MHA CEO Report — Impacting Communities

MHA Rounds image of Brian Peters

“People will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou

MHA Rounds graphic of Brian PetersAs we turn the page on 2024 (and celebrate our success in preventing harmful government-mandated nurse staffing ratio legislation, as well as harmful changes to our medical liability system, during the lame-duck session of the legislature), it is appropriate to reflect on the fact that Michigan hospitals and health systems are there for our communities 24 hours a day, 365 days a year in ways that reach far beyond their four walls. What they do adheres to this simple theme: Hospitals help.

Hospitals help strengthen the healthcare workforce, enhance access to care, build healthier communities, serve as an economic driver and more. They provide essential resources and programming that help patients, hospital employees, community groups and local businesses thrive.

We highlight and summarize the impact of these activities annually. We will publish in the coming days the 2024 Community Impact Report, which reflects some of the outstanding ways Michigan hospitals are advancing the health and well-being of patients, our healthcare workforce and communities across nearly every region of the state.

These efforts are made possible through strategic investments, innovative programming, local partnerships and support from state and federal healthcare champions. The stories featured in the report paint a picture of the impact hospitals have on our everyday lives beyond traditional patient care. While there are many other efforts underway, we’re honored to uplift a handful of strong examples in this publication.

Visit our MiCareMatters website to read stories that showcase how Michigan hospitals positively impact their communities every day. And as we look forward to the new year, I invite everyone to join us and consider how you can support these vital organizations and the amazing people who work there. I promise that no matter how you engage with hospitals, it feels good to help.

As always, I welcome your thoughts.

340B Hospital Protections Advance, Medical Liability Blocked During Busy Lame Duck

Various healthcare bills, including increased 340B protections for healthcare providers, received attention by the Michigan Legislature during the week of Dec. 9.

Senate Bill (SB) 1179, sponsored by Sen. Sam Singh (D-East Lansing) and which protects the 340B program in Michigan, saw extensive action during the week. It began with two MHA members providing testimony to the Senate Oversight Committee in support: Ben Frederick, associate vice president of advocacy and government relations, Memorial Healthcare; and Deidra Wilson, senior vice president, government relations and public policy, McLaren Health Care. The bill is vital for hospitals that serve vulnerable populations, helping them stretch scarce resources to care for more patients. SB 1179 safeguards the program, ensuring cost savings and preserving access to affordable healthcare services in both urban and rural Michigan communities. Further, this legislation adds first of its kind pharmaceutical manufacturer transparency requirements, making Michigan’s legislation the strongest in the nation.

During testimony, Frederick emphasized the impact the 340B program has in rural communities and shared a personal story of how 340B helped his father access palliative care following a terminal cancer diagnosis. Wilson highlighted how the 340B program supports cancer patients across the state by helping cover copays and providing access to essential transportation services. She also addressed how current restrictions hinder access to care for vulnerable populations, emphasizing that the program is centered on community, service and resource provision. She concluded her testimony by stating that the bill prioritizes the needs of Michigan patients and communities over the profits of pharmaceutical manufacturers.

Following successful reporting from committee, the full Senate took action on SB 1179. The MHA-supported legislation passed the full Senate 30-3 with overwhelming bipartisan support, reflecting the Senate’s commitment to protecting access to care and the 340B program.  The Senate opted to pair this legislation with SB 952, sponsored by Sen. Jonathan Lindsey (R-Allen), which requires hospital compliance with federal cost transparency laws

The bill now heads to the House of Representatives for approval before it can be sent to Gov. Whitmer’s desk. The MHA continues to advocate for the 340B program and support Michigan hospitals’ efforts to expand access to quality, community-based care. Members are encouraged to use the MHA 340B Action Alert to contact their lawmakers in support of the bill.

In other action this week, MHA-supported HB 5964, sponsored by Rep. Jennifer Conlin (D-Ann Arbor), overwhelmingly passed the House. This bill ensures Michigan’s continued membership in the Interstate Medical Licensure Compact, supporting the recruitment and retention of physicians. This MHA supported bill now heads to the Senate for approval.

House Bills (HBs) 5371 and 5372, sponsored by Rep. Felicia Brabec (D-Pittsfield Township) and Rep. Phil Green (R-Watertown Township), also passed the House and now head to the Senate for approval. HBs 5371 and 5372 add Certified Community Behavioral Health Clinics to the Social Welfare Act, enhancing access to behavioral health services in Michigan and aligning provider funding with federal payment policies.

The House also passed HB 4833, sponsored by Rep. Ranjeev Puri (D-Canton), which eliminates duplicative licensure requirements, reducing administrative burdens for hospitals, psychiatric hospitals, and licensed substance use disorder treatment providers. The MHA-supported bill now awaits action in the Senate.

HB 5833, sponsored by Rep. Kelly Breen (D-Novi), passed the House as well. This bill adds Michigan to the numerous other states that allow family members to step in and make medical decisions in alignment with a loved one’s wishes, if they are incapable. The MHA supports this bill, which will allow patients to receive timely care in the most appropriate setting.

The Michigan House, following an organized walkout by members of the Republican caucus, passed HB 5999, sponsored by Rep. Stephanie Young (D-Detroit). The legislation broadly prohibits the use of mandatory overtime for registered nurses in Michigan, with certain exceptions related to declarations of emergency, mass casualty events and ongoing patient procedures. The MHA, facing significant political headwinds, was able to secure several meaningful amendments related to staffing during unexpected and unpredicted staff absences and public health emergencies, and will continue to work with the Senate to ensure protection of both hospital team members and the patients they serve.

Lastly, SB 1158 (S-1) and HB 6085, which would reform Michigan’s medical liability laws, did not see any action by the full House or Senate. These bills would increase healthcare costs and hinder physician recruitment and retention in Michigan, worsening the critical shortages in primary care, obstetrics and gynecology, and behavioral and mental health providers. Creating a less supportive environment for physicians could further compromise patient care and access to essential healthcare services. The MHA strongly opposes these bills.

Members with questions should contact Elizabeth Kutter at the MHA.

MHA CEO Report — Lame Duck is Here

MHA Rounds graphic of Brian Peters

“Even though you are on the right track, you will get run over if you just sit there.” Will Rogers

MHA Rounds graphic of Brian Peters

The balance of power at both the state and federal levels will change in 2025. Yet lawmakers still have several weeks remaining, a period we refer to as lame duck where a number of elected officials finish their terms with the opportunity to pass bills and create policy prior to leaving office at the end of the year.

Republicans regained majority in the Michigan House of Representatives, changing the balance of power from Democrats controlling both the House, Senate and executive office. This scenario can create a hectic environment where the party in power attempts to push many bills through before they lose influence next term. In many instances, lawmakers may trade their support for completely unrelated bills to gain the necessary support to pass legislation.

This period keeps associations and lobbyists up late at night – both figuratively and literally, as sessions that run into the wee hours are common. The MHA remains vigilant through those many hours and votes on any issues that impact access to care and hospital’s ability to care for Michiganders. The two most important examples are separate bills that would address government mandated nursing staffing ratios and create protections for the 340B drug pricing program.

The MHA has successfully to this point held off any movement on the government mandated nurse staffing ratio legislation, which was introduced in May 2023 and received a committee hearing in the House in November of last year. These bills would severely hamper a hospital’s ability to provide care, with the potential to lead to the closure of up to 5,100 hospitals beds across the state. The MHA has dedicated significant time and resources in educating lawmakers about the practical impacts of these bills and the lengths to which hospitals are going to address workforce challenges and to support their nurses. Our “Think it Through” messaging, which includes billboards in strategic locations as well as digital advertising, is the latest addition to our multi-faceted advocacy on this critical topic. It is safe to say we are counting down the days remaining in the session while these bills remain a threat.

While our association plays defense on nurse staffing mandates, we are playing offense with respect to 340B. We continue to advocate for the passage of House Bill 5350, which would prohibit manufacturers from discriminating against program participants based on their contract pharmacy relationships. A significant number of Michigan hospitals use 340B savings as a force multiplier, allowing these hospitals to stretch incredibly scarce resources to provide care for more patients in their communities, increasing access to care and the quality of care for Michigan’s most vulnerable residents. We’re encouraged that we will see this bill move through both chambers during lame duck and hope you will lend your support to the issue by contacting your state lawmakers through our MHA action alert.

Congress will have their own lame-duck session, which has the potential to impact additional health policy. While it remains to be seen how much activity occurs on Capitol Hill, site-neutral payment policies remain a threat to access to care for patients across Michigan and the country. As with government mandated nurse staffing ratios, policies that add cost or reduce reimbursement can lead to reduced hospital beds, service lines or even potentially hospital closures.

We’re in the home stretch of the 2023-24 legislative sessions in both Lansing and Washington DC. Be rest assured that the MHA is taking every opportunity during lame duck to meet with our state and federal lawmakers, and advocate on behalf of advancing the health and wellness of our patients and communities. While 2025 will present its own unique set of challenges and unpredictability, our focus remains on these final days of session until the last gavel signifies adjournment and sine die.

The bottom line: we are on the right track with respect to our advocacy priorities, but we will never be guilty of sitting still. I encourage all of you to join us and continue to “run through the tape” with these critical efforts during our lame-duck session.

As always, I welcome your thoughts.

First Legislative Policy Panel Meeting of New Program Year

The MHA Legislative Policy Panel held their first meeting of the MHA program year at the MHA Capital Advocacy Center Oct. 30 to develop recommendations on legislative issues impacting Michigan hospitals.

Chad Tuttle, SVP, clinical shared services, Corewell Health, chairs the panel this year with Amanda Shelast, president, Marshfield Medical Center – Dickinson, serving as vice chair. Carlos Jackson with Washington D.C.-based Cornerstone Government Affairs provided a federal update, covering what is at stake in the 2024 election and post-election lame-duck healthcare priorities. MHA CEO Brian Peters also reviewed the MHA 2024-25 strategic action plan.

The Panel took two action items on cybersecurity and pediatric long-term care.

The Panel adopted a position of neutrality on Senate Bills (SB) 888892. The Panel directed the MHA to continue conversations with legislators regarding new requirements related to cybersecurity to recognize and support hospitals as victims of these attacks. SBs 888 – 892 require entities that have access to Michigan resident’s personal information to maintain security procedures for the protection of that information. It also establishes processes for notifying the state and impacted residents of data breaches.

The Panel also heard an update on House Bill (HB) 5974 related to the creation of prescribed pediatric extended care facilities. The Panel asked several questions about the purpose and effectiveness of the legislation. Reintroduction of HB 5974 is likely in the 2025-26 legislative session, giving the Panel another opportunity to consider the concept as introduced, as well as alternatives.

For more information on the MHA Legislative Policy Panel, members may contact Adam Carlson at the MHA.

Peters Featured in Becker’s Hospital Review

MHA CEO Brian Peters

Becker’s Hospital Review published an article July 23 that includes MHA CEO Brian Peters as one of 76 healthcare executives sharing their focus for the second half of 2024.

Peters covered the importance of the upcoming elections and the impact it will have on healthcare policy and access to care.

“As an advocacy organization, every two years we need to be highly focused on impending lame-duck sessions,” said Peters. “The outcome of the November election will go a long way toward determining the relative intensity of these lame-duck sessions, and which of our key issues will be ‘in play.’ We need to use the coming months to strategize appropriately, and be ready to block proposals that would threaten patient access, and also be ready to take advantage of new political dynamics that present a window of opportunity to move beneficial legislation that was previously stalled in the process.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.