Combating the Novel Coronavirus (COVID-19): Weeks of Dec. 20, Dec. 27 and Jan. 3

MHA Covid-19 update

MHA Covid-19 updateAccording to the Centers for Disease Control and Prevention (CDC) COVID Data Tracker, the omicron variant of COVID-19 is now the dominant strain across the U.S. The CDC’s model indicates that more than 95% of cases in the nation as of Jan. 1 may be due to omicron.

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.

President Announces Updated Testing and Military Personnel Strategy

President Joe Biden Dec. 21 announced the federal government will make 500 million at-home rapid tests available to Americans and will deploy roughly 1,000 military personnel to hospitals across the U.S. to help ease the stress the current COVID-19 surge has placed on providers.

The rapid tests will be free of charge and available via an online request form, after which they will be delivered to residents’ homes. The plan also includes opening new federal testing sites and sending out hundreds of federal vaccinators. These tactics will begin in January according to the White House fact sheet on this effort.

Members are encouraged to review the entire fact sheet, which discusses other elements of the plan, including the distribution of more ventilators, production increases for supplies, federal testing sites and more.

The MHA will keep members apprised as more information becomes available about what assistance will be directed to Michigan as a result of this announcement. Members with questions about federal actions may contact Laura Appel at the MHA.

Boosters Expanded to 12- to 15-year-olds; Waiting Period Shortened

The federal Food and Drug Administration (FDA) and the CDC have announced that children aged 12 to 15 may now receive booster doses of the Pfizer and Moderna COVID-19 vaccines. The agencies also approved a shortened waiting period from six months to five months to receive a booster following a primary series of either of the two vaccines. In addition, certain immunocompromised children aged 5 to 11 are eligible for a booster and may receive it 28 days after the completion of their initial series.

The two-month booster interval recommendation for people who received the Johnson & Johnson vaccine has not changed.

The FDA reached its decision after reportedly reviewing data from Israel, which included information on 6,300 people ages 12-15 who received a booster shot at least five months after their initial two-dose series. The data showed no new cases of two possible side effects that had been observed in some young people who received the vaccine — myocarditis and pericarditis.

Urge Senate to Support Healthcare Staffing Funds

The MHA issued an action alert before the holidays, urging all members to contact their state senators and ask that they support critical healthcare staffing funding, which passed the state House with bipartisan support in December. As lawmakers prepare to return to session the week of Jan. 10, it is important to continue advocacy efforts.

House Bill 5523 would appropriate $300 million for healthcare retention and recruitment, which could help hospitals and other providers navigate the serious worker shortages that currently exist amid a pandemic surge. The MHA Legislative Action Center provides key messages on this issue and contact information for senators. Members with questions may contact Adam Carlson at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpageQuestions on COVID-19 and infectious disease response strategies may be directed to the Michigan Department of Health and Human Services Community Health Emergency Coordination Center (CHECC).

MHA and Members Testify in Support of Licensure Exemption Bill

Sean Gehle (left) and Adam Carlson (right) testify in support of SB 759.

The House Health Policy Committee, chaired by Rep. Bronna Kahle (R-Adrian), reported the MHA-supported Senate Bill (SB) 759 to the full House Dec. 9. Before the bill was reported, Adam Carlson, senior vice president of advocacy, MHA, and Sean Gehle, regional vice president, advocacy and government relations, Trinity Health, provided testimony urging support for SB 759 and discussing its importance in continuing care for patients during the pandemic.  

SB 759 codifies into law a flexibility granted by the Department of Licensing and Regulatory Affairs (LARA) Bureau of Professional Licensing that has been imperative in fighting the workforce shortage. In March 2020, due to the COVID-19 pandemic, LARA activated its statutory authority given in the Public Health Code that allows it to grant licensure exemptions “in a time of disaster” such as a pandemic. This permits out-of-state providers who are in good standing and trained, educated and experienced to render medical care in Michigan without a Michigan license.

The LARA provision is set to expire Jan. 11. The MHA has worked collaboratively with the administration to continue to allow hospitals and health systems the ability to quickly and efficiently recruit out-of-state workers during this public health emergency. SB 759 is now awaiting a vote in the full House. Members with questions should contact Adam Carlson at the MHA.

MHA Statement on Department of Defense Approving State Request for Healthcare Staffing Support

MHA CEO Brian Peters

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

Brian Peters

The current situation facing our hospitals and health system is dire and today’s approval by the U.S. Department of Defense to grant clinical staffing support is desperately needed to provide relief to our vital healthcare workforce. Many hospitals throughout the state are operating at capacity, delaying nonemergency medical procedures and placing their emergency departments on diversion. Receiving these teams of federal caregivers can only help those hospitals.

We want to commend Gov. Whitmer and the Michigan Department of Health and Human Services for making the formal request on behalf of Michigan hospitals and express our gratitude to the Department of Defense for granting this request so quickly.

However, the strain on our healthcare system is severe and we still need the public’s help to slow the extreme growth of cases and hospitalizations. Please get vaccinated, whether it is your first dose, vaccination for your children or a booster dose. Adhere to the public health advisory and wear a mask in crowded indoor gatherings. And contact your primary care provider or seek care at an outpatient setting for nonemergency medical needs. Together we can get through this crisis, but it will take all Michiganders doing the right thing.

ACHE Offers Aug. 25 Webinar on Mitigating Nurse Staffing Crisis

As MHA-member hospitals and health systems continue to experience staffing shortages, the association wants to make members aware of an upcoming educational opportunity that addresses this issue. The American College of Healthcare Executives (ACHE) is offering a free webinar looking into the impact of nurse staffing challenges and exploring strategies for engaging and retaining staff.

The webinar Challenges in Nurse Staff Recruiting and Retention: Impact on Safety, Quality and Efficient Patient Throughput will take place from 1:30 to 2:30 p.m. EDT Aug. 25. Speakers include representatives of consulting firm Berkeley Research Group (BRG) and leaders from Bryan Health and Lee Health. The webinar is made possible, in part, by the support of BRG, an ACHE Premier Corporate Partner.

This event is eligible for 1 ACHE Qualified Education Credit. It is offered free of charge, but registration is required.

Chris Mitchell Discusses Hospital Staffing Challenges with FOX 17

Chris Mitchell

MHA EVP Chris Mitchell is interviewed by FOX 17. Chris Mitchell, executive vice president, advocacy & public affairs, MHA, discussed staffing challenges impacting Michigan hospitals with FOX 17 Aug. 4.

The news segment focused on the CDC COVID-19 Reported Patient Impact and Hospital Capacity by State Timeseries, which reported five Michigan hospitals were experiencing critically low staffing. Mitchell discussed the stress and trauma healthcare workers experience while caring for COVID-19 patients and how that impact has led to burnout and healthcare workers leaving the hospital field. Mitchell also discussed steps hospitals have taken to address burnout and retain workers, while stressing the best way to help alleviate the pressure on hospital staff is to get the safe and effective COVID-19 vaccine.

“What we’ve seen is early retirements…we’ve seen some healthcare workers leave the acute care setting and go to home health or other industries where they can use their talents and not feel the stress and strain of dealing with this pandemic,” said Mitchell. “Particularly in some of our smaller communities these folks are caring for their friends, their neighbors, and that has a profound impact on individuals.”

Read the story

CEO Report — Addressing Staffing Challenges

MHA Rounds Report - Brian Peters, MHA CEO

“There is time for work. And time for love. That leaves no other time.” — Coco Chanel

MHA CEO Brian PetersHospitals have displayed tremendous resiliency over the past year and a half responding to the COVID-19 pandemic. That resiliency has come from the healthcare heroes who have served on the front lines of this crisis and experienced extreme physical and mental stress over the course of three trying surges. Yet that toll has elevated staffing, an already existing concern, to the top of every hospital executive’s mind.

We have said throughout the pandemic that the most significant determining factor of a hospital’s capacity is not physical space, beds or technology — rather, it is available staffing.  Even before the pandemic, we understood that healthcare staffing was a challenge. We currently have a population where the baby-boom generation is maturing, leading to an increased demand for healthcare services. It just so happens that many of those baby boomers also work in healthcare, and the incredible pressures brought about by the pandemic have accelerated their retirement plans.

On top of that dynamic, it has become very difficult for hospitals to recruit and retain staff in an increasingly competitive labor market where many opportunities exist outside of healthcare that offer competitive wages, signing bonuses, free or low-cost training, and the like. Nationally, 80% of nursing leaders have reported an increase in nurse turnover due to the pandemic. According to a 2021 study by Incredible Health, the demand for intensive care and emergency nurses grew by 186% over the past year. We are simply in a situation where the demand for labor currently outpaces supply, with 1.4 million job openings currently in the national healthcare sector according to the Labor Department’s Job Openings and Labor Turnover Summary. In Michigan, simply visiting the Careers webpage of your local hospitals will likely show the dramatic number of openings that are currently available.

Lastly, pent-up demand for healthcare services has stretched existing staff over recent months, as those who were hesitant to receive care for fear of contracting COVID-19 delayed seeing a provider and are now visiting our emergency departments (EDs) at very high levels. In fact, we have seen a 16% increase in hospital ED visits during the latest quarter compared to pre-COVID times in the second quarter of 2019. This pent-up demand is increasing the pressure on our hospitals and staff as people use the ED as a point of entry to the healthcare system.

A contributing factor to the staffing shortage prior to the pandemic was the rate of stress and burnout in the healthcare setting. It is apparent that there are certain jobs, especially those dealing with direct patient care, where the burnout factor is especially pronounced. In response, the MHA has assisted our members in recent years in adopting the Quadruple Aim, a framework that focuses on achieving better healthcare outcomes and has the added goal of improving the mental wellness and work/life balance of healthcare providers to address the issue of burnout. The pandemic has added new urgency to this work.

In addition, our member hospitals and health systems throughout the state have been active in identifying solutions for our healthcare heroes. Some have offered bonuses and hazard pay to staff to show their appreciation for their hard work. Hospitals are also deploying more resources toward behavioral health support to help staff cope with the traumatic stress that they have experienced over the past 17 months. During Michigan’s three COVID-19 surges, many hospitals also brought in contract workers and traveling nurses to supplement their existing workforce due to staffing shortages, the cost of which came well above standard rates due to the demand. Hospitals have also gone to great lengths to procure record amounts of personal protective equipment for their staff — yet another unplanned and unbudgeted expense.

For years, the MHA has advocated strenuously to support graduate medical education (GME) in the state budget process, and we have hosted in-person GME Advocacy Day in Lansing events in the past with our partners at the Michigan Osteopathic Association and the Michigan State Medical Society to connect medical residents with their elected officials. GME is critical to attracting medical students and residents from around the globe to Michigan.

In addition, we advocated for passage of House Bill 4359, which modernized the scope of practice for Certified Registered Nurse Anesthetists (CRNAs). Rural providers have a difficult time hiring anesthesiologists, and this new law will allow flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources to offer safe and effective patient care by eliminating the state requirement that a CRNA must work under direct physician supervision. We appreciate all the stakeholders that made this bill possible, as it eliminates a costly regulation while maintaining patient safety.

The MHA has also been active in bringing together stakeholders to identify solutions to healthcare staffing. The MHA Service Corporation (MHASC) Human Resources (HR) Committee was created as a collaborative body for HR leaders to come together and address issues specific to healthcare workforce issues. Led by Peter Schonfeld, senior vice president, policy & chief operating officer, MHASC, the committee has met to discuss current HR leadership priorities and review its role in guiding the purpose and direction for the MHASC efforts to address workforce resources, education, data staff development and more. The committee has also addressed priorities including vaccination policies, staffing shortages, and diversity, equity and inclusion.

We also recently formed the MHA Human Resources Council as a resource for healthcare professionals to provide input on legislative and regulatory issues relevant to healthcare employers. Staffed by MHA COO Nancy McKeague, the council will provide networking and educational opportunities for HR professionals, dissemination of best practices, and data collection and reporting relating to hospital and health system workforce metrics.

The MHASC has also been providing staffing solutions to our members through both the Unemployment Compensation Program and our Endorsed Business Partner (EBP) Program. The Unemployment Compensation Program has seen a dramatic increase in the number of cases filed since the pandemic began, processing over 70,000 unemployment claims in the last year alone, from clients in Michigan and across the country. Their decades of expertise have saved our client organizations tens of millions of dollars while addressing unemployment fraud that has become rampant recently.

We currently have six EBPs that focus on workforce solutions, including Merritt Hawkins, which provides permanent physician recruiting and consulting services. These EBPs have been carefully vetted to ensure they provide high-value services for our members in need of workforce assistance. In fact, we recently added NextJob as our newest EBP to help hospitals better support healthcare workers with re-employment services, which enhances the work of our unemployment program. I’m extremely happy that we have these services available, with other EBPs in this space focusing on compensation, workplace violence training, consulting and performance coaching.

Finally, as we look to the future, we know that telehealth and virtual care, which has seen an acceleration during the pandemic, has the potential to be real game changers for the delivery of healthcare. We will need to do all we can to help ensure that new technologies are adopted in such a way as to maximize access and affordability for all populations, while also doing right by our healthcare staff.

As you can see, the staffing challenges hospitals face are complex; yet across Michigan we are pursuing every tool in our toolbox to create solutions that both bring in top-notch caregivers and retain our healthcare heroes who have treated over 125,000 COVID-19 patients during the pandemic. Michigan hospitals remain committed to protecting our staff and doing everything we can to ensure they feel safe and protected while caring for their patients. From physicians and nurses to environmental service workers and support staff, our hospitals need all levels of team members to efficiently and effectively operate 24/7/365.

As always, I welcome your thoughts.