Bills concerning supplemental nursing service agencies and rural emergency hospitals introduced in Michigan Legislature


Soraya Marashi


Two bills proposing policy changes concerning staffing and beds in health facilities have recently been introduced in the Michigan Legislature.


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On Sept. 7th, Rep. Sarah Lightner (R – Springport) introduced a bill regulating supplemental nursing service agencies to the Michigan House of Representatives.

A supplemental nursing service agency is an entity that provides temporary employment in a health facility for a nurse, nursing assistant, nurse aide, or orderly (a hospital worker whose job is to support nurses and help transport patients). 

House Bill 6364 would establish licensing requirements and minimum standards for the operation of supplemental nursing service agencies in the state. The bill requires, as part of a supplemental nursing service agency’s licensing application, a list of the names, addresses, principal occupations, and official positions of all individuals who have an ownership interest in the agency. 

The bill also requires the agency to establish a policy or procedure describing how it will keep records and make them immediately available upon request to the Michigan Department of Health and Human Services (MDHHS). 

The bill also requires these agencies to keep proof that each nurse, nursing assistant, nurse aide, or orderly provided to a health facility on a temporary basis by a supplemental nursing service agency meets the minimum licensing and training standards for the position they will be working at that facility. The bill prohibits supplemental nursing service agencies from restricting the employment opportunities of nurses, nursing assistants, nurse aides, and orderlies as well as requiring the payment of damages, employment fees, or other compensation if the nurse is hired full-time by the health facility. 

The bill also prohibits supplemental nursing service agencies from charging a rate higher than 25% of the hourly wage rate paid to a nurse currently employed by the health facility. 

The Michigan Health & Hospital Association (MHA) is supportive of the bill “because it would help to address exorbitant contract labor expenses that threaten the financial sustainability of hospitals.”

House Bill 6364 currently awaits its first hearing in the House Health Policy Committee.

Rep. Andrew Fink (R – Hillsdale) introduced HB 6380 on Sept. 20th, which concerns the temporary de-licensure of beds for hospitals designated as rural emergency hospitals. The bill would allow Michigan hospitals to pursue the federal rural emergency hospital designation by allowing them to apply to temporarily delicense beds in order to meet the criteria for this designation. Unlicensed beds will be temporarily unavailable for patient use, and a designation as a rural emergency hospital would limit total beds to 50 and average lengths of stay to 24 hours or less, as well as require a transfer agreement with a level I or level II trauma center.

According to MHA (also in support of this bill), rural emergency hospital designation would allow the hospital to receive enhanced federal reimbursement to provide critical emergency and outpatient services.

The bill requires the owner, operator, or governing body of a hospital to notify MDHHS if they apply for designation as a rural emergency hospital. The bill also allows these hospitals to apply to MDHHS to temporarily delicense 100% of its licensed beds for no more than 5 years. 

HB 6380 also currently awaits its first hearing in the House Health Policy Committee.