Healthcare Hot Topics: MHA Keystone Center – 2021 Priorities and Leadership Changes

MHA Keystone Center Healthcare Hot Topics

Brittany Bogan, FACHE, CPPS, senior vice president of safety and quality, MHA, and executive director of the MHA Keystone Center, discusses the MHA Keystone Center’s 2021 focus areas in addition to announcing her departure from the MHA.

As we look back on 2020, we remember a year that challenged our hospitals, healthcare systems, employees and communities in unimaginable ways. We also remember a year during which, despite extraordinary circumstances, the front line remained resilient and determined, providing high quality, compassionate care to the people of Michigan. In recognition of this dedication, in this new year more than ever, the MHA Keystone Center remains committed to its mission: supporting healthcare providers to achieve excellence in the outcomes desired by the people they serve.

Our priorities across 2021 include:

Health Equity

We will devote our efforts and resources to eliminating health disparities and dismantling institutional racism. The COVID-19 pandemic has only further highlighted the racial injustices vulnerable populations face, and while some progress has been made, we have a long way to go.

We commend the MHA-member hospitals and healthcare organizations that have taken the first step to address this critical issue by pledging to listen, act and lead as we eliminate healthcare disparities to achieve equitable outcomes for all. The organizations that have signed the pledge will be recognized on the MHA Keystone Center’s public website in the coming weeks. I encourage the healthcare organization chief executive officers who have not yet signed the pledge to contact the MHA Keystone Center.

Improving Care for Older Adults

The older adult population has also been adversely affected by the COVID-19 pandemic. The MHA Keystone Center is enrolling sites for its second Age-Friendly Health Systems Action Community, which will start in March and will support organizations working to improve healthcare outcomes for older adults. The Action Community will adapt its content to meet the needs of the ever-evolving pandemic.
 

The MHA Keystone Center is also one of eight organizations that came together to create the Superior Health Quality Alliance, a joint venture intended to improve the quality of health and healthcare for the Medicare population by designing and implementing initiatives that are person-centered and integrated across the continuum of care and services. Under Superior Health, the MHA Keystone Center is engaged in efforts with hospitals, nursing homes and community coalitions to prevent harm, save lives and lower healthcare costs.

Ensuring Healthy Mothers and Babies

On the opposite end of the life spectrum, I am excited to announce the recent launch of Project Baby Deer, a statewide initiative offering rapid whole-genome sequencing (rWGS) for critically ill babies and children. The MHA is working collaboratively with several other organizations to support Project Baby Deer and aiming to make Michigan the first state in the nation to offer rWGS to all babies and children that meet the clinical criteria, regardless of location or type of insurance. More information on Project Baby Deer will be released soon.

In addition to serving families and children through Project Baby Deer, hospital teams across Michigan are focusing on addressing factors contributing to maternal mortality through the Michigan Alliance for Innovation on Maternal Health (MI AIM). Across 2021, birthing hospitals will be invited to attend regional safety sessions, which will enhance healthcare providers’ ability to work toward full implementation of the MI AIM safety bundles, including those focused on hypertension, hemorrhage and sepsis. 

Workplace Safety and Well-being

The MHA Keystone Center will continue efforts to improve workplace safety through the MHA Workplace Safety Collaborative, convened in 2019 to identify, develop and implement risk-reduction strategies. The MHA Workplace Safety Collaborative is hosting a webinar Jan. 28 to educate members on the Institute for Healthcare Improvement Staff Wellness Tool, which serves as a guide for those in leadership positions to have structured conversations with their colleagues to help ensure staff well-being.

Addressing the Opiod Epidemic

The MHA Keystone Center and the Michigan Center for Rural Health partnered in 2020 to ensure that providers and health systems focus on preventing opioid-related morbidity and mortality. This partnership offers academic detailing training so providers can offer peer-to-peer educational outreach within their facilities. The training is intended to help providers identify patients at-risk for overdose or opioid use disorder and to offer or connect patients with care appropriate for their individual needs. Our goal is to continue to expand access to this training across the year and align with other state and national efforts to curb opioid abuse in Michigan and beyond.

As evidenced by the information above, the MHA Keystone Center team has a lot of fantastic resources and events planned to support healthcare providers in 2021, kicking off with our first PSO Safe Table of the year Jan. 13 and followed by the PSO Annual Member Meeting March 10 and 11. Please save these dates and watch for more details in our weekly communications.

As my time with the MHA and MHA Keystone Center comes to a close, I want to express my gratitude to everyone I have worked with and learned from over the past 12 years. I am honored to have been part of the MHA and MHA Keystone Center teams and humbled by all that has been achieved through collaboration to advance safety and healthcare quality. As MHA’s leader Brian Peters repeatedly says, “we are in this together,” and working together, we really do make a difference. Thank you for being part of the collective effort.

Bogan to Leave MHA for Position at University of Michigan Health System

Brittany Bogan

Brittant Bogan, senior vice president, safety and quality, MHA, and executive director, MHA Keystone CenterBrittany Bogan, senior vice president, safety and quality, MHA, and executive director, MHA Keystone Center, will end 12 years with the MHA staff Jan. 15. The following Monday, she will begin a position on the executive team for C.S. Mott Children’s Hospital at the University of Michigan.

Bogan’s leadership has been integral to the many successes of the MHA Keystone Center. She also helped bring the MHA into a multistate collaboration, now called the Superior Health Quality Alliance, and is currently its chair.

In addition to her work in the safety and quality realm, she has served as president of the Upper Peninsula Hospital Council and as lead staff to the MHA Children’s Hospital Council. In 2020, she has provided extraordinary support to members in dealing with multiple aspects of the COVID-19 pandemic. She has frequently made presentations to the MHA Board of Trustees and has earned the respect of colleagues and healthcare leaders throughout the state, region and nation. 

During her tenure with the MHA, Bogan earned a master’s degree in Health Services Administration from the University of Michigan and fellowship status in the American College of Healthcare Executives.

The MHA wishes her well in this new endeavor and looks forward to working with her as a representative of a member organization.

Implicit Bias Training Rules Advisory Work Group Releases Final Recommendations

Gov. Gretchen Whitmer on July 9 signed Executive Directive 2020-07, directing the state Department of Licensing and Regulatory Affairs (LARA) to begin promulgating rules to establish implicit bias training standards as part of the knowledge and skills necessary for health professionals’ licenses and registrations in Michigan. To comply with the directive’s provision to consult with key stakeholders, LARA launched and recently concluded an Implicit Bias Training Rules Advisory Work Group. The group met for eight weeks, spending over 20 hours discussing examples from other states and offering suggestions and feedback for the rules that will be promulgated in Michigan. The work group and subcommittees included representatives from 86 different organizations, including the MHA and several MHA members.

The MHA supports implicit bias training for all healthcare personnel and is working to ensure equitable access and care is provided to all patients. The final recommendations have been shared with the Bureau of Professional Licensing, which will file a request for rulemaking and begin drafting the rule set. The rule promulgation process can be tracked by subscribing to receive administrative rules email notices. Additional ideas and recommendations should be emailed to the Office of Policy & Legislative Affairs.

For more information or to request a copy of the executive summary of the work group’s final recommendations, contact Brittany Bogan or Paige Fults at the MHA.

Nursing Home Recommendations on COVID-19 Discussed at Sept. 30 Webinar

The Michigan Nursing Home COVID-19 Task Force and the Center for Health and Research Transformation (CHRT) recently endorsed recommendations to inform the state’s response for a potential second wave of COVID-19. The MHA will host a member webinar at 10 a.m. ET Sept. 30 to review the recommendations, which have been submitted to Gov. Gretchen Whitmer and the Michigan Department of Health and Human Services (MDHHS).

Betty Chu, MD, senior vice president and associate chief clinical officer/chief quality officer, Henry Ford Health System, served as the co-chair of the task force and will share an overview of the group’s 28 recommendations. Members will also hear from Marianne Udow, executive director, CHRT, on the recommendations her organization submitted to the MDHHS on the regional nursing home hub approach and additional strategies to better prepare the long-term care community.

The state has not yet acted on either set of recommendations, so this is a good opportunity for members to hear discussion and perspective on what actions may be taken in the coming months related to COVID-19 and long-term care facilities. There is no cost to attend the webinar, and members may register by contacting Naomi Rice at the MHA. Those with questions on this topic may contact Brittany Bogan at the MHA.

Leadership Corner: Eliminating Disparities to Advance Health Equity and Improve Quality

MHA Keystone Center Leadership Corner

The Leadership Corner features updates from the MHA leadership team. The updates will provide new insights to safety and quality, as well as updates on MHA Keystone Center activities and initiatives.

Brittany Bogan, FACHE, CPPS, senior vice president of safety and quality, MHA, and executive director of the MHA Keystone CenterBrittany Bogan, FACHE, CPPS, senior vice president of safety and quality, MHA, and executive director of the MHA Keystone Center, urges healthcare organizations to prioritize and act on addressing health disparities using a newly released guide.

Disparities remain a prevalent and persistent issue across the healthcare continuum, as we have seen demonstrated historically and with the recent COVID-19 pandemic. The importance of a wide range of demographic and socioeconomic conditions must be understood and addressed to eliminate disparities and achieve equity. Healthcare leaders are the cornerstone for influencing change within their organizations. I urge each leader to ask themselves the following questions to prompt activity to address disparities and advance equity:

How can I identify the health disparities that exist in my community?

What can I do to prevent disparities that exist in our patient outcomes?

How can I create a culture and system that reduces disparities to improve quality, save lives and reduce cost?

The questions are derived from the MHA Keystone Center’s recently published guide, Eliminating Disparities to Advance Health Equity and Improve Quality, designed to provide practical guidance for healthcare organizations seeking to eliminate disparities in care to advance health equity.

Organizations are encouraged to use the guide to evaluate their current level of implementation of key strategies to reduce disparities and improve quality for better patient outcomes. This resource will guide organizations to prioritize and act on identified gaps so that thoughtful and focused actions transpire to ensure that the outcomes across all patient populations are equitable.

The guide states that diversity and inclusion are fundamental building blocks for cultural competency that celebrate the differences between individuals by bringing them together. Once organizations understand their communities’ makeup through consistent data collection, they must evaluate whether their providers and leadership reflect that community. When a gap is identified, healthcare systems should develop strategic efforts and programs to recruit and retain a diverse workforce that reflects their patients’ backgrounds and needs. In short, we must ensure that health equity is a leadership-driven priority that aligns with the organization’s mission and vision.

The MHA Keystone Center has long been committed to addressing health disparities, a foundational concept that shapes all the organization’s quality improvement and safety efforts.

I challenge and encourage your organization to be a pioneer in the movement towards achieving health equity for all populations. Please know that the MHA Keystone Center is available to support you every step of the way. 

Please view the MHA website for additional MHA Keystone Center quality improvement projects and future cohorts of the Age-Friendly Health Systems Action Community. 

MiBiz: Health leaders back Whitmer order to formalize implicit bias training

Brittany Bogan

MiBiz published a story July 19 on the recent executive directive from Gov. Whitmer that directs state regulators to craft rules requiring implicit bias training for Michigan health professionals as they seek licensure, registration and license renewals.

On July 9 MHA CEO Brian Peters released a statement expressing his support of the executive directive, stressing the critical importance of addressing health disparities.

Brittany Bogan, FACHE, CPPS, senior vice president of safety and quality, MHA, and executive director of the MHA Keystone Center, is quoted in the story discussing the benefits of implicit bias training and the efforts Michigan hospitals have taken to improve health equity.

“Many of our hospital systems across the state have already been doing this for some time,” said Bogan. “The training itself helps individuals to identify and acknowledge the biases that you have individually, and these often exist outside of our conscious awareness. So, there’s benefit to everyone for some sort of conversation and training about implicit bias.”

Read the article

Combating the Novel Coronavirus (COVID-19): Week of June 1

MHA Covid-19 update

COVID-19 UpdateGov. Gretchen Whitmer announced June 1 that certain sectors of Michigan’s economy would reopen across the state and the “safer at home” executive order was rescinded effective immediately. In a June 5 news conference, the governor stated that, effective June 10, the Upper Peninsula and 17 counties in the northern Lower Peninsula can allow larger numbers of people to gather if social distancing guidelines are observed. In addition, personal care services such as hair salons and gyms that follow safety guidelines will be allowed to reopen statewide effective June 15.

As these changes take place, the MHA will continue to keep members apprised of these and other developments during the COVID-19 pandemic through regular email updates and the MHA Coronavirus webpage. Important updates on how the pandemic is affecting Michigan hospitals are outlined below.

State Directives Affect Healthcare Facility Visitors, Emergency Certificates of Need

The governor has extended Executive Order (EO) 2020-108 regulating visitors entering health facilities through June 26. However, a June 3 order from the Michigan Department of Health and Human Services (MDHHS) effectively creates a separate set of visitor restrictions for the facilities to which it applies (hospitals, psychiatric hospitals, outpatient clinics and doctors’ offices). The new visitor policy does not prohibit providers from implementing additional restrictions; however, antidiscrimination/disability requirements apply to people who provide support for disabled or impaired patients. In addition, the MDHHS order applies only to people visiting patients and not to employees or contractors of the facility, who are addressed by other orders. MHA members with questions about the MDHHS guidelines should contact Ruthanne Sudderth at the MHA.

The order that allowed for swift approval of emergency certificates of need (CON) to increase hospital capacity was rescinded June 3, effective immediately. Hospitals that set up emergency CON beds/capacities under EO 2020-82 may retain them through July 31. The MHA is seeking further clarification on spaces that were set up under EO 2020-82 and will inform members of any additional guidance received. Those with question should contact Adam Carlson at the MHA.

In addition, the state has launched the MI Symptoms web portal that allows individuals to create an account and track their possible COVID-19 symptoms, find testing information and more. The MDHHS also announced June 5 that the state’s coronavirus webpage now contains data that conveys information in several additional categories.

Blue Cross Blue Shield of Michigan Extends Prior Authorization Suspension

Blue Cross Blue Shield of Michigan (BCBSM) recently announced it will extend through June 12 its prior authorization suspension for all inpatient acute-care hospital admissions for all diagnoses. Prior authorization has also been suspended through June 30 for the first three days of all skilled nursing facility admissions for patients who transfer from an acute-care hospital. BCBSM has provided guidance regarding its temporary utilization management program changes. Members with questions may contact Jason Jorkasky at the MHA.

 Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. If staff members at MHA-member facilities are not receiving necessary information from the MHA, they are asked to check the spam/junk mail folders in their email systems or ask their information technology departments to ensure MHA messages are not being blocked.

Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members:

Leadership Corner: MHA Keystone Center’s Commitment to Addressing Health Disparities and Achieving Health Equity

MHA Keystone Center Leadership Corner

The Leadership Corner features updates from the MHA leadership team. The updates will provide new insights to safety and quality, as well as updates on MHA Keystone Center activities and initiatives.Brittany Bogan, FACHE, CPPS, senior vice president of safety and quality, MHA, and executive director of the MHA Keystone Center

Brittany Bogan, FACHE, CPPS, senior vice president of safety and quality, MHA, and executive director of the MHA Keystone Center, discusses the MHA Keystone Center’s commitment to support hospitals in addressing health disparities and achieving health equity.  

Commitment to Achieving Health Equity

The events of the past several months have highlighted and amplified the systemic racism that is a persistent and widespread problem in our society. The disproportionate impact of COVID-19 on persons of color has called out, in yet another example, the racial disparities that exist in access to healthcare and health outcomes. These disparities and inequities must be confronted, and we believe that healthcare systems are the epicenter for leading these efforts and playing an essential role in the wellbeing of communities. The MHA Keystone Center has long been committed to this call – addressing health disparities is a foundational concept that shapes all our quality improvement and safety efforts. Through this commitment, the MHA Keystone Center continues to provide numerous resources to assist organizations in delivering equitable healthcare:

Educational Opportunities 
In addition to evidence-based practices, resources and recordings of the following events/webinars are available on the MHA Community site, within the “Health Disparities Resources” folder:

Resources 

  • The Reliability Culture Implementation Guide is a tool that incorporates elements of safety culture with the five principles of high-reliability organizations – preoccupation with failure, reluctance to simplify, sensitivity to operations, commitment to resiliency and deference to expertise.
  • A dedicated MHA Community site, Advancing Health Equity, where members can view resources, connect with other healthcare organizations and ask questions. Contact the MHA Keystone Center to request access. 
  • An article, debunking seven common misconceptions about health equity.
  • In the following weeks, the MHA Keystone Center will release a comprehensive guide to support members in ensuring that every person in every community receives high-quality, equitable and safe care.  

Next Steps for Hospitals

  • Complete or update the Health Equity Organizational Assessment (HEOA) to assess your organization’s current activity, which is identified through national research as critical components of an organization’s ability to identify and address disparities. Results of the HEOA help your organization identify areas of improvement. To request access to the HEOA, visit the KeyMetrics website and select “Request Access”. 

The MHA Keystone Center’s mission, supporting healthcare providers to achieve excellence in the outcomes desired by the people they serve, and vision statement, achieving the highest quality healthcare outcomes that meet individual values, is directly aligned with addressing health disparities. We remain dedicated to supporting hospitals and caregivers by offering structure and actionable steps to ensure the healthcare system is active and transparent in addressing disparities and implicit bias. Please join us. Together we can prevail in achieving health equity, improving population health and meeting the needs of all patient populations, regardless of race, ethnicity, gender, age, sexual orientation, education, culture, heritage, religion, location, physical ability or socioeconomic status. 

Combating the Novel Coronavirus (COVID-19): Week of May 18

MHA Covid-19 update

MHA COVID-19 UpdateThe MHA has continued to keep members apprised of developments during the COVID-19 pandemic through regular email updates and the MHA Coronavirus webpage. Important updates on how the pandemic is affecting Michigan hospitals are outlined below.

Executive Order 2020-17 Rescinded, Other Restrictions Eased

Gov. Gretchen Whitmer announced May 21 that she is rescinding Executive Order (EO) 2020-17 effective May 29. This EO was issued in March and banned “nonessential” medical procedures in hospitals, ambulatory surgery centers and dentists’ offices. The MHA issued a media statement in support of her action and will continue to run statewide television and social media ads urging people not to delay care and assuring that hospitals are safe places to receive services.

The governor also announced during a May 21 news conference that auto dealerships, retailers and veterinarians can open to the public, by appointment only, effective May 29, and that, effective immediately, groups of 10 or fewer people may gather outside of their homes. Whitmer announced May 18 that the Upper Peninsula (Region 8) and 17 counties in northern lower Michigan (Region 6) will be permitted to partially reopen their economies May 22, in accordance with the “Safe Start” recommendations developed by the Michigan Economic Recovery Council.

Liability Protections for Healthcare Workers, Facilities

The MHA testified May 19 via videoconference before the state House Judiciary Committee to advocate for Senate Bill (SB) 899, which offers strong and broad liability protections for healthcare workers and facilities treating COVID-19 patients. The MHA and members have identified this as an important element to operating within pandemic and emergency situations. A variety of other healthcare groups submitted cards of support for the bill, including the Michigan State Medical Society and the Healthcare Association of Michigan, which represents long-term care facilities.

SB 899 originally passed the Senate May 7. The MHA will continue to work with members of the House of Representatives as the legislation progresses to support healthcare personnel responding to the COVID-19 pandemic. Members with questions may contact Adam Carlson at the MHA.

Laboratories and Testing

The Michigan Department of Health & Human Services (MDHHS) announced May 18 that the Laboratory Emergency Response Network (MiCLERN) hotline will be taken offline at 5 p.m. ET May 22. The announcement stated that this is due to “recent changes to COVID-19 prioritization criteria and stabilized testing capacity that no longer requires prior issuance of Person Under Investigation (PUI) identifiers for MDHHS Bureau of Laboratory (BOL) testing of COVID-19 specimens.” The state clarified that COVID-19 specimens that are sent to the state laboratory no longer require a PUI form, but should still include the State of Michigan Test Requisition form (DCH-0583) and two unique identifiers.

Hospitals in need of swabs and transport media for testing are reminded to report their needs to the BOL by sending an email to MDHHSLab@michigan.gov using the subject line “EM COVID-19 Supplies,” per recent guidance shared with members in the May 6 email update. Members with questions should contact Brittany Bogan at the MHA.

MVC Offers Resources for Resuming Non-COVID Procedures

The Michigan Value Collaborative (MVC) represents a partnership among 87 Michigan hospitals and 40 physician organizations that aims to improve the health of Michigan through sustainable high-value healthcare. Supported by Blue Cross Blue Shield of Michigan, the MVC helps its members better understand their performance using robust multipayer data, customized analytics and at-the-elbow support.

To assist hospital systems with prioritizing the restart of surgical services with the least impact on caring for remaining COVID-19 patients, the MVC has designed reports that display resource utilization metrics at a statewide and member hospital level for 17 elective surgical procedures. More information is available by contacting the MHA Keystone Center.

Pharmacy Refill Order Extended

The governor signed EO 2020-93 May 19, extending a previous order giving pharmacists increased operational capacity. It also expands access to prescriptions for patients. The order allows pharmacists to dispense emergency refills of prescriptions for up to a 60-day supply and requires insurers to cover early refills for up to a 90-day supply during the pandemic. It also allows pharmacists to dispense COVID-19 treatments according to government-approved protocols. EO 2020-93 took immediate effect and will expire at 11:59 p.m. June 16, 2020. Members with questions may contact Paige Fults at the MHA.

EMResource Now Tracking Psychiatric Facility Data

The state of Michigan recently launched a new module in EMResource targeted toward freestanding psychiatric facilities. The data collected in this new module requests data on beds, COVID-19 patients, staffing and personal protective equipment availability. Psychiatric facilities are required to report this information weekly by 11:59 p.m. ET every Friday. The MHA is seeking clarification from the state on whether this data will also be posted to its COVID-19 data website alongside existing health system/hospital data on related measures, or on any other public website. Members with questions may contact Jim Lee at the MHA.

Multisystem Inflammatory Syndrome in Children

A Clinician Outreach and Communication Activity webinar on the clinical characteristics of Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 is now available online. The Centers for Disease Control & Prevention (CDC) hosted the webinar May 19. The MDHHS reported that, since April 1, there have been 28 identified cases in Michigan, and treatment with intravenous immunoglobulin and steroids is proving to be effective. The CDC issued a Health Advisory May 14 and recommends healthcare providers report any patient who meets the case definition to local and state health departments to enhance knowledge of risk factors, clinical course, and treatment of this syndrome.

Healthcare Workers Still Permitted to Cross Closed Canadian Borders

The U.S. Department of Homeland Security May 19 reissued its order closing the United States – Canadian ground border through 11:59 p.m. ET June 22. Healthcare workers will continue to be permitted to cross to report to work.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. If staff members at MHA-member facilities are not receiving necessary information from the MHA, they are asked to check the spam/junk mail folders in their email systems or ask their information technology departments to ensure MHA messages are not being blocked.

Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of May 11

MHA Covid-19 update

Despite slowing rates of infection, the state of Michigan surpassed 50,000 COVID-19 cases May 15. The MHA has continued to send regular updates to MHA members on matters related to the pandemic. Additional updates and resources are available on the MHA COVID-19 webpage. Following are highlights from the week of May 11.

Funding

The federal Family First Coronavirus Act provided a temporary 6.2 percentage point increase to the federal medical assistance percentage (FMAP) rate effective Jan. 1, 2020, through the end of the quarter in which the federal emergency expires, at least through June 30. Because of the increased FMAP rate, Michigan hospitals paid $29 million less tax to support supplemental Medicaid payments for the two most recent quarters. The MHA will provide additional information on the enhanced rate changes as it becomes available. Members with questions may contact Vickie Kunz at the MHA.

An extended increase in the FMAP rate is one aspect of the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act that the U.S. House of Representatives introduced May 12. Developed by House Democrats and passed by the full House late May 15, this COVID-19 response package includes several positive items for hospitals and health systems.

The act would increase the FMAP by 14 percentage points from July 1, 2020, through June 30, 2021, returning to 6.2 percentage points for the subsequent year. Some of the additional healthcare-related provisions include:

  • $100 billion for hospital and healthcare providers to be reimbursed for healthcare-related expenses or lost revenue directly attributable to the public health emergency.
  • $75 billion to bolster testing and contact tracing efforts.
  • Modified terms for the accelerated and advanced payments available through the Medicare program.
  • Elimination of cost-sharing for COVID-19 treatment in most forms of healthcare coverage.
  • Increased research of the impact of COVID-19 on behavioral health, including the impact on healthcare providers.
  • Nearly $1 trillion for states and local governments to respond to COVID-19.
  • Numerous changes to Medicare, Medicaid and other health programs.

The MHA will continue to express support for passage of this package with the Michigan congressional delegation. Members with questions may contact Laura Appel at the MHA.

Testing Updates

As the criteria for those eligible to receive a COVID-19 test has expanded, the state has focused on increased testing among four vulnerable populations: residents in long-term care facilities, residents in assisted living facilities, inmates in prisons and county jails, and the homeless/underserved. At the same time, the state is supporting the launch of several new drive-thru and community-based testing sites in targeted counties, cities and neighborhoods that have been most impacted by COVID-19. A Request for Proposals (RFP) was issued to set up these COVID-19 test sites around the state. The submission deadline for proposals is 11:50 a.m. May 18. A link to the RFP and additional information was sent to members in the May 14 email update. Members with questions may contact Brittany Bogan at the MHA.

Michigan Chief Medical Executive Joneigh Khaldun, MD, has clarified her April 20 memo regarding expanded criteria for COVID-19 testing eligibility. Although the memo allows for asymptomatic healthcare works and first responders, as well as critical infrastructure workers with or without COVID-19 symptoms, there is no requirement for healthcare providers to test any certain population. The expanded criteria are meant to allow for testing of these individuals if testing supplies are available.

Remdesivir Distribution

The Michigan Department of Health and Human Services (MDHHS) notified the MHA that the state received from the federal government 1,600 vials of the antiviral medication remdesivir May 9 and distributed them to 41 Michigan hospitals, in accordance with an “Interim Emergency Allocation Strategy” developed by the MDHHS. Remdesivir has been authorized for emergency use in the U.S. to potentially shorten the effects of COVID-19. The state received another supply of the drug May 14 and gathered data to determine the hospitals to distribute it to.

The U.S. Department of Health and Human Services (HHS) has set 11:59 p.m. ET May 18 as the next deadline for submitting data to inform the agency's distribution of its limited supply of remdesivir. Hospitals that already use the TeleTracking web portal for their daily reporting need to do nothing differently for this remdesivir data collection, except to ensure these data are submitted by the May 18 deadline. If hospitals encounter issues with accessing the TeleTracking portal or have questions about the data, they should contact TeleTracking Technical Support at (877) 570-6903.

The HHS will allocate all of the donated supply of remdesivir from Gilead in the coming weeks and anticipates that no more will be available in the U.S. until the fall or later. Thus, hospitals that receive an allocation should carefully consider decisions about how the drug is used. Members with questions may contact Laura Appel at the MHA.

Multisystem Inflammatory Syndrome in Children

The MDHHS issued a notice to healthcare providers May 15 regarding the symptoms of multisystem inflammatory syndrome in children (MIS-C), a condition related to COVID-19. Access to the notice was sent to members in the May 15 email update.

The Centers for Disease Control and Prevention (CDC) has provided additional background information on several cases of MIS-C and a case definition for this syndrome. The MIS-C case definition is as follows:

  • An individual under 21 years of age presenting with fever, laboratory evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND
  • No alternative plausible diagnoses; AND
  • Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms

According to the state, “The CDC recommends healthcare providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.” Although some individuals may have symptoms of Kawasaki disease, they should be reported if they meet the MIS-C case definition. The MIS-C diagnosis should also be considered in any pediatric death with evidence of SARS-CoV-2 infection.

Emergency CON Executive Order Extended to June 9

The governor issued Executive Order (EO) 2020-82 May 12, extending emergency Certificate of Need (CON) flexibility for healthcare providers to June 9. Initially, these CON measures were part of EO 2020-49, which was set to expire May 12. The EO relaxes regulatory requirements on hospitals and healthcare facilities that need to expand capacity to care for COVID-19 patients. The order also grants additional flexibility in the Department of Licensing and Regulatory Affairs’ decisions about licensing, registration and workflow requirements to help ensure adequate numbers of care providers. Members with questions may contact Adam Carlson at the MHA.

Telehealth Legislation

The Michigan House of Representatives acted on telehealth legislation May 13, passing bills that would expand access and improve reimbursement for telehealth services. The bipartisan package was introduced before the COVID-19 pandemic, but there is renewed urgency given the current necessity for telehealth services (see related article).

Reporting Deaths Due to COVID-19

The MDHHS recently provided guidance for healthcare providers on procedures to follow when someone dies of COVID-19 in their facility. The local health officer should be informed of the death between 8 a.m. and 5 p.m. the day the death occurs, seven days a week. Deaths occurring after 5 p.m. should be reported as soon as possible the following morning, but no more than 24 hours following the death. The MDHHS has provided more information online for reporting deaths from COVID-19.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. If staff members at MHA-member facilities are not receiving necessary information from the MHA, they are asked to check the spam/junk mail folders in their email systems or ask their information technology departments to ensure MHA messages are not being blocked.

Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members: