Grants Awarded to Address Substance Use Disorder in Upper Peninsula

Blue Cross Blue Shield of Michigan announced Jan. 19 that four Upper Peninsula community organizations will receive $490,000 in grant funding to help them address gaps in service for individuals and families facing substance use disorder (SUD) and to support the development and growth of recovery communities. Recovery communities offer a variety of services to support people recovering from SUD and their family members.

The MHA is a community partner in the project, along with the Upper Peninsula Health Plan and four members of the Michigan Opioid Partnership: Blue Cross Blue Shield of Michigan, the Blue Cross Blue Shield of Michigan Foundation, the Michigan Health Endowment Fund and the Superior Health Foundation.

The organizations’ two-year grant programming begins in January 2022. Organizations receiving the funding include the Eastern Upper Peninsula Opioid Response Consortium, Great Lakes Recovery Centers Inc., the Western Upper Peninsula Health Department and Superior Housing Solutions.

The MHA Board of Trustees identified behavioral health as a critical priority for the association in its 2021-2022 Strategic Action Plan. The board established goals for behavioral healthcare that include setting guiding principles, overcoming obstacles and seeking new funding. The MHA’s partnership in this grantmaking project is one of several steps toward achieving those goals.

Coverage of the press release includes stories from WJMN-TV and WLUC-TV6. For more information on the grants, contact Ruthanne Sudderth at the MHA. Additional information on the association’s efforts to address behavioral health is available from Laura Appel at the MHA.

Combating the Novel Coronavirus (COVID-19): Week of Jan. 10

MHA Covid-19 update

MHA Covid-19 updateThe state of Michigan held a press conference Jan. 11 to discuss the rapid rise in case numbers, hospitalizations (especially pediatric hospitalizations) and positivity rates. Speakers urged all residents who are eligible to be both vaccinated and boosted as quickly as possible. Representatives from Children’s Hospital of Michigan joined the event to discuss the concerning rise in childhood case rates and hospitalizations.

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.

SCOTUS Upholds CMS Vaccine Mandate, Enforcement Proceeds

The U.S. Supreme Court issued decisions Jan. 13 on the Centers for Medicare & Medicaid Services (CMS) and Occupational Safety and Health Administration (OSHA) vaccine mandates. As expected, the court blocked the Biden administration from enforcing the vaccine or test mandate issued under OSHA, but upheld the ability of the CMS to enforce the healthcare worker vaccine mandate.

The Supreme Court has repeatedly upheld the constitutionality of state vaccine mandates in a variety of settings, as well as mandates by private employers. These challenges were different because they presented the question of whether Congress had authorized the executive branch to institute the requirements through the agencies of OSHA and the CMS/Department of Health and Human Services.

Michigan was not one of the 26 states covered by the court injunction to the CMS mandate, and Michigan has no other state-issued prohibitions on enforcing federal or private vaccine mandates. Hence, the mandate and enforcement move forward. The currently posted deadline for completing the first required vaccine dose is Jan. 27, and the second dose is required by Feb. 28. Boosters are currently not part of the mandate.

The MHA responded to a number of media inquiries following the Supreme Court announcement, including from The Detroit News, Detroit Free Press and MiBiz. The association reiterated its long-standing position that mandates of this kind should be left up to local healthcare decision-makers and that hospitals and the MHA have always urged every resident who is eligible to get vaccinated to protect themselves and others. The MHA also stressed that, while the small number of hospital workers who have already ended their employment due to an organization’s mandate did not necessarily worsen the existing staffing shortages, the timing of a nationwide mandate amid this omicron surge could not be worse, as the shortages are more serious than ever. The association assured reporters that hospitals will proceed with compliance and that the MHA and its members will continue to strenuously advocate for staffing assistance from federal and state partners.

Members with questions about deadlines, enforcement or other elements of the mandate are encouraged to review the posted CMS guidance to ensure their organizations are prepared to comply.

MIOSHA: Hospitals May Currently Use CDC Quarantine Guidance Without Penalty

The MHA has continued to work with state regulators on securing updated guidance for hospitals and health systems as it relates to worker quarantine periods. Federal Occupational Safety and Health Administration (OSHA) rules have not yet been fully rescinded to allow for healthcare settings to confidently follow new, less restrictive Centers for Disease Control and Prevention (CDC) quarantine guidance.

However, the Michigan Occupational Safety and Health Administration (MIOSHA) has stated it was told OSHA is in the process of withdrawing the relevant rules and the state agency is preparing to update its rules to align with the revised federal rules. MIOSHA also indicated that, until updates are made at the federal and state levels, it will not issue citations specifically regarding quarantine and isolation requirements if an employer were following the Dec. 23, 2021, updated CDC guidance for healthcare personnel.

An existing OSHA provision recognizes the CDC’s ‘‘Strategies to Mitigate Healthcare Personnel Staffing Shortages.’’ This guidance allows elimination of quarantine for certain healthcare workers as a last resort if the workers’ absence would mean there are no longer enough staff to provide safe patient care, specific other amelioration strategies have already been tried, patients have been notified, and workers are using additional personal protective equipment at all times.

The MHA will continue to keep members apprised of developments on this issue. Members with questions may contact Laura Appel at the MHA.

Long-term Care Facility Capacity for COVID Care Increases

Michigan now has 50 Tier-2 COVID-19 Relief Facilities (CRFs) able to take COVID-19 patients from hospitals at discharge if their normal nursing facility isn’t able to accommodate them. This is an increase from just 27 CRFs late in 2021 and includes an Upper Peninsula facility in Hancock.

In addition, Michigan now has nine facilities designated as Care and Recovery Centers (CRC)s, including one in Escanaba in the Upper Peninsula.

The CRC and the CRF programs were established under Michigan Public Act 231 of 2020. These programs were designed to ensure Michigan’s nursing homes were prepared to provide care to individuals who have tested positive for coronavirus under transmission-based precautions within the guidelines and best practices from the Centers for Disease Control and Prevention. Michigan’s nursing homes must be reviewed by the Michigan Department of Health and Human Services (MDHHS) to ensure they meet the minimum criteria outlined within the legislation and associated MDHHS policies. Members with questions may contact Paige Fults at the MHA.

Red Cross Declares First Ever National Blood Supply Crisis

The American Red Cross declared a national blood supply shortage and operational crisis Jan. 10. This is the first time such a crisis has been declared, and it could impact hospitals’ ability to provide certain types of care or transfusions in the coming days and weeks. This is a result of the current COVID-19 surge causing canceled donation appointments, Red Cross staffing shortages and more.

The Red Cross chief medical officer sent a notification directly to hospital transfusion leaders outlining these operational challenges and how to plan for expected shortages. The Red Cross also urged the public to donate blood as soon as possible.

The MHA will be amplifying to the public the need for blood donors through its social and traditional media channels.

Michigan Sees Surge in Unemployment Fraud

Michigan has seen a recent surge in unemployment fraud claims, according to the MHA Unemployment Compensation Program (MHA UCP). The increase in unemployment fraud is related to identity theft that occurs when the state Unemployment Insurance Agency (UIA) system is penetrated. Over the past several weeks, the MHA UCP has seen fraud in about 15 to 20% of all new claims for its clients.

The MHA UCP has worked closely with the UIA on this issue and has mitigated the impact for clients, who have not been assessed charges on these claims. To learn more about the services available through the MHA UCP, contact Neil MacVicar at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpageQuestions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Weeks of Dec. 20, Dec. 27 and Jan. 3

MHA Covid-19 update

MHA Covid-19 updateAccording to the Centers for Disease Control and Prevention (CDC) COVID Data Tracker, the omicron variant of COVID-19 is now the dominant strain across the U.S. The CDC’s model indicates that more than 95% of cases in the nation as of Jan. 1 may be due to omicron.

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.

President Announces Updated Testing and Military Personnel Strategy

President Joe Biden Dec. 21 announced the federal government will make 500 million at-home rapid tests available to Americans and will deploy roughly 1,000 military personnel to hospitals across the U.S. to help ease the stress the current COVID-19 surge has placed on providers.

The rapid tests will be free of charge and available via an online request form, after which they will be delivered to residents’ homes. The plan also includes opening new federal testing sites and sending out hundreds of federal vaccinators. These tactics will begin in January according to the White House fact sheet on this effort.

Members are encouraged to review the entire fact sheet, which discusses other elements of the plan, including the distribution of more ventilators, production increases for supplies, federal testing sites and more.

The MHA will keep members apprised as more information becomes available about what assistance will be directed to Michigan as a result of this announcement. Members with questions about federal actions may contact Laura Appel at the MHA.

Boosters Expanded to 12- to 15-year-olds; Waiting Period Shortened

The federal Food and Drug Administration (FDA) and the CDC have announced that children aged 12 to 15 may now receive booster doses of the Pfizer and Moderna COVID-19 vaccines. The agencies also approved a shortened waiting period from six months to five months to receive a booster following a primary series of either of the two vaccines. In addition, certain immunocompromised children aged 5 to 11 are eligible for a booster and may receive it 28 days after the completion of their initial series.

The two-month booster interval recommendation for people who received the Johnson & Johnson vaccine has not changed.

The FDA reached its decision after reportedly reviewing data from Israel, which included information on 6,300 people ages 12-15 who received a booster shot at least five months after their initial two-dose series. The data showed no new cases of two possible side effects that had been observed in some young people who received the vaccine — myocarditis and pericarditis.

Urge Senate to Support Healthcare Staffing Funds

The MHA issued an action alert before the holidays, urging all members to contact their state senators and ask that they support critical healthcare staffing funding, which passed the state House with bipartisan support in December. As lawmakers prepare to return to session the week of Jan. 10, it is important to continue advocacy efforts.

House Bill 5523 would appropriate $300 million for healthcare retention and recruitment, which could help hospitals and other providers navigate the serious worker shortages that currently exist amid a pandemic surge. The MHA Legislative Action Center provides key messages on this issue and contact information for senators. Members with questions may contact Adam Carlson at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpageQuestions on COVID-19 and infectious disease response strategies may be directed to the Michigan Department of Health and Human Services Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of Dec. 13

MHA Covid-19 update

MHA Covid-19 updateA full year after COVID-19 vaccines were made available in the U.S., the coronavirus continues to sicken and kill people, with nationwide deaths from the illness surpassing 800,000. As demonstrated in a collection of headlines, Michigan’s hospitals are being stretched to treat COVID-19 patients across the state.

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.

Legislation Signed to Delay Sequestration Cuts

President Joe Biden signed legislation Dec. 10 to stop Medicare cuts to hospitals, physicians and other providers from going into effect early next year. As urged by the MHA and the AHA, both the U.S. Senate and House recently voted to pass the legislation.

Specifically, the bill would extend the moratorium on the 2% Medicare sequester cuts until April 1, 2022, and reduce the cuts from 2% to 1% from April 1 through June 30, 2022. The package also would stop the 4% statutory Pay-As-You-Go sequester from taking effect early next year. Other provisions in the package would mitigate a separate Medicare payment cut to physicians; delay payment cuts and private payer data reporting requirements for certain hospital laboratories; and more (see related article). Members with questions may contact Laura Appel at the MHA.

Licensing Flexibility Passes Legislature, Awaits Governor’s Signature

The state Legislature completed work Dec. 14 on Senate Bill 759, which allows healthcare workers licensed in another state to work in Michigan during times of great need (see related article). The MHA issued a media statement both thanking legislators for their support of licensing flexibility and encouraging Gov. Gretchen Whitmer to sign the bill into law as soon as it’s enrolled.

Members with questions may contact Adam Carlson at the MHA.

State Approves Additional Tier-2 COVID Relief Facilities

Fifteen additional Tier-2 COVID Relief Facilities (CRFs) were recently approved by the state at a time when post-acute placements are critically needed.

Tier-2 CRFs can keep their own COVID-19-positive residents and are able to admit new residents who test positive only if additional capacity is needed and the nearest COVID Recovery Center (CRC) is more than 25 miles away or at maximum capacity with patients positive for the disease.

With the additional facilities, there are currently 27 CRFs in the state. While this is a positive development, the number is significantly lower than the more than 100 CRFs the state had approved before starting its annual renewal process in October. That process took nearly a month to approve the additional facilities. The MHA continues to advocate that the state not use an annual application process for approving CRFs due to the time involved and the delays it causes for hospital transfer.

In addition, Michigan currently has no Tier-2 CRFs north of Grayling. Therefore, the MHA is urging the state to work with facilities in the northern Lower Peninsula and Upper Peninsula to quickly approve them as CRFs. Members with questions may contact Paige Fults at the MHA.

Changes Continue with Legal Action on Vaccine Mandates

The U.S. Court of Appeals for the Fifth Circuit issued a ruling Dec. 15 ordering the Centers for Medicare & Medicaid Services (CMS) vaccine mandate rule to resume in about half of the country while saying 24 states are not subject to the mandate. This means that the mandate is back in place for Michigan, requiring healthcare workers to be fully vaccinated. However, the suspension of enforcement of the mandate continues.

The Fifth Circuit upheld the Louisiana district court’s preliminary injunction as applied to facilities in the 14 states that are plaintiffs in the case. An additional 10 states that are plaintiffs in a Missouri case do not need to comply with the mandate while the injunction stands. Michigan is not a plaintiff in either lawsuit.

The American Hospital Association (AHA) provides a blog with the latest details of the CMS vaccine mandate cases, as well as an update on an appeals court ruling challenging the Occupational Safety and Health Administration vaccine mandate.

The recent court actions are additional steps toward the suits eventually being appealed to the U.S. Supreme Court. These legal actions do not impact individual organizations’ vaccine policies. Members with questions should contact Amy Barkholz at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpageQuestions on COVID-19 and infectious disease response strategies may be directed to the Michigan Department of Health and Human Services Community Health Emergency Coordination Center (CHECC)

Advocacy Continues to Defend Healthcare from Harmful Federal Policies

President Joe Biden Dec. 10 signed legislation to postpone several proposed cuts in Medicare rates recently approved by Congress. The MHA and the American Hospital Association had urged lawmakers to delay the cuts that would have taken effect Jan. 1 due to the pandemic-related financial pressures healthcare providers continue to experience. Provisions in the legislation include:

  • Eliminating the 2% Medicare sequester cuts from Jan. 1 to April 1, 2022. The legislation would also reduce the cut to 1% from April 1 to June 30, 2022. Absent future legislation, the 2% cuts will take effect July 1, 2022. The package is being funded by increasing the sequester percentage in 2030.
  • Halting the 4% statutory Pay-As-You-Go (PAYGO) sequester for 2022 and adding them to the “2023 scorecard.” This will require additional advocacy with the Congress in late 2022 to eliminate these cuts again.
  • Mitigating the 3.75% payment cut to the Medicare physician fee schedule (PFS) payments finalized for calendar year 2022 by implementing a one-year 3% increase to the PFS conversion factor.
  • Delaying the Clinical Laboratory Fee Schedules cuts for one year, from Jan. 1, 2022, to Jan. 1, 2023. The requirements that certain hospital laboratories report their private payer clinical laboratory test codes, payments and volume data are also delayed.
  • Delaying implementation of the Radiation Oncology Model finalized in the 2022 Medicare outpatient prospective payment system final rule from Jan. 1, 2022, to Jan. 1, 2023.

Despite the limits on visiting Capitol Hill due to the COVID-19 pandemic, the MHA is continuing its work with the Michigan delegation using virtual connections to protect hospitals and other providers from detrimental payment cuts and other healthcare policies. Members with questions regarding payment implications should contact Vickie Kunz at the MHA, while questions regarding advocacy efforts should be addressed to Laura Appel at the MHA.

Comments Due Jan. 4 on Federal Vaccine Mandates; MHA Summary Available

The Centers for Medicare & Medicaid Services (CMS) and the federal Occupational Safety and Health Administration recently released the anticipated detailed rules mandating vaccines for employees of healthcare facilities and businesses with 100 or more workers.

The MHA has prepared a detailed accounting of the key elements, highlighting deadlines, definitions and more. Members are urged to review the summary of the rules as soon as possible. Comments are due Jan. 4, the same date by which workers must be fully vaccinated.

The MHA is aware of potential issues with the CMS rule’s requirement that first shots be given by Dec. 6. The association is communicating its serious concern about the restricted timeframe to the MHA’s state and federal partners and regulators and will keep members apprised of any updates on this deadline.

Members with questions about the rules may contact Laura Appel at the MHA.

Appel Discusses Managed Care in Crain’s

Laura Appel

Laura AppelLaura Appel, senior vice president, health policy & innovation, MHA, participated in a Crain’s Detroit Business virtual roundtable to discuss how collaboration between employers and managed care plans can control rising healthcare costs.

The story includes perspectives from a variety of individuals in the healthcare and insurance industries. Topics that Appel addresses include value-based care, behavioral health integration and healthcare overutilization.

“A lot of people want to say, ‘mental health care and physical health care.’ And I try to stay away from that because, last I checked, my brain is part of my body,” said Appel. “If I could wave a magic wand, it would be to have employers demand integration. We really need a demand that says, ‘I want you to take care of my person in a way that recognizes those two things are coming together.’”

Read the article

Implementation Delayed on Portions of No Surprises Act

The federal departments of Health and Human Services (HHS), Labor and Treasury recently issued a frequently asked questions (FAQs) document regarding requirements for providers and health plans under the No Surprises Act and the Transparency in Coverage final rule.

Under the No Surprises Act, providers and facilities are required to prepare a “good faith estimate” of expected charges for the services the patient has scheduled. This includes expected charges for other providers and facilities used in the services. The notice is provided to the health plan or other source of coverage and will be required beginning Jan. 1, 2022.

The FAQ document says the HHS will not complete the necessary rulemaking to implement this provision of the No Surprises Act by Jan. 1 and will delay enforcement. However, the HHS does intend to do rulemaking to implement the requirement to provide an estimate of charges to patients who are not enrolled in health coverage or who will not be making a claim for services (i.e., paying out of pocket.)

The delay in enforcing the good faith estimate will also delay enforcement of the requirement that health plans and other sources of health benefits provide an “Advanced Explanation of Benefits” after they receive the estimate from the provider. The FAQs do not indicate when rulemaking will take place or estimate when enforcement will begin. For more information about these requirements and enforcement delays, contact Laura Appel at the MHA.

Appel Featured in Bridge Series on Michigan’s Mental Health Services for Children & Teens

Appel

MHA Senior Vice President Laura AppelBridge Michigan published a series of articles the week of June 28 that examine Michigan’s mental health system for children and teens.

Shared in three installments, the pieces look at the strain on families, the boarding of children in the emergency department as they await treatment, and potential solutions.

The series includes Laura Appel, senior vice president, health policy & innovation, MHA, discussing the challenges that hospitals and health systems experience when providing behavioral health treatment to children and teens. Specifically, Appel discusses the constantly changing state pediatric psychiatric bed census, and legislation that would provide transformational funding to increase child inpatient psychiatric beds and to update emergency department facilities to mirror environmental features found in psychiatric facilities.

Part 1: Mental health crisis: Children at breaking point during COVID

Part 2: Emergency rooms confront ‘tidal wave of sadness’ among young patients

Part 3: A child mental-health fix takes early action, more help. Here are 7 ideas.

CEO Report — Incorporating a Federal Advocacy Strategy

MHA Rounds Report - Brian Peters, MHA CEO

“You want a friend in Washington? Get a dog.” – Harry S. Truman

MHA CEO, Brian PetersI have a dog — a beautiful German Shepherd that joined our family in the midst of the pandemic.  I know that many of you have a family dog too, and they are indeed wonderful friends. But as it turns out, the MHA family is also fortunate to have friends in Washington, DC, and never before has that been more important. 

Hospitals and health systems play a key role in their local communities, both as healthcare providers and economic engines. While much of the funding, regulatory, and other public policy decision-making occurs at the local or state level, the truth is that federal politics has become increasingly important, as decisions made at the federal level can have profound impacts on the healthcare delivered in Michigan. The dramatic increase in enrollment for both Medicaid (a shared state/federal program) and Medicare (a strictly federal program) is just one of many reasons why. 

Over the years, the MHA’s engagement at the federal level has increased dramatically, to the point where we have now established meaningful relationships with the entire Michigan congressional delegation and their staffers. These relationships were on display early in the pandemic when we were able to convene conference calls with our delegation — both Republicans and Democrats together on the line at the same time — to listen to our insights and requests and target much-needed assistance to our members who were dealing with a true crisis. We have done all the blocking and tackling that is instrumental to federal advocacy, including routine in-person visits to our delegation members’ DC offices, developing congressional district-specific data and talking points on key issues, coordinating closely with the government relations officers of our member health systems (including those with multistate operations), organizing fundraising events and much more.   

We are fortunate to have a very close partner in this regard: the American Hospital Association.  I’m happy to share that more than 100 of our Michigan community hospitals are also AHA members, a penetration rate that puts Michigan in the very top tier nationally. As a result, our voice is heard clearly as many Michigan healthcare executives are actively involved in the policymaking process of the AHA, serving on various committee and task forces, including the AHA’s Regional Policy Boards. In this manner, we are able to identify needs unique to our region and provide direct input on public policy — and political strategy — to the AHA.  On that note, we are fortunate that Michigan’s own Wright Lassiter, president and CEO of Henry Ford Health System, is now the chair-elect of the AHA Board. 

In addition, the MHA’s political action committee, Health PAC, also has a formal working partnership with the AHAPAC, allowing us to support our members of Congress in this important way.

Recent examples of this partnership in action include our advocacy to protect the Affordable Care Act (ACA), as well as the 340B Drug Pricing Program, and our efforts to combat the COVID-19 pandemic. Several weeks ago, the United States Supreme Court released its opinion in the California v. Texas case that challenged the constitutionality of the ACA. The opinion reversed the Fifth Circuit’s judgement in the matter and upheld the constitutionality of the ACA. The MHA was formally involved in the case, as we joined a number of other state hospital associations in filing an amicus brief with the Supreme Court. We are very pleased with this outcome, which will help to preserve coverage for as many Michiganders as possible — a key MHA priority.

The MHA has also been involved in the federal legal strategy to support the 340B Drug Pricing Program, which is a federal program created by Congress to help provide relief from escalating drug prices to safety-net hospitals and other healthcare providers serving vulnerable patient populations. Over the past year, six drugmakers have stopped providing discount drug prices for pharmacies that contract with 340B providers. The MHA is working with the American Hospital Association Advocacy Alliance for the 340B Drug Program and the 340B Health coalition to protect this vital program. Last fall, the MHA organized a letter to the Michigan congressional delegation that was signed by representatives from 68 of the more than 80 Michigan 340B hospitals to share hospitals’ concern regarding drug manufacturers’ attempts to limit payment to contract pharmacies and other actions that are a significant detriment to 340B hospitals and the services they can provide to eligible patients because of the program. The MHA also joined other state hospital associations earlier this spring in submitting an amicus brief in support of the AHA’s petition to the U.S. Supreme Court for certiorari (a formal request to the court to take up the case) in its appeal of an appellate court decision unfavorable to hospitals on 340B.

Lastly, the MHA has been involved with various aspects of the COVID-19 response at the federal level, from advocating for provider relief funds to providing data and insights on the impact of the pandemic. In May, the MHA worked quickly to get a majority of Michigan’s U.S. House delegation to sign onto a letter urging Department of Health and Human Services (HHS) Secretary Xavier Becerra to extend the deadline for hospitals to use provider relief funds. This joint effort with the AHA and other groups ultimately led to the HHS announcing extended deadlines by which hospitals and other providers that received Provider Relief Fund (PRF) money may use their COVID-19 PRF payments. We also had several MHA members directly involved in submitting statements to Sen. Gary Peters on the impact of healthcare supply chain shortages during the pandemic, which were utilized by the Senate Homeland Security and Governmental Affairs Committee that Sen. Peters chairs.

The MHA is currently working on a comment letter for the recently released federal Occupational Safety and Health Administration (OSHA) Emergency Temporary Standards (ETS). Although the AHA achieved several improvements in the final proposed ETS, a number of issues remain. Because Michigan uses a state plan for OSHA regulation, MIOSHA adopted these rules June 22. The MHA is aware that the federal ETS is under regular review and amendments are possible. Filing comments brings attention to those parts of the rule that require further action.

Laura Appel, MHA senior vice president of health policy and innovation, has done an outstanding job as our point person on federal advocacy for many years now. I can tell you from firsthand experience that she knows her way around the federal policymaking process as well as she knows her way around the maze of offices on Capitol Hill. In addition, MHA Executive Vice President Chris Mitchell is serving as the chairman of the SAGRO (State Association Government Relations Officers) group, representing all the state hospital association advocacy leaders. MHA Chief Medical Officer Gary Roth, DO, is also serving as chairman of the SHAPE (State Hospital Association Physician Executives) group, leading his peers across the country. And for the past year I have had the privilege of serving as the chairman of the AHA State Issues Forum, which is the group of state hospital association CEOs focused on the strategic issues that we all share. Collectively, these engagements are just another indication of the stature and leadership of our association on the national level.

As you can see, our dedication to advocating for our members — and the pursuit of our mission to advance the health of individuals and communities — extends from Lansing to Capitol Hill. I am proud of the strong foundation that we have established in this regard and, given the increased focus on hospitals and healthcare in the national conscience as a result of the pandemic, I am convinced that our work at the federal level will continue to be critical. 

As always, I welcome your thoughts