Combating the Novel Coronavirus (COVID-19): Week of March 21

MHA Covid-19 update

MHA Covid-19 updateWith the number of new cases trending downward, Michigan hospitals continued to have patients with severe cases of COVID-19 in their intensive care units (ICUs). As of March 25, 100 Michiganders with confirmed or suspected COVID-19 were in ICUs, 44 of them on ventilators. They were among the 516 adults and 22 children hospitalized with confirmed or suspected cases that day.

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.

Legislative Action Will Assist Hospitals in Providing High-quality Care

The Legislature has sent Senate Bill (SB) 247 to Gov. Gretchen Whitmer to be signed into law, making significant changes to prior authorization in the state of Michigan. The MHA-supported  bill would shorten the timelines for approval of authorization requests, ensure that emergency care can be provided without prior approval, and require insurers to post their prior authorization policies on their website and accept electronic requests, among other improvements to the process.

Whitmer signed SBs 246 and 435, increasing forgivable loan amounts for health professionals who work in medically underserved communities as part of the Michigan Essential Health Provider Program and expanding the physician specializations that qualify for the program to include behavioral health professionals. The new law also extends the sunset on the interstate Physician Licensure Compact, ensuring that physicians coming to Michigan from another compact state can quickly become licensed to practice in the state.

More information on these bills and other legislation affecting hospitals is available in a related article.

Vaccination Progress Among Michiganders Highlights Racial Disparities

More than 60% of all Michigan residents aged 5 and older are fully vaccinated against COVID-19. However, only slightly more than 40% of Black residents are among those fully vaccinated. Nearly 28% of Michigan children aged 5 through 11 years have received their first dose of the vaccine, but fewer than 17% of Black Michigan children in that age range have received their first dose. Providers should continue efforts to reach families with young children and nonwhite patients to reduce the disparities in the impact of COVID-19 on different populations. For information on vaccines, contact Ruthanne Sudderth at the MHA.

MHA Creates State/Federal COVID-19 Guidelines Tracker

The MHA recently developed a tracking tool outlining state and federal COVID-19 protocols for healthcare personnel. The document is updated as agencies revise their guidelines or mandates and includes vaccination, masking and COVID-19 testing guidelines from both the Centers for Disease Control and Prevention and the Michigan Department of Health and Human Services (MDHHS). The downloadable tool can also be found on the MHA website on the COVID-19 Resources page under Resources for Healthcare Professionals. Members with questions may contact Lucy Ciaramitaro at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

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.

Essential Health Provider Loan Repayment Program Bills Advanced to Governor

capitol building

capitol buildingThe Michigan Legislature addressed several bills impacting hospitals during the week of March 7. A pair of bills to expand the Essential Health Provider Loan Repayment Program and extend the Physician Licensure Compact (PLC) were sent to the governor’s desk for signature. In the Senate, action was taken on a bill to create new high school opioid education curriculum and a bill to make changes to non-opioid directives.

The bills to expand the Essential Health Provider Loan Repayment Program were approved by the Senate March 8. Senate Bills (SBs) 246 and 435 were introduced by Sens. Curt VanderWall (R-Ludington) and Michael MacDonald (R-Macomb Township) and supported by the MHA. SB 246 would expand the total allowable loan repayment from $200,000 to $300,000 for 10 years of service in a health resource shortage area. SB 435 would make mental health professionals eligible for the program and extend the sunset on the PLC for another 3 years. The bills now head to Gov. Gretchen Whitmer for signature into law.

The full Senate sent another MHA-supported bill to the governor’s desk March 10. House Bill 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 was introduced by Rep. Abdullah Hammoud (D-Dearborn) and now awaits the governor’s signature.

In the Senate Health Policy and Human Services Committee, testimony was taken on a bill to require the state to adopt a 9th grade opioid education curriculum. Introduced as SB 107 by Sen. Michael MacDonald (R-Macomb Township), the curriculum would include a video developed or adopted by the Michigan Department of Education. The MHA supports the bill and will update members on additional action taken.

Members with questions on state legislation related to healthcare may contact 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.