The COVID-19 vaccines appear to be effective in protecting against serious illness from the more contagious delta variant of the virus. However, the variant continues to infect many in regions throughout the world, with news reports of renewed lockdowns in Australia and New Zeeland and increasing numbers of cases in U.S. states including Missouri, California, Florida and Texas, where fewer residents are vaccinated. Meanwhile, Michigan’s vaccine dashboard shows more than 61% of residents ages 16 and older have received at least one dose of a COVID-19 vaccine, with nearly 9 million doses administered.
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.
Emergency Orders Rescinded Effective June 22
Several emergency public health orders that have been in place for much of the last 15 months are rescinded as of 12:01 a.m. June 22. The orders rescinded and the dates on which they took effect are:
Safe Housing for Michigan Homeless (April 28, 2020)
While the rescission of the facemask and hospital visitor restrictions would seemingly allow hospitals to stop screening visitors and make their own determinations about masking, the Michigan Occupational Safety and Health Administration (MIOSHA) announced new rules June 22 that essentially defer to the OSHA at the federal level. The OSHA rules currently in place still require healthcare facilities to screen visitors and require masks for employees. However, some exceptions are outlined by the OSHA for well-defined areas where employees are fully vaccinated; a flowchart on the OSHA website provides details. The OSHA also refers healthcare facilities to Centers for Disease Control and Prevention recommendations that continue to urge mask requirements for visitors. The MHA is reviewing the OSHA complete set of rules.
Because the MIOSHA adopted the OSHA rules by reference, the OSHA effective and compliance dates apply. The OSHA COVID-19 Emergency Temporary Standard (ETS) is effective June 21, 2021. The compliance date for the ETS is July 6, 2021, with a few exceptions. Compliance with paragraphs (i) Physical Barriers, (k) Ventilation, and (n) Training is required by July 21, 2021.
As an interim final rule, the new OSHA standard is open for comment. The MHA will submit comments on behalf of its members after a more thorough review of the rule, and members are encouraged to share content for the MHA comment letter with Laura Appel. The MHA will continue to advocate with the MIOSHA for consistency in state and federal rules for healthcare settings and keep members apprised of any developments on this issue. Members with questions may contact Adam Carlson at the MHA.
The Michigan Department of Health and Human Services (MDHHS) issued a new emergency order the evening of Nov. 15 limiting certain indoor gathering opportunities for three weeks in light of the exponentially increasing COVID-19 cases and hospitalization across the state. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
MDHHS Issues Emergency Order Outlining Restrictions
The MDHHS issued a new emergency order Nov. 15 that attempts to curb community spread of COVID-19 by limiting indoor gathering opportunities at various venues for three weeks. These new restrictions do not place any limits on access to healthcare. The order takes effect at 12:01 a.m. Wednesday, Nov. 18.
Under this order, indoor residential gatherings are limited to two households at any one time. The order is aimed at limiting residential and nonresidential gatherings where COVID-19 spreads rapidly. Bars and restaurants will be open for outdoor dining, carry-out and delivery only. Gyms will remain open for individual exercise with strict safety measures in place. Casinos, movie theaters and group exercise classes will be closed. Professional and college sports meeting extraordinary standards for risk mitigation may continue without spectators; however, all other organized sports must stop. Colleges and high schools may proceed with remote learning, but must end in-person classes. The MDHHS has created an infographic explaining what is closed and what will remain open.
The MHA issued a media statement upon the MDHHS announcement, indicating appreciation for the strong and swift response to the current surge in COVID-19 cases that is stretching hospitals and healthcare personnel thin.
Public Cooperation Urged to Prevent Community Spread
The Michigan Economic Recovery Council held a virtual news conference Nov. 12 featuring its healthcare leader members to urge Michiganders to improve their preventive actions to help stop community spread of COVID-19. Participants included MHA CEO Brian Peters; Ed Ness, president & CEO, Munson Healthcare, and MHA Board Chair; Wright Lassiter, president & CEO, Henry Ford Health System; John Fox, president & CEO, Beaumont Health; and Tina Freese Decker, president & CEO, Spectrum Health. To add an Upper Peninsula perspective, Gar Atchison, market president, Upper Peninsula Health System, also took part in the conference. More than 20 news outlets from around the state joined the event (see related article).
Health system leaders shared the increasing challenges their facilities are having due to staff becoming sick in the community, tightening testing capacity, transfer difficulties as a result of widespread surge and more. When asked about state government action, the health leaders reminded Michigan residents that, if everyone does the right thing, there will be no need to return to the strict shutdowns experienced in the spring. Gov. Gretchen Whitmer held a news conference later that day, sharing updated case numbers and urging public compliance with preventive measures.
The MHA also issued a news release containing current data on hospitalizations. Members are encouraged to continue to engage their trustees and local business networks to emphasize that, by working together, the surge can be stopped. For more information, contact Ruthanne Sudderth at the MHA.
Distribution of Bamlanivimab Monoclonal Antibody
The MDHHS held a conference call with healthcare providers Nov. 12, outlining the process for distributing the newly approved COVID-19 antibody treatment bamlanivimab in Michigan. The state expects to receive 3,240 vials in the initial shipment and will release information on the treatment protocols. The MDHHS is still confirming the allocation strategy and expects to coordinate weekly distributions directly from Amerisource Bergen to hospitals based on the data reported for COVID-19 cases and hospitalizations. The MDHHS stated that it has been in direct contact with hospital pharmacy directors to discuss the distribution process, which will be adjusted weekly based on need. The MHA will provide an update as more information becomes available. Members with questions may contact Paige Fults at the MHA.
New COVID-19 Task Force Named; Pfizer States Vaccine 90% Effective
Though President Donald Trump’s campaign team continues to challenge election results, the Biden/Harris campaign has announced its COVID-19 task force and plan to handle the pandemic. The likely change in administrations is sure to bring change in pandemic response that will impact health systems and hospitals, as well many others. The MHA has begun to review the Biden/Harris plan and will inform members about what is expected to change or remain the same. Some of the key areas the association will watch include:
Supply chain strategy.
National consistency in preventive/containment measures.
In addition, Pfizer announced that its COVID-19 vaccine, long expected to be the first available, is currently showing 90% effectiveness against the virus. According to reports, Pfizer plans to ask the Food and Drug Administration for emergency authorization of the two-dose vaccine by the end of November, after it has collected the recommended two months of safety data. Pfizer also stated that it will have manufactured enough doses to immunize 15 million to 20 million people by the end of 2020.
COVID-19 Vaccine Distribution Plans Reviewed
The MHA held a call Nov. 13 for member hospitals and the MDHHS to discuss plans for distribution of the COVID-19 vaccines to health system and hospitals in the coming weeks. More than 170 individuals joined this important discussion.
The MHA will update and share with members a frequently asked questions document that will capture the lengthy question-and-answer session from the call. The discussion recapped expected shipment and storage requirements for vaccines A and B (expected to be Pfizer and Moderna vaccines), working with local health departments to ensure coordination in specific regions/communities, and much more. The MDHHS will send hospitals a follow-up survey to guide distribution, as well as a form for eventual redistribution among each organization’s locations. Members with questions may contact Ruthanne Sudderth at the MHA.
State Launches COVID-19 Contact Tracing Smart App
The state has officially launched MI COVID Alert, an app that lets users know if they have been in close physical proximity to someone who has tested positive for COVID-19. The app maintains broad privacy for users; it asks users to self-report positive COVID-19 tests and, using smartphone technology, knows what other users may have been exposed. It then alerts those users to a potential exposure. As hospital and health system employees are increasingly impacted by community spread, members are encouraged to have them consider using MI COVID Alert to help maintain maximum awareness of exposure risks. The app is free to download on both iPhone and Android devices via their respective app stores.
Members’ marketing and communications teams should also consider sharing this app on social media sites for communities to see and access. The state has created social media graphics so anyone can easily share information about the app on their social networks.
Given the ongoing challenges with Michiganders’ comfort level with standard contract tracing, this is another more confidential tool providers can urge the public to use to improve exposure awareness.
Operation Warp Speed Releases Playbook for COVID-19 Therapeutics
Operation Warp Speed, the federal government’s operation for planning COVID-19 vaccination and treatment, recently released an initial playbook to assist providers in planning. The playbook comes in anticipation of the likely issuance of emergency use authorizations for at least two monoclonal antibody therapeutic drugs developed to treat certain COVID-19-positive patients. The playbook lays out important information for hospitals and health systems to consider, including administration, details on the two drug options, who should receive the therapeutic and a site checklist. Members are encouraged to review the playbook for additional details.
Revised Clarification on License Exemptions
The Bureau of Professional Licensing within the Michigan Department of Licensing and Regulatory Affairs (LARA) has released a revised version of its guidance document clarifying when exemptions of Michigan licensure apply to health professionals. The most notable update includes flexibility to allow providers from other countries that are licensed and in good standing to practice in the state and permit students in their last year of an accredited program to assist in care for those affected by COVID-19. That flexibility had been lost with the rescission of Executive Order 2020-61.
Although LARA does not require documentation on these individuals, it must be made available in the event the department receives an official complaint about an individual provider. The MHA recommends hospitals continue to follow the updated compliance memo related to proper tracking for all individuals who are eligible for the license exemption. Members with questions should contact Paige Fults at the MHA.
MDHHS Announces New Reimbursement for SNF Care and Recovery Centers
The MDHHS rolled out a new application for skilled nursing facilities that are interested in becoming Care and Recovery Centers (CRCs). Included in that application is an updated reimbursement schedule for CRCs that, upon approval by the department, specialize in the care and treatment of nursing facility patients who have previously tested positive for COVID-19 and have not yet met criteria for discontinuation of Transmission-Based Precautions. The reimbursement schedule now provides payments based on number of beds with a $40,000 – $80,000 preparedness stipend, monthly deposit of $10,000 – $20,000, and a bed premium of $200 per COVID-19 day.
Job Fair for Southeast Michigan Healthcare Scheduled for Dec. 2
As members’ staffing challenges grow, the MHA continues to seek opportunities to assist. The association is a member of the Health Careers Alliance for Southeast Michigan, which is hosting a healthcare job fair from 9 a.m. to noon Dec. 2 and urges any employers in or near that region to participate. Hospitals and health systems can register online as employers; 20 employer slots were available as of Nov. 13. Members with specific questions about participation may contact Sarah Gregory, director of talent development, at the Workforce Intelligence Network.