Bill to Codify Licensure Exemptions Awaits Governor’s Signature

capitol building

capitol buildingThe full House passed Senate Bill (SB) 759 Dec. 14 and it now awaits the governor’s signature. Introduced by Sen. Curt VanderWall (R-Ludington) and supported by the MHA, SB 759 would codify a provision that has given hospitals flexibility to appropriately respond to the pandemic; however, the provision is set to expire Jan. 11.

In March 2020, due to the COVID-19 pandemic, the Department of Licensing and Regulatory Affairs activated its statutory authority given in the Public Health Code that allows it to grant licensure exemptions “in a time of disaster” such as a pandemic. This permits licensed out-of-state providers who are in good standing and trained, educated and experienced to render medical care in Michigan without a Michigan license. The MHA greatly appreciates the collaborative work with the administration to codify this flexibility into law and expressed its gratitude in a letter submitted to the Executive Office of the Governor. The letter thanks Gov. Gretchen Whitmer for her continued partnership in battling COVID-19 and urges her to quickly sign SB 759, which would allow hospitals and health systems to recruit out-of-state workers quickly and efficiently. Members with questions should contact Adam Carlson at the MHA.

MHA and Members Testify in Support of Licensure Exemption Bill

Sean Gehle (left) and Adam Carlson (right) testify in support of SB 759.

The House Health Policy Committee, chaired by Rep. Bronna Kahle (R-Adrian), reported the MHA-supported Senate Bill (SB) 759 to the full House Dec. 9. Before the bill was reported, Adam Carlson, senior vice president of advocacy, MHA, and Sean Gehle, regional vice president, advocacy and government relations, Trinity Health, provided testimony urging support for SB 759 and discussing its importance in continuing care for patients during the pandemic.  

SB 759 codifies into law a flexibility granted by the Department of Licensing and Regulatory Affairs (LARA) Bureau of Professional Licensing that has been imperative in fighting the workforce shortage. In March 2020, due to the COVID-19 pandemic, LARA activated its statutory authority given in the Public Health Code that allows it to grant licensure exemptions “in a time of disaster” such as a pandemic. This permits out-of-state providers who are in good standing and trained, educated and experienced to render medical care in Michigan without a Michigan license.

The LARA provision is set to expire Jan. 11. The MHA has worked collaboratively with the administration to continue to allow hospitals and health systems the ability to quickly and efficiently recruit out-of-state workers during this public health emergency. SB 759 is now awaiting a vote in the full House. Members with questions should contact Adam Carlson at the MHA.

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Out-of-state Licensure Provider Exemption to Expire Jan. 11

The Michigan Department of Licensing and Regulatory Affairs has provided a 30-day notice that the out-of-state licensure provider exemption will no longer be in effect as of Jan. 11, 2022. The MHA worked with the state to develop this provision effective March 16, 2020, and to keep it in effect since …


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News to Know

  • The MHA Monday Report will not be published Nov. 29, but timely news will continue to be posted in the MHA Newsroom prior to publication of the Dec. 6 edition of Monday Report.
  • The MHA will offer a webinar on Unemployment Compensation and Vaccine Mandates at 10 a.m. EST Dec. 9.
  • The MHA will host a free webinar from noon to 12:45 p.m. EST Dec. 9 to review new requirements from The Joint Commission on workplace violence that take effect in January.

Out-of-state Licensure Provider Exemption to Expire Jan. 11

This article was updated Nov. 17 to reflect an extension of the expiration date from Dec. 12 to Jan. 11, 2022. 

The Michigan Department of Licensing and Regulatory Affairs (LARA) has provided a 30-day notice that the out-of-state licensure provider exemption will no longer be in effect as of Jan. 11, 2022. The MHA worked with the state to develop this provision effective March 16, 2020, and to keep it in effect since then. This decision means healthcare providers should not rely on MCL 333.16171(c) to respond to the COVID-19 pandemic beyond 11:59 p.m. Jan. 11. The clarification document from LARA reflects the Jan. 11 expiration date.

Providers working in Michigan with out-of-state licenses will not be grandfathered into compliance. To continue to support healthcare systems, LARA has agreed to assist in expediting complete license applications for individuals who have been using this provision in response to COVID-19. The department has clarified that this provision cannot be used for labor disputes in the days leading up to its expiration.

Members needing assistance with expediting complete license applications should contact Paige Fults at the MHA.

Nursing Home On-site Survey Waiver Request for Eligible Facilities

The Department of Licensing and Regulatory Affairs Bureau of Community and Health Systems (BCHS) is required to make at least one visit to each licensed nursing home every three years for an evaluation of licensure. The department may waive this required visit if the licensed provider is eligible, requests a waiver and submits evidence that the facility is fully accredited from an acceptable accrediting body by Aug. 27. Eligibility can be looked up on the department’s website. If a facility is not listed, it either means they are not scheduled for a state licensing survey in the coming year or they are a licensed-only program that is not eligible for the waiver.

 Instead of performing an unannounced on-site state licensing survey, the department will perform a desk review of documentation submitted through the waiver request. The licensed provider will be contacted by the State Licensing Section with its decision by Sept. 24. The process for nursing homes to submit a request for a state licensing survey waiver must be done online.

Members with questions about the procedure should reach out to the BCHS State Licensing Section at (517) 241-1970, BCHS-StateLicensing@michigan.gov or Paige Fults at the MHA.

Brian Peters Discusses Implicit Bias Training Requirement with Modern Healthcare

Brian Peters

MHA CEO Brian Peters speaks with Modern Healthcare Managing Editor Matthew WeinstockModern Healthcare published an interview with MHA CEO Brian Peters June 7 discussing the new administrative rules adopted by the Michigan Department of Licensing and Regulatory Affairs that require implicit bias training as part of the knowledge and skills necessary for licensure or registration of healthcare professionals in Michigan. The interview is part of The Check Up, a Modern Healthcare video interview series with executives from across the healthcare industry on key leadership issues.

The story includes a video interview between Peters and Modern Healthcare Managing Editor Matthew Weinstock. Throughout the conversation, Peters discusses the MHA’s support of efforts to reduce barriers to access care address and to eliminate health disparities. Also discussed was the MHA membership’s commitment to lead on this issue, with Peters citing the MHA Pledge to Address Racism and Health Inequities as an example. A transcript of the interview is also available in the story.

“The Michigan Health and Hospital Association is very supportive of this direction that Governor Whitmer and her team is taking and this is a group effort,” said Peters. “This is, as I've said for a long time, an all hands on deck effort. Because if it is strictly hospitals or strictly a physician practices or strictly skilled nursing facilities that are doing this work, we're never going to get where we need to be. This is something that the entire care continuum, but even beyond the care continuum, we need to join arms. We need to learn from each other. I think this is a step in the right direction. It's one step of what I think will be many steps that that will be necessary in this journey. But the bottom line is we're on the journey and that's something to celebrate. I think having the conversation and the sunlight, if you will, on this issue finally is something to have to be very proud of. I know we're very excited to be part of this work.”

Read the article

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.

Implicit Bias Training Draft Rules Released and Hearing Date Set

The Michigan Department of Licensing and Regulatory Affairs (LARA) is seeking public input on draft rules regarding implicit bias training that were ordered in Executive Directive 2020-07. Aimed at reducing racial disparities in the delivery of healthcare services, the directive instructed LARA to establish implicit bias training standards as part of the knowledge and skills necessary for health professionals’ licenses and registrations in Michigan.

During the fall of 2020, the MHA and several member hospitals were among nearly 100 stakeholders that participated in the Implicit Bias Training Rules Advisory Work Group to help develop the draft rules. Members are asked to review the rule set and submit any feedback to Paige Fults at the MHA by March 3 in preparation for an upcoming virtual public hearing scheduled for 1 p.m. March 9. A notice of public hearing and a copy of the draft rule language can be downloaded from the LARA Administrative Rulemaking System webpage.

The MHA supports implicit bias training for all healthcare personnel, and ensuring equitable access and care for all patients is an MHA strategic priority. Those wishing to track the rulemaking process can do so by subscribing to receive administrative rules email notices. For more information, contact Paige Fults at the MHA.

Clarification for Out-of-State Provider License Exemptions during COVID-19

Health professionals who are licensed in another state and are in good standing in that state can practice in Michigan without a separate Michigan license during the current COVID-19 pandemic.

The Bureau of Professional Licensing within the Michigan Department of Licensing and Regulatory Affairs (LARA) has issued a guidance document clarifying when exemptions of Michigan licensure apply to health professionals. LARA is applying the use of a Public Health Code provision (as referenced in the document) that allows providers who have the education, training and experience to meet the requirements for Michigan licensure to provide medical care in a time of disaster, such as the COVID-19 crisis, without applying for licensure within the state. This flexibility is greatly appreciated while the medical community continues to work together in providing the necessary personnel resources to treat patients affected by COVID-19 and to respond appropriately to the urgent needs and issues related to the pandemic. The guidance also indicates that providers who had a Michigan license but retired within the last five years and certain students in their last year of an accredited program can assist in care for those affected by COVID-19 without applying for a license.

Health systems must keep complete documentation of these individuals and make it available in the event LARA receives an official complaint about an individual provider. The MHA recommends hospitals continue to follow the compliance memo they received in October related to proper tracking for all individuals who are eligible for the license exemption. Members needing a copy of the memo should contact Paige Fults at the MHA.

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.