As the number of new cases and hospitalizations due to COVID-19 begin to diminish in Michigan, both Pfizer and Moderna have launched trials for vaccines targeting the omicron variant of the coronavirus. The variant is estimated to make up 99% of the current cases in the United States.
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.
CMS Vaccine Requirement for Healthcare Workers Began Jan. 27
The Centers for Medicare & Medicaid Services (CMS) requirement that healthcare workers be vaccinated against COVID-19 took effect Jan. 27. Employees are required to have received a first dose by that date and a second dose — if getting a two-dose vaccine — by Feb. 28.
The Michigan Department of Health and Human Services (MDHHS) issued a letter to all providers detailing the requirements of the CMS rule and provided implementation tools for providers to execute the policy internally. These include FAQs, education materials and more. MHA members are encouraged to use these tools as necessary to comply with the mandate.
The 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.
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.
The state’s coronavirus webpage indicates there were an average of 9,222 new COVID-19 cases per day Dec. 2 and 3, bleakly demonstrating the current surge of the disease in Michigan. However, 55.6% of Michiganders ages 5 and older were fully vaccinated as of Dec. 3, and more than 1.6 million residents had received booster shots as of that date.
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.
Collaborative Efforts Urge Public to Take Precautions, Get Vaccinated
As the omicron variant, the latest version of the evolving coronavirus, begins to appear in the United States, the MHA, its members and public health agencies are urging the public to be particularly mindful of precautions they can take to guard against infection.At this time, there is no evidence to indicate omicron is present in Michigan. However, the MHA will remain in close contact with the State Department of Laboratories as it sequences samples and will keep members apprised of any developments.
The Michigan Department of Health and Human Services (MDHHS) and the MHA issued a joint press release Dec. 2 using a new set of infographics developed by the association. These images show the percentages of vaccinated versus unvaccinated COVID-19 hospitalizations, those in ICUs and those on ventilators. The release urged the public to get vaccinated to not only protect their own health, but the health of healthcare workers and to avoid additional strain on the state’s healthcare systems.
MHA-member health systems provided the data for this effort. The release included the following messages:
Three out of four COVID-19 patients are unvaccinated (76%).
87% of COVID-19 ICU patients are unvaccinated.
88% of COVID-19 ventilator patients are unvaccinated.
Members are encouraged to share these figures along with their organizations’ local data to maintain the public’s awareness. Members with questions may contact Ruthanne Sudderth at the MHA.
In addition, the MHA published a consensus statement Nov. 22 to statewide media on behalf of the chief medical officers of its member hospitals urging the public to take action to help slow COVID-19 growth throughout the state and educate them about the serious nature of the current surge and hospital capacity issues. MHA members are encouraged to use this statement locally or use it as a template for an organization-specific update to their communities. This message has been widely broadcast throughout the state (see related article).
Members with questions about vaccines and COVID-19 precautions may contact Ruthanne Sudderth at the MHA.
CMS Delays Enforcement of Healthcare Worker Vaccine Mandate as Courts Issue Injunctions
Although Michigan was not impacted by the Nov. 29 preliminary injunction against enforcement of the Centers for Medicare & Medicaid Services (CMS) healthcare worker vaccine mandate in 10 states, a separate preliminary injunction issued Nov. 30 does affect Michigan by placing a hold on the mandate in all other states. The federal government has appealed each order to the U.S. Court of Appeals in their respective circuits and asked the appellate courts to set aside the district courts’ preliminary injunction pending appeal.
Subsequently, the CMS issued a memorandum Dec. 2 confirming that it will not enforce its vaccine mandate while the court orders are in effect. The memo states that the CMS has “suspended activities related to the implementation and enforcement of this rule pending future developments in the litigation.” It also states that “while these preliminary injunctions are in effect, surveyors must not survey providers for compliance with the requirements of the” mandate.
The document does not state what the CMS would do when and if the preliminary injunctions are removed, such as setting new compliance dates.
The federal mandates do not impact hospitals’ ability to implement their own organization-based staff vaccine requirements if they choose to adopt such a policy.
MHA members are encouraged to follow the American Hospital Association (AHA) blog authored by Sean Marotta, a partner at Hogan Lovells and outside counsel for the AHA. The blog will be updated regularly as new developments occur. The MHA will also keep members apprised of developments. Members with questions may contact Amy Barkholz at the MHA.
Medicaid Coverage Expands to Cover Authorized In-home COVID Test Kits
The MDHHS recently released concurrent proposed and final policies to expand Medicaid coverage of COVID-19 testing to include home testing kits authorized by the U.S. Food and Drug Administration when administered consistent with recommendations by the Centers for Disease Control and Prevention. The expanded coverage for dates of service on and after Aug. 30, 2021, is contingent upon approval by the CMS. Approved testing kits must be prescribed or ordered by a Medicaid-enrolled participating pharmacy. Coverage will continue through 15 months following the end of the federal public health emergency. Comments should be submitted by Jan. 4. Questions may be directed to Vickie Kunz at the MHA.
As the number of new cases and hospitalizations due to COVID-19 begin to diminish in Michigan, both Pfizer and Moderna have launched trials for vaccines targeting the omicron variant of the coronavirus. The variant is estimated to make up 99% of the current cases in the United States.