Hospital and CMH leaders discuss continued workforce struggles with the legislature

In the last week before their spring break, the Michigan House Health Policy Committee heard testimonies from experts about the status of workforce shortages in the state. 

Persistent gaps in the health workforce continue to concern experts, who highlighted the need for building the workforce pipeline, starting recruitment in high school, and funding loan repayment programs. 

 

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Dr. Julie Yaroch, president of Charles and Virginia Hickman Hospital—representing the Michigan Health and Hospital Association (MHA)—said they were already experiencing concerning workforce shortages before the pandemic hit. Shortage not only includes nurses, but also technicians, pharmacists, and food service workers. 

Before the pandemic, the certified nursing assistant (CNA) turnover rates exceeded 27%. Yaroch also said the state predicted 124,000 physicians openings by 2033. 

During the pandemic, Yaroch said those shortages accelerated rapidly and only exacerbated the problem. These shortages led to increased workforce costs to pay for travel nurses, increased delays in accessing timely and quality care, and high provider burnout.

“The compounding issues are resulting in concerns that many hospital administrators share regarding what these workforce challenges can mean to our communities and the people we serve,” said Yaroch. 

She said a  most recent survey of hospitals and health systems in the state showed over 50,000 vacancies in the state with a vacancy rate of 16.6%. The average monthly turnover rate is at 27%, which equates to roughly 200 health care professionals. This data includes eight health systems and one independent hospital. 

Yaroch said that these shortages lead to the inability to staff roughly 1,200 inpatient beds during the omicron surge, which equates to the bed capacity of the University of Michigan Medical Center. 

“These numbers have continued to increase and without creative solutions to building our state’s talent economy, the risk to communities and Michigan residents continues to grow,” said Yaroch. 

The behavioral health workforce is also struggling. Yaroch said Michigan is in need of providers, psychologists, psychiatrists, medical social workers, nurses, security, and more. 

These shortages led to increases in emergency department (ED) boarding during the pandemic for behavioral health issues. It also led to increased wait times for services for providers and inpatient care. 

Kathryn Szewczuk, executive director of the Lenawee Community Mental Health Authority, highlighted that the infrastructure is not in place for the increased funding for behavioral health services in schools. This leads to more funds and providers for services that cannot be met due to infrastructure issues. In turn, it causes a damaging loss of an already strained workforce and a loss of providers from community mental health centers (CMHs).

“It has created a gap in the availability of services outside of schools. This school year alone, I have lost five master-level clinicians to the schools,” said Szewczuk. “[We need] to get into the high schools and encourage students to get into health fields and behavioral health fields. We also need to identify an effective process that we can use right now to share the limited resources that we have here in Michigan.”

Szewczuk recommended expanding loan repayment programs for graduates who stay in Michigan. She also recommended legislation to reduce the administrative burden faced by CMHs, which would be addressed by the creation of ASOs in Rep. Mary Whiteford’s (R-South Haven) bill package

She mentioned her concerns and disagreement with the specialty integrated plan legislation and prefers to keep the behavioral and mental health system in Michigan in the hands of public plans. 

Yaroch recommended that the legislature look into solutions to make the health care field more appealing to younger generations through informative programs starting in high school or middle school. She said the legislature should also work with experts to collaborate and come up with outside-the-box solutions to supplement the workforce.