Trustee Insights Edition Explores DEI and Supporting Nursing Professions

The latest edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), is now available. This month’s issue includes an article about the board’s role in diversity, equity and inclusion (DEI). As DEI strategies are developed and ultimately woven into everyday policy and procedure, boards should play a significant role in lending support, driving accountability and inspiring culture in those strategies. Two areas of emphasis are recognizing the increasing prominence DEI plays in quality and playing an important role as vocal leaders to move DEI forward.

There is also a link to the quantitative and qualitative research done by Johnson & Johnson, the American Nurses Association and the American Organization for Nursing Leadership that evaluate the impacts of the pandemic on the nursing profession. The research provides next steps and promising practices that will be essential in delivering the full potential of the nursing profession.

The expanded website and enhanced monthly e-newsletter of Trustee Insights are available through the AHA Trustee Services webpage. They are free, do not require AHA membership and include articles, tools and webinars. Those interested in subscribing to AHA Trustee Insights may do so online.

For information about MHA trustee resources, contact Erin Steward at the MHA.

Webinar Addresses Differences Between DEI and Health Equity

Often the phrases “diversity, equity and inclusion,” or DEI, and “health equity” are used interchangeably. While they do overlap and there is synergy between the two, the terms are not synonymous.

In a free webinar hosted by the MHA Keystone Center and the Michigan Public Health Institute from 10 to 11 a.m. July 15, Lynn Todman, PhD, and Ovell Barbee of Spectrum Health will share how diversity, equity and inclusion and health equity are distinct but overlapping and mutually supportive bodies of work.

Todman and Barbee will use patient “personas” to illustrate the differences and points of overlap. Additionally, Barbee will cover Spectrum Health’s framework for DEI strategy, and Todman will provide an overview of the guiding principles, goals and strategic framework of health equity work.

Todman is the vice president of health equity at Spectrum Health Lakeland, where she leads efforts to advance health equity. She is also the catalyst behind Community Grand Rounds, which aims to educate and share the impact of structural racism on health and stimulate community and health system action to address racial health inequities.

Barbee, senior vice president, human resources, and chief diversity officer, Spectrum Health, leads and directs various workplace strategies in the health system, including talent acquisition, DEI and employee relations.

The webinar is offered free of charge, but registration is required. Members with questions may contact the MHA Keystone Center.

Register by June 22 for Diversity, Equity and Inclusion Virtual Series

As part of its work to address racism and health inequities, the MHA is offering a virtual series to address numerous diversity, equity and inclusion (DEI) concepts, including:

  • Why equity remains the missing element in achieving a more inclusive and diverse work environment.
  • Staff resistance that routinely surfaces and how to engage employees in every step of the DEI journey.
  • Equitable messaging to advertising, media and business-to-business partners that connects with the emotions of DEI.
  • Partnerships that enhance and increase DEI credibility and how to use the “win-when” partnership assessment framework.
  • The professional and personal member organizations that are based on racial affinity and can build on your DEI strategy, as well as the do’s and do nots in developing a pipeline for inclusion.

An important orientation webinar will take place from 11 a.m. to noon June 30, followed by four webinars held from 11 a.m. through 12:15 p.m. Chief executive officers, medical, nursing and human resources executives, governing board members, and key DEI leaders are encouraged to participate. Pricing includes the entire series and is available for teams of five members and larger. Registration is due June 22.

To register, contact the MHA Field Engagement division indicating the intention to register for the DEI series and providing an email address and phone number. Registrants will be contacted for additional information to complete the process. Questions about the series should be directed to Erin Steward at the MHA.

The MHA is discussing with the state whether the information provided in the DEI virtual series will fulfill the new implicit bias training requirement for healthcare providers who apply for initial licensure or relicensure after May 31, 2022. For more information on the new rules, contact Paige Fults at the MHA. An additional opportunity to learn about DEI is available through a July 15 webinar offered by the MHA Keystone Center, which is not related to the new rules.

MHA and MHA Keystone Center Events Focus on Diversity, Equity and Inclusion

To act deliberately and purposefully to ensure outcomes across all patient populations are equitable, leaders should know where disparities exist, ways to prevent disparities and how to create a culture and system that reduces disparities to improve quality and save lives. As part of the work of the MHA Pledge to Address Racism and Health Inequities, the MHA and the MHA Keystone Center are offering multiple events to address diversity, equity and inclusion (DEI).

A virtual series beginning June 30 and concluding Aug. 31 will address four DEI concepts: DEI implementation; equitable conversations; equitable messaging; equitable partnership building; and diversity pipeline development.

The June 30 webinar is an orientation from 11 a.m. to noon, followed by four webinars held from 11 a.m. through 12:15 p.m. EDT. Hospital and health system executives, including chief executive officers; medical, nursing and human resources executives; governing board members; and key DEI leaders are encouraged to participate to advance their health equity efforts. Pricing includes the entire series and is available for teams of five members and larger. To register, contact the MHA Field Engagement division by June 22 and indicate the intention to register for the DEI series, providing an email address and phone number. Registrants will be contacted for additional information to complete the process. Questions about the series should be directed to Erin Steward at the MHA.

The MHA Keystone Center and Michigan Public Health Institute are offering an additional webinar, separate from the series, from 10 to 11 a.m. EDT July 15. The event, Addressing the Confusion: Diversity, Equity and Inclusion (DEI) and Health Equity, will address key distinctions between the phrases “diversity, equity and inclusion” and “health equity.” These phrases are often used interchangeably; however, the terms are not synonymous. Lynn Todman, PhD, and Ovell Barbee, SPHR, of Spectrum Health will use patient “personas” to illustrate the differences and points of overlap.

Additionally, Barbee will cover Spectrum Health’s framework for DEI strategy and Todman will provide an overview of the guiding principles, goals and strategic framework of health equity work. The event is offered free of charge, but registration is required. For more information on this virtual offering, contact the MHA Keystone Center.

Implicit Bias Training Rules Officially Adopted

The Department of Licensing and Regulatory Affairs adopted new administrative rules that require implicit bias training as part of the knowledge and skills necessary for licensure or registration of healthcare professionals in Michigan, which were ordered in Executive Directive 2020-07. Adopted June 1, the new training requirement will take effect one year later, June 1, 2022.

During the fall of 2020, the MHA and several member hospitals were among nearly 80 stakeholders that participated in the Implicit Bias Training Rules Advisory Work Group to help develop the draft rules. The MHA also provided testimony in support of the rules during the public hearing held March 9 and expressed its support to the Joint Committee on Administrative Rules.

The MHA and its member hospitals support unconscious bias training for all healthcare personnel. Ensuring equitable access and care for all patients is an MHA strategic priority, and eliminating health disparities is crucial to the MHA mission of advancing the health of individuals and communities.

Even before Executive Directive 2020-07 was ordered, the MHA and the MHA Keystone Center were working to make strides in this area. Addressing health disparities is a foundational concept that shapes all the organizations’ quality improvement and safety efforts. There is ample evidence of the impact bias has on health, and healthcare systems have a moral obligation to equalize care, starting first by identifying and addressing any bias that may exist within their organization. The training helps individuals identify and acknowledge the biases they have, which often exist outside of their conscious awareness; this process helps providers deliver the best care possible. For more information, contact Paige Fults at the MHA.

Registration Open for Virtual MHA Annual Membership Meeting

Annual Meeting icon

MHA Annual MeetingThe 2021 Virtual MHA Annual Membership Meeting will take place from 9:30 to 11:30 a.m. June 24. The event will feature a federal update from Rick Pollack, president and CEO of the American Hospital Association, and remarks by Kevin Ahmaad Jenkins, a leader in health equity who serves as a fellow within the Veterans Health Administration’s Office of Minority Health.

The virtual meeting will include the MHA House of Delegates business meeting; recognition of the annual MHA award winners; and remarks from incoming board chair Tina Freese Decker, president and CEO, Spectrum Health.

Event details are available on the meeting’s webpage, and members should register online by June 16 to participate. The meeting is open to MHA members, meeting sponsors and invited guests of the MHA. To learn more about the meeting or opportunities for sponsorship, which are available through June 4, contact Erica Leyko at (517) 285-7785.

Comments Being Accepted on Inpatient Rehabilitation Facilities Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to update the Medicare fee-for-service prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year (FY) 2022, which begins Oct. 1, 2021.

Key provisions of the proposal would:

  • Increase the standard federal rate by 2.5% from $16,856 to $17,273 for facilities that comply with the IRF quality reporting program (QRP). Facilities that fail to comply are subject to a 2 percentage point reduction.
  • Increase the cost outlier threshold by 16% from $7,906 to $9,192, resulting in fewer cases qualifying for an outlier payment.
  • Modify the IRF QRP by:
    • Proposing the addition of the COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure, requiring IRFs to report HCP vaccinations in their facilities.
    • Updating the denominator for the Transfer of Health Information to the Patient-Post Acute Care quality measure to exclude patients discharged home under the care of a home health or hospice provider.
    • Updating the number of quarters of data used for public reporting to account for the COVID-19 public health emergency reporting exception granted for Jan. 1 – June 30, 2020.

As it works to make healthcare quality more transparent to consumers and providers, the CMS is seeking input on ways to attain health equity for all patients through policy solutions, as demonstrated by the adoption of standardized patient assessment data elements (SPADEs). These data elements include several social determinants of health that were finalized in the FY 2020 final rule for the IRF QRP. Through a Request for Information within the proposal, the CMS is seeking comment on expanding measure development and the collection of other SPADEs that address health equity gaps. The agency also seeks feedback on its plans to define digital quality measures for the IRF QRP and the potential use of fast healthcare interoperability resources within the IRF QRP, aligning with other quality programs where possible.

The CMS will accept comments on the proposed rule until June 7. The MHA will provide IRFs with an estimated impact analysis and summary of the proposed rule within the next month. Members with questions should contact Vickie Kunz at the MHA.

Combating the Novel Coronavirus (COVID-19): Week of Nov. 16

MHA Covid-19 update

MHA COVID-19 UpdateAs the Thanksgiving holiday approaches, the number of hospitalizations due to COVID-19 continues to rise. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Vaccine Studies Show 95% Effectiveness

Moderna announced Nov. 16 that the latest trials and studies of its COVID-19 vaccine show 95% effectiveness, and Pfizer updated its findings Nov. 18, announcing its vaccine also shows 95% effectiveness. Moderna’s results stem from its Phase 3 clinical trial of 30,000 individuals, and Pfizer’s efficacy rate resulted from a final analysis of its trial with more than 41,000 volunteers. Both vaccines use messenger RNA (mRNA) technology to cause the effective immune response. A key difference between the vaccines is that Moderna’s vaccine can be safely stored in freezers at about 25 degrees Fahrenheit (minus 4 degrees Celsius), a temperature easily reached by a normal freezer. The Pfizer vaccine requires ultracold storage only achieved by specialized freezers or dry ice.

Pfizer applied with the Food and Drug Administration for emergency use authorization of its vaccine Nov. 20, and Moderna expects to soon apply for the authorization. Although distribution dates are not yet certain, the Michigan Department of Health and Human Services (MDHHS) has advised that providers should be prepared to accept vaccine by early December to ensure expedient distribution and administration when shipments begin. Members with questions may contact Ruthanne Sudderth at the MHA.

Provider Relief Fund Further Clarified

The U.S. Department of Health and Human Services (HHS) has issued two important clarifications related to Provider Relief Fund (PRF) reporting.

The HHS had previously stated that providers could claim only the value of depreciation for COVID-19-related capital purchases with useful lives of more than 12 months. However, after urging from the American Hospital Association and the MHA, the agency stated that expenses for capital equipment, facilities projects and inventory may be fully expensed in cases where the purchase was directly related to the prevention, preparation for and response to COVID-19. Examples of such purchases include:

  • Upgrading heating, ventilation and air conditioning systems to support negative pressure units.
  • Retrofitting COVID-19 units.
  • Enhancing or reconfiguring intensive care unit capabilities.
  • Leasing or purchasing temporary structures to screen and/or treat patients.
  • Leasing permanent facilities to increase hospital capacity.

The HHS also clarified that providers’ reporting of net patient revenue should NOT include payments received from or made to third parties that relate to care not provided in 2019 or 2020.

For more information on the PRF, contact Jason Jorkasky at the MHA.

COVID-19 ICU Best Practices Follow-Up Webinar Offered Nov. 24

A Nov. 11 COVID-19 webinar titled “ICU Management & Treatment of COVID-19 Patients” was hosted under the MI-COVID19 registry continuous quality improvement initiative and provided meaningful discussion for participants. As a result, a follow-up webinar has been scheduled for noon to 1 p.m. EST Nov. 24. Objectives include:

  • Summarizing the latest COVID-19 intensive care unit (ICU) guidelines and recommendations.
  • Discussing best practices for management of critically ill COVID-19 patients.
  • Identifying resources and creating a network for ICU leaders in Michigan to advance the care of critically ill COVID-19 patients.

Members may register online, and questions should be emailed to covid19clinicalsupport@umich.edu.

CDC Offers Education on Telehealth and Health Equity Dec. 8

The Centers for Disease Control and Prevention (CDC), through its Clinician Outreach and Communication Activity division, will host an educational event via Zoom from 2 to 3 p.m. EST Dec. 8 that will focus on telehealth and health equity. Details and access information for the event are available online. Presenters from Kaiser Permanente and the Veterans Health Administration will discuss how telehealth has affected health equity in their patient populations before and during the COVID-19 pandemic.

Topics will also include challenges and opportunities related to telehealth implementation. Presenters will share strategies to expand access that can reduce disparities and improve culturally responsive care to help achieve health equity within each organization. In addition, presenters from the CDC will share telehealth strategies that incorporate the CDC’s frameworks for Addressing Health Equity in Public Health Practice.

In associated news, the MHA recently released its Pledge to Address Racism and Health Inequities that was approved by the MHA Board of Trustees at its Nov. 4 meeting (see related article).

COVID-19 Relief Facility Application Now Open

The state has released the application for being designated a COVID-19 Relief (CR) Facility, which are designed to allow eligible Nursing Facilities to retain COVID-19-positive residents. These facilities will meet criteria established in Senate Bill 1094 to care for COVID-19-positive residents who become ill and do not require hospital-level care. The purpose of the CR Facilities is to provide care in place with enhanced infection control measures for individuals with confirmed COVID-19 who have not met the criteria for discontinuation of Transmission-Based Precautions and have limited access to the state’s Care and Recovery Centers. All approved CR Facilities may retain, or readmit after acute care, their own COVID-19-positive residents.

Facilities must meet certain criteria to qualify for CR Facility designation or admission of new COVID-19-positive residents, as detailed in Bulletin Number MSA 20-73 from the Medical Services Administration. The bulletin also provides a list of documents and details applicants should have prepared before applying.

Completed applications should be submitted by 5 p.m. Dec. 1. The MDHHS, in partnership with the Michigan Department of Licensing and Regulatory Affairs, will review applications as they are received. Notification of application status will be contingent upon the volume of applications received. However, it is estimated that facilities seeking CR Facility designation may expect to be notified about the determination within one to two weeks of application submission. Questions about CR Facilities may be submitted to the MDHHS via email.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. 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: