Media Recap: SCOTUS Dobbs Decision, State Budget and Rural Hospital Challenges

Brian Peters

The MHA received media coverage on a variety of topics during the weeks of June 27 and July 4. Areas of focus included the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women’s Health, the passage of the fiscal year 2023 state budget and challenges facing small and rural hospitals.

The MHA shared a statement with media following the SCOTUS decision that repealed Roe v. Wade. Outlets that included comment from the MHA in their stories included the Detroit Free Press, Bridge and Gongwer.

The passage of the state budget the morning of July 1 by the Michigan Legislature was celebrated by MHA CEO Brian Peters in a media statement that outlined the existing MHA budget priorities that continue to be protected as well as significant new funding to support behavioral health capacity and the healthcare workforce. MLive, MiBiz, The Center Square and Gongwer carried portions of the statement.

Renewed attention was brought to financial challenges faced by small and rural, particularly independent, hospitals due to a legislative request for funding from Sturgis Hospital as the organization pursues the possibility of converting to the new rural emergency hospital designation through the Centers for Medicaid and Medicare Services. MiBiz and Bridge published articles that include reaction from the MHA following assistance the association made in the legislative ask that secured $11 million for Sturgis Hospital.

Members with any questions regarding media requests should be directed to John Karasinski at the MHA.

Fiscal Year 2023 State Budget Advances Health of Individuals and Communities

Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association. *The budget has since been signed by Gov. Whitmer on July 20, 2022.

Brian PetersThe fiscal year 2023 state budget approved by the Michigan Legislature provides necessary resources to assist hospitals and health systems in advancing the health of individuals and communities throughout our state. We appreciate the work and consideration placed by lawmakers that continues to protect hospital priorities.

These priorities include maintaining funding for the Healthy Michigan Plan, graduate medical education of physician residents, disproportionate share hospitals which treat the highest numbers of uninsured and underinsured patients, the rural access pool and obstetrical stabilization fund, and critical access hospital reimbursement rates which all support access to healthcare services in rural areas. Each of these areas are instrumental to keeping hospitals financially secure, particularly in areas serving vulnerable and underserved populations.

We are also extremely happy to see new funding to improve and enhance state behavioral health facility capacity and to address the healthcare workforce. Michigan lacks adequate capacity to treat patients with behavioral and mental illness and this new funding is an important and necessary step to address the shortage. The investment of state funds to expand access to bachelor of science in nursing degree programs at the state’s community colleges is a significant movement towards replenishing Michigan’s healthcare talent pipeline.

We look forward to a signed budget that provides the resources necessary for hospitals and health systems to care for all Michiganders.

Prior Authorization, Statewide Broadband Efforts Advance to Governor

capitol building

capitol buildingDuring the week of March 21, the Michigan Legislature advanced several bills related to MHA priorities, including legislation to change the prior authorization process for commercial insurers, expand the Essential Health Provider Loan Repayment Program, and to provide supplemental appropriations to implement statewide broadband. Hospital testimony was also provided to the House Health Policy Committee on the ongoing staffing crisis for Michigan hospitals.

Senate Bill (SB) 247, which would decrease wait times for commercial insurance prior authorization requests, is now heading to Gov. Gretchen Whitmer’s desk for signature. Introduced by Sen. Curt VanderWall (R-Ludington), the legislation would shorten the timeline for approval to seven calendar days, or 72 hours for urgent requests, as well as ensure that emergency care can be provided without prior approval. Both the House and Senate voted during the week of March 21 to advance the bill before legislative spring break. The MHA provided testimony in support in both chambers and has shared a letter with the governor encouraging her to sign the bill.

The governor March 24 signed SBs 246 and 435 into law, which will expand the allowable use of the Essential Health Provider Loan Repayment Program. The two MHA-supported bills would increase the total allowable repayment from $200,000 to $300,000 and make certain mental health professionals eligible for the program. An MHA-proposed amendment to SB 435 was added in the House that will extend the sunset on the Physician Licensure Compact, which was set to expire March 28. More information on the program is available on the Michigan Department of Health and Human Services website.

The Michigan Legislature passed SB 565, sending the $4.7 billion supplemental appropriation bill to the governor for signature. The new spending was infrastructure focused, including $250 million and eight new full-time positions for the Michigan High-Speed Internet Office (MIHI). The MHA supports the MIHI funding, which will help Michigan take advantage of available federal funding to ensure access to reliable broadband for telehealth.

In the House Health Policy Committee, Julie Yaroch, DO, president of the Charles and Virginia Hickman Hospital, spoke to members on behalf of the MHA about the ongoing staffing crisis. Yaroch shared how the shortage is directly impacting her hospital, as well as the data from the most recent MHA survey that revealed there are 50,000 open positions across the state, with an average hospital vacancy rate of 16.6%. She told the committee that “staffing shortages took an average of 1,200 beds offline during the most recent surge, which in terms of bed capacity is equivalent to pulling the entire U of M Health System offline.”

Questions regarding state legislation affecting healthcare should be directed to Adam Carlson at the MHA.

Behavioral Health Funding, Essential Health Provider Program Expansion is Advanced

capitol building

capitol buildingThe Michigan Legislature acted on several pieces of legislation impacting hospitals during the week of Feb. 28. Some of the covered topics included behavioral health funding, streamlining prior authorization requests, increased penalties for assaulting healthcare workers, expanding the essential health provider loan repayment program and changes to non-opioid directive forms.

In the Senate, the supplemental funding bill that includes the MHA’s request to support behavioral health was discharged from the Senate Appropriations Committee to the Senate floor. Senate Bill (SB) 714, introduced by Senate Majority Leader Mike Shirkey (R-Jackson), would appropriate a total of $539 million and includes several MHA-supported one-time line items for behavioral health. Included in the supplemental bill is $100 million in infrastructure grants for pediatric inpatient psychiatric services, $20 million in infrastructure grants for hospital behavioral health intake enhancements, $25 million to prepare for the expansion of the essential health provider loan repayment program, and $30 million to expand the state’s apprenticeship program for new behavioral health staff. Shirkey’s SBs 597 and 598, which are related behavioral health bills that are also supported by the MHA, could receive a vote as early as the week of March 7.

In the House Health Policy Committee, testimony was taken on SB 247, which would make changes to decrease wait times for commercial insurance prior authorization requests. Introduced by Sen. Curt VanderWall (R-Ludington), the legislation would shorten the timeline for approval to seven calendar days, or 72 hours for urgent requests, as well as ensure that emergency care can be provided without prior approval. The MHA supports the bill and provided written testimony to the committee March 3. A committee vote has not yet been held.

On the House floor, representatives voted in favor of SBs 246 and 435, which would expand the allowable use of the Essential Health Provider Loan Repayment Program. The two bills would increase the total allowable repayment from $200,000 to $300,000 and allow for certain mental health professionals to also be eligible for the program. An MHA-proposed amendment to SB 435 was added in the House that would extend the sunset on the Physician Licensure Compact, which is set to expire March 28. The bill now heads back to the Senate for a concurring vote before being sent to the governor for signature. The MHA supports the bills and will continue to apprise members of any related action in the coming weeks.

The House Government Operations Committee voted in support of legislation to increase penalties for assaulting healthcare employees. House Bill (HB) 5682, introduced by Rep. Mike Mueller (R-Linden), went through several changes in committee, with the language now doubling the fines for assaulting a healthcare employee or volunteer in any care setting. HB 5682 would also require the posting of signage in hospital emergency rooms to deter potential assaults. The MHA has developed example signs that are available to Michigan hospitals free of charge. The MHA-supported bill will now go to the House floor for a full vote.

The Senate Health Policy and Human Services Committee reported another MHA-supported bill that was introduced by Rep. Abdullah Hammoud (D-Dearborn). HB 5261 would create specific exemptions for providers to administer opioids to a patient who has an active non-opioid directive form if the medications are provided during a surgical operation or the provider deems the opioids medically necessary. The bill now awaits a vote on the Senate floor.

Members with questions on state legislation related to healthcare should contact Adam Carlson at the MHA.

Media Recap: Auto No-fault & Crain’s Detroit Business Coverage

MHA CEO Brian Peters

The MHA received media coverage the week of Feb. 21 on efforts to amend Michigan’s auto no-fault law and from Crain’s Detroit Business advocating for state funding support for midsize vital hospitals and behavioral health.

The MHA sent a memo Feb. 16 to the Michigan House of Representatives encouraging the Legislature to focus on improving the auto no-fault law, including quickly addressing payment issues with post-acute care providers, including a proper definition of Medicare rates, and clarifying that the reimbursement rates outlined in law were intended to be minimum amounts. The Detroit News and Michigan Radio published stories on the memo, which was signed by Adam Carlson, senior vice president, advocacy.

Adam Carlson
MHA Senior Vice President Adam Carlson

“Numerous cases have occurred of patients being transferred to hospitals who did not otherwise need hospitalization because of a lack of long term post-acute care providers to care for them in their home or an appropriate facility,” said Carlson. “In addition, it has become increasingly difficult to transfer patients to post-acute settings as the number of providers and staff has diminished. Both of these circumstances is putting unsustainable pressure on hospitals that don’t have the beds or staff to care for patients who shouldn’t be in the hospital.”

Crain’s Detroit Business also published their latest Forum edition, which includes several pieces of content relevant to Michigan hospitals. An article published Feb. 25 reviews the significant challenges facing midsize vital hospitals, particularly independent hospitals not affiliated with a larger health system. MHA CEO Brian Peters is quoted in the article discussing the financial issues impacting those hospitals. Supporting the article is an op-ed submitted by Hillsdale Hospital President and CEO Jeremiah J. Hodshire.

MHA CEO Brian Peters
MHA CEO Brian Peters

“The volume-based approach to reimbursement has always been a problem and that doesn’t go away,” said Peters.

Crain’s also published an op-ed from Peters encouraging more state funding investments to address Michigan’s broken and fragmented behavioral health system.

“The MHA believes an appropriation to fund additional support for pediatric behavioral health, a grant pool to improve behavioral healthcare in emergency departments and recruitment support for behavioral health providers will have significant and lasting improvements in access to care and quality,” said Peters. “This appropriation will help address a major barrier to improving access right now, which is the lack of appropriately trained and educated behavioral health providers available in Michigan to serve our population. It would also help modify the way emergency departments are prepared to temporarily care for patients in behavioral health crises — especially Michigan’s children.”

Members with any questions regarding media requests should be directed to John Karasinski at the MHA.

Healthcare Priorities Protected, Workforce Sustainability Addressed in Executive Budget

MHA CEO Brian Peters

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

Crucial healthcare funding sources remain protected in the fiscal year 2023 executive budget recommendation. We’d like to express our gratitude toward Gov. Gretchen Whitmer and her administration for their commitment supporting rural and critical access hospitals, graduate medical education, the Healthy Michigan Plan and Michigan’s Medicaid population.

Our hospitals are also experiencing a staffing crisis that requires multiple solutions. We are thrilled to see programs that would improve retention and recruitment of healthcare workers. The proposed Hero Pay recognizes the tremendous dedication and sacrifice of healthcare workers throughout the pandemic, while the talent pipeline will be expanded through additional investments in medical education and reviewing potential licensing flexibility for foreign-trained medical professionals.

Michigan’s behavioral health system is also stressed to its limits, and we’re encouraged to see a greater focus and financial resources toward providing potentially transformational improvements to the state’s behavioral health system that can address many of the challenges patients and families currently face.

We’d be remiss if we did not thank all lawmakers and state officials who have worked tirelessly over the past two years to provide relief and support to hospitals and health systems over the course of the pandemic. As we enter another budget cycle, we look forward to continuing to engage with the Michigan Legislature to advance the health of Michigan individuals and communities.

MHA Statement on Passage of Vital Healthcare Workforce Funding

Brian Peters

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

MHA CEO Brian PetersHospitals throughout all regions of Michigan are experiencing significant workforce shortages. The passage today of House Bill 5523 provides critically needed resources for recruitment and retention of healthcare workers to care for our communities. This funding is vital to assist hospitals and health systems in addressing high job vacancy rates, providing training and development, and supporting existing workers who have resiliently provided care for patients throughout the two years of this pandemic.

We’d like to express our gratitude to the Michigan Legislature for prioritizing this funding that will go directly toward Michigan healthcare workers. We encourage Gov. Whitmer to sign this bill as soon as it reaches her desk to bring urgently needed relief to our healthcare workforce.

MHA Statement on Passage of Senate Bill 759

MHA CEO Brian Peters

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

Brian Peters

The situation in Michigan hospitals is dire and the overwhelming support of Senate Bill 759 from the Michigan Legislature places into law another tool hospitals can use to address staffing shortages in the short-term. We appreciate the speed which lawmakers prioritized this bill and encourage Gov. Whitmer to sign this important piece of legislation so out-of-state providers who are in good standing and trained, educated, and experienced to provide medical care can continue to do so in Michigan without a Michigan-specific license.

Fiscal Year 2022 State Budget Protects Healthcare

MHA CEO Brian Peters

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

MHA CEO Brian Peters

The pandemic has challenged hospitals throughout the state and, on behalf of our members, we commend Gov. Whitmer for signing today a state budget that continues vital funding sources for our hospitals, increases support for direct care workers and ambulance services, and maintains extended Medicaid coverage for mothers up to 12 months postpartum. We extend equal appreciation to both the Legislature and Gov. Whitmer and her administration for passing a budget on time that maintains access to care throughout Michigan.

As our hospitals continue to face both a behavioral health and workforce crisis that is stressing hospitals to capacity, we look forward to continued discussions on how additional state and federal funding can be allocated through the supplemental budget process to secure support for transformational solutions

MHA Values Work of Michigan Legislature on FY 2022 State Budget

MHA CEO Brian Peters

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

MHA CEO Brian PetersOn behalf of Michigan hospitals and health systems, we value the work of the Michigan Legislature to pass a budget that protect MHA priorities that include fully funding the Healthy Michigan plan, the rural access pool, the obstetrical stabilization fund, and maintaining rate increases for Medicaid and critical access hospitals. We also commend the legislature for expanding postpartum coverage to a full year for mothers on Healthy Michigan. However, more work remains, particularly to address the behavioral health crisis in Michigan. We look forward to working with the legislature through the supplemental appropriations process to secure transformational behavioral health solutions.