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Innovative strategies for protecting low-income communities from COVID-19

Laptop screen that reads, "webinar"

Image of a webinarThe COVID-19 pandemic has disproportionately impacted low-income areas, escalating already-existing health disparities and economic difficulties. As a result, innovative strategies have been developed to aid in protecting these communities from the virus and its effects.

In this 10-minute webinar by Samantha Iovan, a senior analyst for health and human services at the Center for Health and Research Transformation (CHRT), viewers will learn about the disproportionate impact of COVID-19 on low-income communities, including homeless populations residing in aggregate housing facilities.

Iovan shares innovative strategies to protect these populations that have emerged in communities across the country, as well as funding sources that can be used to implement these solutions in other low-income communities.

Listen to The impact of COVID-19 on homeless and impoverished populations, one in a series of COVID-19 webinars organized by the Michigan State University College of Osteopathic Medicine.

The webinar emphasizes the need for collaborative efforts to address these problems and offer assistance to those who need it most in these historic times. Together, we can lessen the pandemic’s harmful effects on vulnerable people and make sure that everyone has access to the services, supplies, and assistance they need. Ongoing dissemination of information is critical to the health and well-being of our nation.

 

Udow-Phillips in Michigan hospitals are needed now more than ever. Why are they laying off workers?

Hospital corridor

Image of a hospital

For hospitals and health systems in Michigan and the U.S., outpatient and elective procedures are the foundation of sustainable business. The March 10 executive order putting a hold on “non-essential procedures” in Michigan has had a profound effect on the viability of large and small health providers. MLive’s Malachi Barrett spoke with CHRT Executive Director Marianne Udow-Philips about the conditions that led up to the precipitous drop in hospital revenues, and the perils that may lie ahead for health facilities and systems.

While the executive order was aimed at protecting tenuous supplies of personal protective equipment as hospitals prepared for a wave of COVID-19 patients, it unavoidably halted the “non-emergency” procedures that provided a major income stream for hospitals. In the MLive article. the Michigan Health and Hospital Association estimates that without non-emergency and elective procedures Michigan hospitals are losing $300 million a week while simultaneously spending $100 million on COVID-related equipment, staff, and treatments.

This widening gap between revenue and expenses is forcing layoffs of healthcare workers throughout Michigan and threatening the existence of some rural hospitals. Udow-Phillips expressed guarded optimism that hospitals may be able to resume elective procedures sometime in May. “I am expecting that we’ll start seeing in May some cases coming back into the hospital.” But, she says, “it really depends on how well we do in containing this virus. If the health system gets overwhelmed again, then they’re going to have to cut back.”

Udow-Phillips also discussed how providers are adapting to COVID-imposed health protocols and the expansion of telemedicine.

READ THE ENTIRE MLIVE ARTICLE HERE

CHRT speaks with Huffington Post about improving senior housing options as COVID-19 ravages nursing homes

2 women looking at each other through a pane of glass, hands pressed together

Image of a senior in a nursing home

The COVID-19 pandemic’s impact on nursing home residents’ vulnerability has highlighted the need for a conversation about improving and enhancing senior housing facilities. This is crucial since a sizable portion of COVID-19 deaths are occurring in nursing homes in some areas.

In “As COVID-19 ravages nursing homes, a new push for better senior housing,” medical writer Patricia Anstett looks at why nursing home residents, who in some states account for more than 50 percent of all COVID-19 deaths, are so vulnerable. These alarming statistics, writes Anstett, “have intensified an important discussion the nation will wrestle with for years to come: How can the United States expand community-based alternatives for seniors and improve care in larger facilities?”

Steve McAlilly, the chief executive officer of Methodist Senior Services, said, “a pandemic magnifies and highlights the strengths and weaknesses of the entire system, I hope we wake up and understand we need to have a policy conversation in Washington about the fact that long-term care needs to be adequately funded to keep this from happening again. Hopefully we will seize this as the moment that caused us to have that conversation, because until now long-term care has gotten the crumbs on the healthcare plate.”

CHRT’s Marianne Udow-Phillips, just one of the many experts Anstett cites in the piece, says governments, foundations, insurance plans, philanthropic organizations, and advocacy groups have to come up with more creative solutions for elder care. Among the solutions Anstett features in the Huffington Post story is the Ann Arbor Area Community Foundation’s Vital Seniors Initiative, which CHRT supports. 

READ THE STORY HERE

Related content:

COVID-19 rapid response brief: Best practices for protecting populations in nursing homes, long-term care settings

Telehealth services have expanded to address COVID-19 emergency. Let’s preserve the most effective innovations.

Rural hospitals continue to suffer financially due to coronavirus, even hospitals with few COVID-19 patients

Hospital road sign

Hospital road signAs the COVID-19 pandemic forces hospitals to focus on essential procedures, reducing revenues at healthcare facilities across Michigan, many rural hospitals are struggling to stay open. In this Michigan Health Watch series, Bridge Magazine’s Ted Roelofs examines some of the ways the coronavirus response is squeezing operating margins for rural healthcare providers, even if they may not be treating many COVID-19 patients.

In 2019, before the COVID-19 crisis, 18 rural hospitals in Michigan were at risk of closing, threatening access to care for about one-quarter of Michigan’s rural communities. Long-term population loss, fewer revenue-generating procedures to help pay for expensive diagnostic tools, and costly staffing of 24-hour emergency rooms all contributed to precarious financial situations. Now, the March 10 Executive Order  that puts a hold on “non-essential” procedures is further compounding an already-tenuous revenue situation for rural – and some non-rural – health facilities.

There may be some relief on the horizon, with possible federal assistance for hospitals that treated COVID-19 patients and, importantly, a loosening of restrictions on elective and outpatient procedures says Marianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation. “I think there’s going to be some ability to be doing some of these procedures soon,” she reports.

The Bridge article also examines how hospitals in other states are responding to the focus on COVID-19 patients and looks at the financial impact of the coronavirus caseload on larger hospitals in Michigan.

READ THE FULL ARTICLE HERE

Udow-Phillips in HuffPo on what’s missing in the debate over Michigan’s ongoing stay-at-home orders

no people around michigan state capitol lansing because of the stay-at-home orders

no people around michigan state capitol lansing because of the stay-at-home ordersMichigan has been especially hit hard by COVID-19. In an effort to slow the spread of coronavirus and to reduce the strain on hospitals and healthcare workers, Michigan Governor Gretchen Whitmer has issued aggressive stay-at-home orders. In “Something big is getting lost in the debate over stay-at-home orders,” Jonathan Cohn, a Huffington Post reporter, explores why these guidelines have sparked protests by those who believe their freedoms are unnecessarily inhibited. Some people are demanding an end to the lockdown procedures and a return to normal life.

Marianne Udow-Phillips, CHRT’s founding executive director, talks about the strain public health agencies are under as they work to support the health and human needs of Michiganders who have lost employment during the crisis. Udow-Phillips believes that state and local agencies are struggling to support the wave of needs because “we’ve underinvested in public health forever.

READ THE ENTIRE HUFFPOST POST ARTICLE HERE

CHRT Health Policy Fellow Denise Anthony talks to WEMU about immunity certification, unintended consequences

Photo of a lady wearing a mask

Photo of a lady wearing a maskWEMU’s Lisa Barry explores the idea of an immunity certification system that could exempt those who have COVID-19 antibodies from some social distancing restrictions and allow them to go back to work. Dr. Denise Anthony, CHRT Health Policy Fellow and Professor of Health Management and Policy at the U-M School of Public Health, joins Barry, cautioning that in the U.S., “There is not yet a certified test…It is in the development and research phase.”

The interview explores the potential use of technology to track people with a COVID-19 diagnosis and how testing data could be misused to discriminate against those who test negative for the coronavirus. Dr. Anthony points out that “It’s possible that people if they are found to not have the antibodies, could end up suffering from a surprising form of reverse discrimination…They might try to seek out exposure…or face restriction on their movement, employment, or other access to resources.”

In the interview, Dr. Anthony also points out that socioeconomic factors play a role in the transmission effects and deaths related to COVID-19. She articulates the critical policy safeguards that will be necessary to prevent discrimination and inequitable community impacts as immunity testing moves forward.

LISTEN TO THE INTERVIEW

Marianne Udow-Phillips on why Michigan hospitals are laying off workers even as they battle coronavirus

health worker using a calculator

Health worker using a calculatorAs part of their continuing Health Watch series, Bridge Magazine continues their focus on hospital staffing and the economics behind the perplexing circumstance of healthcare workers losing their jobs during a health crisis. Writing for today’s Bridge, Brie Zeltner notes that the surge in coronavirus patients has increased staffing and equipment costs even as COVID-19 treatments bring in less revenue than the outpatient and elective procedures that have previously been the foundation of hospital business models.

Marianne Udow-Phillips, CHRT’s founding executive director, points out that the need to reserve space for coronavirus patients also affects hospital occupancy rates — further compounding challenges to the hospital’s bottom line. “We have a lot of [COVID-19] patients,” Udow-Phillips said, “but it’s a relatively small percentage of our total capacity.”

The article points out that the widening gap between costs and revenue is also a concern for many rural hospitals in Michigan — and thousands across the U.S. — many of which were facing financial challenges and potential closure before the coronavirus struck. Udow-Phillips reflected on what health care systems will need to recover, and raised the possibility that mergers and consolidations may accelerate as hospitals and providers seek to bolster their fiscal positions.

“Health care systems are going to need more support because the system is going to have to retool and regear,” she said.

READ THE ENTIRE ARTICLE HERE

–Summary by Benjamin Kohrman

In Powering Up, we explore the disproportionate impact of COVID-19 in African American communities

Powering Up with Anne Doyle

Powering up with Anne DoyleMarianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation, joined Anne Doyle for this week’s Powering Up! podcast, “African Americans Bearing the Brunt of U.S. COVID-19 Pandemic.”

Detroit, Michigan, one of the COVID-19 hot spots in the U.S., is bearing witness to the disproportionate impact the pandemic is having on African American communities. To date, 35 percent of the virus victims in Michigan are African Americans, although they make up only 15 percent of the state’s population. The same is true in other U.S. states with significant African American populations.

Podcast guests Marianne Udow-Phillips, former director of the Michigan Department of Human Services, and Vernice Davis Antony, former public health officer for Detroit, both saw this coming, writes Powering Up, because they each have decades of expertise in the devastating toll of generational poverty and the weaknesses in the U.S. health care system.

LISTEN TO THE ENTIRE PODCAST HERE

In Detroit, CHRT’s Cover Michigan Survey illuminates health care access challenges for HuffPo, Type Investigations

Detroit buildings

Detroit buildingsThe COVID-19 pandemic has had an unprecedented impact on healthcare systems worldwide, and Detroit is no exception. 

In “Detroit’s health care workers ask: ‘How many lives can we save?’ a Huffington Post and Type Investigations story, Patricia Anstett, Jonathan Cohn, Tom Perkins, and Anna Clark describe the impact of coronavirus in “one of the most segregated regions in the country, where a separate-and-unequal system magnifies racial disparities.”

Healthcare workers in Detroit struggle to cope with the surge in COVID-19 patients. The difficulties experienced by healthcare professionals have been made worse by the lack of personal protective equipment (PPE) and the demand for hospital resources.

“As of Wednesday, COVID-19 had infected more than 7,141 Detroiters and killed 469 of them,” write the authors. “Michigan, which has reported 1,921 coronavirus deaths, has the country’s highest death rate. Of the statewide death count, 80 percent have been in the Detroit region. Wayne County, where Detroit sits, has more deaths than the state of California.”

A lack of access to health care has exacerbated the situation in Detroit, where “more than 30 percent of the city’s residents had trouble paying medical bills in the last 12 months,” write the authors. They are citing Cover Michigan Survey findings, not yet published, from the Center for Health and Research Transformation.

READ THE FULL INVESTIGATION PIECE HERE

Marianne Udow-Phillips offers insights on complex hospital staffing issues during the COVID-19 crisis

A Michigan healthcare worker holding a paper heart.

A Michigan healthcare worker holding a paper heart.As hospitals and health systems across Michigan scramble to address a surge in COVID-19 patients, there is competition over the short supply of highly sought-after critical care nurses – driving up labor costs and pulling some Michigan nurses away from their regular jobs to take higher-paying temporary positions. In “Michigan nurses getting fat pay raises or pink slips in coronavirus crisis,” Bridge Magazine takes an in-depth look at this trend and related hospital staffing issues that have a direct impact on the ability of hospitals and caregivers to manage the coronavirus caseload across Michigan.

The article notes that in some cases, Michigan critical care nurses are being lured out of state by lucrative offers from hospitals in other regions, and some Michigan hospitals are seeking staffing help from other states and health systems that are not currently as over-burdened by the coronavirus crisis.  Even as some hospitals are in a bidding war to hire critical care nurses for coronavirus care, Bridge Magazine’s Kelly House notes that other health care workers are losing their jobs as elective procedures, planned surgeries, and outpatient medical services are being cancelled during the pandemic.

“As the coronavirus pandemic leaves a trail of devastation in Michigan, it is also defying the laws of health care workforce supply and demand, creating a maddening musical chairs of labor, forcing executives to adjust in real-time, and fueling frustrations among some workers who say they’re tired of being called heroes but treated like pawns,” House writes.

The perplexing circumstance of health care workers losing their jobs during a health crisis has led to calls for retraining so that those workers can assist on the front lines. “But retraining workers in the midst of a pandemic could prove tricky, said Marianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation at the University of Michigan and a former director of the Michigan Department of Human Services. “You’ve got everybody deployed to the front lines and you don’t have the capacity to do that kind of training,” Udow-Phillips said. “But it’s a lesson learned for what we could do to prepare for the future.” Udow-Phillips also notes that policy changes at the state and federal level could help Michigan and other states be better prepared for future pandemics.

READ THE FULL BRIDGE MAGAZINE ARTICLE HERE

–Summary by Benjamin Kohrman.