ANA-MI Opposes Mandated Nurse Staffing Ratio Legislation

The American Nurses Association – Michigan (ANA-Michigan) publicly announced their opposition Oct. 11 to Senate Bill 334 and House Bill 4550, which require state mandated ratios for hospital nurses.

The ANA-MI joins the MHA and the Michigan Organization for Nursing Leadership (MONL) in publicly opposing a one-size-fits-all state mandate. ANA-MI is a statewide professional nursing association with over 3,000 members, representing the needs and interests of all nurses. It has been a long-standing advocate for nurses to have safe staffing assignments while ensuring the safety of Michigan patients.

“ANA-Michigan wishes to empower all nurses in our state to be part of the conversation on safe staffing and how best to address it,” said Bridget Leonard, DNP, MBA-HCM, RN, CRRN, NEA-BC, president of ANA-MI. “We cannot address a long-standing problem across the continuum of care with a one-size-fits-all solution.”

ANA-MI emphasized staffing levels should depend on the following factors:

  • Patient complexity, acuity, or stability.
  • Number of admissions, discharges, and transfers.
  • Professional nurses’ and other staff members’ skill level and expertise.
  • Physical space and layout of the nursing unit.
  • Availability of technical support and other resources.

“Addressing safe staffing is a complex process that should not be handled legislatively or without the input of nurses,” said Barbara Medvec, DNP, MSA, MSN, NEA-BC, President-Elect of ANA-Michigan. “If that’s the route, we’re setting ourselves back before we can put one foot forward in the right direction.”

Bridge Michigan also published Oct. 10 an op-ed from MHA CEO Brian Peters expressing the MHA’s opposition to the legislation and the need to support new and existing solutions that support nurses and maintain access to quality healthcare for all Michiganders.

Members with any questions related to the legislation and advocacy efforts may contact Adam Carlson or Elizabeth Kutter at the MHA. Members with questions regarding media or requesting additional communications tools should contact John Karasinski at the MHA.

MHA Podcast Explores Harmful Nurse Staffing Legislation

MI care matters
Kim Meeker, RN, BSN, MBA, president of the Michigan Organization for Nursing Leadership (MONL).

The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities.

On episode 31, MHA CEO Brian Peters and Kim Meeker, RN, BSN, MBA, president of the Michigan Organization for Nursing Leadership (MONL), discuss a recent package of bills introduced in the Michigan Legislature that could severely harm hospitals and access to patient care, if passed.

Senate Bills 334 – 336 and House Bills 4550 – 4552 propose a one-size-fits-all nurse ratio staffing mandate. In a recent joint statement, the MHA and MONL noted how this approach would limit the number of patients receiving hospital care at any one time and services hospitals can offer to their communities, prolong the time it takes for a patient to receive care and hinder many hospital’s ability to respond to a crisis in fear of violating Michigan law.

Throughout the episode, Peters and Meeker explain exactly what this could look like for Michigan nurses and patients while addressing false claims that the bills will help nursing shortages in Michigan – noting more effective solutions, including:

  • Michigan joining the national Nurse Licensure Compact to reduce barriers for out-of-state nurses to move to and practice in Michigan immediately.
  • 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 episode is available to steam on SpotifyYouTubeApple Podcasts and SoundCloud. Those interested in learning more or connecting with local lawmakers on this issue are encouraged to visit the MHA’s Legislative Action Center.

Note: Each interview in this episode was recorded prior to the passing of the legislative fiscal year 2024 state budget. To see MHA CEO Brian Peters statement on new healthcare funding, visit the MHA Newsroom. Additional resources mentioned include the MHA Keystone Center and Duke Center for Healthcare Safety and Quality WellB program and the MI Hospital Careers webpage.

The MiCare Champion Cast is part of the statewide #MiCareMatters campaign, launched in 2017, which aims to build a network of citizens — “MiCare Champions” — who will be called upon to engage in advocacy efforts to protect access to affordable healthcare services in Michigan. Members with questions or who would like to submit ideas for future podcasts should contact Lucy Ciaramitaro at the MHA.

Harmful Nurse Staffing Legislation Introduced in Michigan Legislature

capitol building

capitol buildingHarmful nurse staffing legislation was introduced May 11 in the Michigan Legislature that would mandate nurse staffing ratios, require public disclosure of the ratios and restrict mandatory overtime for nurses. The bill package is pushed by the Michigan Nurses Association (MNA) and was announced during a press conference with some of the bill sponsors.

A joint media statement was published by the MHA and the Michigan Organization for Nursing Leadership (MONL) immediately following the press conference to express each organization’s opposition to the legislation. The statement referenced the potential to severely harm hospitals and access to important services for patients if the bills become law. A statement was included in multiple media stories throughout the state.

The series of bills are even more harmful than prior versions. Changes for this session include:

  • Increasing the timeline for implementation from three years to two years for rural hospitals and one year for all other hospitals.
  • Removing a committee approach to establish staffing models, within statutory minimum staffing ratios. The new bills do not call for or allow for the establishment of a committee.
  • Increasing ratios from prior versions. The maximum allowance is now 1:4 in behavioral health, acute rehab, med/surg and post-partum.
  • Specifying ratios to only registered nurses (RNs). Prior versions referenced licensed practical nurses (LPNs) in the definition section, but these bills do not define LPNs and only specifically reference RNs only.

The bills introduced include:

  • Senate Bill (SB) 334 introduced by Sen. Sylvia Santana (D-Detroit).
  • SB 335 introduced by Sen. Stephanie Chang (D-Detroit).
  • SB 336 introduced by Sen. Jeremy Moss (D-Southfield).
  • House Bill (HB) 4550 introduced by Rep. Stephanie Young (D-Detroit).
  • HB 4551 introduced by Rep. Betsy Coffia (D-Traverse City).
  • HB 4552 introduced by Rep. Carrie Rheingans (D-Ann Arbor).

Several other bills saw action during the week. Members of the House Health Policy Committee voted to report legislation requiring drug manufacturers to report certain data and price changes to the state of Michigan. Introduced by Rep. Samantha Steckloff (D-Farmington Hills), HB 4409 would also be known as the Drug Manufacturer Data Reporting Act. The MHA sees this as an important step in providing transparency into the fastest growing expense for Michigan hospitals. For example, drug costs rose nationally by 36.9% between 2019 and 2021. This bill now heads to the House floor for further consideration.

On the Senate floor, a vote was held on Sen. Santana’s bill intended to increase access to vaccines and certain laboratory tests. SB 219 would allow pharmacists to order and administer immunizations and certain diagnostic tests for their patients without physician supervision. A new substitute was adopted on the floor, incorporating feedback from the MHA’s Pharmacy Management Committee. The new language removes unnecessary continuing medical education requirements for vaccinations, matching current standards. The MHA is supportive of SB 219, which the Senate passed by a vote of 36-1.

On the House floor, votes were taken on a package of bills that would allow Michigan citizens to designate themselves as an organ donor on state tax forms. Introduced by Rep. Felicia Brabec (D-Pittsfield Twp), Rep. Cynthia Neeley (D-Flint) and Rep. Natalie Price (D-Berkley), HBs 4362 through 4364 would provide for the question to be asked on tax forms starting in the 2023 tax year. The MHA is supportive of the legislation, which is being led by Gift of Life Michigan to reverse the decline in individuals signing up for the donor registry. Gift of Life Michigan testified in committee that states across the country are dealing with this decline, as the pandemic and online services have led to fewer trips to Secretary of State offices. The bills passed with bipartisan support and now move to the Senate.

Members with questions about state legislative action may contact Adam Carlson at the MHA.

Headline Roundup: Nurse Staffing Legislation & Staffing Shortages

Brian Peters

The MHA received media coverage the week of May 8 regarding nurse staffing legislation, healthcare worker shortages, the ending of the COVID-19 public health emergency and more. A joint media statement was published May 11 by the MHA and the Michigan Organization for Nursing Leadership (MONL) immediately following a press conference announcing legislation that would mandate nursing staffing ratios. The statement referenced the potential for the proposed bills to severely harm hospitals and access to important services for patients, if the bills become law.

MHA representatives appearing in published stories include CEO Brian Peters, Executive Vice President Laura Appel and Senior Vice President Sam Watson. MONL President Kim Meeker, RN, BSN, MBA, also appears in a collection of stories on the nurse staffing legislation. Below is a collection of headlines from around the state.

Friday, May 12

Thursday, May 11

Wednesday, May 10

Tuesday, May 9

Members with any questions regarding media requests should contact John Karasinski at the MHA.

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.

MHA Monday Report Sept. 26, 2022

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MHA Hosts Valuable Advocacy Events

The MHA participated in several advocacy events in September, providing opportunities for MHA members to share their experiences with both current and future decision-makers.

Several MHA staff helped lead a virtual advocacy event Sept. 9 for the Michigan Organization of Nurse Leaders (MONL). Nearly 100 nurse leaders and students from across the state gathered to discuss important issues facing nurses and advocate for legislative solutions. The Health Policy Committee Chairs of each chamber, Rep. Bronna Kahle (R-Adrian) and Sen. Curt VanderWall (R-Ludington), joined the group to provide legislative updates, outline future priorities and share their insight on the remaining legislative term.

Dr. Cynthia McCurren, dean of nursing at U-M Flint, and Brandy Johnson, president of the Michigan Community College Association, also joined the MONL event to provide an overview of a new model that will allow for community colleges to offer baccalaureate degrees in nursing. The new funding will go toward community college and university partnerships that will allow Associate Degree in Nursing graduates to pursue a Bachelor of Science in Nursing degree at a community college campus. Participants also received a crash course in how to advocate as a nurse and were able to earn 2.5 continuing education credit hours for their participation.

The MHA helped prepare Michigan’s next generation of leaders Sept. 16 and 17 by leading a Healthcare Weekend for the fellows of the Michigan Political Leadership Program (MPLP). The weekend event was held in Grand Rapids and organized in partnership with the Michigan Association of Health Plans (MAHP). The MPLP fellowship is made up of a diverse group of Democrats, Republicans and Independents from around the state who all have an interest in running for office.

The MPLP fellows received a Healthcare and Lobbying 101 from Dominick Pallone, executive director of the MAHP, and Marc Corriveau, vice president of government affairs at Henry Ford Health, as well as participated in a healthcare bill exercise designed to mimic health policy committee work. The fellows also visited Hope Network in Grand Rapids and learned directly from Megan Zambiasi, chief development officer of Hope Network, as well as Mark Eastburg, president and CEO of Pine Rest Christian Mental Health Services. Lastly, the MHA convened a lawmaker panel of Sen. Mark Huizenga (R-Walker) and Rep. Rachel Hood (D-Grand Rapids) to speak on how to run a successful campaign.

Brian Peters presenting Sen. Jim Stamas with his Special Recognition Award that was originally announced July 2022.

The MHA held Sept. 21 their first ever Rural Hospital Advocacy Day. Leaders from rural hospitals across the state joined MHA staff in Lansing to meet with lawmakers and share the unique challenges they are facing. MHA members were able to meet with lawmakers that are local to their hospital service areas, as well as key legislative and health policy committee leadership. The rural advocacy day came at an important time to impact decision making during lame-duck as the MHA expects several bills directly impacting rural hospitals to move before the end of the year. Some of the key issues discussed included continued hospital staffing challenges, preservation of the 340B drug pricing program and opportunities to address emergency department crowding through behavioral health investments at the state level. During the event, Sen. Jim Stamas (R-Midland) was also presented with his Special Recognition Award that was originally announced July 2022.

The events would not have been possible without the assistance of MHA partners and members who helped make these advocacy events a success. Members with questions about future advocacy days may contact Sean Sorenson-Abbott at the MHA.