Combating the Novel Coronavirus (COVID-19): Week of Dec. 6

MHA Covid-19 update

MHA Covid-19 updateAs MHA CEO Brian Peters outlines in his December CEO Report, the situation confronting Michigan hospitals is dire, with hospitalizations due to COVID-19 exceeding record highs and intensive care units full of patients — most of whom are unvaccinated. The MHA joins healthcare experts around the country in urging the public to get one of the available COVID-19 vaccines.

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.

Legislature Considers Bills to Assist in Treating COVID-19

The Michigan House Appropriations Committee voted Dec. 8 in support of House Bill 5523, a bill that would provide critical staffing resources to hospitals and other providers. The MHA urges hospitals and others to contact their legislators, urging them to support the bill (see related article).

In addition, the Michigan Senate unanimously voted Dec. 8 in support of Senate Bill (SB) 759, a bill that would allow healthcare workers licensed by another state to continue to practice in Michigan during COVID-19 (see related article).

Court Issues Temporary Stay of Vaccine Mandate Enforcement for Federal Contractors

A federal district judge in Georgia issued an injunction Dec. 7 that is applicable to all states and temporarily pauses enforcement of the Centers for Medicare & Medicaid Services (CMS) COVID-19 vaccine mandate for federal contractors.

This is a preliminary injunction; until there is a final decision from the highest appellate court on these challenges to the CMS rule, federal contractors should be prepared to comply if the requirement is upheld. Like previous injunctions, this does not impact a contractor’s ability to implement and enforce its own organization-based vaccine policy.

The MHA will apprise members of updates on legal challenges to President Joe Biden’s vaccine mandates as they become available. Those with questions may 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).

MHA CEO Report — Staying Resilient Through the Ongoing Pandemic

MHA Rounds Report - Brian Peters, MHA CEO

“If you’re going through hell, keep going.” — Winston Churchill

MHA Rounds Report - Brian Peters, MHA CEOHere are the facts, and they are not pretty: as we enter the final month of 2021, the situation confronting our Michigan hospitals is as dire as it has been since the start of the pandemic. A prolonged fourth surge has driven COVID-19 inpatient hospitalizations above 4,600 and ICU occupancy rates to nearly 90% — both metrics hovering near our all-time record highs. Michigan hospitals are also dealing with extraordinarily high volumes of non-COVID patients — likely the result of months of pent-up demand for healthcare from Michiganders who have delayed seeking treatment for a wide range of issues. Throughout the state, elective procedures are being deferred, emergency departments are placed on diversion, patients ready for discharge are stuck in hospital beds due to transportation shortages and wait times in emergency departments can often be measured in hours. As if this wasn’t enough, we are now beginning to see the first flu cases arrive in our hospitals, at the same time that the specter of yet another new COVID-19 variant looms on the horizon. In short, we’re going through hell.

Given this reality, it is no wonder that the significant workforce challenges that predated the pandemic have only gotten worse by the month (it doesn’t help that the rates of violence, either verbal or even physical, are increasing as patients and their families become impatient with longer wait times or visitor restrictions due to infection control protocols). Many of our caregivers have headed to jobs in other fields or retired altogether. The end result of this phenomenon: nationally, hospitals and health systems remain nearly 100,000 jobs below their pre-pandemic February 2020 peak. And here in Michigan we have approximately 800 fewer staffed hospital beds today than we did one year ago — in essence, this is the inpatient capacity equivalent of shuttering one of our largest hospitals. The workers who remain are facing unprecedented stress and fatigue. Already, three Department of Defense medical teams have been called in to provide staffing support to some of our hospitals. We welcome this support, but much more is needed.

However, Michigan’s healthcare community is coming together to advocate for solutions that address healthcare workforce sustainability in both the short and long term. Together with long-term care, medical transportation providers and higher education leaders, we are advocating for funding to support healthcare workforce staffing and growing the talent pipeline.

House Bill (HB) 5523 was introduced Dec. 8 and includes $300 million for healthcare workforce recruitment and retention payments. We are extremely appreciative of this appropriation and encourage lawmakers and the administration to quickly approve the funding for the healthcare workforce before the holiday break. Our communities depend on our hospitals both for life-saving treatment and as economic engines. An investment today will help set Michigan on a path forward to addressing this crisis.

In addition, first hearings were held Nov. 30 on HBs 5556 and 5557, which would allow community colleges to offer four-year bachelor of science in nursing degrees. The MHA supports this legislation that would improve the long-term nursing talent pipeline and would increase access to high-quality nurses in some areas served by Michigan’s small and rural hospitals where a four-year school does not currently exist.

At the MHA we have a mantra: “no data without stories, and no stories without data.” It takes both to move the needle on public opinion and, hence, public policy. We have heard countless stories about the current environment from nurses, doctors, hospital and health system leaders, patients and others. The stories range from insightful, to heartbreaking, to maddening. Now here is some compelling data, which points to what all Michiganders can do to help: 76% of COVID-19 hospital inpatients are unvaccinated, 87% in the ICU are unvaccinated and 88% on ventilators are unvaccinated. The data is clear; vaccines are safe and effective at preventing severe illness. It is quite literally the most powerful tool in our toolbox. While we recently surpassed 70% of the population age 16 and older receiving at least one dose of COVID-19 vaccine, we have a long way to go on this front. The vaccine uptake among eligible children ages 5-11 now stands at just 16.2%, with large disparities existing between suburban communities and their rural and urban counterparts.

What we need to do to get out of this current COVID-19 surge is simple, and the message from our hospitals is clear: get vaccinated, have your children vaccinated and receive your booster dose when eligible. Adhere to the Michigan Department of Health and Human Services mask advisory in large indoor gatherings. And if you do visit a healthcare facility, whether for a medical emergency or to accompany a loved one, please be patient and display some grace and empathy toward our healthcare workers. The pandemic is clearly not over, and they need your help and support now more than ever.

As always, I welcome your thoughts.

Prepare Now for March Application Period of State Loan Repayment Program

Applications for the 2022 Michigan State Loan Repayment Program (MSLRP) will be accepted from March 7-11 through the File Transfer Application System. Providers should create an account in the system as soon as possible, but should not upload their MSLRP application documents before March 7.

The MSLRP assists employers in the recruitment and retention of medical, dental and mental health primary care providers who continue to demonstrate their commitment to building long-term primary care practices in underserved communities designated as Health Professional Shortage Areas. Those selected will receive up to $200,000 in tax-free funds to repay their educational debt over a period of up to eight years of participation. Priority will be given to applications from inpatient pediatric psychiatrists, providers working at practice sites in Genesee County, and obstetric service providers working in northern Michigan.

The review process has been updated for this application period. Providers and employers are strongly encouraged to read more about the review process in the Selection Criteria, Application Review and Final Phase Process section of the MSLRP website. For more information, contact Brittany Brookshire at the Michigan Department of Health and Human Services.

Michigan Hospitals Give More Than 500,000 COVID-19 Vaccines

Celebrating 500k Administered Doses of the COVID_19 Vaccine in Michigan Hospitals

Michigan hospitals have now given more than half a million COVID-19 vaccine doses, representing 55% of the total 909,038 doses provided in Michigan, according to data published Jan. 29 by the Michigan Department of Health and Human Services.

“Hospitals have played a vital role throughout this pandemic, and now they are leading the way delivering COVID-19 vaccine to our communities,” said MHA CEO Brian Peters. “While we still have a long way to go before all Michiganders are vaccinated, we celebrate today’s milestone as a sign of the progress we are making toward ending the pandemic. As vaccine supply increases, hospitals are at the ready to vaccinate more people every day.”

All vaccine received by hospitals is either administered or is scheduled to be provided as quickly as possible. Hospitals throughout the state are running vaccination clinics and scheduling appointments to help ensure vaccines are provided in a safe and orderly environment.

“Recipients of the over half a million vaccine doses include physicians, nurses, teachers, food service workers, security staff, patients and members of the community,” said MHA Chief Medical Officer Gary Roth, DO. “My colleagues in hospitals throughout Michigan are setting an example for the public: we believe in the safety and efficacy of the COVID-19 vaccine. Along with wearing a mask, practicing social distancing and washing hands regularly, receiving the vaccine, when it’s your turn, is something everyone can do to slow and ultimately stop the spread of COVID-19.”

Clinical studies have shown the two currently approved COVID-19 vaccines to be up to 95% effective in preventing the COVID-19 virus and safe for use in adults. These vaccines require two doses to get full protection, which are given over the course of either three or four weeks.

Healthcare workers, individuals aged 65 or older and some essential workers are currently eligible to receive the vaccine. Many hospitals are contacting their patients who have been or are currently under the care of their healthcare systems to inform them of vaccine availability. Other members of the public should contact their local health department, call 2-1-1 or visit the state’s COVID-19 website for information on scheduling a vaccine appointment. Individuals with questions about the vaccine, how it was developed and how it prevents COVID-19 are encouraged to talk with their healthcare provider or visit reputable sources of facts, such as the Michigan Department of Health and Human Services vaccine website.

MHA Statement on Appointment of Elizabeth Hertel as Director of MDHHS

MHA CEO Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.    

MHA CEO Brian PetersMichigan hospitals have been working around the clock to get more people vaccinated and keep our communities safe. Elizabeth Hertel is exactly the partner we need leading the state’s response to this virus, and we are eager to work closely with her moving forward.

Michigan Hospitals, Health Systems Issue Joint Statement on COVID-19 Progress, Urge Extension on MDHHS Order

covid cell

The following statement is made on behalf of chief medical officers of Michigan hospitals and health systems

As the chief medical officers representing Michigan hospitals and healthcare systems, we want to tell the public that the recent Michigan Department of Health and Human Services three-week order is doing what we expected: it’s slowly stabilizing the spread of COVID-19 and leading to stabilized hospitalizations. To see meaningful change that truly alleviates stress on the healthcare system, we urge the state to extend protections through the holiday season. We still don’t know what impact Thanksgiving will have, but we do know that with the recent pause, we’re seeing some slight improvements. As a state, we must not let our guard down and reverse this progress.

Michigan was on the path to record COVID-19 case rates, deaths and hospitalizations when this order was adopted in November. Today, our hospitals continue to face critical healthcare worker staffing shortages and troubling bed capacity numbers. Our teams on the front lines are exhausted as this second surge continues; we never truly recovered from the first. Now, data is indicating slight declines in COVID-19 emergency department visits, daily admissions and total hospitalizations. As physicians, we’re telling you: these measures are working. 

We urge Michiganders to continue taking preventive measures — stay home whenever possible, wear a mask, maintain at least six feet of distance from others, avoid crowds (especially indoor spaces where masks are removed), do not congregate with people other than those from your own household, get your flu shot and wash your hands frequently. Urge your friends, family and acquaintances to do the same.

Those of us working in hospitals are members of your community. We are your neighbors and friends. We have families and holiday traditions of our own that we’re missing, too. With vaccines now in sight, nobody wants to see the progress of the last three weeks go to waste.

All of us wish this holiday season could be normal. The reality is, this year is a time to focus on giving others, and yourself, the gift of health. That’s something we can all celebrate together in 2021.  

OBRA Online System Implementation Delayed

The Michigan Department of Health and Human Services Office of Specialized Nursing Home/Omnibus Budget Reconciliation Act (OBRA) Programs has delayed the implementation of the online system for submitting forms 3877 and 3878 regarding the discharge of certain patients to a skilled nursing facility, inpatient rehabilitation facility or other post-acute care location. The OBRA office intends to allow hospital organizations to test the new online system beginning Nov. 12 and fully implement the e-file system Jan. 19. Statewide registration for the electronic system is scheduled to begin Jan. 4, prior to the Jan. 19 go-live date.

The MHA will begin working with members soon to assist with implementation. For more information, contact Vickie Kunz at the MHA.

MHA Joins Public Health Officials in Urging Residents to Prevent COVID-19 and Flu

MDHHS

The MHA joined the Michigan Department of Health and Human Services (MDHHS) and the Michigan Association for Local Public Health at a press conference Oct. 13 to provide COVID-19 data updates and urge residents to step up their efforts to prevent both COVID-19 and the flu to avoid a simultaneous surge that could be disastrous for Michigan communities and the healthcare delivery system.

At the event, Dr. Joneigh Khaldun, MDHHS chief medical executive and chief deputy director for health, reviewed current COVID-19 data and trends that show Michigan COVID cases trending upward in all regions of the state (89 cases per million people per day) despite positive momentum in testing numbers (30,000 average daily tests). The top areas of outbreak continue to include nursing home/long-term care facilities, K-12 schools, colleges/universities and social gatherings. Khaldun noted that, as the colder months and flu season have arrived, this concerning jump in cases can be reversed if best practices are followed to slow the spread of COVID-19.

“State and local public health officials have been concerned about the risk of a surge in cases in the fall, and this recent increase should remind us all to refocus on preventing the spread of COVID-19,” said Nick Derusha, president of the Michigan Association for Local Public Health. “Wearing masks, practicing social distancing, washing our hands, and participating in contact tracing with public health officials are proven, effective ways to slow the spread of this virus.”

The MHA focused on hospital trends, noting COVID-19 hospitalizations have surged more than 80 percent in recent weeks, and the risk of a capacity crisis could overwhelm the state’s healthcare system without the cooperation of the public to step up efforts preventing COVID-19 and the flu.

“At the height of the COVID-19 response in Michigan, our front-line hospital workers were working around the clock to treat COVID-19 patients. As we see cases on the rise again and more hospital beds with patients than we have in weeks, we must remember what mask wearing and social distancing does: it prevents cases, it prevents hospitalizations and it prevents deaths,” said Brian Peters, chief executive officer of the MHA.

MHA CEO Report – Preventing a Flu Surge

MHA Rounds Report - Brian Peters, MHA CEO

“Health care is vital to all of us some of the time, but public health is vital to all of us all of the time.” C. Everett Koop

MHA CEO Brian PetersThe mission of the MHA is to advance the health of individuals and communities. I have never been prouder of that mission than I am today and of how that mission is being fulfilled by the hospitals and health systems throughout our state that are truly on the front lines of the COVID-19 pandemic. Our association has been in constant daily contact with the amazing men and women who work in those hospitals and health systems, and it is from that unique perspective that we are very concerned about the potential for a COVID-19 surge at the same time as an influenza surge here in Michigan later this year. In that scenario, many of our hospitals could potentially fill to capacity — a scenario that we have seen earlier this year in several communities throughout Michigan.

Looking back at the 2019-2020 influenza season, we had 952 flu-related hospitalizations in Michigan and, tragically, six pediatric deaths. Without question, this is deadly serious business.  But the good news is that we can avoid that same scenario if we take strong actions today.

Everyone is speculating today when we’ll have an approved and widely available vaccine for COVID-19. When you talk about the flu, the reality is that tool already exists in our toolbox. We know that flu vaccines work. From the perspective of the MHA and our hospitals and health systems, we know that flu vaccines have been proven to reduce the risk of hospitalization for both children and adults, which is validated by a wide range of peer-reviewed literature. The bottom line is, the science is clearly with us.

As we enter the 2020-2021 flu season, we have strengthened our partnership with the Michigan Department of Health and Human Services (MDHHS) in several ways. Last year, just over 30% of Michiganders received an influenza vaccine. This is why we’re proud to support the MDHHS Facing the Flu Together statewide public awareness campaign, which seeks to increase flu vaccination rates in Michigan by at least 33% this year. In addition, all hospital and health system CEOs received a letter last month co-signed by myself and Dr. Joneigh Khaldun, chief medical executive and chief deputy director for health at the MDHHS, outlining how hospitals can help increase influenza vaccines this year across Michigan.

The first ask is urging all hospitals to use both existing and innovative outreach modalities to offer the flu vaccine to their communities. That could include mobile clinics, emergency departments and outpatient facilities. In addition, new drive-thru testing sites for COVID-19 organized and funded by our member hospitals are perfect opportunities to deliver the flu vaccine to the public.

We’re also asking our hospitals to mandate and provide flu vaccine to all healthcare personnel. The vast majority of our members have had mandatory flu vaccine policies in place for front-line caregivers. We’d like to expand that to all employees of our hospitals and health systems because they can easily come in contact with those front-line caregivers, not to mention families, friends and others. Think about the fact that hospitals in Michigan employ over 230,000 individuals, and it is clear that we have the opportunity as employers to lead by example in this way.

Finally, we’re urging our members to amplify public messaging to lift the importance of flu vaccines this fall. The MHA works with I Vaccinate, the Alliance for Immunizations in Michigan, the Parent Information Network and others to measure, educate and promote appropriate vaccinations for all Michigan residents. This communications work is now more important than ever.

Rest assured that the MHA and our membership are actively engaged as we continue to combat COVID-19 and the flu in Michigan. We ask our fellow Michiganders to do all they can to help. 

As always, I welcome your thoughts.

Combating the Novel Coronavirus (COVID-19): Week of Sept. 14

MHA Covid-19 update

The MHA continues to keep members apprised of developments affecting Michigan hospitals during the pandemic through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

HHS Instructs States to Submit Plans for COVID-19 Vaccine Distribution

The U.S. Department of Health and Human Services (HHS), in partnership with the Centers for Disease Control and Prevention (CDC) and Department of Defense, Sept. 16 announced its preliminary strategy for COVID-19 vaccine distribution and planning. The announcement included a CDC playbook for states to use to create their COVID-19 vaccine plans, which they must submit to the HHS no later than Oct. 16. The guide recommends states develop COVID-19 vaccine stakeholder committees to guide their work; these committees should include hospital representation — particularly from rural facilities — among other key stakeholders.

The MHA is reviewing the CDC guidance and will share additional details with members in the coming days. The association is also contacting the Michigan Department of Health & Human Services (MDHHS) to ensure the MHA can provide hospital input as the department begins to create a plan for Michigan. Once the MHA has obtained some initial detail from the MDHHS, the association expects to request member input on operationalizing the vaccine distribution process.. Members with questions may contact Ruthanne Sudderth at the MHA.

Study Released on COVID-19 and Antibiotics Use During Hospitalizations

The University of Michigan Institute for Healthcare Policy & Innovation recently published a study about overuse of antibiotics in hospitalized COVID-19 patients in Michigan. The study was published in Clinical Infectious Diseases and included a sample of 1,705 patients from 38 Michigan hospitals.

The study found that more than half of COVID-19 patients treated in Michigan hospitals in the spring received antibiotics soon after admission, in case they had bacterial infections in addition to suspected COVID-19 infection. However, the study showed that 96% of those who received antibiotics were found not to have a bacterial infection.

The study also notes the importance of rapid-turnaround testing for both COVID-19 and bacterial infections in these patients to guide appropriate antibiotic use, reduce antibiotic-related side effects, and lower the incidence of drug-resistant “superbugs.”

MHA Supporting MDHHS “Spread Hope, Not COVID” Campaign

A new public education campaign launched Sept. 14 by Michigan public health officials urges all Michiganders to unite to contain the spread of COVID-19 so the state’s economy, schools and communities can safely reopen – and stay open. 

The “Spread Hope, Not COVID” campaign includes a coalition of about 50 of Michigan’s leading healthcare, business, education, community, manufacturing, tourism, senior citizen, labor, faith-based and public safety organizations — including the MHA — and is led by the MDHHS. The campaign calls on all Michiganders to join together to “Spread Hope, Not COVID” by taking actions that will significantly reduce the spread of the virus, including wearing masks, washing and sanitizing hands, practicing physical distancing and more.

The campaign will communicate with residents through broadcast, outdoor, social and digital media and the news media. The campaign’s messaging is based on a survey of 2,047 Michigan residents ages 18 and older conducted July 8-13. The “Spread Hope, Not COVID” campaign includes facts about mask-wearing and details about the other simple behaviors Michiganders must take together to control the virus. 

As part of the coalition, the MHA released a statement of support for the campaign. MHA-member organizations are encouraged to join the MDHHS and the coalition in helping to disseminate campaign materials throughout their communities. An initial set of communications tools is available for social media channels, websites, newsletters, internal and external emails, and more. Members with questions may contact Ruthanne Sudderth at the MHA.

COVID-19 Antigen Testing – Classification of Positive Results

During a recent MHA call with hospital laboratory directors, a question was raised regarding positive test results for an antigen test. The MHA has since confirmed with the state that, while a positive antigen test result is labeled as a “probable” case in the state’s overarching numbers, these cases are treated as confirmed for public health. As such, contract tracing for these cases will be conducted as they are for any other COVID-19 positive test result. Members with questions may contact Brittany Bogan at the MHA.

Hospitals Offered Alternative Source for Approved N95 Respirators

During a recent call that the MHA hosted with hospital supply chain managers, the group discussed Adaptive Energy, a local Michigan company that is offering an alternative supply chain source for approved N95 respirators.

Adaptive Energy is offering potential buyers a reliable, trusted domestic source of N95s at competitive prices, with no stock allocation limits. While Adaptive Energy is not seeking actual contracts at this time, it would like to hear directly from buyers if they would be interested in these domestic N95s. This will inform the company’s decisions for launching this business. To learn more or to offer a verbal intent to purchase, contact Adaptive Energy CEO Mike Edison. To obtain a copy of the specifications sheet for these supplies or for additional information, contact Rob Wood at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members: