Michiganders Need Continued Access to High-quality, Timely Healthcare

Michigan’s hospitals are facing a funding crisis, putting communities and families across the state at risk of losing access to high-quality, timely healthcare. Health systems, business and university leaders are urging policymakers to address the crisis to avoid further reduction of available beds and access to care and healthcare services.

Michigan has lost a high of 1,700 staffed hospital beds since 2020 due to lack of staffing. This creates a cascade of problems, from longer wait times in the emergency department, reduced services, particularly in rural areas, and more difficulty transferring patients to the appropriate care setting. Respiratory illnesses are also surging, making problems worse.

T. Anthony Denton

“Recently, we have seen a surge in cases of respiratory syncytial virus (RSV), flu and COVID. This puts an additional pressure on emergency departments and our already-strained inpatient bed capacity across Michigan, impacting care statewide. Without funding to address staffing shortages, we run the risk of compromising our ability to provide the same level of exceptional care that we’re accustomed to across the state,” said T. Anthony Denton, senior vice president and chief operating officer, University of Michigan Health System and Michigan Health & Hospital Association board chair.

A 2021 Washington Post-Kaiser Family Foundation survey found that nearly 30% of healthcare workers are considering leaving their profession altogether. The U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses nationwide by 2030, the Association of American Medical Colleges estimates two out of every five active physicians nationwide will be 65 or older within the next 10 years, and the nation faces a projected shortage of more than 3.2 million lower-wage healthcare workers such as medical assistants, home health aides and nursing assistants, according to a Mercer report.

“The overall health and prosperity of Michigan is inextricably tied to the state’s investment in its healthcare and higher education enterprises,” said Daniel Hurley, CEO of the Michigan Association of State Universities. “Michigan’s public universities, together with our hospital and other healthcare partners, look forward to working with state leaders to ensure a future healthcare workforce that is capable of providing the highest levels of quality care for all Michiganders.”

The healthcare workforce shortage — combined with an aging population, a rise in chronic diseases and behavioral health conditions and advancements in medical care delivery — all contribute to an immediate need for resources that will allow hospitals to continue to provide the care residents need and deserve.

Despite staffing losses attributed to the COVID-19 pandemic, healthcare directly employed nearly 572,000 Michigan residents in 2020, continuing to make it the largest private-sector employer in the state. The 2022 Economic Impact of Healthcare in Michigan report found that direct healthcare workers in Michigan earned $44.2 billion in wages, salaries and benefits, with indirect, healthcare-supported workers earning about $28 billion wages, salaries and benefits.

“With healthcare being the largest private-sector employer, a healthy Michigan economy is directly linked to a properly funded healthcare system,” said Susan Smith, executive director, Economic Development Partnership of Hillsdale County. “Without access to healthcare services to support our communities, ranging from obstetrical units to trauma centers, we cannot remain economically competitive, attract or retain talent, or support placemaking for young families and care for everyone at all stages of life.”

Michigan officials have made recent short-term investments to address the hospital staffing crisis, but additional funding remains unappropriated that if used as intended, can improve hospital capacity and service lines. Michigan also needs a long-term funding solution to address stagnant reimbursement that has yet to respond to inflationary pressures to improve the retention of existing healthcare workers and recruit future workers to ensure that residents continue to have access to healthcare services.

Learn how you can help your local hospital or health system by visiting MiCareMatters.org.

Additional quotes:

JJ Hodshire

“Hospitals have an immediate need for resources to continue to provide the services residents need and deserve – like ambulances available for lifesaving care,” said JJ Hodshire, president and chief executive officer, Hillsdale Hospital. “As a rural hospital, we excel at being innovative to make the best use of our resources, particularly staff. However, we can only stretch resources for so long. Everyone can agree that access to lifesaving emergency medical care is a basic need for Michiganders and residents should be able to receive specialized care no matter where they live.”

“My colleagues in pediatric units across the state have spent the past month responding to one of the worst respiratory illness surges I can remember as a physician and the biggest challenge to our ability to care for more children was our lack of available staff,” said Dr. Rudolph P. Valentini, chief medical officer, Children’s Hospital of Michigan and group chief medical offer at Detroit Medical Center. “We can’t afford to have another surge of sick, hospitalized children before something is done to improve the health of our hospitals and health systems.”

Brian Peters

“Michigan residents deserve quality, accessible healthcare services and without hospital resources to adequately provide that care, Michigan hospitals have and will continue to face difficult decisions about what services they can offer,” said Brian Peters, chief executive officer, Michigan Health & Hospital Association.

Combating the Novel Coronavirus (COVID-19): Week of July 11

MHA Covid-19 update

Michigan’s COVID-19 case numbers and hospitalizations have increased since early July with the onset of omicron variant BA.5. Here are the latest key statistics:

  • 875 hospitalizations with confirmed or suspected COVID-19, a 20% increase since July 1.
  • 23 pediatric hospitalizations with confirmed or suspected COVID-19.
  • 67.6% of all residents have at least one dose of vaccine.
  • 29.2% of kids aged 5-11 have now initiated vaccination.
  • Roughly 2% of kids aged 6 months-5 years have initiated vaccination since approval was granted in mid-June.

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.

Governor Signs COVID-19 Liability Legislation

Gov. Gretchen Whitmer recently signed several COVID-19 liability-related bills:

  • House Bill 5244 (Public Act 138 of 2022) amends Public Act 238 of 2020, which prohibits an employer from taking certain actions against an employee who does not report to work under circumstances related to COVID-19, to specify that the Act would not apply to a claim or cause of action that accrued after July 1, 2022. In addition, the bill will repeal PA 238 of 2020 effective July 1, 2023. HB 5244 was sponsored by Rep. Andrew Fink (R-Hillsdale).
  • House Bill 6128 (Public Act 140 of 2022) amends Section 85 of the Michigan Occupational Safety and Health Act to specify that certain conditions establishing immunity for employers whose employees were exposed to COVID-19 would not apply to an exposure that occurred after July 1, 2022. In addition, the bill would repeal Section 85 and Section 85a, which defines COVID-19 under the Act, effective July 1, 2023. HB 6128 was sponsored by Rep. Yousef Rabhi (D-Ann Arbor).
  • House Bill 6215 (Public Act 139 of 2022) amends the COVID-19 Response and Reopening Liability Assurance Act to specify that the Act, which provides immunity to a person that acts in compliance with certain federal, state and local orders related to COVID-19, would not apply to a claim or cause of action that accrued after July 1, 2022. In addition, the bill would repeal the Act effective July 1, 2023. House Bill 6215 was sponsored by Rep. Graham Filler (R-DeWitt).

Novavax Vaccine Gets FDA Authorization

The Food and Drug Administration (FDA) granted emergency use authorization to Novavax’s COVID-19 vaccine July 13. The vaccine is a two-dose series administered three weeks apart and uses a different, older vaccine technology than is used in the messenger RNA vaccines and Johnson & Johnson shot.

Novavax’s vaccine is authorized for people ages 18 and older as a primary series. It may be appealing to those adults who were hesitant to receive another brand of vaccine due to the components or development process.

In a trial of more than 26,000 adults, two doses of the Novavax COVID-19 vaccine were more than 90 percent effective at preventing symptomatic disease. For adults 65 and older, effectiveness was more than 78 percent. There were no serious side effects or safety concerns.

The Centers for Disease Control and Prevention (CDC) will next decide whether it will endorse the vaccine. The CDC Advisory Committee on Immunization Practices will meet July 19, though an agenda is not yet available.

The Biden administration recently announced that it had purchased 3.2 million doses of the Novavax vaccine. If the vaccine is recommended by the CDC, it will be made available at no cost to states, jurisdictions, federal pharmacy partners and federally qualified health centers. The MHA will keep members apprised of vaccine availability and ordering processes at the appropriate time. Members with questions may contact Ruthanne Sudderth 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).

Combating the Novel Coronavirus (COVID-19): Week of April 4

MHA Covid-19 update

MHA Covid-19 update

The Michigan Department of Health and Human Services (MDHHS) reported there were an average of 752 new confirmed and suspected COVID-19 cases per day from April 2 through April 6. As of April 6, 453 adults and 17 children were hospitalized with confirmed and suspected cases; 96 adults were in intensive care units, 39 of them on ventilators. The MDHHS is now reporting this data once a week.

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.

FDA Revokes Sotrovimab Authorization

The Food and Drug Administration (FDA) has revoked emergency use authorization (EUA) for sotrovimab, a monoclonal antibody treatment for COVID-19 patients at risk of developing severe disease. This occurred due to the treatment’s ineffectiveness as a remedy for the omicron subvariant BA.2, which is now responsible for more than half of all U.S. infections.

The FDA authorized a new monoclonal antibody, Eli Lilly’s bebtelovimab, Feb. 11 that remains effective against omicron variants; the bebtelovimab EUA is still in place. The MHA will continue to work with the Michigan MDHHS leadership on therapeutics recommendations and availability in Michigan. Members with questions may contact Laura Appel at the MHA.

President Biden Announces Long COVID-19 Care Planning

President Joe Biden announced April 5 that the U.S. Department of Health and Human Services (HHS) will assemble a cross-government plan to manage “long COVID.” However, it is largely dependent on being funded by Congress.

The plan’s goals are broadening research, detection and treatment access to fight lingering or late-emerging effects of COVID-19 that are estimated to impact between seven million and 23 million Americans. The symptoms include shortness of breath, heart irregularities, kidney problems and more.

The American Hospital Association (AHA) and other federal advocacy groups sent a letter to HHS Secretary Xavier Becerra in March stating that there is “a need for further clinical guidance regarding the symptoms of and best course of treatment for long Covid-19 patients.” According to news reports, the Biden administration needs at least $25 million in the 2023 federal budget to build on tracking and surveillance progress, in addition to the $50 million the Centers for Disease Control and Prevention is already spending.

The long COVID-19 plan further includes establishing a Center of Excellence to treat long COVID-19 patients through in-person, multispecialty and telehealth services. The administration reportedly wants to establish long COVID-19 clinics around the country modeled after a Veterans Affairs clinic setup.

The MHA will continue to work closely with the AHA about the viability of this plan, both operationally and politically, and will keep members apprised of progress or plans that may impact hospitals, health systems and their patients. Members with questions may contact Laura Appel 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).

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).

Combating the Novel Coronavirus (COVID-19): Week of March 8

MHA Covid-19 update

MHA COVID-19 UpdateThe president signed the American Rescue Plan March 11, establishing as law the latest legislation to address the many areas of loss the country has suffered due to the COVID-19 pandemic. It includes $8.5 billion in funding for eligible rural healthcare providers to offset expenses and lost revenues attributable to the pandemic (see related article). 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.

Mass Vaccination Site to Open at Ford Field as Vaccination Eligibility Expands

In a March 11 address, President Joe Biden instructed states to open vaccine eligibility to all adults no later than May 1. The federal government expects a significant increase in vaccine doses in the coming weeks and will make a website available to help anyone find a vaccine appointment near them.

In response to the president’s directive, Gov. Gretchen Whitmer announced that Michigan will open eligibility to adults ages 16 through 49 with certain preexisting conditions March 22 and to any adults 16 and older April 5. This is in addition to all adults ages 50 through 64 becoming eligible March 22. This news is reflected in the state’s official Prioritization Guidance document posted on its vaccine webpage. Officials expect weekly allocations to continue to increase to help meet the increased demand. The MHA will keep members apprised of any additional information relating to the expanded eligibility.

Members are encouraged to prepare for increased calls and website traffic as vaccine eligibility broadens and to provide their communities with details on who they will be able to vaccinate and how to make appointments.

The governor also announced that a mass vaccination site will open March 24 at Ford Field in Detroit. It will have the capacity to administer 6,000 vaccine doses each day to serve residents in the broader southeast Michigan region. The Biden administration, in partnership with the Federal Emergency Management Agency (FEMA), selected southeast Michigan for this major new community vaccination site.

The site, which was selected according to the Centers for Disease Control and Prevention’s priority tool to help those hardest hit and most vulnerable, will operate from 8 a.m. to 8:30 p.m., seven days a week, for eight weeks under the federal government’s vaccination pilot program. The facility will be managed by the state of Michigan with support from FEMA, Wayne County, the City of Detroit, Ford Field, Meijer, Henry Ford Health System and the Detroit Lions.

Federal efforts under development also include a Centers for Disease Control and Prevention (CDC) “equity index” that will rank states based on equity of access/administration of the vaccine in addition to the existing rankings that are based on doses given, speed, etc.

In addition, the CDC will be sending allocations directly to a list of federally qualified health centers across the nation, including those in the Michigan cities of Inkster, Pontiac, Brimley, Gladwin, Flint, Saginaw, Cassopolis, Kalamazoo, Centreville, Ann Arbor and Detroit.

CDC Issues COVID-19 Recommendations for Fully Vaccinated People

The CDC issued new recommendations March 8 for individuals who have been fully vaccinated against COVID-19. The agency considers people to be fully vaccinated two weeks after their second dose of the Pfizer and Moderna vaccines or two weeks after Johnson & Johnson’s Janssen single-dose vaccine.

The recommendations state that those meeting the full vaccination parameters may gather indoors with other fully vaccinated individuals without wearing a mask. In addition, they can gather indoors with unvaccinated people from one other household without masks, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19.

Fully vaccinated individuals who have been near someone who has the disease are no longer asked to avoid others or get tested unless they have symptoms. However, vaccinated people who live in a group setting and have been in contact with someone who has COVID-19 should quarantine for 14 days and get tested, even if they don’t have symptoms.

Because authorities do not yet know the extent to which vaccines mitigate the transmission of COVID-19, the CDC continues to recommend precautions that include wearing a mask, staying at least six feet apart from others, and avoiding crowds and poorly ventilated spaces. Anyone who has symptoms of COVID-19 should be tested and stay away from others.

The MHA will keep members apprised of any changes in these recommendations. Questions on the COVID-19 vaccine may be directed to Ruthanne Sudderth at the MHA.

COVID-19 Variants in Michigan More Transmissible than Original Virus

The Michigan Department of Health and Human Services (MDHHS) Bureau of Laboratories identified on March 8 the first Michigan case of the COVID-19 variant B.1.351 in a male child living in Jackson County. Case investigation is underway to determine close contacts and whether additional cases are associated with this case.

Cases caused by this variant, which originated in South Africa, were first reported in the United States at the end of January. It is believed to be more contagious, but there has been no indication that it affects the clinical outcomes or disease severity compared to the SARS-CoV-2 virus that has been circulating across the United States for the past year. Scientists are evaluating how well COVID-19 vaccines work against this newer variant, which has been identified in at least 20 other states and jurisdictions in the U.S.

The MDHHS has also provided information about the characteristics of the B.1.1.7 variant that was first discovered in the United Kingdom. This variant has now been identified in multiple Michigan communities after having first been detected in an isolate from a Washtenaw County case Jan. 16. It is approximately 50 percent more transmissible, leading to faster spread of the virus and potentially increasing numbers of cases, hospitalizations and deaths. Members should refer to the MHA’s COVID-19 alert sent Friday, March 12, for details and recommendations on managing variants.

The MHA and the MDHHS are closely monitoring case numbers, positivity rates and hospitalizations. The association will keep members apprised of any concerning data trends related to the variants. Members with data questions may contact Jim Lee at the MHA.

New Regulatory Flexibility Approved for Sharps Containers

The Department of Environment, Great Lakes, and Energy March 9 approved an MHA request to provide regulatory flexibility for hospitals facing a shortage of sharps disposal containers. State regulation currently requires hospitals to replace sharps containers every 90 days or when full, whichever is sooner. Through July 31, 2021, hospitals will now be exempt from the 90-day rule, meaning sharps containers will only be required to be replaced when full. The shortage is due to a production facility fire and increasing demand for the containers due to vaccinations; some MHA members had already received similar exemptions. The MHA will work with state government if additional flexibility is needed. Members with questions may contact Sean Sorenson-Abbott at the MHA.

State Provides Vaccine Communication and Administration Materials

A variety of vaccine materials are available for hospitals and other providers on the MDHHS Provider and Partner webpages for communication and administration purposes. These include toolkits for communicating with patients and communities regarding the safety and effectiveness of the vaccines, which are in the “COVID-19 Vaccine Communication Materials” section of the Partner page; Johnson & Johnson materials, including a Standing Order form for this vaccine; and more.

MDHHS Announces 22 Awardees in State’s Vaccine Pilot Program

The MDHHS and the Protect Michigan Commission have awarded 35,800 doses of COVID-19 vaccine to 22 pilot projects to help enhance the state’s vaccine equity strategy. Three of the awards went to Henry Ford Health System, MidMichigan Health and Schoolcraft Memorial Hospital, and the remainder went to health departments, community-based clinics, agencies on aging and other vaccinators.

The pilot program is designed to help remove barriers to vaccine access for Michiganders ages 60 and older who live in communities with a high Social Vulnerability Index (SVI) and high COVID-19 mortality rates. Participating providers that have additional capacity in their projects may expand vaccination to include people ages 50-59 with disabilities or underlying conditions. The awardees were chosen from more than 70 applications. Additional details on the program are available in the MDHHS news release.

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).