Munson Healthcare Chief Operating Officer Laura Glenn will appear before Grand Traverse County commissioners Wednesday to outline the hospital system’s opposition to the Safe Patient Care Act, proposed legislation that would limit nurse-to-patient staffing ratios and end forced RN overtime in Michigan. Munson says the legislation would take nearly 100 beds offline across its system, adding to even longer wait times for patients – while nurses say the bills will increase patient safety and transparency and protect overworked staff.

Glenn will also give commissioners an update Wednesday on a planned new community mental health center – to be located on Munson’s property – that will provide 24-hour behavioral health crisis services for adults and children.

Safe Patient Care Act
A package of bills – House Bills 4550-4552 and Senate Bills 334-336, known collectively as the Safe Patient Care Act – has generated intense debate between hospitals and nurses in Michigan, with Munson Healthcare Chief Operating Officer Laura Glenn to ask county commissioners Wednesday to join in opposing the legislation.

The bills would curb mandatory overtime for nurses, require hospitals to publicly disclose their RN-to-patient ratios, and restrict the number of patients a nurse can be assigned (those levels would vary depending on department, but would generally be between 1:1 and 4:1). Several of the bipartisan bills are sponsored or co-sponsored by northern Michigan representatives Rep. Betsy Coffia (D-Traverse City) and Rep. John Roth (R-Interlochen). Coffia said in a statement that “research has shown that requiring nurses to work too many hours is both unsafe for patients and increases the likelihood of RNs leaving the profession entirely. It’s time to end this outdated and dangerous practice.”

According to the Michigan Nurses Association – citing data from the Michigan Licensing and Regulatory Affairs (LARA) – one-third of RNs with active Michigan licenses are choosing not to work as nurses. Polling data from Emma White Research shows “that the vast majority of RNs blame working conditions, not a shortage of qualified RNs, for the staffing crisis,” according to MNA. Mandatory overtime, emotional exhaustion, and nurses being assigned too many patients are contributing to that crisis, the organization states. “The number of nurses who say they know of a patient death due to nurses being assigned too many patients nearly doubled from 22 percent in 2016 to 42 percent this year,” according to MNA.

But Munson – and groups like the Michigan Health & Hospital Association (MHA) – say the proposed legislation is too extreme, imposing a one-size-fits-all approach on hospitals that vary greatly in their operational structures and needs between rural areas like northern Michigan and urban centers like Detroit. MHA estimates it will cost Michigan hospitals $1.1 billion to comply with the law change and will significantly prolong the time it takes for many patients to receive care. Munson Medical Center Chief Nursing Officer Tami Putney says Munson is already short approximately 161 nurses; the organization would need an additional 417 nurses to comply with the terms of the bills. Finding – much less hiring – over 400 nurses “is not a possibility,” she says, which could require Munson to take 93 beds offline across eight hospitals, leading to “even longer wait times” for treatment.

Putney says hospital administrators and nurses share the same concern for patient safety and staff wellbeing, but believes the legislation “doesn’t address the main problem,” which is the need to build up Michigan’s talent pipeline to address its 28,000 healthcare vacancies. That includes making it easier for out-of-state nurses to work in Michigan, she says.

Mandatory overtime at Munson is also extremely rare, says Chief Marketing and Communications Officer Megan Brown. When it does occur, it’s often in units like OB and NICU where women in labor or infants need around-the-clock care. During the pay period from September 3 to 16, nurses worked a total of 13,199 four-hour blocks at Munson Medical Center, according to Brown. Only 14 of those 13,199 shifts were the result of mandatory overtime, or 0.01 percent. “This is a very typical number, which is why we say it is so rare,” she says. Still, Munson and other hospitals need flexibility to “respond to patient surges and real community needs,” according to presentation materials shared with county commissioners.

Munson plans to ask county commissioners Wednesday to talk to or write letters to their lawmakers and explain to family, friends, and neighbors why the legislation is “not the right approach to address healthcare staffing needs,” according to presentation materials. Dagmar Cunningham, an RN at Munson Medical Center, questions why Munson’s CEO “is being allowed to use a public meeting to give a presentation against bipartisan state legislation.” Cunningham also plans to speak Wednesday to ensure that commissioners “hear from frontline nurses, not just hospital executives,” she says.

“Their presentation even says they want to avoid a legislative hearing. What do they have to hide?” Cunningham says. “I guess it’s a measure of how desperate hospital executives are to escape accountability for safe staffing and transparency. As a longtime Munson nurse, I can tell you that the staffing crisis is unprecedented and it’s hurting our patients – and it’s not because of a shortage of nurses. There are more than 50,000 RNs in Michigan licensed but not working, and many say they will come back if the Safe Patient Care Act is passed. Our patients deserve the Safe Patient Care Act so nurses have enough time to take care of everyone properly and our hospital can keep nurses at the bedside.”

Mental Health Center
Munson’s Glenn is also scheduled to give an update to county commissioners Wednesday on the new Grand Traverse Center for Mental Wellness, planned to be located at 410 Brook Street in Munson Healthcare’s behavioral health services building (pictured), which would be renovated and repurposed for the project. County commissioners previously dedicated up to $5 million in American Rescue Plan Act (ARPA) funding for the facility. Munson and Grand Traverse County are part of a leadership team with Northern Lakes Community Mental Health, Northern Michigan Regional Entity, Community Health Innovation Region, and United Way of Northwest Michigan that put together the proposal to create a center providing 24-hour behavioral health crisis services for both adults and children, regardless of insurance or ability to pay.

According to presentation materials, an architect specializing in behavioral health facilities will have a design for the new center ready by the end of this month, after which a more detailed project budget and construction timelines will be shared. Munson is working on relocating its existing Brook Street services over to Copper Ridge to make way for the new center. A job posting for a full-time director for the center will be posted later this month.

In addition to the ARPA funds – which are primary covering renovations at Brook Street, the relocation of Munson services, and the new director position – Munson has received a $5 million Michigan Hospital Association grant to expand pediatric behavioral health services. Those funds will be used to “improve emergency department behavioral care coordination and wraparound strategies to treat the most complex pediatric patients,” “provide psychiatric urgent care services as part of the center for pediatric patients in crisis,” and “establish a pediatric crisis residential unit at the center,” according to presentation materials.

Other services at the new Grand Traverse Center for Mental Wellness will include behavioral health and nursing screening assessments, a psychiatric urgent care, a “living room” model for people to remain up to a day while receiving treatment, care coordination and peer services, and a pathway for adults and children to enter crisis residential services for longer-term treatment. Short-term outpatient care will also be available, and local law enforcement will be able to bring in individuals in need of behavioral health services, according to presentation materials.