The MHA received media coverage the weeks of Nov. 6 and Nov. 13 regarding a committee hearing on proposed nurse staffing ratio legislation. Additional topics covered include hospital market activity, rural emergency hospitals, behavioral health, the state’s STEMI system and the latest Leapfrog Hospital Safety Grades.
The coverage includes quotes from MHA CEO Brian Peters, as well as MHA board member Beth Charlton, president and CEO, Covenant HealthCare; and Doug Dascenzo, DNP, RN, chief nursing officer, Trinity Health Michigan. MHA Executive Vice President Laura Appel also appears in an American Hospital Association podcast episode.
Below is a collection of headlines from around the state.
The Michigan Department of Health and Human Services will implement a wage increase beginning Oct. 1 for direct care workers in MI Choice Waiver, MI Health Link and Behavioral Health programs. This will provide an additional $0.85 per hour increase in direct care worker (DCW) base wages, supplementing the $2.35 per hour increase previously appropriated. The total increase of $3.20 per hour must be applied to DCW wages, including administrative time and overtime. Members may refer to L 23-64 for more information. Members with questions may contact Kelsey Ostergren at the MHA.
In the new program year, the MHA continues to prioritize several critical issues, like workforce, viability, resilience and wellbeing, behavioral health and health equity.
The MHA will host a virtual membership meeting from 2 to 3 p.m. on Nov. 9 to outline the MHA 2023 – 2024 strategic action plan approved by the MHA Board of Trustees. With presentations from MHA CEO Brian Peters and other MHA leaders, the forum will review the priorities and tactics to accomplish goals and how the membership can support these initiatives.
There is no cost to attend, but members are asked to registerby Nov. 7. Access information for the virtual session will be sent Nov. 8.
Questions about the member forum can be directed to Erica Leyko at the MHA.
Michigan Advance published a story July 9 on the healthcare priorities included in the fiscal year 2024 state budget. Adam Carlson, senior vice president, advocacy, MHA, is quoted multiple times in the story regarding funding specific to hospitals and health systems.
Topics covered by Carlson include hospital security, behavioral health and health equity. The budget included both new funding to support trauma center and inpatient psychiatric services, as well as continued support for long-standing programs crucial to access to healthcare services throughout Michigan.
“We’re in the middle of a behavioral health crisis,” said Carlson regarding the $33 million towards increased Medicaid rates for inpatient psychiatric facilities. “Given the size of the problem, it’s not going to solve it. We’ll still have a shortage of beds, but ideally it will lead to better patient outcomes.”
The MHA Behavioral Health Boarding Survey was also mentioned in an article from Bridge published July 13 which focuses on a new behavioral health unit in northern Michigan as it seeks to address the need for more behavioral health services in the region.
“Plans are only good intentions unless they immediately degenerate into hard work.”— Peter Drucker
The theme of the 2022-2023 MHA program year was telling our story. With focus and passion, we told the stories of our hospitals and health systems, the challenges and adversity they face, and how they still provide high quality and accessible healthcare to their communities. This theme was intended to ensure that we as healthcare leaders continue to help those who don’t live and breathe healthcare understand the ways we are working to meet the most pressing needs, but also the support we need from other sectors to continue to offer strong and daily access to care for all. Our theme served to frame the four distinct pillars of our association strategic action plan, which included the financial sustainability of hospitals, workforce restoration and well-being, the behavioral health crisis and continued efforts towards achieving health equity.
I’m pleased to share we made significant progress in telling our story and achieving tangible, impactful results under each of the four strategic pillars, which is summarized in the latest MHA Annual Report. This work evolved around the ending of the COVID-19 public health emergency, a pandemic that tried our member organizations, and especially their healthcare workers, like nothing has before in most of our lifetimes. A large part of our success in making this transition and achieving so many significant outcomes was due to the MHA Board of Trustees, who I want to thank for their strong leadership and commitment to advancing the health of individuals and communities. I particularly want to express my gratitude to our outgoing Chair, T. Anthony Denton, for his steadfast leadership throughout this year.
Key to our efforts to safeguard the financial viability of hospitals is our continued focus on the state budget. Not only were we successful in continuing existing supplemental payment pools such as for Disproportionate Share Hospitals, Graduate Medical Education, Rural Access and Obstetrical Stabilization, but we also secured a Medicaid outpatient hospital rate increase. Collectively, these victories generated hundreds of millions in funding for Michigan hospitals. Long a priority of our association, the MHA also successfully advocated to ensure the Healthy Michigan Plan (our Medicaid expansion program) is fully funded. Our advocacy team continues to be one of the most respected in Lansing, as we saw several MHA-supported bills signed into law while experiencing a 100% success rate in making sure none of the 10 bills we opposed became statute.
Our work on behavioral health continues, as there remains a need to expand the number of behavioral health professionals and facilities to provide better access to care. The MHA secured both $50 million in the fiscal year 2023 state budget for expanding pediatric inpatient capacity, while adding an additional $10 million to create Psychiatric Residential Treatment Facilities to alleviate state hospital capacity issues. Much of the feedback we have received is the need to add quantitative data to the conversation to demonstrate to lawmakers and stakeholders the degree of the crisis. For several months, our team has been collecting data weekly on the number of patients waiting for a behavioral health bed in Michigan hospitals. This demonstrates the degree to which patients are having difficulty finding care, while also showing how many patients are utilizing hospital resources while the facility receives no reimbursement due to not having an acute care diagnosis billing code.
Lastly, we will not rest as our members continue to address health disparities to ensure health equity. The MHA Keystone Center works closely with the Michigan Alliance for Innovation on Maternal Health (MI AIM) to help address disparities and reduce the risk of maternal death. This past program year, their efforts resulted in 77% of Michigan birthing hospitals participating in MI AIM, 94% of which are compliant with the pre-partum assessment and 89% are compliant with the post-partum assessment. Our work with the MHA Public Health Task Force also continues as they explore strategies for collaboration that can improve data collection and public health initiatives.
Of course, there are always other items that come up that require MHA attention and effort that are not always known during the development of the strategic action plan. Responding to the shortages of chemotherapy drugs cisplatin and carboplatin and working with Michigan’s Congressional delegation is just one example of the value of association membership and how quickly we can mobilize our relationships in a time of crisis. Other wildcards include our work on licensing Rural Emergency Hospitals, tracking and increasing awareness of candida auris infections and expanding hospital bed capacity.
As we concluded our program year during our Annual Meeting on Mackinac Island, we were able to honor a true healthcare champion with our Meritorious Service Award in U.S. Sen. Debbie Stabenow. She announced earlier this year she will not seek an additional term in office and this award is the highest honor our association can bestow on an individual for their years of work towards enabling the health and wellness of individuals and communities. We have worked closely with Sen. Stabenow from her time in elected office in the Michigan Legislature to Congress and she will leave an extraordinary legacy for which the MHA family will be eternally grateful. We also had an opportunity to honor a number of other outstanding individuals for their contributions to Michigan healthcare.
Above all else, I want to take this opportunity to thank all MHA staff for their many contributions which made it another successful program year. The challenges we confront in healthcare are daunting and constantly evolving, but my confidence in our team at the MHA has never wavered, as they continue to display their exceptional commitment to their work and embody the MHA culture of member service and value creation every single day.
Now as we formally begin our 2023-24 program year on July 1, I am excited for the leadership of our new Chair Shannon Striebich. We offer our congratulations to her and look forward to working closely together. A year from now, I am confident we will once again be able to report on the successful outcomes we were able to achieve through our unity, collaboration and plain old fashioned hard work.
The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.
The fiscal year 2024 state budget approved by the Michigan Legislature renews a longstanding commitment lawmakers have made to the health and wellness of Michigan’s hospitals, health systems and communities.
We are extremely pleased to see the inclusion of new funding to support trauma centers and inpatient psychiatric services that will provide a net benefit of $92 million. Trauma centers at hospitals provide lifesaving treatment to people with the most severe injuries, ready at a moment’s notice for mass casualty events and catastrophic accidents with a vital network of EMS services. This added funding makes Michigan a national leader in recognizing the importance of access to trauma services and makes sure trauma centers can continue to be equipped with the resources needed to staff these services 24/7, year-round.
Michigan is also in the middle of a behavioral health crisis where the demand of patients needing inpatient care continues to increase. We commend the Legislature for recognizing this need and increasing rates to inpatient psychiatric facilities based on patient acuity to help hospitals afford the staffing, security and facilities necessary to accept patients with more severe illness.
In addition, the budget continues to support long-standing programs crucial to access to healthcare services throughout Michigan. These include funding for rural and critical access hospitals, obstetrical services, graduate medical education, the Healthy Michigan Plan and Michigan’s Medicaid population.
We look forward to a signed budget that provides hospitals with the needed support to continue to provide high-quality care to every patient.
The Department of Health and Human Services (HHS) launched a $15 million loan repayment program to recruit and retain clinicians who provide healthcare to children and adolescents. The Pediatric Specialty Loan Repayment Program aims to increase access to pediatric subspecialty care, including the behavioral health needs in school-based settings across the United States. The program also offers opportunities in neonatal-perinatal medicine and pediatric cardiology.
In exchange for three years of service working in a health professional shortage area, medically underserved area or providing care to a medically underserved population, the Pediatric Specialty Loan Repayment Program provides up to $100,000 to eligible clinicians providing pediatric medical subspecialty, pediatric surgical specialty, or child and adolescent behavioral health care, including substance use prevention and treatment services.
Behavioral health emergency department (ED) boarding data the MHA has been collecting on a weekly basis from acute care hospitals across Michigan since March 2023 is now available on the Health Data webpage of the MHA website.
The aggregate data shows the total number of patients waiting to receive a behavioral health evaluation and the total number of patients boarding in an ED awaiting an inpatient psychiatric bed. The webpage is updated every Thursday with new weekly data.
As of May 8, 265 behavioral health patients were awaiting a bed across 76 hospitals, demonstrating the crisis your organizations are dealing with daily.
This information is being used by the advocacy and policy departments of the MHA to bring awareness to the issue and pursue legislation to ease the burden on member hospitals and health systems while getting behavioral health patients the care they need. Hospitals are encouraged
to continue participating in the weekly data collection by close of business each Monday.
Members with questions on survey participation and results should contact Lauren LaPine.
The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities.
On episode 29, State Representative Graham Fillerand Dr. Julie Yaroch, D.O.,president of ProMedica Charles and Virginia Hickman Hospital and Senior Vice President of Inpatient & Retail Pharmacy for ProMedica Health System kick off Mental Health Awareness Month discussing how lawmakers, healthcare leaders and the community can work together to address gaps in the state’s behavioral healthcare system.
Additional state behavioral health resources can be found through the Mental Health Association of Michigan and the Children’s Hospital Association. As mentioned in the episode, the MHA issued a request for proposal for a $50 million competitive grant program for Michigan healthcare entities to expand access to pediatric inpatient behavioral health services. The funding was appropriated by the Michigan Legislature as part of the state fiscal year 2023 state budget with the goal to increase the number of beds available to care for pediatric psychiatric patients requiring inpatient hospitalization. Applications are due to the MHA by 11:59 p.m. on June 1.
The MiCare Champion Cast is part of the statewide #MiCareMatters campaign, launched in 2017, which aims to build a network of citizens — “MiCare Champions” — who will be called upon to engage in advocacy efforts to protect access to affordable healthcare services in Michigan.
Members with questions or who would like to submit ideas for future podcasts should contact Lucy Ciaramitaro at the MHA.