MHA CEO Report — The Story of the MHA Program Year

MHA Rounds Report - Brian Peters, MHA CEO

“Plans are only good intentions unless they immediately degenerate into hard work.”Peter Drucker

MHA Rounds Report - Brian Peters, MHA CEOThe theme of the 2022-2023 MHA program year was telling our story. With focus and passion, we told the stories of our hospitals and health systems, the challenges and adversity they face, and how they still provide high quality and accessible healthcare to their communities. This theme was intended to ensure that we as healthcare leaders continue to help those who don’t live and breathe healthcare understand the ways we are working to meet the most pressing needs, but also the support we need from other sectors to continue to offer strong and daily access to care for all. Our theme served to frame the four distinct pillars of our association strategic action plan, which included the financial sustainability of hospitals, workforce restoration and well-being, the behavioral health crisis and continued efforts towards achieving health equity.

I’m pleased to share we made significant progress in telling our story and achieving tangible, impactful results under each of the four strategic pillars, which is summarized in the latest MHA Annual Report. This work evolved around the ending of the COVID-19 public health emergency, a pandemic that tried our member organizations, and especially their healthcare workers, like nothing has before in most of our lifetimes. A large part of our success in making this transition and achieving so many significant outcomes was due to the MHA Board of Trustees, who I want to thank for their strong leadership and commitment to advancing the health of individuals and communities. I particularly want to express my gratitude to our outgoing Chair, T. Anthony Denton, for his steadfast leadership throughout this year.

Key to our efforts to safeguard the financial viability of hospitals is our continued focus on the state budget. Not only were we successful in continuing existing supplemental payment pools such as for Disproportionate Share Hospitals, Graduate Medical Education, Rural Access and Obstetrical Stabilization, but we also secured a Medicaid outpatient hospital rate increase. Collectively, these victories generated hundreds of millions in funding for Michigan hospitals. Long a priority of our association, the MHA also successfully advocated to ensure the Healthy Michigan Plan (our Medicaid expansion program) is fully funded. Our advocacy team continues to be one of the most respected in Lansing, as we saw several MHA-supported bills signed into law while experiencing a 100% success rate in making sure none of the 10 bills we opposed became statute.

Each of the four pillars are equally important to our membership, but it is hard to overstate just how important workforce restoration and well-being is to our healthcare leaders. This is the issue that keeps each of them up at night, whether it is finding new staff or protecting and retaining their existing workers. Our advocacy efforts secured an additional $75 million in funding to support the hospital workforce while also securing $56 million in funding to support partnerships to offer Bachelor of Science in Nursing programs at community colleges. We also continue to advocate for increased penalties for those who verbally or physically harm healthcare workers, providing them with protections they deserve as front-line caregivers, much like emergency responders receive. The MHA Keystone Center has been active in offering well-being resources, trainings, safety and security risk assessments and other offerings, continuing their long history as a leader in safety and quality not just here in Michigan, but nationally and internationally. Lastly, we recently launched a statewide healthcare career awareness campaign to entice students to pursue health career pathways.

Our work on behavioral health continues, as there remains a need to expand the number of behavioral health professionals and facilities to provide better access to care. The MHA secured both $50 million in the fiscal year 2023 state budget for expanding pediatric inpatient capacity, while adding an additional $10 million to create Psychiatric Residential Treatment Facilities to alleviate state hospital capacity issues. Much of the feedback we have received is the need to add quantitative data to the conversation to demonstrate to lawmakers and stakeholders the degree of the crisis. For several months, our team has been collecting data weekly on the number of patients waiting for a behavioral health bed in Michigan hospitals. This demonstrates the degree to which patients are having difficulty finding care, while also showing how many patients are utilizing hospital resources while the facility receives no reimbursement due to not having an acute care diagnosis billing code.

Lastly, we will not rest as our members continue to address health disparities to ensure health equity. The MHA Keystone Center works closely with the Michigan Alliance for Innovation on Maternal Health (MI AIM) to help address disparities and reduce the risk of maternal death. This past program year, their efforts resulted in 77% of Michigan birthing hospitals participating in MI AIM, 94% of which are compliant with the pre-partum assessment and 89% are compliant with the post-partum assessment. Our work with the MHA Public Health Task Force also continues as they explore strategies for collaboration that can improve data collection and public health initiatives.

Of course, there are always other items that come up that require MHA attention and effort that are not always known during the development of the strategic action plan. Responding to the shortages of chemotherapy drugs cisplatin and carboplatin and working with Michigan’s Congressional delegation is just one example of the value of association membership and how quickly we can mobilize our relationships in a time of crisis. Other wildcards include our work on licensing Rural Emergency Hospitals, tracking and increasing awareness of candida auris infections and expanding hospital bed capacity.

As we concluded our program year during our Annual Meeting on Mackinac Island, we were able to honor a true healthcare champion with our Meritorious Service Award in U.S. Sen. Debbie Stabenow. She announced earlier this year she will not seek an additional term in office and this award is the highest honor our association can bestow on an individual for their years of work towards enabling the health and wellness of individuals and communities. We have worked closely with Sen. Stabenow from her time in elected office in the Michigan Legislature to Congress and she will leave an extraordinary legacy for which the MHA family will be eternally grateful. We also had an opportunity to honor a number of other outstanding individuals for their contributions to Michigan healthcare.

Above all else, I want to take this opportunity to thank all MHA staff for their many contributions which made it another successful program year. The challenges we confront in healthcare are daunting and constantly evolving, but my confidence in our team at the MHA has never wavered, as they continue to display their exceptional commitment to their work and embody the MHA culture of member service and value creation every single day.

Now as we formally begin our 2023-24 program year on July 1, I am excited for the leadership of our new Chair Shannon Striebich. We offer our congratulations to her and look forward to working closely together. A year from now, I am confident we will once again be able to report on the successful outcomes we were able to achieve through our unity, collaboration and plain old fashioned hard work.

As always, I welcome your thoughts.

Headline Roundup: Hospital Staffing Shortages

Laura Appel speaks with WXYZ Detroit on cancer drug shortages.
Laura Appel speaks with WXYZ Detroit on cancer drug shortages.
Laura Appel speaks with WXYZ Detroit on cancer drug shortages.

The MHA received media coverage the week of June 19 regarding mandated nurse staffing ratios, legislation to address violence against healthcare workers and chemotherapy drug shortages.

MHA representatives appearing in published stories include CEO Brian Peters, Executive Vice President Laura Appel and Senior Vice President Adam Carlson.

Below is a collection of headline from around the state.

Sunday, June 25

Thursday, June 22

Wednesday, June 21

Tuesday, June 20

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA & MONL Issues Joint Statement on Harmful Nursing Legislation Introduced in the Michigan Legislature

Kim Meeker, RN, BSN, MBA, president of the Michigan Organization of Nurse Leaders.

The following joint statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association, and Kim Meeker, RN, BSN, MBA, president of the Michigan Organization for Nursing Leadership (MONL).

Kim Meeker, RN, BSN, MBA, president of the Michigan Organization of Nurse Leaders.
Kim Meeker, RN, BSN, MBA, president of the Michigan Organization of Nurse Leaders.

A package of bills announced today in the Michigan Legislature has the potential to severely harm hospitals and access to important services for patients, if ultimately passed. Proponents of the legislation falsely claim this will address nursing shortages in Michigan, but those claims couldn’t be further from the truth. Michigan hospitals are trying to fill 8,500 job openings for nurses. Instituting a one-size-fits-all mandate requiring hospitals hire more nurses who do not currently exist will limit the services hospitals can offer to their communities, prolong the time it takes for a patient to receive care and hinder the ability of hospitals to respond to a crisis in fear of violating Michigan law.

Tangible, proven steps are needed to attract more nurses to Michigan. Those include passing legislation that allows Michigan to join the Nurse Licensure Compact, expanding Michigan Reconnect eligibility and increasing penalties for those who commit acts of violence against healthcare workers.

Brian Peters
MHA CEO Brian Peters.

Michigan hospitals and health systems have been hard at work addressing nursing shortages over recent years. Those efforts include:

  • Obtaining a total of $300 million in state funding that has benefitted at least 69,000 healthcare workers for the purposes of the recruitment, retention and training through Public Act 9 of 2022 and Public Act 5 of 2023.
  • Securing additional nurse training opportunities including expanded state policy allowing four-year BSN programs at community colleges.
  • Expanding Michigan Reconnect to allow funds to support Michiganders moving from a licensed practice nurse (LPN) to a registered nurse, or from a patient care technician certificate to a LPN.
  • Modernizing the scope of practice for certified registered nurse anesthetists which allows flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources under Public Act 53 of 2021.
  • Providing emotional well-being support to healthcare workers through a partnership with the Duke Center for Healthcare Safety and Quality that has so far assisted 5,000 healthcare workers from 144 organizations throughout Michigan.

Nursing careers not only provide stable, well compensated jobs with a set of transferrable skills that rarely become obsolete, but in a rewarding environment that truly make a difference in the lives of the patients they serve. The MHA and our member hospitals and health systems, together with MONL, remain committed to focusing on effective solutions that support Michigan nurses and ensure safe patient care.

State Legislation Introduced to Address Violence Against Healthcare Workers, Strengthen Healthy Michigan Plan and Expand Organ Donor Registration

capitol building

capitol buildingLegislation to increase the penalties for assaulting healthcare employees and volunteers was introduced in the state House of Representatives during the week of May 1. Additional legislation was introduced to remove unnecessary provisions of the Healthy Michigan Program, Michigan’s Medicaid expansion program. Additionally, the House Health Policy committee advanced MHA-supported legislation to provide more opportunities for individuals to sign up as organ donors.

House Bills (HB) 4520 and 4521, introduced by Rep. Mike Mueller (R-Linden) and Rep. Kelly Breen (D-Novi), doubles the fines for assaulting a healthcare employee or volunteer while performing their official duties. The legislation was officially introduced and referred to the House Criminal Justice Committee.  The bills would require signage in hospital emergency rooms to deter potential assaults, which the MHA has made available to Michigan hospitals free of charge. The MHA supports the bills and will be encouraging the committee to take swift action to address rising cases of violence against healthcare workers.

House Bills (HB) 4495 and HB 4496, introduced by Rep. Will Snyder (D-Muskegon) and Rep. Graham Filler (R-Clinton County), would eliminate unnecessary provisions in the Healthy Michigan Plan and makes changes to help ensure its long-term success. The bills remove requirements that certain beneficiaries maintain health savings accounts and pay co-pays or deductibles. Additionally, the bill removes the provision that a future administration could repeal the program if state savings are reduced. The MHA supports the legislation to bolster the program that currently enrolls over one million Michigan residents. The bills were referred to the House Health Policy committee for consideration.

Legislation was advanced through the House Health and Tax Policy Committees to allow Michigan citizens to designate themselves as organ donors on state tax forms. Introduced by Rep. Felicia Brabec (D-Pittsfield Twp), HBs 4362 through 4364 would provide for the question to be asked on tax forms starting in the 2023 tax year. The MHA is supportive of the legislation, which is led by Gift of Life Michigan, to reverse the declining growth in individuals signing up for the donor registry. Gift of Life Michigan testified in committee that states across the country are dealing with this trend, as the pandemic and online services have led to fewer trips to Secretary of State offices. The bills now advance to the full House for consideration.

Members with questions about state legislative action may contact Elizabeth Kutter at the MHA for more information.

MHA Keystone Center PSO Annual Meeting May 3

The healthcare workforce is at higher risk of harm due to violence than other professional fields.  Recent increases in workplace violence represent a major barrier to both staff and patient safety, prompting the need for additional resources, training and education.

The MHA Keystone Center Patient Safety Organization (PSO) Annual Meeting brings together national safety and clinical experts each year to discuss trending topics in healthcare. The 2023 meeting will be held virtually 9 a.m. to 3:10 p.m. May 3, focused on workforce safety and security. Speaker presentations include:

  • Stephen Weiler, emergency management specialist at HSS, an MHA Endorsed Business Partner, will provide an overview of HSS and its physical risk assessments.
  • Brian Uridge, deputy director at the University of Michigan Division of Public Safety will outline actions health systems can take to address and reduce healthcare violence. He will also provide examples of safety training procedures and policies for members to replicate.

Registration is free and available to MHA Keystone Center PSO members. Members with questions may contact the MHA Keystone Center PSO.

Ask Congress to Support SAVE Act to Protect Healthcare Workers

The Safety from Violence for Healthcare Employees (SAVE) Act is newly proposed federal legislation to give healthcare workers the same legal protections against assault and intimidation that flight crews and airport workers have under federal law. U.S. Reps. Madeleine Dean (D-PA) and Larry Bucshon, MD, (R-IN) are the original cosponsors of the bill, and the MHA urges all members to contact their U.S. representative to ask them to cosponsor H.R. 7961. Contact information is available through the American Hospital Association’s action alert on the bill.

The increase in acts of violence against healthcare workers in every setting — inpatient, outpatient, ambulatory and home care — is frightening, and the MHA is committed to doing everything possible to respond to this crisis and show support for those delivering patient care. In addition to offering federal-level protections to healthcare workers, the SAVE Act would provide grants to hospitals for programs to help reduce the incidence of violence in care settings. These grants could be used for training hospital personnel, coordinating with state and local law enforcement, and purchasing equipment or technology that will assist in creating a safer environment.

On a related note, the MHA has developed workplace safety posters for members to display throughout their facilities to highlight the consequences of causing physical harm to healthcare workers or hospital property. Complimentary copies of the materials are available to MHA members upon request.

Members and other citizens concerned about the safety of healthcare workers are encouraged to ask their U.S. representative to cosponsor the SAVE Act as quickly as possible. It is among the MHA’s highest legislative priorities at the federal and state level. For more information, contact Laura Appel at the MHA.

Workplace Safety and Minority Health Recognized in April

National organizations are recognizing April as Workplace Violence Awareness Month and Minority Health Month, each of which are key priorities for the Michigan Health & Hospital Association. The Alliance Against Workplace Violence is leading efforts for Workplace Violence Awareness Month while the U.S. Department of Health and Human Services Office of Minority Health is promoting Minority Health Month.

MHA CEO Brian Peters
MHA CEO Brian Peters

“The mission of the MHA is to advance the health of individuals and communities,” said MHA CEO Brian Peters. “Ensuring the safety of our healthcare workers and improving efforts to address health equity, diversity and inclusion fulfills our mission and is critical to every Michigan hospital and community.”

According to the U.S. Bureau of Labor Statistics, the healthcare sector had the highest distribution of nonfatal occupational injuries and illnesses in the private sector in 2020, while OSHA data indicates healthcare workers are nearly four times more likely on average to experience violence than individuals in other industries.

Improving workplace safety in hospitals has been the focus of the MHA, the MHA Keystone Center and Michigan hospitals since the MHA Workplace Safety Collaborative was launched in 2019 with the goal to reduce injuries and increase safety awareness through educational events, webinar series and insights from subject matter experts.

With reported rates of violence against healthcare workers increasing during surges of COVID-19 hospitalizations, the MHA has actively advocated for House Bill 5682. This legislation would double the fines for assaulting a healthcare employee or volunteer in any healthcare setting. To help increase awareness of protecting healthcare workers, the MHA has developed and provided to MHA members free of charge workplace violence posters.

Diversity, equity and inclusion is another key component of the activities of the MHA Keystone Center. The MHA Board of Trustees endorsed in 2020 the Address Racism and Health Inequities pledge, which has since been embraced by all MHA member hospitals and hospital systems. The pledge expresses the need for hospitals to commit to addressing disparities, dismantling institutional racism and achieving health equity. The MHA Keystone Center also released the Eliminating Disparities to Advance Health Equity and Improve Quality guide, which is to be used by hospitals to assess strategies aimed at reducing disparities, achieving equity and improving quality.

“I am very proud of the work the MHA Keystone Center has made on both workplace safety and diversity, equity and inclusion,” said Sarah Scranton, MPA, MPP, vice president, safety and quality, MHA, and executive director, MHA Keystone Center. “The safety of caregivers and addressing health disparities can significantly impact the quality and safety of care delivered inside a hospital.”

Health equity is achieved when all members of society enjoy a fair and just opportunity to be as healthy as possible. As defined by the Centers for Disease Control and Prevention, social determinants of health contribute to racial and ethnic minority groups having disproportionate health outcomes and include neighborhood and physical environment, health and healthcare, occupation and job conditions, income and wealth, and education. The MHA and the MHA Keystone Center have long been committed to addressing health disparities, which is a foundational concept that shapes all the organization’s quality improvement and safety efforts.

More information about the MHA’s efforts and resources on workplace safety and health equity can be found at

MHA Monday Report April 11, 2022

MHA Monday Report

MHA Covid-19 update

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

The Michigan Department of Health and Human Services 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 …

capitol building

Prior Authorization Bill Signed into Law

Legislation to decrease wait times for commercial insurance prior authorization requests was signed into law by Gov. Gretchen Whitmer April 7. Senate Bill 247, introduced by Sen. Curt VanderWall (R-Ludington), will shorten the timeline for approval to seven calendar days or 72 hours for urgent requests, as well as ensure that …

Medicaid Proposed Policy to Allow Back Transfers for NICU Infants

The Michigan Department of Health and Human Services recently released a proposed policy, effective July 1, 2022, allowing authorization for return transfers of stabilized infants from a neonatal intensive care unit back to the community hospital from which the patient was …

Proposed Rule to Update Inpatient Rehabilitation Facilities Payment for FY 2023

The Centers for Medicare & Medicaid Services recently released a proposed rule to update the Medicare fee-for-service prospective payment system for inpatient rehabilitation facilities for fiscal year 2023, which begins Oct. 1, 2022. Key highlights of the proposal include …

CMS Releases FY 2023 Proposed Rule for Inpatient Psychiatric Facilities

The Centers for Medicare & Medicaid Services recently released a proposed rule to update the Medicare fee-for-service prospective payment system for inpatient psychiatric facilities for fiscal year 2023, which begins Oct. 1, 2022. Key highlights of the proposal include …

Webinar Focused on Governance and Leadership Accountability

Where is the line between governance and management? The truth is each board must set its own boundaries on governance versus management decisions, and boards must continuously revisit this line. The webinar You and Your Board: Creating a Synergistic Combination, offered from noon to 1 p.m. April 27 …

MHA Hosts Twitter Chat on Emergency Department Medication for Opioid Use Disorder

The MHA hosted a one-hour Twitter chat March 4 to discuss Emergency Department (ED) Medication for Opioid Use Disorder (MOUD). The chat allowed participants to engage with their peers and share information and resources related to ED MOUD, as many of these programs help address …

Explore Resources During Workplace Violence Awareness Month

Healthcare workers across the country are experiencing a growing rate of incidents of violence against front-line caregivers, including workers in Michigan. In fact, healthcare workers are nearly four times more likely to experience violence than individuals in other industries, according to the …

Paul KeckleyThe Keckley Report

Medicare Trustees’ NHE Report: Interesting Read but Understandably Flawed

“Last Monday, Medicare Trustees released the 56th edition of their National Health Expenditures (NHE) Forecast for 2021-2030 which is widely used by policymakers and operators to gauge what’s ahead for U.S. healthcare. Regrettably, it’s flawed.”

Paul Keckley, April 4, 2022

News to Know

The Circle of Life Awards recognize innovative palliative or end-of-life care providers that measure and evaluate the impact of their work on patients, family and/or the community. Part 1 applications for the 2023 awards will be accepted through May 31.

Explore Resources During Workplace Violence Awareness Month

Healthcare workers across the country are experiencing a growing rate of incidents of violence against front-line caregivers, including workers in Michigan. In fact, healthcare workers are nearly four times more likely to experience violence than individuals in other industries, according to the Occupational and Safety Health Administration (OSHA). In conjunction with the National Institute for Occupational Safety and Health’s declaration of April as Workplace Violence Awareness Month, the MHA is highlighting related resources that are available to its members.

The American Hospital Association has a dedicated webpage providing several workforce and workplace violence prevention tools for hospitals. Additionally, an OSHA publication titled Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers provides healthcare workers with tips to identify and assess workplace violence hazards and detailed information for developing violence prevention programs.

The MHA, the MHA Keystone Center and Michigan hospitals are partnering to address violence against healthcare workers through de-escalation and resiliency trainings and through the work of the MHA Workplace Safety Collaborative. The collaborative launched in March 2019 with the goal to reduce injuries and increase safety awareness through educational events, webinar series and insights from subject matter experts.

The MHA has also developed workplace safety posters for members to display throughout their facilities, communicating the consequences of committing physical harm toward healthcare workers or hospital property. The informational posters are geared toward patients, families and visitors, with various creative options available in two sizes. Complimentary copies of the materials are available to MHA members by request through an online order form. Nonmembers may purchase materials at cost.

The MHA Keystone Center collects member data on workplace safety that is used to determine areas in which their efforts should be focused, especially for workplace violence. Additionally, members can view the Workplace Safety dashboard to recognize trends in their reportable data. Members are encouraged to submit their OSHA recordable incident rate; lost time case rate; and days away, restricted or transfer rate each month in the MHA Keystone Center’s data reporting platform, KeyMetrics. Those with questions may contact the MHA Keystone Center.

MHA Monday Report Jan. 31, 2022

MHA Monday Report

MHA Covid-19 updateCombating the Novel Coronavirus (COVID-19): Week of Jan. 24

As the number of new cases and hospitalizations due to COVID-19 begin to diminish in Michigan, both Pfizer and Moderna have launched trials for vaccines targeting the omicron variant of the coronavirus. The variant is estimated to make up 99% of the current cases in the United States. …

Peters Talks Healthcare with Paul W. Smith on WJR’s Live from Lansing Broadcast

Detroit’s WJR News Talk Radio broadcast Jan. 27 the Paul W. Smith “Live from Lansing” show as part of its annual coverage of legislative and policy issues facing the state the morning after Gov. Gretchen Whitmer’s State of the State address. …

Bills on ED Violence, COVID-19 Medication, Auto No-fault Discussed in State Legislature

The Michigan Legislature returned to Lansing the week of Jan. 24 to address several bills relevant to Michigan hospitals. In the House Government Operations Committee, testimony was taken on a pair of bills to expand penalties for assaulting …

MI care matters

Doctor/Breakthrough Speaker Recalls COVID-19 Hospitalization in MHA Podcast

The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities …

Cybersecurity Member Forum Scheduled for March

Cyberattacks are a clear and present danger to patient care and safety. Questions regarding organizational alignment with the current cybersecurity environment cannot be answered solely by considering the electronic defense measures that are in place. Information technology experts can lead …

The Keckley Report

Paul Keckley

The Uncertainty Agenda for Hospitals in 2022

“The plight of hospitals during the omicron pandemic is prominent in news coverage. Workforce shortages and bed capacity issues grab headlines, especially in regions where the omicron wave is surging.”

“Public health officials predict this wave will pass in the next 1-2 months while cautioning about future variant possibilities. This adds to unprecedented uncertainties facing hospitals.”

Paul Keckley, Jan. 25, 2022

MHA in the News

The MHA responded to several media requests the week of Jan. 24 that focused on the status of COVID-19 and healthcare workforce sustainability.