Tag: Business Leaders for Michigan

Michigan Voters, Healthcare and Business Leaders Agree: One-Size-Fits-All Ratios Will Harm Patients

Issues in Healthcare, News Releases, Top Issues - Healthcare
Michigan coalition opposing mandated nurse staffing ratios.

A diverse coalition of healthcare, business and advocacy organizations published a letter to members of the Michigan Legislature today opposing the proposed House Bills 4550-4552 and Senate Bills 334-336, which threaten to put patient care at risk across Michigan.

“These partners from a broad collection of industries all agree imposing a one-size-fits-all legislative mandate to hospital nurse staffing will harm patients and severely restrict access to care in Michigan communities,” said Brian Peters, CEO of the Michigan Health & Hospital Association. “Our nurses, patients and communities deserve more than political posturing that puts healthcare access at risk.”

The proposed bills would mandate one-size-fits-all nurse staffing ratios for all Michigan hospitals, which would not solve existing staffing shortages, as evidenced in other states that have tried this policy. In California, which has had legislatively mandated staffing ratios for over two decades, the state still faces a shortage of 40,000 RNs. Additionally, Michigan outperforms California in hospital quality, as Michigan has both a higher percentage of 4- and 5-star hospitals than California (49% to 35.3%) and a lower percentage of 1- and 2-star hospitals (18.4% to 38.7%), according to CMS Care Compare Hospital Overall Star Ratings.

The United States is facing a national nurse shortage issue, exacerbated by the aging nursing workforce, as many experienced nurses approach retirement. Currently, 32.3% of licensed RNs in Michigan are 55 years of age or older and nearly 8,500 open nursing positions exist statewide. A survey of 109 Michigan hospitals conducted in July 2023 shows Michigan is at risk of losing up to 5,100 hospital beds across the state if this legislation is implemented. This total represents 23% of Michigan’s overall statewide hospital bed capacity and is equivalent to closing all hospitals north of Grand Rapids and Flint.

The coalition emphasizes that mandatory nurse staffing ratios have a broader impact beyond hospitals alone, affecting all healthcare providers’ ability to hire nurses. With a finite pool of available RNs, nursing homes, rehabilitation facilities, physician practices and other healthcare settings will experience increased difficulty in recruiting and hiring nurses, especially as hospitals compete for the same talent pool.

“The entire healthcare sector is facing historic workforce shortages,” said Melissa Samuel, Health Care Association of Michigan President/CEO. “We all need more nurses. Unfortunately, these bills exacerbate the problem and fail to offer meaningful solutions.”

The potential impact to the business community is significant. Data collected from hospitals indicates the proposed ratios could increase healthcare costs by over $1 billion, impacting economic development and employers.

Recent EPIC-MRA polling of Michigan voters indicates that 82% do not believe the government should mandate one-size-fits-all nurse-to-patient staffing ratios in every hospital, and if the bills were to become law, 83% of Michigan voters would be concerned about their ability to receive care, or the wait times, in a Michigan hospital emergency room.

The coalition supports the following alternative solutions to address the nurse staffing shortages:

  1. Join the Nurse Licensure Compact: Bring Michigan into the national Nurse Licensure Compact to reduce barriers for out-of-state nurses to practice in Michigan immediately, joining 41 other jurisdictions across the country.
  2. Expand Michigan Reconnect Eligibility: Lower the age requirement to 18 and older, encouraging more individuals to pursue nursing careers.
  3. Funding Innovative Approaches to Workplace Violence Prevention in Healthcare Settings: This complements the passage of House Bills 4520 and 4521 that increase penalties for violence committed against healthcare workers and would make the nursing profession more attractive by addressing safety concerns.

To date, Michigan hospitals, health systems and other healthcare providers have focused on addressing staffing shortages by implementing various measures, including increased compensation, partnerships with post-secondary education institutions, emotional well-being support, modernizing scope of practice rules and recruitment awareness campaigns such as MI Hospital Careers.

The coalition includes the following organizations, and joins nursing organizations such as the American Nurses Association – Michigan and Michigan Organization for Nursing Leadership in opposing legislatively mandated nurse staffing ratios:

  • Business Leaders for Michigan
  • Community Mental Health Association of Michigan
  • Detroit Regional Chamber
  • Grand Rapids Chamber
  • Health Care Association of Michigan
  • Michigan Ambulatory Surgery Association
  • Michigan Association of Ambulance Services
  • Michigan Association of Colleges of Nursing
  • Michigan Association of Health Plans
  • Michigan Chamber of Commerce
  • Michigan College of Emergency Physicians
  • Michigan County Medical Care Facilities Council
  • Michigan Health & Hospital Association
  • Michigan HomeCare & Hospice Association
  • Michigan Manufacturers Association
  • Michigan Osteopathic Association
  • Small Business Association of Michigan
  • Traverse Connect

To learn more about the impact of the proposed legislation on care in Michigan, visit www.mha.org/issues-advocacy/key-issues/nurse-staffing-ratios.

MHA CEO Report — New Control in Lansing

MHA Rounds

“I don’t like that man. I must get to know him better.” ― Abraham Lincoln

As I put the proverbial pen to paper, the Michigan Legislature has completed the 2021-2022 legislative session and I am very pleased to report that in the lame-duck session, we successfully advanced several MHA-supported bills – and not a single MHA-opposed bill was signed into law. Another job extremely well done by our MHA Advocacy team as we protect access to affordable, high-quality healthcare for all.

Now shifting to the New Year: 2023 will usher in a monumental shift in power in Lansing as Democrats will control all aspects of government in the state for the first time during my 32-year tenure at the MHA. Following last November’s election results, Democrats not only retain power in all areas of the executive branch and a majority in the judicial, but both chambers of the legislative branch flipped to Democratic control. The last time Democrats had control of the Governor’s office and both chambers of the state legislature was 1984.

This change was due to a multitude of factors, including redistricting, ballot proposals, a trickle-down impact from the top of the ballot, candidate viability and record turnout. Earlier this year, the Michigan Independent Citizens Redistricting Commission established new district maps, which had previously been handled by the majority party in the state legislature in conjunction with the governor. Michigan saw a significant increase in the number of competitive districts due to their nonpartisan work. The Michigan midterm election saw record turnout again, with 4.5 million votes cast, including 1.8 million absentee ballots. This is a 2.4% increase from the prior record set in 2018 with 4.3 million votes. Turnout was partially driven by three ballot proposals as well as over 14,000 same day voter registrations, primarily from young Gen Z voters.

The MHA has a long history of being nonpartisan, but moving from divided government to one-party control will always bring about a change in the political dynamics and associated priorities. Our advocacy culture has long been to establish and maintain relationships regardless of leadership role or party affiliation so that in times of need, you have allies you can rely on. Both new Speaker of the House Joe Tate (D-Detroit) and Senate Majority Leader Winnie Brinks (D-Grand Rapids) have established track-records of working closely with the healthcare community to help us fulfill our mission of advancing the health and wellness of individuals and communities. Our MHA Advocacy team as well as our member hospitals and health systems consider them friends. And of course, our close partnership and personal friendships with Gov. Whitmer extend back to her time in the state legislature when she was recognized with an MHA Special Recognition Award at the 2014 MHA Annual Meeting. Our bonds with the governor and her administration grew even stronger as we confronted the COVID-19 pandemic together.

As a result of term limits, the new legislative session will also welcome an astounding 59 first-time legislators to Lansing. Since the Nov. 8 election, we have been busy establishing new relationships and introducing ourselves to many new faces. Most lawmakers only know healthcare through the prism of a consumer, so it is never too early to begin the education process related to this highly complex field. As part of this process, we hosted the Building Bridges event with our partners at the Small Business Association of Michigan, the Michigan Education Association, Michigan Association for Justice and Business Leaders for Michigan that helped us pursue these goals while also offering new legislators the opportunity to connect with their peers and learn how best to serve in Lansing.

Now I have no magic crystal ball so I can not predict what types of legislation we may see introduced and prioritized over the coming months. Having not held a dual-chamber majority for nearly 40 years, we anticipate there is no shortage of issues for Democrats to work on. There is no question we will continue to express the importance of access to care, which Democrats have traditionally strongly supported. Based on public comments and prior legislative track records, it is reasonable to expect continued activity on improving behavioral health, public health, health equity and addressing pharmaceutical pricing. American Rescue Plan Act funds also remain available and we strongly believe these funds should be appropriated quickly to make a difference in addressing the financial and staffing challenges that our member hospitals throughout the state, regardless of size, are experiencing. Those are positives. In reality, we need to also be prepared to address legislative proposals that we find more concerning – such as nurse to patient staffing ratio mandates which sound good in theory but would be impractical if not impossible to implement in practice.

The truth of the matter is that the Democrat majority is very slim, so we expect Republicans will still play an impactful role in healthcare funding and policy development. We certainly appreciate the work they’ve done for hospitals and healthcare over recent years and look forward to continuing those relationships during the new session.

I hope all our elected officials who will take office in January will reflect on the wise words of Abraham Lincoln above and include among their New Year’s resolutions to pause, set aside whatever preconceived notions they may have about the people across the aisle from them and make an earnest effort to truly get to know them. Will this guarantee that we come together and see eye-to-eye on all the issues? Of course not.  But hopefully, such an approach will lead to more civility in the political process and better public policy for all Michiganders.

The bottom line: 2023 presents new challenges and opportunities for all who work in Lansing. While many of the players in town may have changed, the playbook for successful advocacy has not. On behalf of our member hospitals, I’d like to express my gratitude for those finishing their years of service, congratulate all those who will be serving in office this upcoming year and look forward to working together to achieving a healthier Michigan.

As always, I welcome your thoughts.