Combating the Novel Coronavirus (COVID-19): Week of Feb 1

MHA Covid-19 update

MHA Coronavirus UpdateThe MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

State Changes Hospitals’ Share of Vaccines Distributed

The Michigan Department of Health and Human Services (MDHHS) has adjusted the number of COVID-19 vaccine doses available to each type of vaccination provider.

Although the MDHHS considered shifting to an allocation model of 70% of vaccines going to health departments and 30% going to hospitals, the department confirmed Feb. 4 that it will continue the allocation process it implemented the week of Feb. 1, with 60% of the available vaccine going to health departments and 40% to hospitals, until further notice. The MHA and members have advocated against moving a large allocation away from hospitals, which have administered more than a half million doses to Michigan residents. The MHA will also continue to identify and assist the MDHHS in using the most equitable sources of data to determine vaccine allocations. Member hospitals are encouraged to build partnerships with their local health departments to share resources and vaccine allocations to best serve their communities.

The MDHHS has developed a weekly survey for hospitals and health departments to guide the department’s decision-making on vaccine issues. The survey requests information about COVID-19 vaccine events hosted in the past week, the eligible populations the events targeted, where they were held and more. The hospital survey will be distributed each Friday, and responses to the first survey are due by 5 p.m. Feb. 8. If possible, the survey should be completed for individual facilities rather than at the health system level.

Members who would like assistance in fostering relationships with their local health department, have questions on the new vaccine survey or would like more information on the COVID-19 vaccine should contact Ruthanne Sudderth at the MHA.

FDA Considers EUA for New Vaccine, Revises Authorization for Convalescent Plasma

Johnson & Johnson subsidiary Janssen Biotech has requested emergency use authorization (EUA) from the Food and Drug Administration (FDA) for its COVID-19 vaccine. If approved, the vaccine will be the first single-dose immunization available to fight the pandemic.

The FDA is scheduled to meet Feb. 26 to discuss the EUA request for this vaccine, which trials have shown to be 66% effective in preventing overall moderate to severe COVID-19. The company said the vaccine demonstrated complete protection against COVID-19 serious enough to require hospitalization and was 85% effective in preventing severe forms of the disease.

This vaccine also presents far fewer logistical and cold chain challenges than the Pfizer and Moderna vaccines, as it is estimated to remain stable for two years at minus four degrees Fahrenheit (minus 20 degrees Celsius) and can be stored for three months under standard refrigeration at 36 to 46 degrees Fahrenheit (two to eight degrees Celsius). Johnson & Johnson initially will provide 2 million doses to the U.S., followed by 100 million doses by midyear.

In addition, the FDA recently updated its EUA for convalescent plasma as a COVID-19 treatment. The revision reflects new data regarding the treatment’s efficacy and application and has been included in the agency’s provider fact sheet.

The new EUA for COVID-19 convalescent plasma limits the authorization to the use of plasma with a high concentration of antibodies for the disease, known as “high titer” COVID-19 convalescent plasma. It is authorized only for the treatment of hospitalized patients with COVID-19 early in the disease course and those hospitalized patients whose bodies cannot produce an adequate antibody response. According to the latest data, plasma with low levels of antibodies has not been shown to be helpful in COVID-19. Therefore, low titer COVID-19 convalescent plasma is no longer authorized under the EUA.

Monoclonal Antibody Treatment Encouraged; Mi-COVID19 Initiative Webinar to Discuss

The educational webinar series from the Mi-COVID19 Initiative will continue from noon to 1 p.m. Feb. 10 on the topic Approach to Monoclonal Antibody Treatment. Speakers include Dr. William Fales from the MDHHS and Drs. Tejal Gandhi and Lindsay Petty from Michigan Medicine. Registration is available online, as are recordings from previous events in this series.

Members are encouraged to use monoclonal antibodies as eligible cases of COVID-19 present in their facilities and to consider posting information on the COVID-19 sections of their organizations’ websites for interested and possibly eligible patients. The MDHHS recently issued a letter with information on this type of treatment and sends weekly alerts from the Michigan Health Alert Network about how to request a supply of the antibodies. Members with questions may contact Rob Wood.

Epic Scheduling Loophole Under Investigation

Beaumont Health announced Feb. 1 that an individual had used unauthorized “backdoor” access to Beaumont Health’s Epic patient portal to schedule a COVID-19 vaccine appointment, then shared the pathway publicly. The breach resulted in more than 2,700 unauthorized appointments being made, all of which have now been canceled. Beaumont Health shared the information to help other hospitals ensure a similar issue does not occur in their systems. The health system has contacted Epic and is working to safeguard the system against future unauthorized accessibility. No medical records were compromised due to the incident, and no valid vaccine appointments were affected. Members with questions or concerns about their Epic platform may contact Jim Lee at the MHA.

Moderna Vaccine Doses Thought to be Compromised are Deemed Viable

The Centers for Disease Control and Prevention has notified the MDHHS that Moderna vaccine shipped to Michigan in mid-January and thought to be ruined by a temperature excursion have been determined to be viable and can be used to vaccinate residents. McKesson Corp., which is responsible for shipping the vaccine, completed an internal investigation and determined the cause and lower limit of the cold excursion in these shipments. Based on data provided as part of that investigation, Moderna agreed that the vaccine in this shipment was viable upon arrival and remains viable under either of the following circumstances:

  • Doses are confirmed to have been stored in quarantine at -20C.
  • Doses are confirmed to have been stored in quarantine at 2-8C and the doses were placed in refrigerated storage within 30 days.

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 Jan. 18

MHA Covid-19 update

Among the many actions President Joseph R. Biden took on his first day in office Jan. 20 was creating a White House COVID-19 response team to coordinate federal and state efforts to fight the pandemic. With this and other expected action by the new administration, the state of Michigan anticipates improvements in the production, distribution and operations for the COVID-19 vaccine. As the battle against the evolving virus continues, the MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Updates Provided as Vaccines Administration Continues

President Biden has indicated he will immediately be activating the federal Defense Production Act to significantly increase the supply of vaccine available to Americans. Gov. Gretchen Whitmer’s administration is working closely with the Biden team to increase Michigan’s weekly allocation of vaccine as soon as possible. The state is mapping details on how to support each of Biden’s points and how this plan can support Michigan’s plan to administer 50,000 or more shots per day.

The U.S. Department of Health and Human Services notified the Michigan Department of Health and Human Services (MDHHS) Jan. 20 that modified vaccine supply kits would begin being included that week with the shipments of the Pfizer vaccine to assist in administering the potential sixth dose of vaccine from vials originally labeled for five doses. In January, the Food and Drug Administration amended the emergency use authorization to reflect the additional dose, and McKesson increased the individual Pfizer ancillary kit contents from a kit that supported 975 doses to a kit supporting 1,170 doses. Members with vaccination supply chain questions can contact Adam Carlson or Rob Wood at the MHA.

The MDHHS is working toward using the Centers for Disease Control & Prevention (CDC) Social Vulnerability Index to identify areas and individuals in Michigan that may have less access to COVID-19 vaccine. The department will be encouraging vaccinating providers to use this data to find and vaccinate these individuals and communities. This work is in the early stages, and updates will be provided during the biweekly MDHHS calls with providers. The MHA will provide details on how to reach vulnerable individuals and communities as they become available.

The MHA will conduct a members-only event from 11 a.m. to noon Jan. 29 for an in-depth discussion on the status of COVID-19 vaccine distribution, coordination, coverage, communication and more. Members will receive participation information prior to the event.

In addition, the association (@MIHospitalAssoc) will host a Twitter chat from 1 to 2 p.m. Jan. 28 to inform Michiganders about the COVID-19 vaccine and promote to the public and media the excellent work of hospitals and health systems in leading this effort. The goal of the virtual conversation is to answer frequently asked questions and give hospitals an opportunity to share their experiences and resources related to the COVID-19 vaccine all in one place. Members may preview the chat questions, and those with Twitter accounts are encouraged to join the event to share about hospitals’ role in Michigan’s COVID-19 vaccine effort and be a source of trusted information about the vaccine itself. Members are asked to confirm their participation with Lucy Ciaramitaro at the MHA by Jan. 26.

Local health departments use an online registry to recruit volunteers for COVID-19 vaccine clinics. Vaccine volunteers do not necessarily need to be licensed health professionals, but do need to complete all training to ensure they can appropriately educate, administer, prepare, handle and report vaccine. Anyone interested in volunteering to assist in vaccine administration is encouraged to register. Training materials are available on both the MDHHS and CDC websites.

Members with vaccine questions may contact Ruthanne Sudderth at the MHA.

MDHHS Issues Updated List of COVID-19 Relief Facilities

The MDHHS issued an updated list of COVID Relief Facilities (CRFs), such as nursing homes and rehab facilities, approved to admit and accept transfers of individuals who remain subject to Transmission Based Precautions for COVID-19. The MDHHS will issue its next updated list the week of Feb. 1.

The CRF designation is defined as part of Public Act 231 of 2020. These facilities may care for COVID-19-positive residents of nursing facilities by retaining or admitting those residents. An appropriate CRF resident is a COVID-19-positive person who does not need the acute-care hospital level of services.

CRFs are designed to care for COVID-19-positive residents in-place with enhanced infection control measures for individuals who have not met criteria for discontinuing Transmission-Based Precautions and have limited access to the state’s Care and Recovery Centers. All CRFs may retain or readmit their own residents. Facilities that meet enhanced requirements may receive new admissions from other facilities or hospital discharges. Many other CRFs can retain their own residents even if they become COVID-19-positive. To request a copy of the list of CRFs accepting new admissions, contact Erin Emerson at the MDHHS. For more information on these facilities, contact Kelsey Ostergren 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): Dec. 21 through Jan. 8

MHA Covid-19 update

MHA COVID-19 UpdateDuring the holiday season and into the new year, activity has continued related to the novel coronavirus and vaccines to protect against it, including the emergency use authorization and subsequent distribution of the Moderna vaccine. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Legislation, Policies Enacted to Fight COVID-19

The Michigan Department of Health and Human Services (MDHHS) announced Jan. 6 that additional Michiganders can be vaccinated against COVID-19 beginning Jan. 11, including residents 65 and over; police officers, first responders, front-line state and federal workers and jail and prison staff; and pre-K-12 teachers and childcare providers. The MHA issued a media statement following the announcement.

Joneigh Khaldun, MD, the state’s chief medical executive, advised that seniors and essential workers should contact their local health department (LHD) to seek an appointment for the vaccine. Hospitals that have operational capacity and enough vaccine to vaccinate seniors are encouraged to do so, as many LHDs lack the capacity to serve this large population. The MHA advises all hospitals to issue local media/social media information making clear whether they will vaccinate seniors and essential workers and any details on how to make an appointment to receive the vaccine.

In a Jan. 8 news conference, Gov. Gretchen Whitmer announced that her administration would like all Michigan K-12 schools to prepare to offer in-person learning on or before March 1. A rationale document was issued as part of the announcement, which includes explanations of the risks and safety of in-person learning, impact on those kept at home and their parents/guardians, and more. Members should be aware of this policy change as it may positively impact staffing challenges.

The governor signed Senate Bill (SB) 748 Dec. 30, providing supplemental appropriations for various priorities. While the governor vetoed some items, the MHA’s priorities on healthcare funding were approved. The items the governor and Legislature agreed upon included $10 million to reimburse Michigan hospitals for temporary staffing needs during COVID-19, $17 million to reimburse hospitals for the high cost of remdesivir treatments for patients, and $3.3 million to reimburse hospitals for holding and caring for nursing home patients beyond when they need hospital care. The MHA will work with policymakers as these funding items are implemented and keep members informed on how they may access these reimbursements.

The governor also signed into law two bills the MHA supported and advocated for during the legislative lame-duck session. SB 1258 amended Public Act 238 of 2020 to provide additional flexibilities regarding updated federal guidelines on timing for COVID-19-positive employees and potential exposures. The MHA will continue to seek further clarification from the MDHHS regarding similarities between COVID-19 symptoms and vaccine side effects. SB 1021 makes permanent in state law the flexibilities that allow Canadian health professionals to practice in Michigan.

The period for the governor to sign several bills reforming Michigan’s Certificate of Need (CON) process expired Jan. 6, effectively vetoing the bills. The legislation included several reforms that would have increased covered capital expenditures from $3.3 million to $10 million, added two members to the commission, and removed air ambulance as a covered service in June 2021. The MHA took a neutral position on an additional provision that was vetoed, which would have removed inpatient psychiatric services from CON in counties with populations less than 40,000. Members with questions on state legislation should contact Adam Carlson at the MHA.

Vaccine Distribution Updates

Vials of the Pfizer vaccine often contain a sixth dose that can be used to protect against COVID-19. However, the initial supply kits provided with the vaccine contained only five needles, which has caused some hospitals to experience needle shortages. The American Hospital Association has advised Operation Warp Speed (OWS) officials of these shortages, and OWS plans to increase the number of needles, syringes and other supplies in the kits to correspond with the available dosages in the vials. Members experiencing vaccine supply kit shortages should contact Adam Carlson at the MHA for assistance.

In an apparent response to a letter from the governors of eight states, including Michigan, the transition team for President-elect Joe Biden said it plans to release to states most of the COVID-19 vaccine being held by the federal government once Biden’s administration is in place after Jan. 20. The current stance of the U.S. Department of Health and Human Services and the Centers for Disease Control & Prevention is to hold back 50% of all vaccine supply to later ship second doses to providers. The Biden team states that it will work with manufacturers to ensure second doses are available for Americans. The MHA will work with its state and federal partners and elected officials to identify how this will affect hospitals’ vaccine allotments in Michigan and procedures for ordering doses. The association will provide updates as it obtains more information.

The MDHHS recently indicated that hospitals wishing to set up vaccine clinics at external venues need to follow the guidelines of the Centers for Disease Control and Prevention for quality assurance, storage, electrical, etc. Hospitals do not need to submit COVID-19 vaccine provider enrollment applications for sites that afford space to run mass vaccination efforts, such as hospital-owned/affiliated parking lots or properties or community-based venues. Any off-site clinic should provide guidelines that allow hospitals to do the required data entry, maintain cold storage and prevent wasted vaccine.

The MHA is working with the state and other partners to help hospitals overcome barriers and use opportunities in the vaccination process. To support those advocacy efforts, members are urged to complete a five-minute vaccine barrier survey by 5 p.m. Jan 11. Each hospital’s vaccine coordinator who leads the organization’s COVID-19 vaccine efforts should complete the survey.

The MHA is working daily with state officials to improve vaccine communication, information, transparency, coordination of roles and more. In addition, the association will work more closely with the Michigan Association for Local Public Health to ensure information is consistent across all health departments and hospitals/health systems. Members with vaccine 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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of Dec. 14

MHA Covid-19 update

As hospitals across Michigan and the nation begin vaccinating their personnel against COVID-19, the MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Hospitals Immunizing Staff Against COVID-19

Pfizer began shipping its COVID-19 vaccine from its global warehouse in Michigan Dec. 14 and continued to deliver it to hospitals across the country throughout the week. Healthcare providers began inoculating staff members soon after the vaccine arrived. The MHA joined Gov. Gretchen Whitmer and the Michigan Department of Health and Human Services (MDHHS) in recognizing the start of this significant step and thanking healthcare workers for being first in line to receive the vaccine.

As the Pfizer vaccine was being delivered to hospitals, the Food and Drug Administration continued its process toward of evaluating the Moderna vaccine. The second vaccine was approved for emergency use the evening of Dec. 18, and initial shipments to hospitals began Dec. 20. Inoculations with the new vaccine could begin as soon as Dec. 21.

However, the MHA and its members were disappointed to learn that the U.S. Department of Health and Human Services (HHS) will reduce the originally announced allocations of the Pfizer vaccine to many states, including Michigan, during its second week of distribution. The MHA issued a media statement Dec. 18 relaying the negative impact of the delay on Michigan hospitals and will continue to seek more timely and accurate information from the HHS, as well as additional vaccine.

The MDHHS clarified Dec. 18 that hospitals will be able to request both Pfizer and Moderna vaccine. The state will continue to send weekly surveys to hospitals to determine the amount of vaccine needed the following week, which will allow hospitals to request both types of vaccine. The MHA has created a side-by-side comparison of some of the key storage, shipment and administration features of the Pfizer and Moderna vaccines, and the state will continue to post updated resources and tools on its provider education webpage, as well as additional details on its provider information document. The CDC has posted a webpage with tools and information on the Pfizer product, including interim clinical considerations. A key CDC recommendation is that the vaccine be administered alone and that providers allow 14 days between administering this vaccine and other vaccines.

While the vaccinations are widely seen as the beginning of the end of the pandemic, it will take time to inoculate everyone who wants a vaccine. Michiganders are urged to continue to mask up, practice social distancing, get their flu shots and practice hand hygiene as they await their opportunity to be vaccinated. The state provides a COVID-19 Vaccine Dashboard with information about how many providers in each county are enrolled in the vaccine program, where shipments have gone and more, with a time delay of about 24 hours.

Members with questions on matters relating to COVID-19 vaccines should contact Ruthanne Sudderth at the MHA.

Congress Agrees on National COVID-19 Relief Package

News outlets reported the evening of Dec. 20 that congressional leaders had reached bipartisan agreement on providing financial relief to U.S. residents and businesses struggling due to the pandemic, including making grants available to healthcare providers. The legislative text was still being crafted that night, and voting is expected to take place Dec. 21.

MHA Requests Order Allowing HCP Experiencing Vaccine Side Effects to Work

The MHA sent a letter Dec. 17 to MDHHS Director Robert Gordon and Chief Medical Executive Joneigh Khaldun, MD, urging them to issue an order that ensures healthcare personnel (HCP) who recently received COVID-19 vaccines are not unnecessarily removed from the workforce because of vaccine side effects that mimic COVID-19 infection. The letter requested the order exclude known vaccine side effects from the definition of COVID-19 symptoms Public Act (PA) 238 of 2020, which requires that employees displaying the principle symptoms of COVID-19 not report to work until 10 days after the principal symptoms of COVID-19 first appeared. The principle symptoms of COVID-19 include known side effects of both the Pfizer and Moderna vaccines. PA 238 further gives the director or chief medical executive of the MDHHS the power to issue an order modifying the definition of COVID-19 symptoms. The MHA noted that, without an order from the MDHHS exempting symptoms from a known vaccine administration, there could be unnecessary staff absences due to the inoculations.

The MHA encouraged the state to consider recently issued official CDC guidance on handling HCP who have received COVID-19 vaccines and experience mild side effects as it makes decisions on this issue. The CDC guidance urges healthcare facilities to evaluate any personnel who have symptoms but recently received vaccine and allow HCP to continue working as appropriate, depending on the nature and severity of the symptoms. This guidance applies only to symptoms such as fever and fatigue and not to those that are not known side effects of the vaccines, such as cough and loss of taste/smell.

MDHHS Order Relaxed but Extended to Jan. 15

The MDHHS announced Dec. 18 that it is extending to Jan. 15 a public health order that will keep restaurants and bars closed to indoor dining, but will reopen many other indoor venues where patrons can wear masks while inside. The governor and the MDHHS indicated the orders that have been in place since November have contributed to an improvement in Michigan’s COVID-19 year-end surge.

The new order reopens in-person learning at high schools and indoor entertainment venues. Casinos, bowling centers and movie theatres will be allowed to reopen with total capacity capped at 100; food and drink concessions closed; and social distancing requirements in place. The order takes effect Dec. 21.

OBRA Electronic System Again Delayed

The MDHHS Office of Specialized Nursing Home/Omnibus Budget Reconciliation Act (OBRA) Programs recently announced an additional delay in changing the submission of forms 3877 and 3878 from a paper process to an electronic one. The “go live” implementation date of the online system has been delayed from Jan. 19 to at least April 2021 (see related article).

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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of Dec. 7

MHA Covid-19 update

Developments with the novel coronavirus are occurring quickly, as the first shipments of the Pfizer COVID-19 vaccine have gone out and the federal government continues to grapple with legislation to assist American businesses and residents. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Healthcare Community Urged to Contact Congress on COVID-19 Relief

As the 116th U.S. Congress is entering its final weeks, a COVID-19 relief package is still being negotiated. A bipartisan group of senators led by Sens. Joe Manchin (D-WV) and Mitt Romney (R-UT) is proposing more than $900 billion in aid for state and local governments, small businesses and healthcare providers. Transportation, unemployment, education, vaccine distribution, and testing and tracing are also included in the package. Funding for healthcare providers includes $35 billion allocated to the Provider Relief Fund (PRF), with $7 billion for rural providers and $1 billion for tribes, tribal organizations, urban Indian health organizations and health service providers to tribes. The plan also includes improvements to PRF reporting guidelines, such as clarification that PRF can be used for staffing, including child care staff, and health systems are allowed flexibility to move targeted PRF distributions within their system. It is possible the bipartisan package could be formally introduced Dec. 14.

Hours before funding for the federal government expired Dec. 11, Congress approved a one-week funding extension to Dec. 18. The extension provides negotiators with several more days to agree to a Continuing Resolution for all government funding and a COVID-19 relief package. Members are asked to contact their U.S. House representative and Michigan Sens. Debbie Stabenow and Gary Peters to encourage the following support for hospitals in the end-of-year package:

  • Provide more COVID-19 relief, including additional money for the PRF, federal liability protections, support for front-line healthcare workers, coverage for the uninsured, and accelerated payment forgiveness.
  • Eliminate cuts to the Medicaid disproportionate share hospital program in the next fiscal year.
  • Extend the congressionally enacted moratorium on the application of the Medicare sequester cuts until the public health emergency ends.

Members are also asked to urge that the following provisions be excluded from any package that reaches the House or Senate for a vote:

  • Problematic proposals under consideration related to surprise medical billing, including any “agreement” that takes money from providers without protecting patients.
  • Any provisin that would require new, unrealistic and burdensome Occupational Safety and Health Administration standards.

With strong advocacy from the healthcare community, Congress could pass a COVID-19 Relief Package before adjourning for the year. For more information about end-of-year federal activity, members may contact Laura Appel at the MHA.

Pfizer Vaccine Approved and Being Shipped, Priority Groups Finalized

The U.S. Food and Drug Administration (FDA) issued an emergency use authorization determination for the Pfizer COVID-19 vaccine late Dec. 11 and shipments began leaving Kalamazoo Dec. 13.

The Michigan Department of Health and Human Services (MDHHS) had provided additional information about COVID-19 vaccination plans for the state earlier Dec. 11, including priority groups for vaccination administration. The MDHHS slides from the news conference are available online.

The MDHHS is following the recently issued Centers for Disease Control and Prevention recommendations for prioritization of distribution and administration of COVID-19 vaccines. CDC recommendations are based on input from the Advisory Committee on Immunization Practices (ACIP). In addition, multiple health systems and the MHA took part in a stakeholder meeting in November to provide input on Michigan’s priority groups.

  • Phase 1A includes paid and unpaid individuals serving in healthcare settings who have direct or indirect exposure to patients or infectious materials and are unable to work from home, as well as residents of long-term care facilities.
  • Phase 1B includes some workers in essential and critical industries, including workers with unique skill sets such as nonhospital or nonpublic health laboratories and mortuary services.
  • Phase 1C includes people at high risk for severe COVID-19 illness due to underlying medical conditions and people 65 years and older.
  • Phase 2 is a mass vaccination campaign for all adults.

The MDHHS vaccination plan includes additional prioritization guidance within these categories. It was stressed that vaccination in these phases will likely overlap. The timing of the start of vaccination in a phase is dependent on guidance from the CDC and the ACIP, the supply of vaccine from the manufacturer, how vaccine is allocated from the federal level to Michigan and the capacity to administer the vaccine to populations.

The MHA will continue to provide updates on vaccine distribution as they become available. Members who receive updates directly from the MDHHS are encouraged to share that information with the MHA for vetting or broader distribution. Members with questions and information may contact Ruthanne Sudderth at the MHA.

MDHHS “Pause” Extended to Dec. 20

The MDHHS announced Dec. 7 that it was extending to Dec. 20 its Nov. 18 emergency order limiting indoor gatherings and requiring mask wearing. Previously set to expire at midnight Dec. 8, the extended order slightly relaxes some of the previous order’s restrictions; for example, it allows for in-person instruction of certain trade/vocational programs, with protections in place.

The MDHHS announcement comes on the heels of the MHA’s Dec. 7 letter, published on behalf of MHA-member chief medical officers, urging the state to continue some degree of protection so that the slight progress in hospitalizations achieved since Nov. 18 does not regress. The MHA also issued a statement recognizing the order extension following the MDHHS announcement and has conducted media interviews with outlets from across the state. Links to some of the media coverage is available in a related article.

Data Tracking COVID-19 Patients, New Reporting Requirements

  • Hospitals have asked for clarification on how to count patients who are no longer in COVID-19 isolation for reporting into the state’s EMResource portal or the national TeleTracking portal. According to guidance from the U.S. Department of Health and Human Services (HHS), COVID-19 patients should continue to be counted in the COVID-19 daily census and COVID-19 ICU census regardless of their isolation status or change in location (e.g. transferred out of a COVID-19 unit). Once a patient has been identified as COVID-19-positive, they should always be counted in your daily COVID-19 census until discharged or expired. Only the data field that pertains to hospital onset COVID-19 patients should take into account the change in COVID-19 isolation status.
  • The HHS recently released new COVID-19 reporting guidance for hospitals. The influenza data fields will be mandatory (except psychiatric and rehabilitation facilities) starting Dec. 18. In addition, beginning Jan. 8, 2021, new therapeutic fields will be mandatory each Wednesday. These fields will be designated with generic identifiers (currently using only the letters A and B) to provide flexibility to the HHS on new therapeutics. Therapeutic A has been designated for Casirivimab/Imdevimab and therapeutic B has been designated for Bamlanivimab data collection.

Members with questions on data should contact Jim Lee at the MHA.

COVID-19 Webinar Series Available for All Hospitals

A weekly Mi-COVID19 webinar series began Dec. 9 that aims to continue collaboration and share COVID-19-related lessons learned with stakeholders and experts across multiple disciplines to support Michigan hospitals and providers in caring for COVID-19 patients. The series is hosted by the Mi-COVID19 Initiative, part of the Michigan Hospital Medicine Safety Consortium.

These webinars will be held from noon to 1 p.m. each Wednesday and are currently scheduled through Feb. 24. Webinar topics and registration information are available online.

CME/CE credit is being offered for each webinar. The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of Michigan Medical School designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For information on future webinars, webinar recordings and COVID-related resources, visit the Mi-COVID19 Initiative webpage. To share COVID-19-related resources, contact the Mi-COVID19 leadership team.

An additional series of education webinars for providers on COVID-19 vaccine is available from the MDHHS. Three 30-minute presentations will be offered from noon to 12:30 p.m. on the following dates and can be joined via the appropriate link:

  • Dec. 14: An Update on the Pfizer COVID-19 Vaccine
  • Dec. 21: An Update on the Moderna COVID-19 Vaccine
  • Dec. 22: Talking Points for Common COVID-19 Vaccine Concerns

No registration is required for these three webinars, and no continuing education credits are offered. Recordings will be made available for those who are unable to attend.

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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Weeks of Nov. 23 and Nov. 30

MHA Covid-19 update

COVID-19 patients continued to fill Michigan hospitals throughout the Thanksgiving holiday and into December, while drug companies Pfizer and Moderna applied for emergency authorization of their respective COVID-19 vaccines from the Food and Drug Administration (see related article). The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Nursing Home Application Deadline Extended; CRC Bulletin Issued

The state announced Nov. 30 that it is extending the deadline from Dec. 1 to Dec. 15 for long-term care (LTC) facilities to become care and recovery centers (CRCs) and COVID relief (CR) facilities. The MHA has advocated for this extension to ensure LTCs do not transfer residents to hospitals without medical indication simply to avoid being out of compliance with new law requirements. While this is a positive step, the MHA will continue to advocate for more permanent solutions to transfer issues and the number of LTCs approved as CRCs and CR facilities.

The MDHHS also issued a bulletin for hospital-based CRCs. Bulletin Number MSA 20-78 supplements Bulletin Number MSA 20-73, which established operational requirements for nursing facilities to operate as CRCs during times of a public health emergency and provides a pathway for Michigan hospitals to establish hospital-based CRCs to support the safe care and isolation of COVID-19-positive individuals. Details about requirements for hospitals seeking designation as a CRC, how to apply and more are available in the bulletin.

Quarantine Duration Requirements Addressed

The MHA hosted its weekly call of hospital/health system chief medical officers Dec. 4, which was joined by representatives of the MDHHS. Among the topics discussed was quarantine requirements and the new guidance from the Centers for Disease Control and Prevention (CDC) advising the public that shorter quarantine periods of 7-10 days may be acceptable, depending on their access to testing and their symptoms or lack thereof.

According to Public Act 238 of 2020, healthcare workers who are exposed to COVID-19 but test negative and are not symptomatic are still able to report to work. Employees’ quarantine needs apply to how they spend time outside of work. There remains in state statute a 14-day quarantine provision for employees who test positive for COVID-19. The MHA is working with state officials and legislators to amend Public Act 238 of 2020 to bring quarantine times for employees who test positive in line with the CDC guidance. Additional information on the statute and administration rules is available from the Michigan Occupational Safety and Health Administration (MIOSHA), as discussed below.

Healthcare facilities and professionals may get questions from patients/community members on this change in quarantine guidance. The state announced its recommendation that the public continue to use the 14-day quarantine as a best practice, but if that is not feasible, the 10-day recommendation should be followed. The state did not endorse a seven-day quarantine with a negative test as a safe alternative.

MIOSHA Emergency Rules Clarified

The MHA hosted a call Dec. 1 with representatives from MIOSHA regarding its emergency rules that, among other items, emphasize the use of a remote workforce and proper use of personal protective equipment.

MIOSHA provided an overview of the rule set and answered questions, emphasizing the agency’s reliance on CDC guidelines in developing the rules and the availability of the free MI Symptoms app to assist employers. Questions or requests for the meeting materials should be directed to Adam Carlson at the MHA.

New Uses of Surge Capacity Beds May Require Certificate of Need Approval

Temporarily licensed surge capacity beds that have already been approved by the Bureau of Community and Health Systems (BCHS) may continue to be used if the following criteria are met:

  • An originally required emergency certificate of need (CON) approved by the MDHHS remains in effect.
  • The facility has maintained the BCHS-approved surge capacity so that it can be used within 48 hours if needed.
  • The facility has not notified the BCHS since the original approval that it has voluntarily surrendered the surge capacity.

If facilities with existing BCHS-approved surge capacity beds want to operate these beds in a different location, manner or use than originally requested, they must contact the MDHHS CON program, as applicable, and the Michigan Department of Licensing and Regulatory Affairs (LARA) State Licensing Section to determine whether new approval is required. Such requests must include a detailed narrative description of the proposed new use, space and floor plans of the area showing the new bed locations. If the proposed space deviates from current BCHS physical plant regulatory requirements, such as minimum square footage, hand sink locations or number of patients/residents to a room, the facility must include a narrative description of how those issues will be addressed to ensure patient/resident safety and care needs.

If the state has questions or concerns on a proposal as submitted, the Health Facilities Engineering Section engineer assigned to the facility will follow up as needed to address those concerns.

All applications not previously approved must apply to both the MDHHS and LARA as applicable and required. Both BCHS-HFD and Appendix E forms are required when applying. Members with questions may contact Paige Fults at the MHA.

BCBSM Provides Update on Coverage for COVID-19 Care and Testing

Blue Cross Blue Shield of Michigan (BCBSM) recently announced that it will continue to waive cost-sharing for its members diagnosed and treated for COVID-19 through March 31, 2021. This extension of a temporary benefit, originally set to expire Dec. 31, means members will not pay out-of-pocket costs — copays, deductibles or coinsurance — for the medical care and pharmacy costs associated with COVID-19. Members with feedback or questions are encouraged to contact Jason Jorkasky at the MHA.

Judge Denies Injunction for Bars, Restaurants Ordered Closed by MDHHS

A federal judge Dec. 2 denied a motion for preliminary injunction seeking to end the temporary MDHHS-ordered closure of bars and restaurants intended to prevent further spread of COVID-19. The MHA submitted an amicus or “friend of the court” brief in support of the temporary emergency measures enacted by the MDHHS. The MHA also issued a media statement supporting the order, which is effective from Nov. 18 through Dec. 8.

The ruling on Michigan Restaurant and Lodging Association v. Gordon was issued by Judge Paul Maloney of the U.S. District Court for the Western District of Michigan. It states that the motion was not granted to plaintiffs because it found the MDHHS’ reasoning for the order convincing and that groups tend to linger more in those settings than transitional environments like a food court or airport dining area.

Maloney further stated that, because the Michigan courts have not yet had an opportunity to evaluate the state issues and these challenges must be adjudicated before the federal claims can be considered, he scheduled a Dec. 17 certification hearing and will accept briefs from the parties to determine which legal questions to pass on to the state courts for further consideration. The MHA’s brief in support of the MDHHS provided medical evidence of the effectiveness of face covering and social distancing in curbing the spread of infection and reducing strain on the healthcare system. There are several other legal challenges in federal and state court against state and local public health orders requiring face coverings, social distancing measures and cooperation with contact tracing. Members with questions about the ruling may contact Amy Barkholz 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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of Nov. 16

MHA Covid-19 update

MHA COVID-19 UpdateAs the Thanksgiving holiday approaches, the number of hospitalizations due to COVID-19 continues to rise. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Vaccine Studies Show 95% Effectiveness

Moderna announced Nov. 16 that the latest trials and studies of its COVID-19 vaccine show 95% effectiveness, and Pfizer updated its findings Nov. 18, announcing its vaccine also shows 95% effectiveness. Moderna’s results stem from its Phase 3 clinical trial of 30,000 individuals, and Pfizer’s efficacy rate resulted from a final analysis of its trial with more than 41,000 volunteers. Both vaccines use messenger RNA (mRNA) technology to cause the effective immune response. A key difference between the vaccines is that Moderna’s vaccine can be safely stored in freezers at about 25 degrees Fahrenheit (minus 4 degrees Celsius), a temperature easily reached by a normal freezer. The Pfizer vaccine requires ultracold storage only achieved by specialized freezers or dry ice.

Pfizer applied with the Food and Drug Administration for emergency use authorization of its vaccine Nov. 20, and Moderna expects to soon apply for the authorization. Although distribution dates are not yet certain, the Michigan Department of Health and Human Services (MDHHS) has advised that providers should be prepared to accept vaccine by early December to ensure expedient distribution and administration when shipments begin. Members with questions may contact Ruthanne Sudderth at the MHA.

Provider Relief Fund Further Clarified

The U.S. Department of Health and Human Services (HHS) has issued two important clarifications related to Provider Relief Fund (PRF) reporting.

The HHS had previously stated that providers could claim only the value of depreciation for COVID-19-related capital purchases with useful lives of more than 12 months. However, after urging from the American Hospital Association and the MHA, the agency stated that expenses for capital equipment, facilities projects and inventory may be fully expensed in cases where the purchase was directly related to the prevention, preparation for and response to COVID-19. Examples of such purchases include:

  • Upgrading heating, ventilation and air conditioning systems to support negative pressure units.
  • Retrofitting COVID-19 units.
  • Enhancing or reconfiguring intensive care unit capabilities.
  • Leasing or purchasing temporary structures to screen and/or treat patients.
  • Leasing permanent facilities to increase hospital capacity.

The HHS also clarified that providers’ reporting of net patient revenue should NOT include payments received from or made to third parties that relate to care not provided in 2019 or 2020.

For more information on the PRF, contact Jason Jorkasky at the MHA.

COVID-19 ICU Best Practices Follow-Up Webinar Offered Nov. 24

A Nov. 11 COVID-19 webinar titled “ICU Management & Treatment of COVID-19 Patients” was hosted under the MI-COVID19 registry continuous quality improvement initiative and provided meaningful discussion for participants. As a result, a follow-up webinar has been scheduled for noon to 1 p.m. EST Nov. 24. Objectives include:

  • Summarizing the latest COVID-19 intensive care unit (ICU) guidelines and recommendations.
  • Discussing best practices for management of critically ill COVID-19 patients.
  • Identifying resources and creating a network for ICU leaders in Michigan to advance the care of critically ill COVID-19 patients.

Members may register online, and questions should be emailed to covid19clinicalsupport@umich.edu.

CDC Offers Education on Telehealth and Health Equity Dec. 8

The Centers for Disease Control and Prevention (CDC), through its Clinician Outreach and Communication Activity division, will host an educational event via Zoom from 2 to 3 p.m. EST Dec. 8 that will focus on telehealth and health equity. Details and access information for the event are available online. Presenters from Kaiser Permanente and the Veterans Health Administration will discuss how telehealth has affected health equity in their patient populations before and during the COVID-19 pandemic.

Topics will also include challenges and opportunities related to telehealth implementation. Presenters will share strategies to expand access that can reduce disparities and improve culturally responsive care to help achieve health equity within each organization. In addition, presenters from the CDC will share telehealth strategies that incorporate the CDC’s frameworks for Addressing Health Equity in Public Health Practice.

In associated news, the MHA recently released its Pledge to Address Racism and Health Inequities that was approved by the MHA Board of Trustees at its Nov. 4 meeting (see related article).

COVID-19 Relief Facility Application Now Open

The state has released the application for being designated a COVID-19 Relief (CR) Facility, which are designed to allow eligible Nursing Facilities to retain COVID-19-positive residents. These facilities will meet criteria established in Senate Bill 1094 to care for COVID-19-positive residents who become ill and do not require hospital-level care. The purpose of the CR Facilities is to provide care in place with enhanced infection control measures for individuals with confirmed COVID-19 who have not met the criteria for discontinuation of Transmission-Based Precautions and have limited access to the state’s Care and Recovery Centers. All approved CR Facilities may retain, or readmit after acute care, their own COVID-19-positive residents.

Facilities must meet certain criteria to qualify for CR Facility designation or admission of new COVID-19-positive residents, as detailed in Bulletin Number MSA 20-73 from the Medical Services Administration. The bulletin also provides a list of documents and details applicants should have prepared before applying.

Completed applications should be submitted by 5 p.m. Dec. 1. The MDHHS, in partnership with the Michigan Department of Licensing and Regulatory Affairs, will review applications as they are received. Notification of application status will be contingent upon the volume of applications received. However, it is estimated that facilities seeking CR Facility designation may expect to be notified about the determination within one to two weeks of application submission. Questions about CR Facilities may be submitted to the MDHHS via email.

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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of Nov. 9

MHA Covid-19 update

MHA COVID-19 UpdateThe Michigan Department of Health and Human Services (MDHHS) issued a new emergency order the evening of Nov. 15 limiting certain indoor gathering opportunities for three weeks in light of the exponentially increasing COVID-19 cases and hospitalization across the state. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

MDHHS Issues Emergency Order Outlining Restrictions

The MDHHS issued a new emergency order Nov. 15 that attempts to curb community spread of COVID-19 by limiting indoor gathering opportunities at various venues for three weeks. These new restrictions do not place any limits on access to healthcare. The order takes effect at 12:01 a.m. Wednesday, Nov. 18.

Under this order, indoor residential gatherings are limited to two households at any one time. The order is aimed at limiting residential and nonresidential gatherings where COVID-19 spreads rapidly. Bars and restaurants will be open for outdoor dining, carry-out and delivery only. Gyms will remain open for individual exercise with strict safety measures in place. Casinos, movie theaters and group exercise classes will be closed. Professional and college sports meeting extraordinary standards for risk mitigation may continue without spectators; however, all other organized sports must stop. Colleges and high schools may proceed with remote learning, but must end in-person classes. The MDHHS has created an infographic explaining what is closed and what will remain open.

The MHA issued a media statement upon the MDHHS announcement, indicating appreciation for the strong and swift response to the current surge in COVID-19 cases that is stretching hospitals and healthcare personnel thin.

Public Cooperation Urged to Prevent Community Spread

The Michigan Economic Recovery Council held a virtual news conference Nov. 12 featuring its healthcare leader members to urge Michiganders to improve their preventive actions to help stop community spread of COVID-19. Participants included MHA CEO Brian Peters; Ed Ness, president & CEO, Munson Healthcare, and MHA Board Chair; Wright Lassiter, president & CEO, Henry Ford Health System; John Fox, president & CEO, Beaumont Health; and Tina Freese Decker, president & CEO, Spectrum Health. To add an Upper Peninsula perspective, Gar Atchison, market president, Upper Peninsula Health System, also took part in the conference. More than 20 news outlets from around the state joined the event (see related article).

Health system leaders shared the increasing challenges their facilities are having due to staff becoming sick in the community, tightening testing capacity, transfer difficulties as a result of widespread surge and more. When asked about state government action, the health leaders reminded Michigan residents that, if everyone does the right thing, there will be no need to return to the strict shutdowns experienced in the spring. Gov. Gretchen Whitmer held a news conference later that day, sharing updated case numbers and urging public compliance with preventive measures.

The MHA also issued a news release containing current data on hospitalizations. Members are encouraged to continue to engage their trustees and local business networks to emphasize that, by working together, the surge can be stopped. For more information, contact Ruthanne Sudderth at the MHA.

Distribution of Bamlanivimab Monoclonal Antibody

The MDHHS held a conference call with healthcare providers Nov. 12, outlining the process for distributing the newly approved COVID-19 antibody treatment bamlanivimab in Michigan. The state expects to receive 3,240 vials in the initial shipment and will release information on the treatment protocols. The MDHHS is still confirming the allocation strategy and expects to coordinate weekly distributions directly from Amerisource Bergen to hospitals based on the data reported for COVID-19 cases and hospitalizations. The MDHHS stated that it has been in direct contact with hospital pharmacy directors to discuss the distribution process, which will be adjusted weekly based on need. The MHA will provide an update as more information becomes available. Members with questions may contact Paige Fults at the MHA.

New COVID-19 Task Force Named; Pfizer States Vaccine 90% Effective

Though President Donald Trump’s campaign team continues to challenge election results, the Biden/Harris campaign has announced its COVID-19 task force and plan to handle the pandemic. The likely change in administrations is sure to bring change in pandemic response that will impact health systems and hospitals, as well many others. The MHA has begun to review the Biden/Harris plan and will inform members about what is expected to change or remain the same. Some of the key areas the association will watch include:

  • Testing strategy.
  • Supply chain strategy.
  • Data reporting.
  • Provider relief.
  • National consistency in preventive/containment measures.

In addition, Pfizer announced that its COVID-19 vaccine, long expected to be the first available, is currently showing 90% effectiveness against the virus. According to reports, Pfizer plans to ask the Food and Drug Administration for emergency authorization of the two-dose vaccine by the end of November, after it has collected the recommended two months of safety data. Pfizer also stated that it will have manufactured enough doses to immunize 15 million to 20 million people by the end of 2020.

COVID-19 Vaccine Distribution Plans Reviewed

The MHA held a call Nov. 13 for member hospitals and the MDHHS to discuss plans for distribution of the COVID-19 vaccines to health system and hospitals in the coming weeks. More than 170 individuals joined this important discussion.

The MHA will update and share with members a frequently asked questions document that will capture the lengthy question-and-answer session from the call. The discussion recapped expected shipment and storage requirements for vaccines A and B (expected to be Pfizer and Moderna vaccines), working with local health departments to ensure coordination in specific regions/communities, and much more. The MDHHS will send hospitals a follow-up survey to guide distribution, as well as a form for eventual redistribution among each organization’s locations. Members with questions may contact Ruthanne Sudderth at the MHA.

State Launches COVID-19 Contact Tracing Smart App

The state has officially launched MI COVID Alert, an app that lets users know if they have been in close physical proximity to someone who has tested positive for COVID-19. The app maintains broad privacy for users; it asks users to self-report positive COVID-19 tests and, using smartphone technology, knows what other users may have been exposed. It then alerts those users to a potential exposure. As hospital and health system employees are increasingly impacted by community spread, members are encouraged to have them consider using MI COVID Alert to help maintain maximum awareness of exposure risks. The app is free to download on both iPhone and Android devices via their respective app stores.

Members’ marketing and communications teams should also consider sharing this app on social media sites for communities to see and access. The state has created social media graphics so anyone can easily share information about the app on their social networks.

Given the ongoing challenges with Michiganders’ comfort level with standard contract tracing, this is another more confidential tool providers can urge the public to use to improve exposure awareness.

Operation Warp Speed Releases Playbook for COVID-19 Therapeutics

Operation Warp Speed, the federal government’s operation for planning COVID-19 vaccination and treatment, recently released an initial playbook to assist providers in planning. The playbook comes in anticipation of the likely issuance of emergency use authorizations for at least two monoclonal antibody therapeutic drugs developed to treat certain COVID-19-positive patients. The playbook lays out important information for hospitals and health systems to consider, including administration, details on the two drug options, who should receive the therapeutic and a site checklist. Members are encouraged to review the playbook for additional details.

Revised Clarification on License Exemptions

The Bureau of Professional Licensing within the Michigan Department of Licensing and Regulatory Affairs (LARA) has released a revised version of its guidance document clarifying when exemptions of Michigan licensure apply to health professionals. The most notable update includes flexibility to allow providers from other countries that are licensed and in good standing to practice in the state and permit students in their last year of an accredited program to assist in care for those affected by COVID-19. That flexibility had been lost with the rescission of Executive Order 2020-61.

Although LARA does not require documentation on these individuals, it must be made available in the event the department receives an official complaint about an individual provider. The MHA recommends hospitals continue to follow the updated compliance memo related to proper tracking for all individuals who are eligible for the license exemption. Members with questions should contact Paige Fults at the MHA.

MDHHS Announces New Reimbursement for SNF Care and Recovery Centers

The MDHHS rolled out a new application for skilled nursing facilities that are interested in becoming Care and Recovery Centers (CRCs). Included in that application is an updated reimbursement schedule for CRCs that, upon approval by the department, specialize in the care and treatment of nursing facility patients who have previously tested positive for COVID-19 and have not yet met criteria for discontinuation of Transmission-Based Precautions. The reimbursement schedule now provides payments based on number of beds with a $40,000 – $80,000 preparedness stipend, monthly deposit of $10,000 – $20,000, and a bed premium of $200 per COVID-19 day.

Job Fair for Southeast Michigan Healthcare Scheduled for Dec. 2

As members’ staffing challenges grow, the MHA continues to seek opportunities to assist. The association is a member of the Health Careers Alliance for Southeast Michigan, which is hosting a healthcare job fair from 9 a.m. to noon Dec. 2 and urges any employers in or near that region to participate. Hospitals and health systems can register online as employers; 20 employer slots were available as of Nov. 13. Members with specific questions about participation may contact Sarah Gregory, director of talent development, at the
Workforce Intelligence Network.

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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of Nov. 2

MHA Covid-19 update

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.

Opportunity Set for Hospitals to Discuss Vaccine Distribution with State

The MHA continues to interface with the Michigan Department of Health and Human Services (MDHHS) on both COVID-19 and flu vaccine planning.

The MDHHS Immunizations Division and Michigan Chief Medical Executive Joneigh Khaldun, MD, have invited hospitals to discuss COVID-19 vaccine distribution. MHA members are encouraged to identify a chief medical officer, COVID-19 vaccine director and/or other staff member within their organization to participate in this conversation from 8 to 9 a.m. Nov. 13 via Zoom. The MHA will also provide hospitals with a summary and next steps following the meeting. For instructions to join the meeting, contact the MHA by Nov. 12.

The state is finalizing its COVID-19 stakeholder work group, and the MHA has worked to ensure that the association, a small/midsize hospital and a large health system are represented.

Members with vaccine-related questions should contact Ruthanne Sudderth at the MHA.

Provider Relief Fund Reporting Requirements Clarified

The U.S. Department of Health and Human Services (HHS) recently issued a clarification to its Oct. 22 reporting requirements for providers that received Provider Relief Fund payments. Specifically, the Oct. 22 guidance stated that recipients must report their use of PRF payments by submitting the following information:

  1. Healthcare-related expenses attributable to COVID-19 that another source has not reimbursed and is not obligated to reimburse, which may include General and Administrative or healthcare-related operating expenses.
  2. PRF payment amounts not fully expended on healthcare-related expenses attributable to COVID-19 are then applied to patient care lost revenues, net of the healthcare-related expenses attributable to COVID-19 calculated under Step 1. Recipients may apply PRF payments toward lost revenue, up to the amount of the difference between their 2019 and 2020 actual patient care revenue.

As urged by the MHA and the American Hospital Association, the HHS now states that healthcare-related expenses will not be netted against patient care lost revenue in Step 2.

Members with questions on the reporting requirements may contact Jason Jorkasky at the MHA.

Progress Made on COVID-19-related Legislation

Gov. Gretchen Whitmer signed House Bill (HB) 6293 Nov. 5, allowing nonclinicians to order COVID-19 tests. The legislation largely codifies Executive Order 2020-104, which was invalidated by the Michigan Supreme Court ruling in October. The legislation extends the flexibility on ordering COVID-19 tests through June 30, 2021. To request a list of Executive Orders that have been codified in law or otherwise re-authorized by the administration, contact Sean Sorenson-Abbott at the MHA.

The Michigan Senate passed Senate Bill (SB) 1185, also known as the “pandemic health care immunity act,” Nov. 5. The governor signed identical language into law Oct. 28 (HB 6159), but Sen. Curt VanderWall (R-Ludington) introduced SB 1185 to potentially expand the liability time period beyond March 9 through July 15, should additional protections be necessary. The MHA supports the legislation and will continue to monitor SB 1185.

Nov. 11 Webinar to Discuss COVID-19 ICU Best Practices

A webinar will be held from noon to 1 p.m. EST Nov. 11 to discuss best practices of the treatment and management of COVID-19 patients in preparation for a resurgence of the disease through the fall and winter. Hosted by the Mi-COVID19 registry continuous quality improvement initiative, the webinar will feature panelists from Henry Ford Health System, Michigan Medicine, MidMichigan Health and Spectrum Health. Online registration is required to participate.

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). Members with MHA-specific questions should contact the following MHA staff members:

Combating the Novel Coronavirus (COVID-19): Week of Oct. 26

MHA Covid-19 update

Michigan, the U.S. and much of the world continue to experience increasing numbers of COVID-19 cases, and the Michigan Department of Health and Human Services revised and extended its epidemic order Oct. 29 to contain the spread of the coronavirus. 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.

Polling Shows Michiganders Understand COVID-19 Precautions, Visiting Hospitals is Safe

A statewide survey done by EPIC-MRA conducted on the MHA’s behalf indicates that 91% of Michigan voters agree that Michiganders taking responsibility to wear masks, wash their hands and socially distance would help hospitals fight the virus. The survey also found that 85% of Michigan voters feel comfortable and safe visiting a healthcare facility for routine checkups, medical screenings and emergency room care. (See related news release.)

Information Blocking Rule Deadline Delayed

Due to the ongoing challenges providers are experiencing with the COVID-19 pandemic, the Office of the National Coordinator for Health Information Technology (ONC) released Oct. 29 an Interim Final Rule that extends the compliance dates to meet information blocking and Conditions and Maintenance of Certification from Nov. 2 to April 5. This is welcomed news as the MHA has been engaged with members on the issues and challenges this rule would have with sharing patient information. The extension of various compliance dates in this Interim Final Rule can be found on the ONC Fact Sheet.

Hospitals are encouraged to continue working toward compliance with the Information Blocking Rule, as the ONC stated this is only a delay and it intends to continue moving forward with these rules and regulations. Members with questions can contact Jim Lee at the MHA.

MIOSHA Releases FAQs on Emergency Rules

The Michigan Occupational Safety and Health Administration (MIOSHA) recently released several frequently asked questions (FAQs) regarding its Emergency Rules issued Oct. 14. The rules largely represented the codification of Executive Orders 2020-153, 2020-184 and 2020-190, which set requirements on employers for following COVID-19 protocols such as mask wearing and employee screenings. Of particular note, the FAQs seek to clarify the record-keeping requirements set forth in the emergency rules, especially as they pertain to those working in the health field.

The MHA continues to work with MIOSHA on additional FAQs and clarifications to the rule set. Members with questions should contact Adam Carlson at the MHA.

COVID-19 Meeting Invitation from Legislative Leadership

Senate Majority Leader Mike Shirkey and Speaker of the House Lee Chatfield extended an invitation to Gov. Gretchen Whitmer, Senate Minority Leader Jim Ananich, House Minority Leader Christine Greig, MHA Chief Medical Officer Gary Roth, DO, and the chief medical officers listed in the Oct. 22 joint statement on COVID-19 policies for a discussion regarding the impact of COVID-19 on Michigan. The MHA will provide additional information when it is available. The united message of the MHA and its members remains that following COVID-19 prevention efforts is vital to breaking the cycle of this disease. Members with questions should 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 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members: