Healthcare employees face incredible challenges that take a toll on their physical and mental health. A significant number of healthcare professionals experience burnout and other forms of distress. Providing easy access to awareness, prevention and treatment resources for staff must be a priority.
The May edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), includes a briefing to educate and raise awareness for trustees about suicide prevention and the role that hospital and health system boards can play in this public health issue. The May edition also provides useful resources for boards to initiate a conversation about reducing the risks of and preventing suicides in the healthcare workforce. Another article focuses on proactive board leadership, in conjunction with the CEO, to engage 100% of board members in dialogue and decision making that take full advantage of the board’s assets – with effective governance as the result.
For information about MHA trustee resources or webinars, contact Erin Steward at the MHA.
Several bills tracked by the MHA saw further action in the Michigan Legislature the week of April 17. Committees in the House and Senate took votes on bills to create a new tax credit for blood donations and to allow pharmacists to order and administer certain immunizations and diagnostic tests in Michigan. The MHA also supported legislation in the House Health Policy Committee that would allow citizens to designate themselves as an organ donor on their tax filing and require drug manufacturers to report certain data and information on price changes to the state.
The House Committee on Tax Policy held a second hearing on House Bill (HB) 4068, which would create a new tax credit for blood donations in Michigan. Introduced by Rep. Rachel Hood (D-Grand Rapids), the bill would allow for a $25 state income tax credit for each blood donation during the tax year. The MHA is supportive of the bill, which is a unique way of encouraging good public health decisions in the state. The committee voted unanimously to support the legislation, which now heads to the House floor for further consideration.
In the Senate Health Policy Committee, a vote was held on Sen. Sylvia Santana’s (D-Detroit) bill intended to increase access to vaccines and certain laboratory tests. Senate Bill (SB) 219 would allow pharmacists to order and administer immunizations and certain diagnostic tests for their patients without physician supervision. A new substitute was adopted in committee that limits the diagnostic screening pharmacists would be allowed to perform to COVID-19, influenza, urinary tract infections and diabetes. Pharmacists wishing to provide these additional services must also complete an annual 4-hour training program. The MHA has not yet taken a position on SB 219, which was approved by the committee and sent to the Senate floor.
In the House Health Policy Committee, testimony was taken on a new package of bills that would allow Michigan citizens to designate themselves as organ donors on state tax forms. Introduced by Rep. Felicia Brabec (D-Pittsfield Twp), HBs 4362 through 4364 would provide for the question to be asked on tax forms starting in the 2023 tax year. The MHA is supportive of the legislation, which is being led by Gift of Life Michigan to reverse the declining growth in individuals signing up for the donor registry. Gift of Life Michigan testified in committee that states across the country are dealing with this trend, as the pandemic and online services have led to fewer trips to Secretary of State offices. No vote was taken during the initial hearing on the bills.
The MHA also submitted written testimony in support of a bill to require drug manufacturers to report certain data and price changes to the state of Michigan. Introduced by Rep. Samantha Steckloff (D-Farmington Hills), HB 4409 is also known as the Drug Manufacturer Data Reporting Act. The MHA sees this legislation as an important step in providing transparency into the fastest growing expense for Michigan hospitals. For example, between 2019 and 2021 drug costs rose nationally by 36.9%. This hearing was testimony only and the MHA will continue to track the legislation.
Members with questions about state legislative action can reach out to Adam Carlson for more information.
With the closure of nursing homes and long-term care facilities, hospitals and health systems need options to care for seniors. Dually eligible frail seniors are one of the most complex cohorts with multiple co-morbidities, frequent hospital admissions and readmissions, and expensive care needs that span acute, post-acute and long-term care. Program of All-Inclusive Care for the Elderly (PACE) programs are a model of care that provides community-based care to seniors regardless of whether they have primary, acute or long-term care needs. PACE combines the elements of a patient-centered medical home and an accountable care organization.
Gov. Whitmer released her executive budget recommendation Feb. 8 for fiscal year 2024. The proposed budget fully protects traditional hospital line items for Medicaid and the Healthy Michigan program, continues targeted rate increases from recent budget cycles and includes new investments in workforce training and development. None of the line items important to MHA members were recommended for reductions in the recommendation.
The MHA will share additional information on the new initiatives in the coming weeks, but below are a few key pieces for MHA members.
New or expanded funding items:
Healthy Moms and Healthy Babies – $62 million.
Implementing recommendations from the Racial Disparities Task Force – $58 million.
Increased rates for laboratory services, traumatic brain injury services and other related professional services – $120 million.
Expanding eligibility for the Michigan Reconnect scholarship program – $140 million.
Building capacity for insulin production in Michigan – $150 million.
Discretionary mental health supports for K-12 students – $300 million.
Items receiving continued, full funding:
The Healthy Michigan Plan (Medicaid expansion).
Hospital Quality Assurance Assessment Program.
Rural and obstetrical stabilization pools.
Hospital outpatient rate increase.
Critical access hospital rate increase.
MHA CEO Brian Peters released a statement in support of the executive budget recommendation, thanking Gov. Whitmer for her continued commitment to protecting hospitals and supporting healthcare workers.
Members with questions about the budget or any other state legislation impacting hospitals should contact the MHA advocacy team.
The webinar Dispelling Misinformation About Unionization and Legal Guidelines 8:30 – 10 a.m. ET Nov. 11 has been approved by HR Certification Institute® (HRCI®) for 1.5 hours. The webinar will outline:
Understanding how recent dynamics, including the COVID-19 crisis and worker shortages, have increased healthcare industry’s vulnerability to union organizing.
Exploring current trends and tactics unions use to recruit healthcare employees.
Identifying strategies that boost employee engagement.
How to properly identify and respond to protected concerted activity.
How to navigate evolving rules from the National Relations Labor Board, including those applicable to social media.
Tips and guidelines for leaders in response to a union or other protected concerted activity.
Sponsored by the MHA Service Corporation Unemployment Compensation Program and the Miller Johnson law firm, the webinar is offered free of charge. Human resource executives and professionals, chief nurse executives and legal counsel are encouraged to register.
Details about the HR Certification Institute® credits are on the registration page. Members with questions should contact Erin Steward at the MHA.
The Legislature returned the week of Sept.19 to continue work on several pieces of legislation that the MHA is currently monitoring. Committees met in both the House and Senate, taking up legislation that included several new bills supported by the MHA in the areas of behavioral health, rural emergency hospitals, speech-language pathologist licensure and telemedicine.
In the House Health Policy Committee, initial testimony was taken on new legislation to make changes to the preadmission screening process for behavioral health patients. House Bill (HB 6355), introduced by Rep. Graham Filler (R-St. Johns) and supported by the MHA, would memorialize the requirement for preadmission screening units operated by the Community Mental Health (CMH) services program to provide a mental health assessment within three hours of being notified by a hospital of the patient’s need. If a preadmission screening unit is unable to perform the assessment within the three-hour time frame, HB 6355 would also allow for a clinically qualified individual at a hospital who is available to perform the required assessment.
Kathy Dollard, psychologist and director of behavioral health for MyMichigan Health, joined the committee to testify in support of HB 6355. “Strengthening our behavioral health system includes strengthening our behavioral health workforce and that can start with creative solutions like providing clinically qualified hospital personnel the ability to conduct pre-admission screenings,” said Dollard. No votes were held on HB 6355 at this initial hearing.
MHA staff also provided testimony during committee on HB 6380. Introduced by Rep. Andrew Fink (R-Hillsdale), HB 6380 would make the necessary changes to state law to allow for Michigan hospitals to pursue a new federal designation of “Rural Emergency Hospital” (REH) status. A REH designation comes with significant requirements such as limiting total beds to 50, maintaining an average length of stay of 24 hours or less and a required transfer agreement with a level I or II trauma center. Hospitals that choose to convert to a REH will receive enhanced federal reimbursement to provide critical emergency and outpatient services, especially in geographic areas.
Lauren LaPine, director of small and rural hospital programs, MHA, and Elizabeth Kutter, senior director of advocacy, MHA, testified in support of the legislation. “HB 6380 provides rural hospitals in our state with the ability to continue providing care in our most rural communities,” said LaPine. No votes were taken on HB 6380.
Initial testimony on two bills that were previously reviewed by MHA’s Legislative Policy Panel also occurred during committee. Senate Bill (SB) 811, introduced by Sen. Curt VanderWall (R-Ludington), would extend the length of time for an individual to complete a temporary Speech-Language Pathologist license and extend the length of time those temporary licenses are valid. The MHA is supportive of SB 811, which did not see any votes this week.
House committee members also took initial testimony on SB 450, which would ensure that visitors of cognitively impaired patients are permitted in healthcare facilities. Introduced by Sen. Jim Stamas (R-Midland), the bill would prohibit the director of the Michigan Department of Health and Human Services (MDHHS) or a local health officer from issuing an order that prohibits a patient representative from visiting a cognitively impaired individual in a healthcare facility. As written, the legislation does not prevent a healthcare facility from implementing reasonable safety measures for visitors and will still allow for facilities to limit the number of representatives per patient. The MHA is neutral on the bill and will continue to monitor any action taken.
The Senate Health and Human Services Committee took initial testimony on SB 1135, which was introduced by Sen. Mike MacDonald (R-Macomb Township). SB 1135 would specify that previous expansions to Medicaid telemedicine coverage also apply to the Healthy Michigan Program and Michigan’s medical assistance program. Most notably, the legislation would require continued coverage for audio-only telemedicine services. The MHA is supportive of SB 1135, which would continue virtual care policies that have proved to be effective and safe during the COVID-19 pandemic.
In the Senate’s Regulatory Reform Committee, testimony was taken on another MHA-supported bill to regulate the sale of kratom in Michigan. Kratom is a substance of concern with opiate-like effects that has no approved medical use in the United States. HB 5477, introduced by Rep. Lori Stone (D-Warren), would create a license for kratom sales and manufacturing, require testing of products and require new safety warnings on kratom substances sold in Michigan. While the MHA prefers a federal Schedule I ban of the drug, the association is supportive of HB 5477, which will help limit adolescent addiction and prevent adulterated products from being on the market.
Members with questions on these bills or any other state legislation should contact Adam Carlson at the MHA.
The MHA and the American Association for Physician Leadership (AAPL) announced a partnership Sept. 22 that will provide leadership education and training to MHA physician members. The announcement expands the range of benefits offered through the new MHA Physician Membership category, which is designed to provide physician leadership development opportunities and resources.
The AAPL remains the only association solely focused on providing professional development, leadership education and management training exclusively for physicians, making them an ideal candidate for the MHA.
The new relationship will provide membership in AAPL as part of the MHA Physician Membership. New benefits include:
AAPL will provide critical components and credits toward obtaining the Certified Physician Executive (CPE) certification as well as credits toward selected master’s degrees through AAPL partner universities.
MHA/AAPL physician members will be offered the AAPL’s Physician-Mapped Leadership Assessment & Development Tool.
The MHA/AAPL Physician Membership will include full access to the AAPL Leadership Library with articles, journals, case studies and podcasts and will receive a discount on AAPL programs, products, and services.
All physicians employed by a member hospital in Michigan are eligible for MHA Physician membership, as are physicians who are contracted by member hospitals or those who maintain a strong relationship with member hospitals (upon endorsement of the hospital chief executive officer or chief medical officer).
Registration is now available for the Michigan Health Policy Forum. The event will be at the Kellogg Hotel and Conference Center in East Lansing from 1 – 4:30 p.m. Oct. 3. The MHA is a sponsor of the event, which will focus on the children’s mental health crisis in Michigan and sharing strategies that can be replicated and/or expanded in communities throughout Michigan. Members with questions regarding the event can contact Peter Schonfeld at the MHA.
Members are reminded to review their preliminary wage and occupational mix data released May 23 by the Centers for Medicare and Medicaid Services (CMS) and submit any requests for changes to their Medicare Administrative Contractor by Sept. 2 since no new requests for changes will be accepted after that date. This data is being used by the CMS to develop the fiscal year (FY) 2024 Medicare wage index which will be used to adjust up to nearly 70% of the payment amount across Medicare prospective payment systems including inpatient, outpatient and post-acute care settings effective Oct. 1, 2023. Members with other questions regarding the Medicare wage index or geographic reclassification process should contact Vickie Kunz at the MHA.
Hospitals are encouraged to review their preliminary wage and occupational mix data released May 23 by the Centers for Medicare and Medicaid Services (CMS) and submit any requests for changes to their Medicare Administrative Contractor by Sept. 2 since no new requests for changes will be accepted after that date.
This data is being used by the CMS to develop the fiscal year (FY) 2024 Medicare wage index which will be used to adjust up to nearly 70% of the payment amount across Medicare prospective payment systems including inpatient, outpatient and post-acute care settings effective Oct. 1, 2023. To assist hospitals in reviewing their data, the MHA distributed hospital-specific reports that included comparisons to the previous two years and to that of other hospitals in their core-based statistical area. Materials and a recording of the MHA’s educational webinar held June 29 are available upon request by contacting Crystal Mitchell at the MHA.
Hospitals are also reminded that applications for Medicare geographic reclassifications are due Sept. 1 to the Medicare Geographic Classification Review Board (MGCRB). Applications approved by the MGCRB are valid for three years, FY 2024 -2026, and can be withdrawn if needed. Applications, instructions and other information regarding hospital wage index reclassifications are available on the CMS website.
Members with other questions regarding the Medicare wage index or geographic reclassification process should contact Vickie Kunz at the MHA.