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 CEO Report — Attracting Healthcare Talent

MHA Rounds Report - Brian Peters, MHA CEO

“Individual commitment to a group effort – that is what makes a team work, a company work, a society work, a civilization work.” Vince Lombardi

MHA Rounds Report - Brian Peters, MHA CEOTalent acquisition is always top of mind for all business leaders. Demand for workers now outpaces supply throughout the U.S., but particularly here in Michigan due to our demographic realities, including an aging baby-boom generation entering retirement in significant numbers. A recent presentation by Michigan Senate Fiscal Agency Chief Economist David Zin summarizes these challenges, as Michigan has the eleventh highest median age in the country, a metric which has been increasing rapidly in recent years.

This challenge is clearly felt by Michigan hospitals and health systems, as many retirement decisions made by healthcare workers accelerated during and because of the pandemic. The use of contract agencies for nurses exploded while hospitals also reduced the number of staffed beds in their facilities due to worker shortages. The financial repercussions of these shortages had Michigan hospitals spending more than $1 billion more on contract labor and recruitment and retention expenses in 2022 than in 2020, according to a MHA workforce report.

Although current staffing levels have stabilized somewhat in the state, the demand remains high. According to a March 2023 survey of 95% of the MHA membership, there were over 27,000 job openings in Michigan hospitals, including nearly 8,500 open nursing positions.

While the number of open positions may be surprising, healthcare is historically the largest private-sector employer in Michigan. The next iteration of the Economic Impact of Healthcare in Michigan report publishes May 2, which demonstrates the massive role healthcare plays in the state. Michigan healthcare organizations provided nearly 568,000 direct healthcare jobs in fiscal year 2021, with Michigan hospitals providing roughly 219,000 – or nearly 40% – of those jobs. Once wages, salaries and benefits and tax revenue are factored in, healthcare contributes nearly $100 billion to the state’s economy each year.

The value that our hospitals provide to the health and wellness of a community is obvious and is reason enough to warrant our strong support. But in addition, the magnitude to which our Michigan economy depends on healthcare can easily be overlooked. Hospitals are often the largest employer in their respective communities and serve as critical lynchpins of economic vibrancy. This is why it is so important for hospitals to engage with business and policy leaders to ensure alignment across the state in our efforts to attract and retain talent.

Healthcare careers are not only stable and well compensated, but also provide a set of transferrable skills which rarely become obsolete. We recognize that healthcare careers, particularly clinical positions, can be stressful and emotionally draining. We can’t sugarcoat the challenges associated with caring for all types of patients in organizations that operate 24/7/365.

But the MHA is here to help. In an effort to support the emotional well-being of healthcare workers, in 2021 the MHA Keystone Center launched a partnership with the Duke Center for Healthcare Safety and Quality team led by Bryan Sexton, PhD. More than 5,000 clinical and non-clinical staff from 144 organizations joined in the first 10-week Well-being Essentials for Learning Life-Balance cohort, and our work here is ongoing. We are also advocating for policy change at the state and federal level that would increase the penalties for those who commit acts of violence against our caregivers.

Through our successful advocacy work, the Michigan Legislature appropriated $75 million in funding for the recruitment, retention and training of hospital workers in Public Act 5 of 2023. This funding supplements an earlier $225 million appropriation made in Public Act 9 of 2022 and has played a large part in minimizing further losses to the healthcare workforce. The MHA was named as the fiduciary for both of these funding pools – evidence of the strong bipartisan trust in our association.

Allowing clinicians to work at the top of their license and removing administrative work is another tactic that can help attract healthcare talent. Enacting policy change that reduces rates of healthcare worker violence and expands access to behavioral health treatment are others. The work of the MHA and our members is to make sure healthcare workers have all the tools available to do their work improving and saving lives without unnecessary mandates and other interference that contributes to the challenges healthcare professionals experience.

These workforce challenges and the need for more workers also illustrates the need for local control for hospitals to determine staffing models that best represent the needs of their patients and communities. A one-size-fits-all approach doesn’t work when comparing a rural critical access hospital to an urban Level I trauma center. Successful staffing models incorporate input and feedback from nursing teams and the unique needs of the local community.

There are also a variety of other approaches the MHA and our partners at the American Hospital Association are advocating for to attract healthcare talent. This ranges from increased investment in nursing schools, nurse faculty salaries and hospital training time; enacting protections for healthcare workers against violence and intimidation; supporting apprenticeship programs for nursing assistants; and supporting expedition of visas for foreign-trained nurses.

There is no silver bullet that will fix workforce shortages. The current issue facing hospitals, as well as many other industries, is the reality that the available supply of workers simply doesn’t meet the demand. Michigan continues to be aggressive in efforts to attract businesses to the state. We must recognize our state is in competition with others for a finite amount of available healthcare workers.

Yet things can be done to grow the pie and attract more students into the healthcare talent pipeline. For example, the MHA will be focused this summer on raising awareness about the variety of jobs and career pathways that exist within health systems, and encouraging future and existing workers to consider a career in healthcare where they can truly change lives, whether they’re at the bedside or behind a computer screen.

Healthcare is the ultimate team sport, with the utmost objective – saving lives, and preserving the health and welfare of people. I hope you will join us in this endeavor and invite as many people as you can to the party.

As always, I welcome your thoughts.

Healthcare Remains Michigan’s Largest Private-sector Employer Despite Pandemic Losses

Economic Impact in Michigan infographic

Provides Nearly 572,000 Direct Jobs, 224,000 in Hospitals Alone

Economic Impact in Michigan infographicThe Partnership for Michigan’s Health reports healthcare directly employed nearly 572,000 Michigan residents in 2020, demonstrating that healthcare continues to be the largest private-sector employer in the state despite staffing losses attributed to the COVID-19 pandemic. The 2022 release of The Economic Impact of Healthcare in Michigan shows direct healthcare workers in Michigan earned $44.2 billion that year in wages, salaries and benefits. Hospitals alone employed 224,000 individuals in the state in 2020.

Direct healthcare employment helps create additional jobs that are indirectly related to or induced by healthcare. These indirect, healthcare-supported jobs are held by more than 502,000 people who earned about $28 billion in 2020 in wages, salaries and benefits. Together with their employers, the nearly 1.1 million workers in the healthcare sector contributed almost $15.2 billion that year in local, state and federal taxes. These taxes include Social Security, income, motor vehicle, sales, property, corporate and more.

Data from 2020 shows the early impact the pandemic had on the economic strength of the healthcare sector in Michigan. In particular, the data illustrates the rise in labor costs as many nurses transitioned to contract labor with staffing agencies. Compensation for direct jobs in Nursing and Residential Care rose by about $200 million from 2019 to 2020, although the number of jobs fell by about 11,000. Specific to hospitals, the number of jobs fell by about 7,000 jobs from 2019 to 2020, but total compensation remained about the same.

The loss in jobs represents the initial exit of many healthcare workers due to burnout and stress associated with the pandemic. Both nationally and in Michigan, healthcare experienced a shortage of healthcare employees for several years and the pandemic caused a sudden loss of existing workers. With Medicare beneficiaries in Michigan increasing by more than 8% over the past five years to a total of 2.1 million people, Michigan needs more healthcare workers, now more than ever, to serve the changing needs of the state’s aging population.

The trend of nurses transitioning to contract labor is supported by recent research from the American Hospital Association, which found labor expenses per patient for hospitals increased 19% through 2021 compared to 2019. Increased labor expenses have a more profound impact on hospitals and health systems, as labor expenses account for more than 50% of total expenses for most hospitals. In addition, healthcare reimbursement is unable to quickly respond to inflationary pressures since rates are negotiated months in advance, presenting additional financial challenges when responding to sudden labor market demand.

The report was compiled by the Partnership for Michigan’s Health, which consists of the Michigan Health & Hospital Association, the Michigan State Medical Society and the Michigan Osteopathic Association, all based in the greater Lansing area. It uses 2019 and 2020 data, which is the most recent available.

“This report demonstrates the unquestionable and significant role healthcare, and specifically hospitals, play in Michigan communities,” said Michigan Health & Hospital Association CEO Brian Peters. “Not only have they played a vital role in the care and treatment of patients, but they remain far and away the leading employers and large drivers of economic activity.”

“Healthcare careers are not only extremely rewarding, but crucial to our society,” said Kris Nicholoff, executive director of the Michigan Osteopathic Association. “While healthcare careers remain in high demand, the data shows there are over a million individuals we owe our gratitude toward for providing care during one of the most trying and tumultuous years in modern history.”

“Physicians are and will continue to remain a key driver of healthcare employment and economic growth,” said Julie L. Novak, CEO of the Michigan State Medical Society. “Investing in physician-led team-based care and healthcare careers is key to the economic vitality and health of our state, local communities and residents. Physician practices, hospitals and other care settings offer good paying and stable jobs in careers that truly improve and save lives.”

Hospitals and healthcare providers remain focused on ensuring these jobs meet the needs of their employees, from offering competitive compensation and benefits to ensuring a safe and supportive work environment. The Partnership for Michigan’s Health joined several other organizations in the Healthcare Workforce Sustainability Alliance to advocate for state funding to support the recruitment, retention and training of healthcare workers. These efforts were successful in Public Act 9 of 2022 which allocates $300 million in state funding to support Michigan’s healthcare workforce.

The 16th and 17th editions of The Economic Impact of Healthcare in Michigan were compiled using IMPLAN® cloud software to quantify healthcare’s significant economic impact in the state. The data represents direct, indirect  and induced  healthcare jobs; taxes paid by those workers and their employers; and salaries, wages and benefits earned. The report is an online, interactive tool that allows users to examine these economic impacts from a statewide perspective and by region, county or congressional district. The data from both 2019 and 2020 is provided in two separate data tables. It is available at www.economicimpact.org.