The MHA Board of Trustees held its final meeting of the 2022-2023 program year in conjunction with the MHA Annual Membership Meeting. As part of a standing agenda item focused on safety and quality lessons learned, board member Mark Eastburg, PhD, president & CEO, Pine Rest Christian Mental Health Services, shared a recent incident from his organization that illustrates the value of regular patient safety training and how a strong caring culture saved a patient and helped him continue to heal. In addition, Michigan Supreme Court Chief Justice Elizabeth Clement and Jeff Donofrio, president & CEO, Business Leaders for Michigan, provided guest presentations on areas of common policy interest, including the importance of nonpartisan and efficient court systems, and the attraction of talent and job growth in Michigan.
The board also engaged in a review and discussion of its ongoing strategic priorities focused on workforce sustainability, financial viability, achieving health equity and improving access and funding for behavioral health. In an ongoing effort to continue to improve access to care, the board reaffirmed its support for the association to maximize the use of provider tax programs in support of Medicaid reimbursement.
Current Health PAC Chair and incoming MHA Board of Trustees Chair Shannon Striebich provided an update on the status of the 2023 MHA Health PAC campaign and encouraged eligible individuals and organizations to meet their contribution goals. The board also approved several associate memberships including Executive Core, Findhelp, Greater Flint Health Coalition, Inc., Lawrence Technological University, QURE Healthcare and VativoRx2.
For more information about actions of the MHA Board of Trustees contact Amy Barkholz at the MHA.
The MHA Board of Trustees met April 12 at the MHA Capitol Advocacy Center in downtown Lansing, joined by Michigan Senate Health Policy Chair Kevin Hertel (D-St. Clair Shores). Hertel acknowledged the state’s significant challenges in meeting behavioral healthcare and workforce needs and identified these areas as priorities for the Senate Health Policy Committee. Board members stressed the need for lawmakers to support policies that allow flexibility and foster innovation, such as continuing to expand telehealth options started during the pandemic and looking beyond staffing ratios toward more effective ways to meet patient care needs within a finite labor supply.
The board also heard from colleagues about a recent learning and technology exchange between Michigan health system leaders and their Israeli counterparts and had the opportunity to listen to the reflections of Shreya Desai, a neurobehavioral researcher and current government relations and health policy fellow with the MHA. Desai shared her experiences working with the MHA Advocacy Division and how it will influence her future medical career.
The board spent time providing input and direction on the key pillars of the association’s action plan, which is focused on supporting financial viability, promoting workforce sustainability, fostering health equity and addressing behavioral health needs. This strategic conversation included a review of recent state budget initiatives, including the MHA’s successful advocacy to secure $75 million for healthcare worker recruitment, retention and training for Michigan hospitals, which is the latest victory in a series of state budget appropriations that has resulted in $1.45 billion in new hospital funding since January 2020.
In addition, the board expressed support for ongoing efforts to work with the state to maximize the federal Medicaid match to increase overall Medicaid reimbursement rates and funding for targeted services such as obstetrics, outpatient, psychiatric and trauma care. In furtherance of workforce sustainability, the board supported the association’s social media campaign to promote and increase awareness of a broad range of healthcare careers. The board also engaged in a discussion of health equity and the association’s continued work to assist members in eliminating disparities in healthcare through the leadership of the MHA Health Equity Taskforce. Improving access and funding for behavioral health continues to be a key priority for the association and board members provided input to the MHA on data collection efforts to advance advocacy strategies to reduce emergency department wait times for patients seeking inpatient psychiatric care. Finally, the board approved Type 2B association membership for Southwest Michigan Behavioral Health.
For more information about the actions of the MHA Board of Trustees, contact Amy Barkholz at the MHA.
The MHA Board of Trustees began its Feb. 8 meeting with a federal advocacy briefing from federal lobbyist Carlos Jackson with Cornerstone Government Affairs. Jackson highlighted the policy and funding threats and opportunities healthcare providers face under the new divided Congress and Biden administration, including possible provider cuts to address deficit reduction, programs affected by the expiration of the federal public health emergency declaration and ongoing pharmaceutical industry challenges to 340B drug pricing policies.
The board also examined several state advocacy initiatives to further the board’s strategic priorities focusing on financial viability, workforce wellbeing and restoration and the furtherance of efforts aimed at improving health equity and behavioral healthcare. The board supported pursing additional state funding for workforce security and pediatric psychiatric care, as well as an effort to maximize federal Medicaid matching funds. The board also directed the MHA to work with the MHA Health Equity Taskforce and the MHA Safety and Quality Committee to address health disparities through the development of tools for the transparent reporting of health equity performance measures.
In addition to advocacy efforts aimed at state and federal policymakers, the board continued to support the association’s ongoing partnerships with hospitals throughout the state to “tell our story” publicly about the challenges and opportunities healthcare organizations face and how hospitals can work together to advance the health of individuals and communities.
The board also received a report from the MHA Service Corporation, which included a spotlight of Endorsed Business Partner Merritt Hawkins, as well as a discussion of staff succession in light of the upcoming retirement of longtime Chief Operating Officer Peter Schonfeld at the MHA.
The board concluded with regional hospital council reports and an update from MHA CEO Brian Peters.
For more information about actions of the MHA Board of Trustees, contact Amy Barkholz at the MHA.
The MHA Board of Trustees began their Nov. 2 meeting with a review of key communication strategies to assist hospitals and health systems to “tell their stories” about the unprecedented financial and workforce challenges they currently face and how they are adapting to meet the critical healthcare and economic development needs of their communities …
Michigan children’s hospitals and pediatric healthcare leaders are raising awareness about a pediatric hospital bed shortage and urging the public to help prevent respiratory illnesses, which are rapidly spreading in the form of respiratory syncytial virus (RSV) and influenza …
The MHA, along with stakeholders across diverse fields, supported record state investment in Michigan’s future workforce. On October 11th, the Governor signed Public Act 212 of 2022 establishing the Michigan Achievement Scholarship, and applications starting with students in the high school class of 2023 will now be eligible for increased state financial aid …
At the MHA, we often say that politics is not a spectator sport. It requires continual engagement and relationship building so that when you are in a crisis and need assistance, you have trusted friends you can turn to …
The Keckley Report
The Three Blind Spots in Hospital Strategic Plans
“For 40 years, I have facilitated Board Retreats for hospitals, health systems, insurance plans and medical groups. At no time has the level of uncertainty about the future for hospitals been as intense nor the importance of a forward-looking strategic vision and planning been as necessary as now. The issues are complicated: lag indicators about demand, clinical innovations, reimbursement, costs et al are a foreboding backdrop for these discussions. And three issues have surfaced as blind spots in the environmental assessments and deliberations preceding the plan …”
Many Michigan hospitals are underway with their Michigan Harvest Gathering campaign which runs through Nov. 18. Online donations by hospital employees and community members to the Michigan Harvest Gathering program can be made through the Food Bank Council of Michigan’s website …
The MHA received media coverage on the surge of RSV cases across Michigan’s pediatric hospitals during the week of Oct. 31. The coverage included several comments provided to news outlets and the distribution of a press release Nov. 4 to statewide media …
After a two-year pause due to the COVID-19 pandemic, the MHA Board of Trustees held its final meeting of the 2021-2022 program year on Mackinac Island in conjunction with the MHA Annual Membership Meeting. As part of a standing agenda item focused on safety and quality lessons learned, board member Ed Ness, president and CEO, Munson Healthcare, shared examples of community and workforce resiliency exhibited by the Gaylord community and Otsego Memorial Hospital team members in the wake of the destruction caused by the recent EF3 tornado that carved a path through that community and within a block of the hospital, resulting in injury and loss of life. The board also had a strategic conversation about the most effective association engagement on matters of social and public health, health equity, financial sustainability and improving the patient experience. In all of these areas, the board stressed the importance of focusing on the mission of healthcare organizations to advance the health of patients and communities and explaining the challenges healthcare providers face in achieving this mission with specific examples. Other business included final program year reports from the committees on Behavioral Health and Public Health, with the recommendation to continue the work of these standing committees.
Current Health PAC Chair and incoming MHA Board of Trustees Chair T. Anthony Denton provided an update on the status of the 2022 MHA Health PAC campaign and encouraged eligible individuals and organizations to meet their contribution goals. Information about the MHA Health PAC is available online. The board also approved type 3 membership for BMG Money Inc., Fifth Third Bank, Vituity, and new Endorsed Business Partners AMN Language Services, B.E. Smith, HealthRise and WeLearn.
Board chair Tina Freese Decker, president and CEO, BHSH Health System, acknowledged outgoing board members Tim Johnson, president and CEO, Eaton Rapids Medical Center, and Dan Babcock, CEO, Marlette Regional Hospital and Deckerville Community Hospital. Freese Decker also recognized past chair Ed Ness for his leadership during the pandemic and wished incoming chair T. Anthony Denton, senior vice president and chief operating officer, University of Michigan Health System, well in his leadership role. For more information about actions of the MHA Board of Trustees, contact Amy Barkholz at the MHA.
Legislation enhancing hospital flexibility for anesthesia care went into full effect May 10 following official confirmation from the Centers for Medicare & Medicaid Services (CMS) that it had received the letter of attestation sent by the governor. This was the final step needed for the provisions in House Bill (HB) 4359 to go into full effect in Michigan.
The MHA-supported HB 4359 was signed into law by Gov. Gretchen Whitmer and took effect Oct. 11, 2021. Sponsored by Rep. Mary Whiteford (R-Casco Township), the bill modernizes the scope of practice for certified registered nurse anesthetists (CRNAs) and allows flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources to offer safe and effective patient care by eliminating the state requirement that a CRNA must work under direct physician supervision.
Federal provisions have allowed states to request exemption from physician supervision of CRNAs under 42 CFR 482.852 upon passage of applicable laws and a letter of attestation from the governor to the CMS.
Members with questions on the new law may contact Adam Carlson at the MHA, while questions regarding amending their facility policies should contact Amy Barkholz at the MHA.
The MHA Board of Trustees met at the MHA’s downtown Lansing offices April 13 and were joined by Michigan House of Representatives Appropriations Committee Chair Thomas Albert (R-Lowell). Albert provided an update on the progress of the fiscal year 2023 state budget, which includes funding for the state’s Medicaid and other health-related programs, indicating he expected the budgets to progress in a timely manner and be presented to the governor by the statutory July 1 deadline. The board also heard from State Attorney General Dana Nessel via a recorded video in which she described how the state would be allocating a $776 million legal settlement from opioid drug manufacturers. Nessel indicated the funds would be divided evenly between the state and local county and municipal units of government. The board called on members to share best practices to help hospitals reach out to their local community health departments and seek collaborative ways to use the funds most effectively.
The board also engaged in a strategic discussion on workforce sustainability and behavioral health funding and delivery, noting that both are key priorities in the association’s multiyear action plan. A discussion surrounding the recent Tennessee case involving a criminal conviction of a nurse reinforced the board’s priorities surrounding building a culture of safety and supporting the ongoing work of the MHA Keystone Center. Other action included approval of an amendment to the MHA bylaws to extend Type 2-B membership to Michigan-based ambulatory care organizations. The amendment will also go to the MHA House of Delegates for approval at the association’s annual meeting in June. Finally, the board approved the recommendations of the Task Force on Dues and Governance to provide a 2% annual dues increase over the next three years based on a value-driven performance assessment and approved Type 3 association memberships for Enviah, PC; Joint Venture Hospital Laboratories, LLC; and Lilly USA. For more information, contact Amy Barkholz at the MHA.
As Michigan begins the third year of living with COVID-19, new cases, hospitalizations and deaths are trending downward and hopes are high that a new variant will not emerge to cause another surge of disease. The state reported there were 2,770 cases recorded for March 17 and 18 (including about 825 cases attributable to older lab results), 648 adults and children were hospitalized with confirmed and suspected cases, and 50 deaths caused by the disease were recorded over the two-day period. These numbers are fractions of what was seen in December and January, when Michigan hospitals were at or near inpatient capacity.
The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
MIOSHA Will Not Increase COVID-19 Inspections of Healthcare Facilities
Barton Pickelman, director of the Michigan Occupational Safety and Health Administration (MIOSHA) within the Department of Labor and Economic Opportunity, has confirmed that MIOSHA will not be conducting additional, focused, COVID-19 compliance inspections of healthcare facilities in Michigan. Although a March 2 memo issued by the federal Occupational Safety and Health Administration (OSHA) announced a 90-day COVID-19-focused inspection initiative for hospitals and skilled nursing care facilities, Pickelman noted that MIOSHA and other state plans are not required to adopt the federal OSHA initiative. Because MIOSHA has already conducted state emphasis programs for healthcare over the past two years, it is not adopting the federal inspection initiative.
Separate from the OSHA inspections, surveyors from the Michigan Department of Licensing and Regulatory Affairs (LARA) will continue to check for compliance with requirements of the Centers for Medicare & Medicaid Services and state licensing agencies during regular survey visits or in response to specific complaints. LARA will confirm that facilities have written policies and protocols in place surrounding COVID-19 screening processes, are following their policies as written, and that these policies and protocols can allow either active or passive screening procedures, consistent with guidance from the Centers for Disease Control and Prevention (CDC).
MHA Creates State/Federal COVID-19 Guidelines Tracker for Providers
To help hospitals and health systems keep track of COVID-19 guidelines, the MHA has developed a document outlining state and federal COVID-19 protocols for healthcare personnel, including vaccination, masking and COVID-19 testing guidelines from both the CDC and the Michigan Department of Health & Human Services (MDHHS). The downloadable tool can be found on the MHA’s website on the COVID-19 webpage under Resources for Healthcare Professionals. Those with questions may contact Lucy Ciaramitaro at the MHA.
At its Feb. 9 meeting, the MHA Board of Trustees had robust conversations about key priorities for healthcare and the MHA. Among them were the MHA’s role as healthcare and public policy continue to evolve; workforce development and shortages (including $300 million appropriated by the Michigan Legislature; see related article); auto no-fault insurance; staffing agency challenges; COVID-19 data trends; Medicaid payment and policy; and much more. The MHA will use much of the board’s discussion to address strategic priorities this program year and beyond.
Members with questions about the MHA Board of Trustees may contact Amy Barkholz at the MHA.
A full year after COVID-19 vaccines were made available in the U.S., the coronavirus continues to sicken and kill people, with nationwide deaths from the illness surpassing 800,000. As demonstrated in a collection of headlines, Michigan’s hospitals are being stretched to treat COVID-19 patients across the state.
The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
Legislation Signed to Delay Sequestration Cuts
President Joe Biden signed legislation Dec. 10 to stop Medicare cuts to hospitals, physicians and other providers from going into effect early next year. As urged by the MHA and the AHA, both the U.S. Senate and House recently voted to pass the legislation.
Specifically, the bill would extend the moratorium on the 2% Medicare sequester cuts until March 31, 2022, and reduce the cuts from 2% to 1% from April 1 through June 30, 2022. The package also would stop the 4% statutory Pay-As-You-Go sequester from taking effect early next year. Other provisions in the package would mitigate a separate Medicare payment cut to physicians; delay payment cuts and private payer data reporting requirements for certain hospital laboratories; and more (see related article). Members with questions may contact Laura Appel at the MHA.
The state Legislature completed work Dec. 14 on Senate Bill 759, which allows healthcare workers licensed in another state to work in Michigan during times of great need (see related article). The MHA issued a media statement both thanking legislators for their support of licensing flexibility and encouraging Gov. Gretchen Whitmer to sign the bill into law as soon as it’s enrolled.
State Approves Additional Tier-2 COVID Relief Facilities
Fifteen additional Tier-2 COVID Relief Facilities(CRFs) were recently approved by the state at a time when post-acute placements are critically needed.
Tier-2 CRFs can keep their own COVID-19-positive residents and are able to admit new residents who test positive only if additional capacity is needed and the nearest COVID Recovery Center (CRC) is more than 25 miles away or at maximum capacity with patients positive for the disease.
With the additional facilities, there are currently 27 CRFs in the state. While this is a positive development, the number is significantly lower than the more than 100 CRFs the state had approved before starting its annual renewal process in October. That process took nearly a month to approve the additional facilities. The MHA continues to advocate that the state not use an annual application process for approving CRFs due to the time involved and the delays it causes for hospital transfer.
In addition, Michigan currently has no Tier-2 CRFs north of Grayling. Therefore, the MHA isurging the state to work with facilities in the northern Lower Peninsula and Upper Peninsula to quickly approve them as CRFs. Members with questions may contact Paige Fults at the MHA.
Changes Continue with Legal Action on Vaccine Mandates
The U.S. Court of Appeals for the Fifth Circuit issued a ruling Dec. 15 ordering the Centers for Medicare & Medicaid Services (CMS) vaccine mandate rule to resume in about half of the country while saying 24 states are not subject to the mandate. This means that the mandate is back in place for Michigan, requiring healthcare workers to be fully vaccinated.However, the suspension of enforcement of the mandate continues.
The Fifth Circuit upheld the Louisiana district court’s preliminary injunction as applied to facilities in the 14 states that are plaintiffs in the case. An additional 10 states that are plaintiffs in a Missouri case do not need to comply with the mandate while the injunction stands. Michigan is not a plaintiff in either lawsuit.
The American Hospital Association (AHA) provides a blog with the latest details of the CMS vaccine mandate cases, as well as an update on an appeals court ruling challenging the Occupational Safety and Health Administration vaccine mandate.
The recent court actions are additional steps toward the suits eventually being appealed to the U.S. Supreme Court. These legal actions do not impact individual organizations’ vaccine policies. Members with questions should contact Amy Barkholz at the MHA.