Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Nurses Sue U-M Over Refusal To Bargain

A lawsuit filed in mid-August alleges the University of Michigan is breaking the law by refusing to bargain over nurses’ workloads in contract negotiations with the University of Michigan Professional Nurse Council (UMPNC).

Michigan Nurses Association, the labor organization that filed the suit in the Court of Claims, says the 6,200 UMPNC nurses have worked without a contract since July 1. The organization alleges the university is violating the Public Employment Relations Act, which designates workload and safety as mandatory subjects of bargaining, and it wants an order compelling U-M to bargain.

The “major stumbling block,” MNA claims, is the administration’s refusal to discuss workloads in terms of number of patients assigned per nurse, which is tied directly to patient safety concerns that nurses have raised for months.

“When nurses are forced to take care of too many people at once, patient care gets compromised and nurses are put in danger of injury or burnout, and that’s happening far too often at our hospital,” said Renee Curtis, a registered nurse and president of UMPNC. “Our union is fighting for patient safety, first and foremost. It’s absurd to think that conversations about how to keep patients safe can be effective without talking about our nurses’ workloads.”

Mary Masson, director of U-M public relations, said U-M Health makes “staffing determinations with patient safety at the forefront of its decisions” and it continues to bargain “in good faith.”

Masson highlighted current contract offers including a 6% raise for nurses in the first year and 5% per year for the next three years, which represents a 21% base pay increase and safely eliminating mandatory overtime. The bargaining team also offered a new salary step program for nurse practitioners with an average 20% increase over four years.

“The University of Michigan Health plans to vigorously defend itself in the lawsuit filed by the U-M Professional Nurses Council,” Masson said. “… Although the labor agreement has officially expired, University of Michigan Health’s nurses continue to work under the same terms and conditions of the expired contract and be paid at the same rate as before the expiration.”

According to the complaint, the nurses’ union alleges workload demand has increased, particularly in hospital departments providing critical or intensive care.

Nurses have called it a “workload crisis,” presenting to U-M’s bargaining representatives first-hand stories about under-staffing and its effect on nurses and patient care, the complaint notes.

The nurses have filed 1,090 forms with management that document concerns so far this year. That compares to 1,000 for all of 2021.

However, the complaint claims, U-M’s response was that the workload topic was a “non-mandatory and illegal subject of bargaining” and demanded that MNA “withdraw its proposals.”

MNA also filed an unfair labor practice charge with the Michigan Employment Relations Commission and the group seeks an immediate and temporary injunction, pending MERC’s ruling.

Health Services Academies To Expand Throughout Michigan High Schools

(DENVER) – A chunk of Michigan’s $300 million appropriation meant for recruitment and retention bonuses in healthcare settings will also address education by creating grants for health services academies in high schools.

During a National Conference of State Legislatures learning hub, Justin Clement, a lobbyist at Mitchell Research and Communications, spoke about the academies, some of which he said are already operating in Southeast Michigan.

Pontiac High School currently has a health services academy where students can learn and become certified nursing assistants, he said.

After they receive their certification from the high school, they can become directly employed with McLaren, a Michigan hospital network he reported has committed to students.

“It’s a mutually beneficial way for McLaren to get their talents sooner,” he said.
He added that the state Health and Hospital Association (MHA) reported 20,000 open positions, which is up from pre-pandemic averages.

“It’s a pretty dramatic jump, and something the Michigan legislature felt they needed to put some money behind,” Clement said.

In an interview after the learning hub, Clement said support from The Ballmer Family Foundation allowed the creation of academies in Southeast Michigan schools like Farmington and Southfield.

But funding from several public acts will now allow the program to expand statewide, he added.

“One of the charges from sitting down with members of the legislature was, ‘you’re only in Southeast Michigan,’” he said. “We’d love to expand elsewhere.”

He said the goal is a two-sided approach of working with The Palmer family in Southeast Michigan and seeing “where else we can support healthcare workers, future engineers, future IT professionals and future hospitality workers all across the state.”
The plan is to use grant funding to create workplace learning academies through NAF, a non-profit with academies in 34 states. Michigan has 3,201 students in NAF academies, according to their website. Indiana has 45 students, and South Carolina has 307. Other Midwest states, including Ohio and Kentucky, haven’t attempted the program.

PA 9 of 2022 allocates $250,000 as grants to school districts that provide workplace learning opportunities.

Clement said NAF is working with the state Department of Education on putting together the grants, which will hopefully be available early this fall.

And PA 144 of 2022 allocates $253,000 from the state school aid fund to create similar grants for workplace learning.

Clement said the hope is to use the funds to create at least 45 new academies throughout the state.

He added that they are also working with the Michigan Association of Ambulatory Services to work past barriers allowing 17 year-olds to become certified ambulance drivers, but barring them from operating until 18.

The biggest challenge when creating these programs is making sure that they are well-known in school districts that don’t yet offer them.

Judge Declares Mistrial In Flint Water Civil Trial

A federal jury told the court that it cannot continue its deliberations due to “physical and emotional health of jurors.”

As a result, Magistrate Judge David Grand ruled a mistrial after the jury twice shared today that it could not reach a verdict because if they continued it will “only result in stress and anxiety with no unanimous decision without with someone having to surrender” his or her “honest convictions solely for the purpose of returning a verdict.”

“In my view, the jury has spoken,” he said, noting that continuing “would place undue pressure and coercion on the jury.”

The lawsuit was brought by four Flint children, who alleged engineering firms Veolia North America and Lockwood, Andrews & Newnam were professionally negligent for faulty advice given to the city during the water crisis, which began in April 2014.

The engineering firms’ attorneys argued then-state and city leaders, including former Gov. Rick Snyder, were responsible for the water crisis, which occurred when the city switched its drinking water source to the Flint River.

Plaintiffs’ co-counsel Corey Stern, of New York, said the team appreciated the “work and dedication undertaken and exhibited by the jury,” and they are “eager to re-try” the case as soon as possible.

“Bellwether trials are designed to teach everyone about various issues so that as each case is tried going forward, the parties have more information each time to assist them in narrowing the issues,” Stern said. “We learned plenty and will use all of the knowledge we gained to help us when we re-try this case for our four kids, and for all of the other trials that will follow and while we are disappointed, by all accounts we had seven of eight jurors on our side, and that gives us great pride, and makes us even more determined.”

New York attorney Moshe Maimon, co-counsel for the plaintiffs, asked the court to instruct the jury to continue deliberations until seven of the eight jurors could reach a verdict.

But VNA and LAN attorneys, disagreed, saying the plaintiffs agreed to and the jury was instructed that its verdict had to be unanimous. The attorneys said the jury’s note is not about one juror’s health and mental welfare, but those of “jurors.”
Earlier in the day one juror cried in the courtroom.

Grand rejected a less-than-unanimous verdict suggestion, saying this “is not a focus group,” but a federal court where “a unanimous decision is required.”
Grand said the jury has made clear it is hopelessly deadlocked, acknowledging that they have been on time and ready to do the hard work expected of juries.
The trial took 76 days – from jury selection to the mistrial – spread out over seven months, and saw 45 people testify either in-person or via recorded depositions.

Attorney Hunter Shkolnik, who represents Flint residents whose civil cases are pending, saw the action as a victory for Maimon and Stern.

“It is clear from what was heard in court that this jury was clearly in favor of plaintiffs with a single holdout,” he said. “… We are ready for the next trial. It will be shorter and it will be the death knell to VNA and LAN.”

In closing arguments, Maimon placed 25% of the blame onto consulting firm LAN and 50% onto VNA, with the rest to the city and former state officials.

The water crisis occurred when the city, then under state-ordered emergency manager control, switched its drinking water source from Detroit to the Flint River, which went untreated, allowing lead to leach. The city switched back to Detroit water in October 2015.

LAN and VNA argued in trial that the children were not injured.
The state of Michigan, Flint, McLaren Regional Hospital and Rowe Professional Services avoided trial by reaching a $626 million settlement.

U.S. District Judge Judith Levy approved that settlement in November.
Levy had presided over the trial but stepped away recently due to a medical issue, according to the court.

Survey: 50% Of Voters, Those They Know Seriously Impacted By Medical Debt

A new statewide poll shows that 50% of Michigan voters have had their household finances seriously impacted by medical debt, or know of someone experiencing such a condition.

This morning, the Michigan League of Public Policy (MLPP) hosted an advocate panel, which highlighted a new survey conducted from Jun. 15-20 by the Lansing-based EPIC-MRA research firm and progressive data-collector Impact Research.

Using a sample of 609 registered voters in Michigan, the poll found that while 42% of voters ultimately want to see inflation and rising costs placed as Congress’ top priority, 62% specifically agree that health care expenses are climbing up more than other items they need.

“The voters’ main concern with healthcare is that out-of-pocket costs are simply too high,” said EPIC-MRA President Bernie Porn during the virtual MLPP event. “Among that 50% that said that they have had their finances affected, 71% say that they or someone close to them have had medical bills go into collections.”
Porn said that out of the entire sample of June respondents, it’s indicated that 35% have had excessive medical debts going into collections.

Within the respondent pool, 39% would vote Democratic on a generic ballot, 38% would vote Republican and 23% could be persuadable. When it came to their intent to vote on congressional candidates, which was a focus of Porn’s survey, more than 7-in-10 voters said they would be more likely to support a candidate who makes reducing health care expenses their top priority.

When asked to choose from a list of statements on how to best describe Michigan’s health care system, 37% selected the “it has major problems” option, 40% opted for “it has minor problems” and 7% chose “it is in a state of crisis.”

Other price-related findings included:
– 38% of survey participants pointed to pre-insurance deductibles and the cost of doctor or hospital visits as the biggest issue for them personally. Thirty percent said they felt these expenses have gone up the most in the last two years.
– 30% of respondents said the monthly premium charges set by health insurance organizations were their biggest issue. Thirty-eight percent felt that those premium costs have jumped the most in the previous two years.
– 22% of survey participants highlighted out-of-pocket prescription prices as their largest issue, and 29% of Michigan voters claimed that they felt those expenses have gone up significantly over the last two years.

When asked what are the biggest weaknesses in Michigan’s healthcare infrastructure that sometimes exacerbate the listed concerns, Chief Executive Officer Robert Sheehan of the Community Mental Health Association of Michigan (CMHA) said “one of the biggest things that we see is it’s a market-driven system.”

While people of color and poor residents are often categorized as being greatly disenfranchised within the healthcare ecosystem, Sheehan illustrated how the COVID-19 pandemic revealed that young individuals and senior citizens alike have faced blockades.

“If you’re a kid or if you’re a senior, and you can’t figure out how public health works or (how) preventative measures work, your access to healthcare is incredibly limited,” Sheehan said. “It’s a great healthcare system, really, it’s one of the best in the world. However, it requires you to have sufficient cash to purchase that, or sufficient connections to get into the kind of specialists you might need.”

Alongside Sheehan and data presenter Porn, the virtual panel featured CEO Vanessa Greene of the Grand Rapids African American Health Institute and Collin McDonough – the federal public policy associate of the Arab Community Center for Economic and Social Services.

McDonough said he believes one of the only positive health outcomes to come from the COVID-19 pandemic was the implementation of additional telehealth policies, adding that it has assisted low income and minority residents in Michigan by reducing the extra costs of taking work time off, transportation and childcare.
“Telehealth and phone-only telehealth and those practices are huge and can help save costs,” he said.

Someone Other Than Police Being Sent To Mental Health Emergencies

(DENVER) — Are police the right people to respond to a suicide threat? What about an overdose? A mental health crisis?

In some parts of the country, the answer is no. Instead, a team of public health professionals and EMTs are sent in. Panelists at a National Conference of State Legislatures (NCSL) panel said these “behavioral health crisis response methods” are working.

Since Arkansas created four crisis stabilization units (CSUs) in 2018, 8,138 people have been treated by these teams. Of that number, 3,100 were diverted to the unit by police, who felt that was a better place for them than in jail.

Arkansas Rep. Dwight Tosh, who had a 37-year career in the Arkansas State Police, added that officers supported the training and the four crisis stabilization units (CSUs). Those in a mental health crisis were held in county jails in the past, and to divert them to somewhere else has paid “huge dividends,” he said.

Colorado Sen. Julie Gonzales (D-CO) said a Support Team Assisted Response (STAR) pilot program was created in June 2020 to offer non-police response in Denver. A third of the calls STAR personnel — including EMTs and behavioral health clinicians — received were from police officers themselves, who felt a STAR team was better suited to the situation, she continued.

Gonzales added that crime dropped 34% in the area and said the program cost four times less than the expense of a police response and arrests. She also discussed its scalability and similar efforts. During audience questions, Gonzales also said it is important to offer services in a flexible way, including in languages other than English.

Charles Smith, Region VIII administrator at the U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), said the agency wants to see a comprehensive response system that is rooted in the community and built to provide equitable access.

There should be five principles, he continued:
– A behavioral health crisis is a health care crisis first
– Individuals experiencing a suicide, mental health or substance abuse crisis and their loved ones need high-quality support
– Integrated health and social services have to be available across the entire continuum of care and supported by state and local partnerships;
– Crisis services must have “lived perspectives and experiences” of families, individuals and communities
– Equitable, unconditional access to crisis services is paramount and at-risk populations need to be prioritized.

Smith said there are three components — someone to talk to at the 988 hotline, someone to respond and a safer place for help such as Arkansas’ CSUs. He said the nation is currently in a “transformative moment.”