19th. We have a ton of interest this year, thanks to everyone that has promoted our day. As we approach the deadline for Lobby Day registration next week (April 5), we’d like everyone to follow up on any potential attendees you’ve already talked with and avoid inviting any new volunteers at the last minute.  We still have dozens of potential volunteers to follow-up with so please make that a priority in the next few days. April 5th is a solid deadline due to the amount of interest we have this year for lobby day.

After the registration deadline, all registered participants will be receiving an email about logistics, transportation, and our legislative issues.  We’ll be having a call for volunteers on April 14^th at 7pm to cover the topics that will be discussed at Lobby Day.  Staff can expect an email from me soon to discuss transportation and car-pooling from your areas. Thank you again for everyone that has promoted lobby day around Michigan.

If you have any questions about what is happening in Michigan and beyond please don't hesitate to contact Andrew (andrew.schepers@cancer.org) or Matt (matt.phelan@cancer.org). 

Notebook Page 15, May 2016

Michigan's Cancer Advocates at the Capitol.

Spring has finally made it's way back to Michigan. With the arrival of spring also means that volunteers from around the state will start to make their way to Lansing to talk to our lawmakers about issues that are important to all of those who face cancer every day. Lets review the happenings of April in Lansing:

Michigan Lobby Day a Big Success!

Dr. Randy Hillard sharing his story
about oral chemotherapy fairness.

On April 19, 119 ACS CAN advocates and staff met with state legislators for our annual Michigan Lobby Day. Volunteers held 65 total meetings with legislators or their staff.  This year’s Lobby Day had over 30 more volunteers than last year and you could feel the electricity in the room.

This year’s Lobby Day focused on two policy areas: 1) support for oral chemotherapy fairness legislation and 2) increasing Michigan’s tobacco taxes and using this new revenue to fund Cancer and Tobacco Prevention Programs.

Phil Moilenan meeting with Rep. Maturen.

The day was highlighted by some great speakers.  Cliff Douglas, Vice President of Tobacco Control for the American Cancer Society and Carter Steger, Senior Director of State and Local Campaigns for ACS CAN gave the keynote address about the harms of all tobacco products.  Dr. Randy Hillard gave an inspiring talk about his battle with stomach cancer and how oral chemotherapy was available to him, but isn’t available to everyone because of its cost.

Michigan's Volunteer of the
Year Sandra Westover.

Hailey Urbach speaking at
the rally. 

To close the day, Miss Michigan International, Hailey Urbach from Grosse Pointe spoke during our rally in the Capitol rotunda.  Miss Urbach shared her mother’s story of battling breast cancer and the need to advocate for such important causes.

This year, ACS CAN awarded Sandra Westover from Frederic, MI with the annual Volunteer of the Year award for her outstanding contributions to ACS CAN and the American Cancer Society.

As a result of our Lobby Day, the Senate Insurance Committee passed our oral chemotherapy fairness legislation by a 7-0 the following day.  Our advocates pushed legislators to act and they responded.

State Update

As you can see from above the Senate Insurance committee passed out Senate bill 625 or the oral chemotherapy fairness legislation to the full Senate. It was thanks to the great work of our volunteers that helped the legislation have a smooth transition out of committee and over to the Senate floor. We will continue to monitor the legislation has it moves through the Senate. The expectation is that the legislation will move the first week in May. 

Budgets are also on the move in both chambers. This year's budgeting process is more straight forward with elections looming for House members in August and November. The two main funding lines that ACS CAN concentrates on in the budget are the tobacco and cancer prevention lines in the Health and Wellness Fund. Years past this fund has been used as a funding football but with this being an election year the funding for those programs has not been touched. This is a good first step in the movement of the budget. We will be watching now for the middle of May when both the House and Senate Fiscal agencies and the State Treasurer come together to finalize the expected revenue for the coming fiscal year. That will tell us whether the state needs to cut or if they will have more money than they expected. 

Federal Update

Colorectal cancer screening legislation is gaining momentum in Congress.   The Removing Barriers to Colorectal Cancer Act is legislation supported by ACS CAN to close a loophole in Medicare.  Many seniors are going in to get their regular colonoscopy, but it is standard practice that a doctor removes any suspicious polyp during the procedure.  We know that removing these polyps, saving lives.  The problem is that some seniors are getting bills in the mail after the procedure because the polyp removal is not considered a “screening”.  All screenings must be fully covered by insurance.  We are working hard to close this loophole to save more lives.  To find out more about this legislation, please visit http://www.acscan.org/coloncancer.

As always don't be afraid to reach out to us. Go to our Facebook page at http://www.facebook.com/AcsCanMichigan for all of the latest updates and action going on in Michigan.

Notebook Page 13, March 2016

Last month, Michigan Governor Rick Snyder released his official budget.  Unfortunately, Governor Snyder’s budget called for sustained funding for the state’s cancer prevention and tobacco prevention programs.  Governor Snyder also requested in his budget to use $720 million over 10 years from the tobacco master settlement agreement (MSA) to fix Detroit’s public school system.  ACS CAN does not support this move.  The Governor’s budget did not call for any increases in state revenue.

Work continues on Michigan’s campaign to raise tobacco taxes to fund prevention.  Our coalition called the Prevention Michigan Tobacco Free Campaign continues to grow.  We now have 24 groups on board including the major health organizations in the state.  Most recently, Michigan’s Prevention Network signed onto the campaign.

Recent gains with the Governor’s office toward support of a tobacco tax increase have been significantly delayed due to the water crisis in Flint.  The crisis in Flint is expected to distract the Governor’s office for the foreseeable future so our focus has now shifted towards the legislature. Michigan’s State Lead Ambassador, Phil Moilanen, will meet on March 4 with State Senator Mike Shirkey who is a key lawmaker in the State Senate. Action alerts will be going out to advocates throughout March and April leading up to Michigan’s Lobby Day.

Michigan’s annual Lobby Day will take place on April 19.  In addition to Lobby Day, we have added a Leadership Breakfast on the morning of the 19^th.  This ACS CAN Leadership Breakfast will be a fundraising event geared towards high profile volunteers and ACS CAN partners.  Dr. Randy Hillard and Vicki Rakowski, RN have agreed to serve as honorary chairs for this event.  Members of the legislative leadership and key legislators related to health policy have been invited to the breakfast to talk with those in attendance.

The legislative issues, or asks, have been finalized for Michigan’s Lobby Day.  The day will focus on two major issues, raising the state’s tobacco taxes and creating oral chemotherapy parity to increase access to cancer drugs.

At Lobby day, we’ll be asking legislators to increase the cigarette tax by $1.50 while bringing other tobacco products into parity with the cigarette tax to increase revenue.  We’ll also ask our legislators to invest $50 million of the new revenue created by this tax increase into our prevention programs.  Michigan’s Tobacco Prevention Program only receives $1.6 million in state funds annually while the Cancer Prevention Program only receives $500,000.  These amounts are far below the recommendations set by the Centers for Disease Control.

In 2004, Michigan saw its last increase in tobacco taxes with the majority of the dollars either being absorbed in Medicaid or in education. The funding for prevention efforts such as tobacco and cancer prevention has dropped off significantly during that same time. Additionally, other tobacco products like chew and e-cigarettes have sky rocketed in usage. More and more of our youth are now trying emerging tobacco products because they’ve been told these products “aren’t as bad” as cigarettes or chew tobacco.

The other legislative issue, or ask, that we’ll address at Lobby day will be oral chemotherapy parity, or “fairness.” This issue has finally started to see some action in the Senate. Senate Bill 625 has been introduced and was brought up for a hearing in the Senate Insurance Committee last month. Senate Bill 625 ensures that patients facing cancer won’t have to pay a higher price for chemotherapy taken orally, as opposed to intravenously in a hospital.

Currently, 40 volunteers and 19 staff are registered for Michigan Lobby Day.  Registration will end on April 5.

This week, market teams were pressed to move Lobby Day recruitment to the top of their priorities.  The larger markets of Detroit and Grand Rapids have been goaled at 12 volunteers recruited while the smaller markets (Flint, Lansing, Ann Arbor) have a goal of 6 volunteers.

For more information, go to our website at http://www.acscan.org/action/mi. 

Notebook Page 12 February 2016

February signals the start of budget season in Michigan with the governor scheduled to present his budget to the Legislature on Wednesday, February 10 at 11:00 a.m. You can watch the hearing here.  

 In addition to the budget, there are several other issues we’ve been focused on.

Oral chemotherapy parity, or “fairness,” has finally started to see some action in the Senate. Last month, a coalition, including ACS CAN, worked with Senator Goeff Hansen to have Senate Bill 625 introduced and brought up for a hearing in the Senate Insurance Committee. Senate Bill 625 ensures that patients facing cancer won’t have to pay a higher price for chemotherapy taken orally, as opposed to intravenously. ACS CAN presented a letter to the committee, outlining the need for access to these critical treatment options for patients facing cancer. Our coalition hopes to have the legislation sent to the House before the start of summer recess.

The Senate Health Policy Committee took up House Bill 4812, which would provide regulations for the use of biosimilar medications in Michigan. These are drugs that are almost identical to an original product manufactured by a different company. But unlike generic drugs, they are not exact copies. We continue to support interchanging biosimilar drugs with prescribed medications, as long as the patient’s health care provider is notified.  Because biosimilars are somewhat different from the originally prescribed drug, it’s important to notify a prescribing physician of the switch. This legislation is expected to make it out of the Senate before summer recess. 

Medication synchronization is another issue that the House will take up later this month. Senate Bill 150 would allow patients schedule their medications to be filled on the same day.  This ensures that patients and their caregivers won’t be running back and forth to the pharmacy to constantly refill prescriptions.  The bill has moved from the Senate to the House for further consideration.

February is a busy month for ACS CAN in Michigan. For more information,  go to our website at http://www.acscan.org/action/mi. 

Notebook Page 11 January 2016

Happy New Year and welcome to 2016. ACS CAN's campaigns are in full swing in Michigan with tobacco prevention and cancer prevention on the forefront of the agenda. Michigan lawmakers make their way back to Lansing on January 13th for the first day of session. Not much is expected to happen in the first couple days back since Governor Snyder will be giving his State of the State address on January 19th. We are interested in seeing what the Governor has in store for his agenda for 2016. 

As for issues happening in Michigan that ACS CAN is involved in, we are continuing to meet with our coalition focusing on tobacco prevention in Michigan. The coalition is made up of great partners that are interested in getting tobacco and e-cigarettes out of the hands of our kids in the right and responsible way. The Governor will be presenting his budget message for 2016 in February and we hope that prevention will be on his mind.

Oral Parity for Chemotherapy drugs will be starting as well. Currently, Senate Bill 625 is awaiting a tentative hearing date of January 20th in the Senate Insurance Committee. ACS CAN has been a part of a coalition of partners with the leadership of the Leukemia and Lymphoma Society and Celgene. We are hopeful that the legislation will make its way out of the Senate very soon!

2016 is setting up to have an exciting start to the year. Stay tuned to find out further information on our agenda, the Governor's agenda, and others for 2016

Notebook Page 10 December 2016

The legislature begins its final three weeks of session for 2016 this article we want to take a look back at what 2015 meant for CAN in Michigan.

January:

Governor veto's legislation to regulate E-Cigarettes. The Governor says in his veto statement:

"I believe the preferred way to ensure that e-cigarettes are regulated in the interest of public health is to revise the existing definition of a tobacco product to make clear that e-cigarettes (and other novel nicotine-containing vapor products) are tobacco products subject to any restrictions generally applied to tobacco products under the Youth Tobacco Act, including the minimum age law."

Efforts have been made to reintroduce the legislation that is similar to what passed and was vetoed last session, We continue to work with the legislature to create common sense legislation and regulations surrounding E-Cigarettes.

February:

Governor presented budget to the legislature, restores funding for cancer prevention and included a $100k increase for tobacco prevention.

April:

Over 90 plus cancer advocates take over the Michigan Capitol to ask that cancer and tobacco prevention be a funding priority in the state's budget. With the over 70 volunteers that joined staff at the State Capitol, almost every volunteer met with their lawmakers. Jennifer Varner received CAN's Michigan Volunteer of the Year award and Governor Snyder received Michigan's Distinguished Advocate Award with his efforts around E-Cigarettes and the Healthy Michigan Plan. Lieutenant Governor Brian Calley spoke to the crowd at the end of our busy lobby day!

June:

Legislature finalizes the budget, includes $500k for cancer prevention and $1.6 Million for tobacco prevention. Attempts were made by the Senate to move the cancer prevention line to the Health Endowment Fund; a privately controlled fund set up by the legislature and Blue Cross. If those efforts would have been successful it would've meant that the State would not fund any cancer prevention programs. This was a huge victory for us and other groups that were afraid of losing their program funding.

June-August:

Summer recess! Volunteers made in district meetings and drop by's with state and federal lawmakers, working hard to get our messages to the lawmakers. 

As a result, U.S. Senators Gary Peters and Debbie Stabenow signed on as co-sponsors to S 624, the Removing Barriers to Colorectal Screening bill.

Members of Michigan’s Congressional delegation were targeted for co-sponsorship and support of the 21^st Century Cures Act. Michigan ended up with 11 members signing onto the act and all but one member of Congress voted in support.

September:

The State and Federal legislatures got back to work. In Michigan regulations for Bio-Similar products was a hot topic for the state. Creating regulations for these products could allow them to come to market in Michigan and make them available, creating lower cost options for biological products. This debate would go through until the end of October.

More than 700 volunteers and staff took part in the annual Leadership Summit and Lobby Day in Washington DC. Michigan's delegation represented the state extremely well gaining co-sponsors on critical legislation around polyp removal coverage legislation and legislation supporting palliative care training. Michigan Governor Rick Snyder was recognized at the event with the National Distinguished Advocacy Award.

October - November:

October and November saw bio-similar products at the forefront of the legislative activity. Additionally, the foundation was being set to start a large campaign issue for 2016. ACS CAN started the Prevention Michigan coalition. The coalition’s goal is to raise the tobacco taxes and use the funding to support prevention efforts in cancer and tobacco and to support the state's trauma system. We kicked off our activities with a poll and release the week of the Great American Smoke Out. The poll found 6 out of 10 Michiganders support an increase in the cigarette tax and 6 out of 10 provide more support when they know the new funding would go towards health initiatives. This shows clear support from the State for an increase in the tax and support for health in Michigan. We continue to grow our coalition to gain more support throughout the health community.

December:

December looks as if it might be quiet for our issues in Michigan. We will continue our work on Bio-Similar products, support the newly introduced oral parity legislation and continue our work around the tobacco taxes. Petitions for the Prevention Michigan campaign are being collected with a goal of 5,000 petitions collected in 2016.

We also want to take a moment to say thank you. Our volunteers, ACT Leads, State Lead Ambassador, Community Ambassadors, and others give so much of their time to help support our efforts. Without your voice, the voice of cancer would go away. Thank you for all that you do and we hope you have a great 2016.

Notebook Page 9 November 2015

October found the state in full gear working on trying to find a solution to the road situation in Michigan.  This left a lot of the health issues and others on the back burner for many different groups including ACS CAN. The House Health Policy Committee did consider one issue that ACS CAN has some interest in; Bio-similars.

Biologic drugs are a classification of drugs that are made through a process that involved a living organism. The process uses that living organism to create the active ingredient in the drug that will be used to fight whatever the drug has been approved for. Biological drugs have been used to treat breast cancer and other cancers  so access to these critical medications is crucial. Today, the science is evolving and how biologic drugs are being made is changing. Many manufactures are creating what’s called a Bio-similar medication. That drug is similar to the biologic that it is trying to replicate but not quite the same thing. 

The US Food and Drug Administration (FDA) has created regulations that govern these bio-similar products creating two classifications, bio-similars and interchangeable bio-similars, which are even closer in resemblance to the primary biological drug.  These drugs are usually less costly to the patients, making access to them extremely important. Michigan does not have any regulations that would allow these drugs to come to market and the first bio-similar is about to hit store shelves here in the next couple months, therefore regulation of these products is needed. 

House Bill 4812 was introduced by Representative John Bizon, a physician from Battle Creek, to provide regulations around bio-similars. A critical part of his legislation provided an avenue for physicians and pharmacists to communicate when an interchangeable bio-similar is changed out for a biologic. For safety reasons physicians have the knowledge if there is a switch and the patient has an adverse reaction. For the patient it can provide a piece of mind that the physician knows what is happening with their care. Another piece of legislation was introduced, House Bill 4437, which we oppose that does not provide the communication piece in the legislation.

The House Health Policy Committee took testimony on House Bill 4437 with the majority of the testimony being against the legislation. ACS CAN provided written testimony explaining our support for communication for safety and peace of mind. We expect the House committee to take up HB 4812 since there is a lack of support for HB 4437. 

This past month we also had our second meeting of the Michigan Palliative Care Summit. Health leaders from around the state met in Lansing and began work on a road map to quality palliative care in Michigan. Close to twenty health care professionals and patient advocates participated in the great work that was done. We are hopeful that with all of the great notes that were taken by each work group a draft document can be created to provide the road map that Michigan needs.

Lastly, Michigan has leveraged Breast Cancer Awareness month to push Governor Snyder to increase funding for the Cancer Prevention Program.  Michigan’s Cancer Prevention Program houses the Breast and Cervical Cancer Control Navigation Program.  This program is vital to making sure all women have access to the screenings and follow-up care necessary to make an accurate cancer diagnoses and secure the proper treatment.  Volunteers from around the state have been collecting postcards throughout the month asking the Governor to increase funding by $2 million in his next budget.  Over 2,000 postcards have been sent to the Governor so far.