Follow-up to recent virtual Town Hall

August 6, 2020  //  FOUND IN: Strategy & Leadership

As a follow-up to the July 17 Virtual Town Hall, here are responses to a number of questions that were submitted online:

Q. Now that we know the financial situation is not as dire as originally presented, and the rationale for stopping our retirement benefits is no longer valid, will it be reinstated? $400 million deficit is not the same as $3 million.

A. It is correct that Michigan Medicine lost $3 million in Fiscal Year 20.  However, this isn’t the full picture. The below slide shows that the University of Michigan Health System was projecting to make $175 million in FY20 and $200 million in FY21 for a total of $375 million. 

Instead, we lost $21 million in FY20 and are forecasting generating only $53 million in income in FY21.  This is a gap of $340 million that would have been used to carry out the priorities identified in our tri-partite mission, including investments in our people and patient care, enhancements in medical education and advancements in research.

These dollars that are generated by Michigan Medicine are infused right back into the organization and are critical to financial sustainability. The $400 million expense reduction plan was undertaken to offset these losses and help us continue our mission.

Q. When might we plan for further layoffs and how many will be affected?  

A. Nearly all reductions in staff that were part of the Economic Recovery Plan have been completed. While we firmly believe that enterprise-wide reductions are a last resort, we do not currently know if there will be further layoffs in the future, given the uncertainty of the pandemic. However, we are committed to continuing to do all that we can to preserve jobs and minimize the impact to our workforce.

Q. Leadership makes lip service to anti-racism; but it is evident that racist practices still continue. Very few people of color are in leadership positions.

A. Michigan Medicine is committed to creating fundamental change that leads to a culture of anti-racism, and a medical school and health system that are leaders in equity, justice and inclusiveness for people of all colors. Michigan Medicine recently formed an Anti-Racism Oversight Committee that is working diligently with leadership, as well as our Office for Health Equity & Inclusion and others, to ensure that this movement is not a moment in time but, instead, leads to actions and real and sustainable change.

Q. Please send the suggested overarching guidelines regarding trainees rounding on inpatient and outpatient areas — residents, fellows, students, etc.

A. Please see the information in the COVID-19 Preparedness and Response Plan.

Q. Why is there no performance metric used in the standard practice guidelines (SPG) for reductions in force (RIF)?

A. The University of Michigan Reduction in Force SPG outlines the process for selecting staff for RIF notification, which Michigan Medicine follows as a unit within U-M. The SPG outlines a seniority-based approach to RIF selection. Performance is not to be used to determine RIF status per these guidelines.

Q. How will the shift in COVID-19 data collection and reporting from CDC to HHS affect our ability to understand COVID-19 trends and related planning?

A. We do not believe this will have any impact on our ability to understand COVID trends. We continue to have access to a wide array of internal, local, state and national data to guide our planning, including access to state-wide hospitalization data.

Q. Is Michigan Medicine continuing to send hospital numbers to the CDC?

A. We are submitting information to all state and national agencies that require submission of data. CDC is no longer collecting hospital census data.

Q. Have the projections for beds in the fall and winter taken into account the students (potentially) returning to campus in the fall?

A. Yes. Our planning includes the understanding that students returning to campus may impact the spread of COVID-19 in the community.

Q. Should we report people we see on campus without masks? How should we do so?

A. If anyone has safety concerns regarding compliance with masking policy, please call:

  • Michigan Medicine Properties: 734-936-7890
  • Campus: 734-763-1131

Q. Can additional garbage cans be placed in parking garages (e.g. near the gates) to facilitate disposal of masks upon leaving?

A. The recent change in the university policy regarding wearing masks does extend into our parking facilities. We evaluated the pros and cons of your idea regarding placing trash receptacles at parking exits, but this would present other operational challenges and possible fire code concerns. We encourage disposal of unusable masks at home or in receptacles away from the parking decks, at your discretion.

Q. The changes in N95 requirements — does this change whether students can see patients with respiratory symptoms (since the student would be using N95)? Do we have enough N95’s for students to be using them regularly?

A. At the current time, students may care for patients with COVID-19 infection if they are fit-tested for N-95 masks, trained in Special Pathogens PPE use, and there is an educational objective to the encounter.

Q. If a symptomatic patient shows up in clinic and needs to be tested, will we have N95 masks available for the faculty/staff evaluating them?

A. All staff are required to wear masks per the universal masking protocol. N95s are available for health care workers providing care to COVID patients/PUIs. 

Q. Given the general concern regarding asymptomatic carriers, why isn’t Michigan Medicine doing some randomized testing of faculty and staff providers?  

A. Michigan Medicine is offering testing to symptomatic workforce members and asymptomatic workforce members following a high-risk exposure at work or in the community. Thus far, more than 5,000 out of our approximately 28,000 workforce members have been tested. Recently, Occupational Health Services (OHS) has been coordinating testing for about 500 workforce members each week.

Symptom screening remains an integral part of preventing transmission in the workplace. All workforce members should complete the COVID-19 screening survey at https://healthscreen.umich.edu/ prior to reporting to work each day. Workforce members with a negative screen (green check) may come to work as usual. Workforce members with a positive screen (red warning sign) should not report to work and should contact OHS for further direction, which may include testing for COVID-19.

Q. What is the protocol for contact tracing and testing for employees who test positive?

A. When an employee tests positive for COVID-19, their supervisor may notify others working in the same department or area that a coworker has tested positive. Per direction from Human Resources, the privacy of the workforce member who tests positive for COVID-19 must be protected. Others working in the area should continue to follow universal masking and social distancing measures, and should monitor carefully for symptoms and not report to work when ill.

Workforce members who know they were exposed to a coworker with COVID-19 may contact OHS for further direction. When there is concern for multiple ill workforce members in the same department or area, an investigation will be initiated by Infection Prevention and Epidemiology.

Q. Can you talk about the criteria for who can get tested?

A. Current COVID-19 PCR testing criteria can be found at: http://www.med.umich.edu/asp/pdf/adult_guidelines/COVID-19-testing.pdf

Any provider can order COVID-19 serology testing for their patients. Serology testing is also available for Michigan Medicine workforce members: https://mmheadlines.org/2020/07/faqs-michigan-medicine-covid-19-serology-testing-for-employees/

Q. Why does the health screen monitoring app ask if we have traveled internationally when it would be more relevant to ask if someone has traveled to Florida or California or any of the states with rising cases?

A. The questions in the health screening app are based on guidance from the Centers for Disease Control and Prevention (CDC). The questions will be reviewed and updated regularly as CDC guidance changes.

Q. What are the standards to make sure that the vaccine is safe when it does appear?

A. There are several COVID-19 vaccine candidates entering clinical trials. The data from these clinical trials will offer data on the efficacy and safety of a potential vaccine. When available, these data and FDA/CDC recommendations will be reviewed to inform any plans for vaccination of employees.   

Q.  It looks increasingly likely that Ann Arbor school children will have to be engaged in online learning for the upcoming school year. This will have an enormous impact on faculty and staff with school-aged children. What plans are being put in place to accommodate our colleagues (at the same time as the clinical faculty are being asked to significantly ramp up their clinical productivity)? 

A. Ann Arbor Public Schools confirmed this past week that they will be having all virtual classrooms when the school year begins. Other school districts are still determining their education plans for the upcoming school year. Recognizing that virtual learning will create challenges for our work force, we have convened a Family Care Task Force to identify specific family care issues and make recommendations to address them. A new page on the Wellness Office website offers family care resources for those who need additional support. 

The University Human Resources also has a list of child care resources and in-home care and tutoring available on their website.

If school buildings remain closed in the fall, employees may be eligible to use Expanded FMLA, which provides expanded paid time off benefit for employees who need to provide child care and cannot work remotely due to school closures and child care closures related to the COVID-19 pandemic. This extended use of FMLA expires Dec. 31, 2020.

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