Media Recap: Pediatric RSV Surge

Laura Appel

Laura AppelThe MHA received media coverage during the weeks of Nov. 21 and 28 on the capacity status of hospital pediatric units amid the surge of hospitalized pediatric patients with respiratory illnesses driven by respiratory syncytial virus (RSV).

The Detroit Free Press published an article Nov. 23 on the status of hospitals throughout the state caring for a large number of children and requests made by hospitals to add additional licensed beds. Laura Appel, executive vice president of government relations and public policy, MHA, is quoted in the story on how staffing challenges continue to hamper hospitals, even for those with declining pediatric patient census.

“It’s worth noting that even where hospitalizations have receded, many of our members continue to face severe space and staffing challenges,” said Appel

Additional stories were published by The Detroit News and The Center Square.

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

MHA CEO Report — Pediatric Capacity Crisis

MHA Rounds Report - Brian Peters, MHA CEO

Every child begins the world again.Henry David Thoreau

MHA Rounds Report - Brian Peters, MHA CEOIn all of my life experiences to date, none have been so challenging in every sense as those times when my young children were hospitalized in the NICU, fighting for their very lives. We were incredibly fortunate to have positive outcomes with both of them, thanks to the efforts of our Michigan hospitals and the incredible people who work there every day.

I share this perspective because there is a crisis throughout Michigan that truly hits home with me. I know the angst and exhaustion being felt by far too many parents right now – emotions that are also being acutely felt by our heroic caregivers. In short, it feels like déjà vu in Michigan’s children’s hospitals, but instead of a surge of COVID-19 patients stressing capacity to the limits, our facilities are strained by a high number of pediatric patients suffering from respiratory illnesses largely driven by RSV. Similar tactics that have been implemented in prior years, such as initiating incident command systems, have been in operation to ensure appropriate direction and communication is occurring throughout those systems impacted by this crisis.

Hospitals operating at capacity is nothing new and the staffing challenges that continue to result in Michigan operating with 1,700 fewer staffed beds than we had prior to the pandemic are well documented. What we’re seeing today is the real impact of what those staffing challenges mean: longer wait times in the emergency department, lack of available beds for patient transports (particularly in rural Michigan) and pediatric ICUs operating at beyond 100% capacity.

There are few professionals in the world that have proven to be more resilient than healthcare workers, whether they are physicians, nurses, respiratory therapists, environmental service workers…the list goes on and on (and I am proud to say that the MHA Keystone Center has played an important role with the launch of our WELL-B initiative that continues to provide resiliency tools for our clinicians and other team members). But as residents of our communities, we can no longer take our healthcare workers and the access to care they provide for granted. These workers, and their organizations, need help.

Thankfully, the Michigan Legislature provided funding earlier this year through Public Act 9 to improve the recruitment, retention and training of healthcare workers. So far, over 69,000 healthcare workers have benefitted from that funding and it has helped to stabilize existing staffing levels. Hospitals are also exploring innovative ways to grow the talent pipeline, such as investment in higher education partnerships and other apprenticeships. However, while impactful, this funding is a finger in the dyke. Without additional attention, the problem will persist.

Addressing the strain on our children’s hospitals is a multi-pronged approach, and in addition to the aforementioned work of our MHA Keystone Center, we are also deriving input and guidance from our MHA Council on Children’s Health, led by Laura Appel, executive vice president for government relations and public affairs, as well as our system chief medical officer (CMO) group, led by our own CMO Gary Roth, DO.

While the MHA will continue to pursue legislative and regulatory solutions to the staffing crisis, there are actions anyone can undertake to help our healthcare workers caring for very sick children across Michigan, particularly as COVID-19, RSV and the flu converge to drive hospitalizations.

First and foremost, ensure that both you and your children are up to date on all the relevant vaccinations that are now readily available. The MHA is a long-time supporter of I Vaccinate which is a good source of information on vaccines, and our MHA Senior Vice President of Public Affairs and Communications Ruthanne Sudderth continues to be our point person with this organization. Second, practice proper hygiene, including handwashing and staying home when sick. Third, seek the appropriate setting for care; visit the hospital for emergencies but contact your primary care physician or an urgent care facility for testing or care for mild symptoms. Lastly – and very importantly – be sure to express some grace and appreciation for any healthcare worker you meet. As we approach the winter and holiday season, they are here to provide exceptional care to all who need it and deserve to be treated with respect both on and off duty.

If you have not done so already, please join me in sharing this messaging within your networks. Our hospitals need the support from our partners in healthcare, the business community and in Lansing and Washington, DC to weather this storm. Respiratory illnesses will always be here, but there are many small actions we can take to care for the health and wellness of our communities well into the future.

As always, I welcome your thoughts.

Urge Congress to Support Hospitals by Enacting Key Priorities in Lame-duck Session

The American Hospital Association (AHA) recently released an action alert to impress upon lawmakers the immediate need to support hospitals and health systems. It is important the last session days of the year are used as an opportunity to advance key priorities at the federal level. The AHA has already urged congressional leaders to include a number of important provisions in a year-end legislative package to ensure that hospitals and health systems can continue their mission of caring for the communities they serve.

Lawmakers need to hear how managing the aftermath and aftershocks of the biggest public health crisis in a century has left hospitals and health systems facing significant financial and workforce challenges that are jeopardizing access to care for patients. Members are asked to contact their legislators today and continue to make the case why additional support and resources are needed.

Lawmakers should be urged to:

  • Prevent any further damaging cuts to health programs, including stopping the forthcoming 4% Statutory Pay-As-You-Go (PAYGO) sequester.
  • Establish a temporary per diem payment targeted to hospitals to address the issue of hospitals not being able to discharge patients to post-acute care or behavioral facilities because of staffing shortages.
  • Extend or make permanent the low-volume adjustment and the Medicare-dependent hospital programs — critical rural programs that are due to expire on Dec. 16.
  • Make permanent the expansion of telehealth services and extend the hospital-at-home program.

Participate in AHA Advocacy Day on Capitol Hill: Members are asked to inform the MHA if they will be in Washington, D.C. on Dec. 6 and would like to be included in the schedule for visits with members of Congress.

Contact Laura Appel at the MHA for more details.

Media Recap: Hospital Financial Viability

Laura Appel

Laura AppelThe MHA received media coverage during the week of Nov. 14 on financial and staffing challenges impacting hospitals in Michigan and the potential for further state funding support.

The Detroit Free Press published an article Nov. 14 that reviewed the factors influencing declining financial performance, including lower patient volume, increased supply costs, higher workforce expenses and stagnant reimbursement. Laura Appel, executive vice president of government relations and public policy, MHA, is quoted throughout the story. Appel expressed appreciation for the one-time $225 million state grant for the recruitment, retention and training of healthcare workers and discussed the increased rates for staffing agencies.

“We are immensely grateful for that,” said Appel. “But the $225 million (is) a one-time payment that really only offsets a small amount of what we’re paying in 2022 … and none of it is designed to help us in 2023.”

Additional stories were published by Crain’s Detroit Business and The Detroit News.

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

Headline Roundup: Pediatric Hospital Capacity & Medical Respite

Laura Appel

Laura AppelThe MHA received media coverage on the continued surge of RSV cases across Michigan’s pediatric hospitals that is stressing hospital capacity during the week of Nov. 6. Laura Appel, executive vice president of government relations and public policy, MHA, also contributed to a story on the importance of medical respite with Michigan’s vulnerable population who need continued care after discharge from the hospital.

Below is a collection of headlines from around the state that include interviews or statements from MHA representatives.

Friday, Nov. 11

Thursday, Nov. 10

Monday, Nov. 7

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

MHA Race of the Week – Michigan Ballot Proposals

Logo for MI Vote Matters, Tuesday Nov. 8


The MHA’s Race of the Week series highlights the most pivotal statewide races and ballot questions for Election 2022. The series provides hospitals and healthcare advocates with the resources they need to make informed decisions on Election Day, including candidates’ views and background.


Proposal 1 – Term Limit Reform and Financial Disclosure (MHA Supported)

If approved, Proposal 1 would reduce overall term limits from 14 years split between the two state legislative chambers to 12 years in one or both chambers. Further, the proposal would require each member of the legislature, the governor, lieutenant governor, secretary of state and attorney general to file annual financial disclosure reports.

Proposal 2 – Promote the Vote

If approved, Proposal 2 would add new opportunities to increase access to early voting, provide more absentee voting options and allow for the use of a signed affidavit in lieu of state-issued identification.

Proposal 3 – Reproductive Freedom for All

If approved, Proposal 3 would enshrine an individual right to reproductive health decisions in the Michigan Constitution and effectively repeal the existing Michigan law from 1931 which prohibits most abortion procedures.


The Citizens Research Council of Michigan, a well-respected, independent, nonpartisan public policy research organization, currently has available on their website three excellent analyses of each statewide ballot proposal. Each analysis provides an in-depth look at how the proposals will impact Michigan residents free of any support for one side or another.


Statewide ballot proposals serve an important role in public policy by putting the power to approve or reject changes to Michigan’s Constitution or state law in the hands of voters. Nearly all ballot measures have a significant impact on Michigan citizens and those which amend the Michigan constitution cannot be changed by the state legislature once passed. While the MHA has only taken a position on Proposal 1 this year, we encourage voters to learn more about each proposal to make informed decisions on Election Day.


View both sides of the ballot before submission, as ballot proposals often appear on the back side of a ballot.


View an episode of the MiCare Champion Cast which features Laura Appel, executive vice president of government relations and public policy at the MHA, discussing the upcoming general election, including the three ballot proposals.

Logo for MI Vote Matters, Tuesday Nov. 8


For more election information and updates or to request Election 2022 informational materials, visit the MHA Election webpage or email Join the MHA in talking about Election 2022 on social media using #MIVoteMatters.

MHA Podcast Details Upcoming Election

The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities.

On this episode, Laura Appel, executive vice president of government relations and public policy at the MHA, discusses the upcoming general election which will set the stage for critical healthcare decisions for Michigan and the nation in the years ahead. Appel explains how voting directly impacts healthcare in Michigan and outlines details on this year’s candidates and ballot proposals.

The episode, currently available via SpotifyYouTube, Apple Podcasts and SoundCloud, also explores examples of past and present legislation that have had a lasting impact on healthcare, along with key dates to keep in mind ahead of Election Day.  

In November, Michigan voters will help elect the next governor, attorney general and secretary of state of Michigan, decide who will represent the state in all 13 Michigan seats in the U.S. House of Representatives, plus cast ballots for all 110 seats of the Michigan House of Representatives and 38 seats of the Michigan Senate, among other contests.

The MHA MI Vote Matters 2022 election webpage provides the latest information about the election. Members are encouraged to use #MIVoteMatters to join the election 2022 conversation on social media and follow along for the MHA’s Race of The Week series to learn more about candidates and ballot proposals.

The MiCare Champion Cast is part of the statewide #MiCareMatters campaign, launched in 2017, which aims to build a network of citizens — “MiCare Champions” — who will be called upon to engage in advocacy efforts to protect access to affordable healthcare services in Michigan.

Members with questions or who would like to submit ideas for future podcasts should contact Lucy Ciaramitaro at the MHA.

Crain’s Healthcare Leadership Summit Features MHA and Hospital Leaders

The Oct. 20 Crain’s 2022 Healthcare Leadership Summit featured speakers from the MHA and member hospitals in a series of panels on policy issues, labor force solutions and technology integration.

MHA EVP Laura Appel spoke on a policy panel that covered what role government can play in affordability, equity & improving care.

Rising costs, uncertain governmental policies, workforce challenges, behavioral health and equity issues have put hospitals and health systems in a compromising position. The summit aimed to connect industry experts to collaborate on solutions and share best practices to tackle these issues.

Laura Appel, executive vice president of government relations and public policy at the MHA, spoke on a panel that covered solutions to the labor challenges and measures that reduce pressure on healthcare institutions throughout the state.

“There are no quick, easy fixes,” Appel noted. “Public health is a way for us to get people in a better place in the aggregate – we cannot solve diabetes, for example, with healthcare alone. We’ve got to do the policy work that it takes to push back and reduce rates [of illness], as opposed to just stopping the upward trends.”

Leaders from MHA-member hospitals and health systems were also featured in breakout sessions that covered workforce challenges and technological solutions to improve efficiency and safety. Panelists included:

  • Kimberly Keaton Williams, vice president of talent acquisition and development and chief diversity officer at McLaren Health Care.
  • Shana Lewis, vice president of talent acquisition and workforce development programs at Trinity Health.
  • Lisa Ouellette, interim chief human resources officer at Corewell Health.
  • Robert Riney, president & CEO of Henry Ford Health.

The event also featured keynote speaker Dr. Joneigh Khaldun, vice president and chief health equity officer at CVS Health, who spoke about attainable solutions for addressing inequities and improving health outcomes for underserved, vulnerable communities.

DIFS Publishes Bulletin on No-fault Reimbursement Following Andary Decision

The Michigan Department of Insurance and Financial Services (DIFS) issued Bulletin 2022-17-INS Oct. 5 in the matter of payment and billing guidance for no-fault automobile insurers and healthcare providers following an order from the Michigan Supreme Court in the Andary v. USAA lawsuit that effectively reinstated the obligation of auto no-fault insurers to cover benefits for the catastrophically injured as those benefits had been in place prior to June 11, 2019.

The lawsuit was brought by a group of catastrophically patients injured before June 11, 2019, which is prior to passage of changes to Michigan’s auto no-fault law. Auto insurers implemented benefit and payment reductions for all claims including for patients who were injured before the new law took effect. The plaintiffs in Andary sued their insurer to establish that they are entitled to full lifetime no-fault benefits (such as unlimited hours of family attendant care) and claimed the limited reimbursement for medical and other personal injury protection coverage does not apply retroactively.

The bulletin explains the process providers who believe they are due additional reimbursement for claims subject to the Andary decision should follow if a provider believes a reprocessing of a claim is necessary. As outlined in the bulletin, providers are advised to first contact the insurer to request reprocessing of those claims. If a dispute related to a reprocessed claim cannot be resolved directly with the insurer, the provider may contact DIFS for assistance at

The Michigan Supreme Court also issued a separate order granting USAA’s application for permission to appeal the question of whether the Court of Appeals erred when it:

  • Held that claimants injured before June 11, 2019 are not subject to the reduced reimbursement for care under the new law.
  • Held that application of the new law to claimants injured before June 11, 2019 violates the Contracts Clause of the Michigan Constitution.
  • Remanded the case to the circuit court for discovery to determine if the new law passes constitutional muster.

The MHA is evaluating the DIFS bulletin and have submitted clarifying questions to external legal counsel. Members with questions may contact Laura Appel at the MHA.

Appel Discusses Behavioral Health Bed Shortage with Bridge

Laura Appel

Laura AppelBridge Michigan published an article Oct. 4 which focuses on the staffing challenges impacting behavioral health providers that limit bed capacity. The article begins by reviewing the number of reduced beds at state psychiatric facilities.

Laura Appel, executive vice president of government relations and public policy, MHA, contributed to the story. The article also references statewide aggregate data compiled by the MHA on the loss of staffed hospital beds and the dramatic increase in contract labor expenses. Shared in a report recently provided to the Michigan Legislature, the state has approximately 1,400 less staffed acute-care inpatient beds now compared to Oct. 2020 and Michigan hospitals are expected to spend $1.1 billion on contract labor compared to $516 million in 2021.

“We are working with the state to try and figure out how to make it through this crisis,” said Appel. “At the same time, I can’t blame (state officials) for their challenges.”