Proposed Hospital Nurse Staffing Bills Harm Public’s Access to Healthcare

82% of Michigan Voters Oppose Mandated Hospital Nurse Staffing Ratios

The Michigan Health & Hospital Association (MHA) released data today illustrating strong public opposition to legislation proposing one-size-fits-all state mandated hospital nurse-to-patient staffing ratios and hospital survey data on the severe impact of the legislation on access to care for Michiganders.

A survey of 600 Michigan voters conducted by EPIC-MRA in August shows 82% of Michigan voters do not believe the government should mandate one-size-fits-all nurse-to-patient staffing ratios in every hospital, which is currently proposed in Senate Bills 334 – 336 and House Bills 4550 – 4552.

If the bills were to become law, 83% of Michigan voters would be concerned about their ability to receive care, or the wait times, in a Michigan hospital emergency room.

“These survey results are abundantly clear; Michigan voters have no appetite to remove hospital staffing decisions from clinical nursing leaders to implement an arbitrary one-size-fits-all mandate by politicians,” said MHA CEO Brian Peters. “Such a decision would be harmful to patients and have dire consequences for healthcare throughout the state. Our hospitals and health systems are focused on proven solutions to address staffing shortages that address the talent pipeline and retain existing nurses.”

The MHA also released the results from a survey of 109 Michigan hospitals conducted in July and August on the potential impact of the proposed legislation. Implementing staffing ratios will either require hiring 12,954 registered nurses or the state risks closing up to 5,074 hospital beds to comply. These results follow a survey of 95% of the MHA membership in March 2023 which found Michigan hospitals had 8,438 immediate openings for nurses amid a nationwide nursing shortage. The loss in hospital bed capacity is roughly equivalent to Michigan closing its six largest hospitals determined by licensed hospital beds.

“The significant and devastating impacts these bills can have on patient care and patient access make these the top concern for hospitals and health systems throughout our state,” said Shannon Striebich, MHA Board Chair and Ministry President and Senior Vice President of Operations at Trinity Health Michigan. “We value our nurses and are working diligently to offer recruitment and retention options that do not come at the expense of access to care for Michiganders.”

Hospital staffing decisions and nurse-to-patient ratios are currently made by nursing leaders in each individual hospital based on years of clinical experience and a complex set of variables. These decisions weigh a multitude of factors which vary from each hospital and community and can include the number of patients in a hospital unit, how sick each patient is, the training and experience level of nurses and other members of the care delivery team, available technology and existing hospital data and metrics.

“The decades of experience I have serving as a bedside nurse, nursing supervisor and in other nursing leadership roles inform decisions I make every day when it comes to helping create the best possible environment for our patients and our clinical team,” said Kelli Sadler, MHA, BSN, RN, senior vice president and chief nursing executive of Corewell Health in Southeast Michigan. “We should be able to determine the staffing ratios that best fit our communities. This legislation doesn’t address the real problem, which is a lack of nurses statewide.”

Hospitals remain committed to identifying tangible solutions to recruit more workers to healthcare careers and to retain existing healthcare workers. The actions by the MHA include:

  • Launching a statewide public awareness campaign in June 2023 targeting high school students and professionals considering a career change to express the value of healthcare careers.
  • Distributing a total of $300 million in state funding to at least 69,000 healthcare workers for the purposes of the recruitment, retention and training through Public Act 9 of 2022 and Public Act 5 of 2023.
  • Successfully advocating for additional nurse training opportunities including funding to incentivize four-year Bachelor of Science in Nursing programs at community colleges and the expansion of Michigan Reconnect to allow funds to support Michiganders in their healthcare career pursuits.

The MHA has also identified several public policy solutions that can be enacted today to help solve nurse staffing shortages. Those solutions include:

  • Michigan joining the national Nurse Licensure Compact to reduce barriers for out-of-state nurses to move to and practice in Michigan immediately, which is supported by 67% of Michigan voters according to the August EPIC-MRA survey.
  • Increasing eligibility for Michigan Reconnect by lowering the age requirement to 18 and older.
  • Expanding Michigan Reconnect availability to include 4-year institutions.
  • Increasing penalties for violence committed against healthcare workers.

The data was released as part of Hospitals for Patient Access Advocacy Day, which brought more than 130 hospital and nursing leaders to Lansing to meet with state lawmakers about nurse staffing shortages and access to care for Michiganders. More information can be found on the MHA nurse staffing ratios webpage.

Governor Signs New Budget Including Investments in Hospitals

capitol building

capitol buildingGov. Whitmer signed the fiscal year 2024 state budget Aug. 1, which includes $92 million in new investments directly to hospitals. It specifically provides $59 million to support increased Medicaid reimbursement rates at Level I and II trauma centers and $33 million to support an increase in Medicaid inpatient psychiatric reimbursement rates. The signed budget will go into effect Oct. 1.

In addition to the ongoing and targeted new investments, the agreement provides necessary resources to assist hospitals and health systems in advancing the health of individuals and communities throughout Michigan. It maintains funding for the Healthy Michigan Plan, Medicaid, graduate medical education, disproportionate share hospitals and the rural access and obstetrical stabilization pools.

The MHA is also pleased with new investments in workforce by lowering the age for Michigan Reconnect from 25 years to 21 years of age and investing $2.5 million to support recruitment and retention programs for behavioral health professionals. The budget also increases ongoing funding for the Michigan Achievement Scholarship, which provides significantly reduced tuition for many students at public universities.

Consistent with the strategic action plan of the MHA, the budget places a new emphasis on health equity and reducing disparities for maternal health care with specific, targeted new investments. Funding is included for the Michigan Alliance for Innovation on Maternal Health and $49.5 million for community health programs, healthy community zones, IT improvements and mobile health units to address racial disparities in health. Additionally, the budget further expands the Medicaid program by eliminating the five-year waiting period for pregnant and new mothers who are legally residing in Michigan.

Members with questions on the state budget may contact Adam Carlson.

MHA & MONL Issues Joint Statement on Harmful Nursing Legislation Introduced in the Michigan Legislature

Kim Meeker, RN, BSN, MBA, president of the Michigan Organization of Nurse Leaders.

The following joint statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association, and Kim Meeker, RN, BSN, MBA, president of the Michigan Organization for Nursing Leadership (MONL).

Kim Meeker, RN, BSN, MBA, president of the Michigan Organization of Nurse Leaders.
Kim Meeker, RN, BSN, MBA, president of the Michigan Organization of Nurse Leaders.

A package of bills announced today in the Michigan Legislature has the potential to severely harm hospitals and access to important services for patients, if ultimately passed. Proponents of the legislation falsely claim this will address nursing shortages in Michigan, but those claims couldn’t be further from the truth. Michigan hospitals are trying to fill 8,500 job openings for nurses. Instituting a one-size-fits-all mandate requiring hospitals hire more nurses who do not currently exist will limit the services hospitals can offer to their communities, prolong the time it takes for a patient to receive care and hinder the ability of hospitals to respond to a crisis in fear of violating Michigan law.

Tangible, proven steps are needed to attract more nurses to Michigan. Those include passing legislation that allows Michigan to join the Nurse Licensure Compact, expanding Michigan Reconnect eligibility and increasing penalties for those who commit acts of violence against healthcare workers.

Brian Peters
MHA CEO Brian Peters.

Michigan hospitals and health systems have been hard at work addressing nursing shortages over recent years. Those efforts include:

  • Obtaining a total of $300 million in state funding that has benefitted at least 69,000 healthcare workers for the purposes of the recruitment, retention and training through Public Act 9 of 2022 and Public Act 5 of 2023.
  • Securing additional nurse training opportunities including expanded state policy allowing four-year BSN programs at community colleges.
  • Expanding Michigan Reconnect to allow funds to support Michiganders moving from a licensed practice nurse (LPN) to a registered nurse, or from a patient care technician certificate to a LPN.
  • Modernizing the scope of practice for certified registered nurse anesthetists which allows flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources under Public Act 53 of 2021.
  • Providing emotional well-being support to healthcare workers through a partnership with the Duke Center for Healthcare Safety and Quality that has so far assisted 5,000 healthcare workers from 144 organizations throughout Michigan.

Nursing careers not only provide stable, well compensated jobs with a set of transferrable skills that rarely become obsolete, but in a rewarding environment that truly make a difference in the lives of the patients they serve. The MHA and our member hospitals and health systems, together with MONL, remain committed to focusing on effective solutions that support Michigan nurses and ensure safe patient care.

Executive Budget Recommendation Supports Hospitals & Healthcare Workforce

Brian Peters

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

Brian PetersGov. Whitmer and her administration demonstrated their commitment to protecting hospitals and supporting healthcare workers with the release today of the 2024 executive budget recommendation. Not only does it continue to protect vital funding pools in the state budget, but also provides health equity resources and includes significant workforce investments that should help grow the healthcare talent pipeline.

Important items included in the state budget include support for rural and critical access hospitals, obstetrical services, graduate medical education, the Healthy Michigan Plan and Michigan’s Medicaid population. The investments to expand the Healthy Moms, Healthy Babies program and to implement recommendations from the Racial Disparities Task Force should help improve health outcomes and reduce disparities in care. The announced workforce development investments such as lowering the eligibility age for Michigan Reconnect are long-term strategies that should help fill the incoming talent pipeline as staffing challenges continue to impact hospitals and their overall patient capacity.

Actions like today show Gov. Whitmer is a healthcare champion and on behalf of Michigan’s hospitals, we thank her for helping Michigan advance the health and wellness of individuals and communities. The MHA is committed to working with lawmakers throughout the budget process to identify funding solutions that expand access to care, protect the viability of hospitals and assist healthcare workers.

Peters Featured on Paul W. Smith Live from Lansing Broadcast

MHA CEO Brian Peters appeared on Detroit’s WJR News Talk Radio’s Paul W. Smith “Live from Lansing” show.

MHA CEO Brian Peters appeared on Detroit’s WJR News Talk Radio’s Paul W. Smith “Live from Lansing” show Jan. 26 as part of its annual coverage of legislative and policy issues facing the state the morning after Gov. Gretchen Whitmer’s State of the State address. The MHA sponsored the program, with the broadcast hosted at downtown Lansing’s Courtyard by Marriott.

As part of the program lineup, Smith spoke with Peters about the state of hospitals and the many challenges they face, including workforce sustainability, behavioral health and financial viability. Other notable interviewees during the event included Whitmer; Senate Minority Leader Aric Nesbitt (R-Lawton), Sen. Sam Singh (D-East Lansing) and Wayne County Executive Warren Evans.

The State of the State address the previous evening primarily focused on lowering costs for Michigan residents, economic development, expanding education opportunities and public safety and gun violence prevention. One specific item mentioned by Whitmer relevant to hospitals is the intention to reduce the age to qualify for Michigan Reconnect from 25 years old to 21. Doing so would increase the number of individuals eligible to pursue scholarships to qualify for scholarships to pursue high-demand healthcare credentials.

As a sponsor of the event, the MHA developed a 60-second message for airing before and during the broadcast. For more information, contact John Karasinski at the MHA.