Parents Urged to Take Preventive Measures As Pediatric Beds Fill Up

As Respiratory Viruses Circulate, Michigan Hospitals Urge Vigilance, Prevention

Michigan children’s hospitals and pediatric healthcare leaders are raising awareness about a pediatric hospital bed shortage and urging the public to help prevent respiratory illnesses, which are rapidly spreading in the form of respiratory syncytial virus (RSV) and influenza.

Michigan pediatric intensive care unit hospital beds are currently 89% occupied, according to data from the Michigan Health & Hospital Association (MHA) and Michigan Department of Health & Human Services (MDHHS). Hospitals are also reporting large surges in young patients visiting emergency departments, for both emergent and non-emergent care. Hospitals are urging those with mild cold-like symptoms to stay at home. If symptoms worsen, an urgent care or primary care physician’s office would be the most appropriate setting to seek care, while emergency department visits should be reserved for those with moderate to severe symptoms including shortness of breath. Wait times and patient volumes in emergency rooms are increasing, and emergency department capacity in some areas is being depleted by visits for non-emergency medical conditions. Pervasive hospital staff shortages further complicate surges in hospital visits.

These pediatric bed shortages are impacting care statewide, making transfers of the sickest young patients to higher acuity care settings difficult.

“Hospitals are here for Michiganders, particularly in emergencies,” said Gary Roth, DO, chief medical officer, MHA. “But our capacity to provide pediatric hospital care is extremely strained. Right now, the staffing challenges we have been sounding the alarms about all year combined with rapid spread of respiratory illnesses are impacting our hospitals’ ability to care for our sickest children in a timely manner.”

The MHA and the MDHHS are monitoring the pediatric bed capacity among Michigan hospitals. Nationally, the U.S. Department of Health and Human Services data shows that 76% of pediatric beds across the country are full, with anecdotal reports largely pinning the shortage on widespread RSV infections.

“Many of us in the pediatric medical community across Michigan are working to care for the surge of children battling RSV,” Matthew Denenberg, MD, chief of pediatrics, Corewell Health East, the new name for Beaumont Health, and chair of the MHA’s Council on Children’s Health. “Our teams are here to help when the illness becomes severe. Parents and guardians can also help stop the spread of illness in our communities by getting children vaccinated against both flu and COVID-19. We all need to work together to keep our children safe.”

“In recent weeks we have seen a significant surge in cases of RSV which is most greatly impacting our infants and young children,” said Rudolph Valentini, MD, chief medical officer, Children’s Hospital of Michigan. “Since Oct. 1, more than 450 patients have tested positive for RSV at our hospital. This is putting a strain on our hospital’s emergency department and inpatient bed capacity; further, this could intensify if influenza cases begin to rise in the near future. It is also important to note that RSV and its associated bronchiolitis cause symptomatic disease in 20% of infants and children less than one year of age. Although RSV may only cause a mild cold in older children and adults, it is important for parents to keep their infants and young children away from others who are ill, because RSV causes inflammation to the smallest airways making infants especially vulnerable sometimes resulting in hospitalization or ICU care. Other patients who need to avoid RSV are children with a history of prematurity, chronic lung disease, congenital heart disease, immunodeficiency or solid organ transplant.”

“As we see this concerning trend in high volumes of pediatric emergent care and hospitalizations, we need to all work together to protect our children and conserve resources.  Pediatric beds are a shared resource across the state,” stated Christine Nefcy, MD, chief medical officer, Munson Healthcare. “Many smaller community or rural hospitals in Michigan have minimal pediatric bed capacity and rely on other facilities for higher level or specialty care for these patients. At this time of year, we naturally want to gather more often with family and friends; so as you make plans, we urge parents to follow these guidelines to ensure we manage this surge using all the tools at hand.”

“We are urging Michiganders to have a plan for their families this respiratory season to help prevent hospital overcrowding and prevent outbreaks of respiratory illnesses using the tools available,” said Dr. Natasha Bagdasarian, the state’s chief medical executive. “This includes getting available vaccines, staying home if unwell, having a supply of masks at home, covering coughs, washing your hands often and finding out if you are eligible for treatment options if you do become unwell.”

The MHA and its pediatric clinical leaders and partners offer the following tips for the public:

  • DON’T: Seek hospital emergency care for non-emergency medical conditions, such as mild symptoms and routine testing.
  • DO: Seek hospital emergency care if symptoms are worrisome and emergency care is needed. Emergency medical conditions can include difficulty breathing, dehydration and worsening symptoms.
  • DO: Immediately get vaccinated against respiratory illnesses. Visit www.vaccines.gov to search for vaccine availability or call your provider or the local health department.
  • DO: Be patient if seeking care through a hospital emergency department. Consider that wait times may be elevated as respiratory illnesses reach seasonal peak levels.
  • DO: Consider having your children wear a mask in public places including school when you know local case rates of respiratory illnesses are high.
  • DO: Practice frequent and proper hand washing and stay home if you’re not feeling well.

Additional information: 

Influenza is a viral respiratory illness with symptoms that include fever, cough, stuffy or runny nose, sore throat, headache, chills and fatigue. A flu test is not always needed to diagnose the flu, however in some cases it may be recommended by a healthcare provider. People at risk of complications should consult their healthcare provider.

RSV infection is a viral respiratory illness that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. Symptoms include runny nose, decreased appetite, coughing, sneezing, fever and wheezing.

Reporters may contact the following representatives from the Pediatric Leadership Collaborative to schedule interviews:

Natasha Bagdasarian, MD, MPH, FIDSA, Chief Medical Executive, State of Michigan
Media Contact: Lynn Sutfin, SutfinL1@michigan.gov

Francis Darr, MD, Pediatrician, UP Health System – Marquette
Media Contact: Janell Larson, Janell.Larson@mghs.org

Marcus DeGraw, MD, Chairman, Department of Pediatrics, Ascension St. John Hospital St. John Children’s Center
Media Contact: Airielle Taylor, airielle.taylor@ascension.org

Matthew Denenberg, MD, Chief of Pediatrics, Corewell Health East
Media Contact: Mark Geary, mark.geary@beaumont.org

Michael Fiore, MD, Medical Director, Pediatric Intensive Care Unit, Covenant Healthcare
Media Contact: Kristin Knoll, kknoll@chs-mi.com

Steven Martin, MD, E.W. Sparrow Hospital, Interim Chief Medical Officer & Co-Director of University of Michigan Health at Sparrow Children’s Center, Sparrow Health System
Media Contact: John Foren, John.Foren@Sparrow.org

Kimberly Monroe, MD, MS, Interim Chief Clinical Officer, C.S. Mott Children’s Hospital & Von Voigtlander Women’s Hospital
Media Contact: Beata Mostafavi, bmostafa@med.umich.edu

Christine Nefcy, MD, Chief Medical Officer, Munson Healthcare
Jacques Burgess, MD, MPH, System Pediatric Medical Director, Munson Healthcare
Media Contact: Dale Killingbeck, dkillingbeck@mhc.net

Brian M Nolan, MD, Hurley Children’s Hospital
Media Contact: Peggy Agar, pagar1@hurleymc.com

Dominic Sanfilippo, MD, Associate Department Chief / Pediatrician-in-Chief, Corewell Health Helen DeVos Children’s Hospital
Media Contact: Andrea Finnigan, Andrea.Finnigan@spectrumhealth.org

Uzma Shah MD, FAAP, FAASLD, Chair, Department of Pediatrics, Henry Ford Health
Media Contact: Dana Jay, djay2@hfhs.org

Gregory Tiongson, MD, Medical Director, Bronson Children’s Hospital
Media Contact: Erin Smith, smither@bronsonhg.org

Rudolph Valentini, MD, Chief Medical Officer, Children’s Hospital of Michigan
Media Contact: Brian Taylor, BTaylor8@dmc.org

Provider Enrollment Requirements Reinstated Effective Dec. 1, 2022

The Michigan Department of Health and Human Services (MDHHS) issued MMP 22-38 COVID-19 Response: Termination of Bulletin MSA 20-28, which reinstates provider enrollment requirements. The following processes with be reinstated effective Dec. 1, 2022:

  • Community Health Automated Medicaid Processing System (CHAMPS) enrollment revalidations. The MDHHS will begin provider revalidation date notifications starting Nov. 2022.
  • Resume site visits for prospective and current providers.
  • Fingerprint-based criminal background checks.
  • Enrollment application fees. Providers may still request a hardship waiver.

Members with questions should contact Renée Smiddy at the MHA.

MDHHS Releases Proposed Policy on Medicaid Rates for Dental Services

The Michigan Department of Health and Human Services (MDHHS) recently released a proposed policy to increase Medicaid payment rates to $2,300 for dental services provided at outpatient hospitals and $1,495 for services provided in an ambulatory surgical center (ASC).

Pending approval by the Centers for Medicare and Medicaid Services, the policy would go into effect Oct. 1, 2022. The proposal states that services would move from the current outpatient prospective payment system to a Medicaid fee schedule. Services should be billed using dental surgery procedure code 41899 with payment based on the Medicaid fee schedule in effect on the date of service for the procedure code(s) billed. Outpatient hospital and ASC fee schedules are available on the MDHHS website under the billing and reimbursement and provider specific information tab.

Hospitals are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 23, 2022. Members with questions should contact Vickie Kunz at the MHA.

MDHHS Announces Plans to Establish Stroke and Heart Attack Systems of Care

The Michigan Department of Health and Human Services (MDHHS) announced Oct. 28 they are reorganizing to create systems of care for stroke and acute heart attack emergencies. The Bureau of EMS, Trauma & Preparedness within the MDHHS has been renamed the Bureau of Emergency Preparedness, EMS, and Systems of Care. The new systems of care will be integrated into the existing statewide trauma system and will help ensure every patient is taken to a facility with the proper level of care for their current condition.

The announcement came in recognition of World Stroke Day on Oct. 29 and reflects several years of MHA advocacy for the initiative. The MHA successfully advocated for funding in the fiscal year (FY) 2022 and 2023 state budgets that directed the MDHHS to undergo these efforts. That $3 million line-item, which will now be a part of the trauma system, will remain a priority for the MHA going into the next budget year.

The MHA also pursued legislation this session to this effect. Senate Bill (SB) 521, introduced by Sen. John Bizon (R-Battle Creek), would have memorialized the stroke and heart attack systems of care in statute. Adam Carlson, senior vice president, advocacy, MHA and Alex Chebl, MD, director of the Henry Ford Stroke Center and head of the Division of Vascular Neurology at Henry Ford Health System, provided testimony to the committee in support of SB 521. “It is critical all patients throughout the state have access to the best stroke care possible,” said Chebl. “SB 521 is an essential step to improving the quality of stroke care in the state of Michigan.”

Official draft rules have not yet been released and the MHA will keep members informed once more information is available for comment or review.

Members with questions about these changes should contact Sean Sorenson-Abbott at the MHA.

MHA Monday Report Oct. 17, 2022

MHA Monday Report

Legislative Policy Panel Convenes for Program Year

The MHA Legislative Policy Panel convened Oct. 12 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals …


MDHHS Releases Medicaid Rate Increase Policies

The Michigan Department of Health and Human Services (MDHHS) recently released two concurrent final and proposed policies to implement Medicaid rate increases included in the fiscal year (FY) 2023 budget for dates of service on and after Oct. 1, 2022 …


MHA Keystone Center Presents Annual Health Equity Summit

Registration is now open for the Michigan Health Equity Summit that will take place in-person at Lansing Community College West Campus and virtually from 9 a.m. to 3:30 p.m. ET on Nov. 3 …


ED MOUD Funding Available – Applications Due Dec. 16

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Webinar Prepares for The Joint Commission and CMS Health Equity Requirements

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MHA Podcast Explores Program Year Priorities with Michigan Medicine

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MHA Race of the Week – Michigan Supreme Court

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The Keckley Report

Paul KeckleyIs the Honeymoon Over for Medicare Advantage?

“The bottom line: in the next 2-3 years, regulatory scrutiny of Medicare Advantage will increase and funding by Medicare will decrease. Congress will press for a clear correlation between Medicare’s solvency and MA cost-savings. Thus, it’s likely Medicare Advantage plans will charge higher premiums, limit benefits, intensify medical management activities, share more financial risk with high-performing provider organizations and offer services to new populations. Their margins will shrink, access to capital and enrollment growth will be imperatives, and innovation in holistic cost-effective care management and affordability key differentiators.”

Paul Keckley, Oct. 10, 2022


Logo for MI Vote Matters, Tuesday Nov. 8News to Know

  • The last day to register online to vote in the Nov. 8 election is Oct. 24, 2022.
  • Early in-person voting by absentee ballot at a clerk’s office remains available.
  • Complimentary MI Vote Matters informational posters and the 2022 Candidate Guide are still available for MHA members.

ED MOUD Funding Available – Applications Due Dec. 16

The Community Foundation for Southeast Michigan (CFSEM) is partnering with the MHA Keystone Center, the Michigan Opioid Partnership (MOP) and the Michigan Department of Health and Human Services (MDHHS) to provide funding and technical assistance for members to implement Medication for Opioid Use Disorder (MOUD).

The goal of the Emergency Department Medication for Opioid Use Disorder (ED MOUD) initiative is to increase access to evidence-based medication for opioid use disorder and support the transition to long-term office-based treatment upon discharge.

Applications for the upcoming ED MOUD funding will close on Dec. 16. Members should note there is currently legislation pending to implement an opt-out program for Michigan emergency departments (ED) to implement a medication for opioid use disorder (MOUD) program. If passed, hospitals would be required to offer ED-MOUD services or complete a form developed by MDHHS to opt-out.

The MHA Keystone Center is also partnering with MOP to host a webinar Oct. 19 about obtaining an X-Waiver and prescribing MOUD. While this webinar will not fulfill the training requirements for X-Waivers, CME credits will be offered and will provide attendees the opportunity to ask questions about the process.

If you are interested in receiving future communication surrounding opioid use disorder treatment programs and initiatives, please fill out this brief survey.

Members with questions about the webinar may contact the MHA Keystone Center.

MDHHS Releases Medicaid Rate Increase Policies

The Michigan Department of Health and Human Services (MDHHS) recently released two concurrent final and proposed policies to implement Medicaid rate increases included in the fiscal year (FY) 2023 budget for dates of service on and after Oct. 1, 2022. These include:

  • 2235-Practitioner proposes to update rates for physician neonatal and pediatric critical and intensive care services for certain current procedural terminology (CPT) codes from 95% to 100% of Medicare rates. Members are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 7, 2022.
  • 2234-Practitioner proposes to increase Medicaid rates for primary care services for CPT codes 99421 through 99423 and 99441 through 99443. The MDHHS indicates rates for the applicable CPT codes will increase from roughly 75% of Medicare to 88% of Medicare. These CPT codes include:
    • Established patient office or outpatient evaluation and management (E/M) visits.
    • Initial subsequent, discharge and other nursing facility E/M visits.
    • New and established patient domiciliary, rest home or custodial care E/M services.
    • New and established patient home E/M visits.
    • New and established patient preventive medicine services.
    • Online digital E/M services and E/M services provided via telephone.

Members are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 9, 2022.

Members with questions should contact Vickie Kunz at the MHA.

MHA Monday Report Oct. 10, 2022

MHA Monday Report

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 …


MDHHS Releases Proposed Policy to Resume Required Enrollment Activities

The Michigan Department of Health and Human Services (MDHHS) released a proposed policy to rescind remaining waived provider enrollment (PE) requirements implemented by MSA 20-28 and resume required enrollment activities that were waived during the federal COVID-19 Public Health Emergency (PHE) …


CMS Announces 2023 Medicare Premiums and Deductibles

The Centers for Medicare & Medicaid Services (CMS) recently announced the calendar year 2023 Medicare fee-for-service Part A deductible for inpatient hospital services will increase by $44 to a new total of $1,600 …


MHA Creates Workforce Sustainability Communications Toolkit

As hospitals and health systems across Michigan continue to face workforce challenges, the MHA has developed a downloadable communications toolkit focused on workforce sustainability …


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Opportunities for Immunization Grants – Applications Due Nov. 1

The American Academy of Pediatrics (AAP) recently announced multiple grant opportunities for health organizations and AAP Chapters to improve community confidence in vaccines and to support pediatricians in the delivery of on-time vaccinations …


Webinar Dispels Misinformation About Unionization and Outline Legal Guidelines

Healthcare workforce shortages, particularly nursing shortages, are severely hindering the ability to provide patient-centered care. Unionizing to negotiate for policies like staffing ratios is popular but does not consider the complexity of significant workforce shortages …


MHA Race of the Week – Michigan Secretary of State

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


Paul KeckleyThe Keckley Report

The White House Strategy for Nutrition and Hunger: Three Glaring Oversights

“Last Wednesday, the White House hosted the White House Conference on Hunger, Nutrition, and Health in DC—the first since the Nixon administration’s conference in 1969. Noting that food insecurity is an issue in one in four US households and the eroding nutritional value of the food supply chain, the Administration laid out its strategy in a 44-page document featuring 5 pillars of its attention…

The White House Strategy is a great start but the issues of food insecurity and nutritional deficiency require urgent, comprehensive and dedicated attention. The White House says it has secured pledges of $8 billion from the private sector to advance the strategy: that’s a good start, but only a fraction of what’s needed.”

Paul Keckley, Oct. 3, 2022


Logo for MI Vote Matters, Tuesday Nov. 8News to Know

  • A second gubernatorial debate is scheduled for 7 p.m. Oct. 25 on the Oakland University campus between Gov. Gretchen Whitmer and Republican candidate Tudor Dixon.
  • Early in-person voting by absentee ballot at a clerk’s office is currently available.
  • Complimentary MI Vote Matters informational posters and the 2022 Candidate Guide remain available for MHA members.

Laura AppelMHA in the News

Bridge 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 …

MDHHS Releases Proposed Policy to Resume Required Enrollment Activities

The Michigan Department of Health and Human Services (MDHHS) released a proposed policy to rescind remaining waived provider enrollment (PE) requirements implemented by MSA 20-28 and resume required enrollment activities that were waived during the federal COVID-19 Public Health Emergency (PHE).  The MDHHS proposes to reinstate the following processes beginning Dec. 1, 2022:

  • Community Health Automated Medicaid Processing System (CHAMPS) enrollment revalidations with MDHHS notifying providers beginning November 2022 of their rescheduled validation date, which will be assigned on a rolling basis starting with providers who have had the longest revalidation pause. Providers may view their rescheduled revalidation date in CHAMPS.
  • Site visits for prospective and current providers which will be performed following all state and federal public health guidelines, such as masking and social distancing.
  • Fingerprint-based criminal background checks associated with providers in the high-risk category.
  • Enrollment application fees for providers who had their fees waived under MSA 20-28. Providers may still request a hardship waiver per the Centers for Medicare and Medicaid Services (CMS) guidelines which will only be granted after the MDHHS receives approval from the CMS.

Members are encouraged to review the proposed policy and submit comments to the MDHHS by Oct. 28. Members with questions should contact Renée Smiddy at the MHA.

MHA Monday Report Oct. 3, 2022

MHA Monday Report

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The Michigan Legislature was back in session the week of Sept. 26 to finish voting on a multitude of bills as committees and the full body met for the last time before the Nov. 8 election …


Workforce Funding ReportMHA Distributes Workforce Grant Report to Legislature

Based on requirements in legislative boilerplate, the MHA created and distributed to the Michigan Legislature Sept. 28 a report on the results of the state healthcare workforce grant, which brought $225 million to Michigan hospitals for workforce recruitment, retention and training …


MDHHS Releases Proposed Policy for Attending Physician Claims

The Michigan Department of Health and Human Services (MDHHS) released a proposed policy to update existing policy for the attending provider field on institutional hospital inpatient and outpatient claims …


MHA Keystone Center Presents Annual Health Equity Summit

Registration is now open for the Michigan Health Equity Summit that will take place in-person at Lansing Community College West Campus and virtually from 9 a.m. to 3:30 p.m. ET on Nov. 3.


Trustee Member Forum Outlines Membership Strategies

The MHA will host a Trustee Member Forum from noon to 4:30 p.m. Nov. 2 at the MHA Headquarters in Okemos for trustees from MHA member organizations to explore the MHA’s 2022-2023 program year’s strategic action plan, which the MHA Board of Trustees approved in August …


Revised Doula Services Policy Released by MDHHS

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“With 6 weeks to the mid-term election, one thing is certain: healthcare issues will be prominent in campaign rhetoric but the reality is not much will change until after 2024. Economic conditions, Congressional dysfunction and effective advocacy efforts by trade groups representing hospitals, drug and device manufacturers, and health insurers will limit major reforms… ”

Paul Keckley, Sept. 26, 2022


Logo for MI Vote Matters, Tuesday Nov. 8News to Know

  • As Election Day nears, the Citizens Research Council of Michigan is hosting a free webinar from 10 to 11:30 a.m. Oct. 5 on the three proposed constitutional amendments that will appear on the Nov. 8 ballot.

Laura Appel speaks with WILX.

MHA in the News

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