Love and compassion are necessities, not luxuries. Without them humanity cannot survive.
— Dalai Lama XIV
At the beginning of every MHA program year (which officially kicks off every July 1), in close consultation with our MHA Board Chair and Board of Trustees, we develop a “strategic action plan” that serves as a road map for our important efforts over the coming 12 months. While the process involved in crafting the 2021-2022 plan was very similar to prior years, the environment was anything but.
One thing every Michigander surely has in common: we are all eager to see a significant decline in COVID-19-related positivity rates, hospitalizations, morbidity and mortality, and the unprecedented disruption brought about by the pandemic. Every day, we closely examine the data and – equally important – the real-time stories from the administrative leaders and clinicians in our member hospitals and health systems throughout the state. As I write this report, we unfortunately remain mired in a pandemic that simply will not fully release its grip. Hospital beds are filling up with both COVID-19 patients (over 2,000 as of today) as well as patients who likely delayed seeking treatment for a range of other, non-COVID-19 issues. Supply chain issues persist, and clinical and nonclinical staffing challenges are as severe as ever. Any notion that we are out of the woods is misguided; we must remain as vigilant as when the pandemic began.
Against that backdrop, our action plan has been designed with our association mission in mind: we advance the health of individuals and communities. The following synopsis represents just a few highlights:
- Policy and Advocacy: Our hospitals and their front-line caregivers need fair and adequate funding support now more than ever. Our priorities here include full funding for the Healthy Michigan Plan (our Medicaid expansion plan which now covers over 950,000 Michiganders), pools that protect access in rural communities and obstetrical care, graduate medical education, and the preservation of our robust provider tax program and Medicaid payment rates. We successfully achieved all of these objectives in the budget that just began Oct. 1; in addition, the budget includes new special appropriations specific to hospitals, including $3 million to fund the stroke/STEMI system of care to mirror the trauma system; ensured a continuation of the direct care worker increase at long-term care facilities to $2.35/hour; raised ground ambulance service reimbursement to the highest possible rate, valued at $54 million; and extended funding for 12 months of Medicaid coverage postpartum to improve maternal and infant health. As soon as one budget is finalized, the planning and negotiations begin for the next – and we are already gearing up to do right by our members and the patients they serve.
- Workforce Sustainability: We must find ways to remove unnecessary barriers that prevent the recruitment and education of qualified individuals, and we must provide our healthcare workforce with the critical assistance they need to continue caring for and supporting our communities. In the short term, the MHA has formed both a Human Resources Council and a Human Resources Subcommittee of the MHA Service Corporation Board of Directors to convene leaders in the field to closely monitor the staffing crisis and provide guidance on our emerging efforts. This is an “all-hands-on-deck” affair for the association and will be on the agendas of every MHA council, committee and task force this year. In the days and weeks ahead, you will hear more about our very specific request related to healthcare workforce sustainability in the state budget supplemental process – just one aspect of a multiprong strategy that will also include regulatory flexibility, a renewed push to join the multistate nurse licensure compact, immigration policies, expanding scope of practice, virtual health, and addressing workplace violence and burnout.
- COVID-19: The MHA will also continue to respond to immediate COVID-19 issues, which includes continuing to promote the effectiveness and safety of vaccines. Our vaccine focus areas will also move toward third doses and boosters, childhood vaccination for those ages 5-11, federal mandates for employers and healthcare providers, and flu vaccines. The MHA will also continue to work closely with the American Hospital Association on ensuring the federal mandates provide consistency between the upcoming Centers for Medicare & Medicaid Services and Occupational Safety and Health Administration rules on how the federal mandates will be enforced for hospitals.
- Behavioral Health: The MHA has already requested $125 million to expand inpatient pediatric capacity and improve psychiatric services in the emergency department, where far too many patients have been treated due to a lack of suitable alternative psychiatric care settings and providers. We are engaging in the public policy process to make sure that those Michiganders in desperate need of behavioral health services will ultimately have access to compassionate, high-quality care.
- Health Equity: I am proud that all Michigan hospitals and health systems have signed on to our Board-approved pledge to address racism and health inequities. Through information gained from the Health Equity Organizational Assessment (completed by 113 hospitals to date), we will now identify and implement meaningful and actionable steps to address gaps and disparities in care to support the unique needs of individuals and local communities, particularly those that are underserved.
Other important priorities in this year’s action plan include the preservation of a robust certificate of need program, prevention of harmful nurse staffing ratio legislation, development of new data collection and analysis opportunities, safety and quality improvement, physician integration and cybersecurity.
To successfully achieve all the action plan priorities – as well as effectively respond to the “wild-card” events that inevitably occur during the program year – will require all arms of our organization: our traditional trade association, our 501(c)(3) MHA Health Foundation and MHA Keystone Center, and our for-profit MHA Service Corporation and Endorsed Business Partners. We are fortunate to have such a strong platform from which to launch our current and future efforts.
There is no doubt that the pandemic has been the biggest disruptor in my professional career. In an ecosystem that was already becoming more integrated, value-driven and transparent, the pandemic exposed all the inherent weaknesses within American healthcare delivery. Yet, throughout the past 20 months, the MHA staff and members have demonstrated our resolve and resiliency. As a result, I have full confidence that at the conclusion of this program year, we will be able to demonstrate strong success on our strategic action plan objectives and, accordingly, will have positioned hospitals to improve the health and wellness of their communities. And we will do so with love and compassion.
As always, I welcome your thoughts.