Clark Twp. Board Asks UPHP for Uninterrupted Coverage
By Amy Polk

Clark Township wants residents insured by MIChild and Medicaid to continue having their visits to Northern Michigan Hospital in Petoskey covered by insurance without interruption, and wrote a letter to Upper Peninsula Health Plan asking it to reinstate the Petoskey hospital in its network of health care providers.

At a February 7 special meeting, trustees cited the board's interest in making Mackinac County "a county of choice" by allowing health professionals at Mackinac Straits Hospital to make referrals they believe are in the best interest of patients.

The Upper Peninsula Health Plan (UPHP), which administers MIChild and Medicaid to lowincome adults and children, announced it would stop covering client visits to Northern Michigan Hospital unless the patient has prior permission to go there. The health plan, which is owned by a number of Upper Peninsula hospitals, announced that starting March 1, referrals to Northern Michigan Hospital for tests and other medical procedures must first be approved by UPHP.

Mackinac Straits Hospital Chief Operating Officer Rod Nelson believes the only visits that will be approved by UPHP after March 1 will be emergency visits.

"Our doctors are not pleased," he said, adding that the decision affects not only 629 patients in Mackinac County, but possibly another 3,422 in Chippewa and Luce counties who are covered by Medicaid and MIChild through UPHP. Patients affected by the decision include those who need diagnostic tests, Xrays, Magnetic Resonance Imaging (MRI), and ultrasound exams, among other tests that cannot be performed locally. Pregnant women under Medicaid who are seeing one of the visiting Northern Michigan Hospital obstetricians at Mackinac Straits Hospital in St. Ignace will have to select an Upper Peninsula hospital to deliver their babies, said Sue Anderson, Primary Care Clinic Manager. UPHP will no longer cover deliveries at Northern Michigan Hospital as of March 1.

Mackinac Straits Hospital did not invest in UPHP when it was formed some years ago, and, thus, is not a voting member of the organization. Other health plans cover regions in lower Michigan, but Mackinac County Medicaid patients must have their medical services administered through UPHP, which operates similarly to a health maintenance organization (HMO).

UPHP administers MIChild health insurance to Michigan children younger than age 19, whose parents cannot afford regular health insurance coverage. MIChild is a state-regulated, managed health care program and was established to provide care for low-income, uninsured children of working families for $5 a month.

In the Upper Peninsula, UPHP administers Medicaid, a nationwide federal health care program for certain low-income people who qualify, including families, elderly, blind, and disabled people, caretaker relatives, eligible people younger than 21, disabled adult children, and pregnant women.

Clark Township trustees are concerned that the action by UPHP will compromise the health and convenience of residents covered by Medicaid or MIChild by forcing them to travel to Sault Ste. Marie or Marquette for certain medical procedures.

Treasurer Katie Carpenter said that traveling round trip to Marquette for an appointment takes roughly a day, while traveling to Petoskey takes roughly half a day.

"If someone were to schedule outpatient surgery [in Marquette], they would have to plan on spending a night over there," Mrs. Carpenter said. "We already have limited access to certain services and conveniences where we live. Why make it even more difficult for people?"

Close proximity to specialized health care services are reasons people choose to live in places with hospitals and health services nearby. In a fall 2006 survey of Mackinac County residents, Clark and Marquette township residents said they need better access to medical services. People in the west end of the county said distance from a hospital and other health care services was a problem. People in the St. Ignace area said there is a need for limited specialty medical services like cancer and pediatric care; and that the area must adjust to the needs of the growing retirement age population.

Mr. Nelson said he will travel to Marquette February 20 to attend the UPHP meeting and request the board reinstate Northern Michigan Hospital.

"The [Upper Peninsula] Health Plan needs to reverse their decision, because it is right for the residents of the Eastern Upper Peninsula," Mr. Nelson said.