St. Clair County opposes ‘metro area’ classification

Classification precludes county from rural health grant opportunities

ST. CLAIR COUNTY — The St. Clair County Board of Commissioners is challenging the county’s “metro” classification within the Michigan Department of Health and Human Services, arguing it shuts local providers out from potential millions of dollars in assistance.

Rural counties can apply for an expansive rural health grant pool that addresses rural provider recruitment and retention, maternal health training, and financial education assistance.

The classification is based on a federal methodology. 

The board directed staff to pursue whatever legal means necessary to rectify the county’s designation. But as it stands, the funding lies out of reach. 

The grant funding stems from a $173 million federal award to the state from the Centers for Medicare & Medicaid Services to support rural healthcare workforce initiatives, of which Michigan is making over $34 million available via five key streams through its Rural Health Transformation program.

“It’s a nonpartisan issue. We are clearly misclassified, and it’s a disservice to everyone in our community,” said Lisa Beedon, the District 3 Commissioner. 

The whole county is zoned metropolitan, while the counties of Macomb and Oakland, which contain numerous Detroit suburbs alongside smaller townships, are partially zoned rural. 

The classification is based on a federal formula that considers commuting patterns and census-tract characteristics, beyond just land use. 

“Somebody from the state either did this intentionally or just didn’t look at this, and just expects us to just sit there and be excluded in a rural community like St. Clair [County] from all this medical funding when there’s such a need for outlying medical facilities,” said Steven Simasko, the District 1 Commissioner representing Yale and northern townships. 

In making the stance, the board emphasized county issues including transportation barriers to care, especially in the county’s west, provider shortages, and distance to essential services for residents outside of Port Huron.

Data from the Health and Resources and Services Administration shows the majority of St. Clair County is generally lacking in primary and preventive healthcare access. 

HRSA’s Unmet Needs Score, a number on a 0-100 scale allotted to zip codes that quantifies health care deficits, rate Port Huron and Port Huron Township near the top of the scale at 82.2. The rating is distinguished by its inclusion into HRSA’s highest of five number groupings.   

ZIP codes containing Yale and surrounding townships check in between 64 and 77.

The move follows the Yale Bulldog clinic’s closure last fall after the county medical director Dr. Remington Nevin stepped down from his supervisory role of the clinic last July. A new candidate that could have stepped into that role withdrew interest last fall, citing public attacks. The position remains vacant. 

Nevin first brought this matter regarding St. Clair County’s “metro” classification to the board’s attention this summer.

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— Max Kappel is a Report for America corps member, covering local government and agriculture for The Yale Expositor in Yale, Michigan. Report for America places talented journalists in local newsrooms to report on under-covered issues and regions. Reach out to him at max@yaleexpositor.com with tips.