As Michigan begins the third year of living with COVID-19, new cases, hospitalizations and deaths are trending downward and hopes are high that a new variant will not emerge to cause another surge of disease. The state reported there were 2,770 cases recorded for March 17 and 18 (including about 825 cases attributable to older lab results), 648 adults and children were hospitalized with confirmed and suspected cases, and 50 deaths caused by the disease were recorded over the two-day period. These numbers are fractions of what was seen in December and January, when Michigan hospitals were at or near inpatient capacity.
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.
MIOSHA Will Not Increase COVID-19 Inspections of Healthcare Facilities
Barton Pickelman, director of the Michigan Occupational Safety and Health Administration (MIOSHA) within the Department of Labor and Economic Opportunity, has confirmed that MIOSHA will not be conducting additional, focused, COVID-19 compliance inspections of healthcare facilities in Michigan. Although a March 2 memo issued by the federal Occupational Safety and Health Administration (OSHA) announced a 90-day COVID-19-focused inspection initiative for hospitals and skilled nursing care facilities, Pickelman noted that MIOSHA and other state plans are not required to adopt the federal OSHA initiative. Because MIOSHA has already conducted state emphasis programs for healthcare over the past two years, it is not adopting the federal inspection initiative.
Separate from the OSHA inspections, surveyors from the Michigan Department of Licensing and Regulatory Affairs (LARA) will continue to check for compliance with requirements of the Centers for Medicare & Medicaid Services and state licensing agencies during regular survey visits or in response to specific complaints. LARA will confirm that facilities have written policies and protocols in place surrounding COVID-19 screening processes, are following their policies as written, and that these policies and protocols can allow either active or passive screening procedures, consistent with guidance from the Centers for Disease Control and Prevention (CDC).
MHA Creates State/Federal COVID-19 Guidelines Tracker for Providers
To help hospitals and health systems keep track of COVID-19 guidelines, the MHA has developed a document outlining state and federal COVID-19 protocols for healthcare personnel, including vaccination, masking and COVID-19 testing guidelines from both the CDC and the Michigan Department of Health & Human Services (MDHHS). The downloadable tool can be found on the MHA’s website on the COVID-19 webpage under Resources for Healthcare Professionals. Those with questions may contact Lucy Ciaramitaro at the MHA.
The state of Michigan held a press conference Jan. 11 to discuss the rapid rise in case numbers, hospitalizations (especially pediatric hospitalizations) and positivity rates. Speakers urged all residents who are eligible to be both vaccinated and boosted as quickly as possible. Representatives from Children’s Hospital of Michigan joined the event to discuss the concerning rise in childhood case rates and hospitalizations.
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.
The U.S. Supreme Court issued decisions Jan. 13 on the Centers for Medicare & Medicaid Services (CMS) and Occupational Safety and Health Administration (OSHA) vaccine mandates. As expected, the court blocked the Biden administration from enforcing the vaccine or test mandate issued under OSHA, but upheld the ability of the CMS to enforce the healthcare worker vaccine mandate.
The Supreme Court has repeatedly upheld the constitutionality of state vaccine mandates in a variety of settings, as well as mandates by private employers. These challenges were different because they presented the question of whether Congress had authorized the executive branch to institute the requirements through the agencies of OSHA and the CMS/Department of Health and Human Services.
Michigan was not one of the 26 states covered by the court injunction to the CMS mandate, and Michigan has no other state-issued prohibitions on enforcing federal or private vaccine mandates. Hence,the mandate and enforcement move forward. The currently posted deadline for completing the first required vaccine dose is Jan. 27, and the second dose is required by Feb. 28. Boosters are currently not part of the mandate.
The MHA responded to a number of media inquiries following the Supreme Court announcement, including from The Detroit News, Detroit Free Press and MiBiz. The association reiterated its long-standing position that mandates of this kind should be left up to local healthcare decision-makers and that hospitals and the MHA have always urged every resident who is eligible to get vaccinated to protect themselves and others. The MHA also stressed that, while the small number of hospital workers who have already ended their employment due to an organization’s mandate did not necessarily worsen the existing staffing shortages, the timing of a nationwide mandate amid this omicron surge could not be worse, as the shortages are more serious than ever. The association assured reporters that hospitals will proceed with compliance and that the MHA and its members will continue to strenuously advocate for staffing assistance from federal and state partners.
Members with questions about deadlines, enforcement or other elements of the mandate are encouraged to review the posted CMS guidance to ensure their organizations are prepared to comply.
MIOSHA: Hospitals May Currently Use CDC Quarantine Guidance Without Penalty
The MHA has continued to work with state regulators on securing updated guidance for hospitals and health systems as it relates to worker quarantine periods. Federal Occupational Safety and Health Administration (OSHA) rules have not yet been fully rescinded to allow for healthcare settings to confidently follow new, less restrictive Centers for Disease Control and Prevention (CDC) quarantine guidance.
However, the Michigan Occupational Safety and Health Administration (MIOSHA) has stated it was told OSHA is in the process of withdrawing the relevant rules and the state agency is preparing to update its rules to align with the revised federal rules. MIOSHA also indicated that, until updates are made at the federal and state levels, it will not issue citations specifically regarding quarantine and isolation requirements if an employer were following the Dec. 23, 2021, updated CDC guidance for healthcare personnel.
An existing OSHA provision recognizes the CDC’s ‘‘Strategies to Mitigate Healthcare Personnel Staffing Shortages.’’ This guidance allows elimination of quarantine for certain healthcare workers as a last resort if the workers’ absence would mean there are no longer enough staff to provide safe patient care, specific other amelioration strategies have already been tried, patients have been notified, and workers are using additional personal protective equipment at all times.
The MHA will continue to keep members apprised of developments on this issue. Members with questions may contact Laura Appel at the MHA.
Long-term Care Facility Capacity for COVID Care Increases
Michigan now has 50 Tier-2 COVID-19 Relief Facilities (CRFs) able to take COVID-19 patients from hospitals at discharge if their normal nursing facility isn’t able to accommodate them. This is an increase from just 27 CRFs late in 2021 and includes an Upper Peninsula facility in Hancock.
In addition, Michigan now has nine facilities designated as Care and Recovery Centers (CRC)s, including one in Escanaba in the Upper Peninsula.
The CRC and the CRF programs were established under Michigan Public Act 231 of 2020. These programs were designed to ensure Michigan’s nursing homes were prepared to provide care to individuals who have tested positive for coronavirus under transmission-based precautions within the guidelines and best practices from the Centers for Disease Control and Prevention. Michigan’s nursing homes must be reviewed by the Michigan Department of Health and Human Services (MDHHS) to ensure they meet the minimum criteria outlined within the legislation and associated MDHHS policies. Members with questions may contact Paige Fults at the MHA.
Red Cross Declares First Ever National Blood Supply Crisis
The American Red Cross declared a national blood supply shortage and operational crisis Jan. 10. This is the first time such a crisis has been declared, and it could impact hospitals’ ability to provide certain types of care or transfusions in the coming days and weeks. This is a result of the current COVID-19 surge causing canceled donation appointments, Red Cross staffing shortages and more.
The Red Cross chief medical officer sent a notification directly to hospital transfusion leaders outlining these operational challenges and how to plan for expected shortages. The Red Cross also urged the public to donate blood as soon as possible.
The MHA will be amplifying to the public the need for blood donors through its social and traditional media channels.
Michigan Sees Surge in Unemployment Fraud
Michigan has seen a recent surge in unemployment fraud claims, according to the MHA Unemployment Compensation Program (MHA UCP). The increase in unemployment fraud is related to identity theft that occurs when the state Unemployment Insurance Agency (UIA) system is penetrated. Over the past several weeks, the MHA UCP has seen fraud in about 15 to 20% of all new claims for its clients.
The MHA UCP has worked closely with the UIA on this issue and has mitigated the impact for clients, who have not been assessed charges on these claims. To learn more about the services available through the MHA UCP, contact Neil MacVicar at the MHA.
As Michigan begins the third year of living with COVID-19, new cases, hospitalizations and deaths are trending downward and hopes are high that a new variant will not emerge to cause another surge of disease. The state reported there were 2,770 cases recorded for March 17 and 18 (including about 825 cases attributable to older lab results), 648 adults and children were hospitalized with confirmed and suspected cases, and 50 deaths caused by the disease were recorded over the two-day period. These numbers are fractions of what was seen in December and January, when Michigan hospitals were at or near inpatient capacity.