LANSING — Grilled by Republicans during a heated exchange Wednesday, the state’s public health director mounted a vigorous defense of Michigan’s COVID-19 nursing home policy, calling allegations it helped fuel a high death toll “baseless and groundless” while promising continued improvements.
Robert Gordon, director of the Michigan Department of Health and Human Services, testified for a third time before the Legislature’s Joint Select Committee on the COVID-19 Pandemic, where Republicans have spent months investigating the effect of executive orders issued by Democratic Gov. Gretchen Whitmer, including a policy for hospitals to discharge medically stable seniors with the coronavirus to nursing homes that had isolation units and sufficient personal protective equipment.
It was a tense, sharply partisan back-and-forth. Republican critics of Whitmer’s handling of the pandemic argue the state should have created COVID-only facilities for seniors who were released from hospitals.
Whitmer’s “inexplicable actions… put elderly citizens at risk can only be described as disappointing and reckless,” Sen. Aric Nesbitt, R-Lawton, said in an opening statement, setting the stage for a combative hearing punctuated with heated exchanges and a threat of legislative subpoena.
“The Whitmer administration’s policies put coronavirus infected patients in nursing homes, threatening the lives of other seniors and health care staff,” Nesbitt said.
But Gordon argued new state and national data show that “community spread” — high numbers of cases in communities surrounding nursing homes — is the primary predictor of the virus’ spread inside nursing homes, which has slowed in Michigan.
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States like Florida and Massachusetts that created separate facilities for infected seniors have abandoned that approach, he said. Michigan, by comparison, has designated certain nursing homes as “regional hubs” for COVID patients.
“To the extent our nursing home policies mattered, they reduced deaths compared to other states,” Gordon told lawmakers.
Gordon once again presented data that he said were evidence that the state’s efforts ultimately saved lives.
Among the highlights he cited, drawn from the Center for Health & Research Transformation at the University of Michigan and the U.S. Centers for Medicare & Medicaid Services:
- Among every 1,000 residents in Michigan, 69 died of COVID through August — a rate that falls between the highest death rate — New York’s at 180.2 deaths per 1,000 residents, and the lowest — Alaska’s at 5.7 deaths per 1,000 residents. The data illustrates that the state’s initial explosion of cases — or the virus’ community spread — has since declined. “Because the state was hard hit, our nursing homes were hit hard as well,” Gordon said.
- Michigan’s proportion of nursing home deaths among all COVID-19 deaths falls below the national average — 33.2 percent, compared to 38.6 percent nationally.
- In the week ended Aug. 23, 1.8 percent of Michigan nursing homes had three or more confirmed COVID cases, compared to 4.7 percent nationally.
- In Michigan, a lower percentage of residents in specially assigned regional hubs that accepted COVID patients died from the virus than did residents in other nursing homes — 17 percent, compared to 26 percent.
And despite widespread claims by Republican lawmakers and frustrated families, no nursing homes were forced to take COVID-19 residents, Gordon said.
“This is not about me, not about the department. It is about doing the right thing for nursing home residents, their staff and their loved ones where the evidence says to change course, that's what we do. Period,” Gordon said.
The data indicate, he said, “there's no basis to argue that Michigan's nursing policies hurt Michigan's nursing home residents, but overall, our residents had somewhat better outcomes that might be predicted,” he said.
Republican lawmakers took a different view. Their criticism of the state’s nursing home policies are part of a broader attack on Whitmer’s forceful use of emergency powers during the coronavirus pandemic. The GOP has been locked in rhetorical and legal battles with the governor for months over her ability to unilaterally extend her emergency powers without input from the legislative branch.
Rep. Matt Hall, a Marshall Republican who chairs the committee, asked Gordon if he had asked the Legislature for money to buy more personal protective equipment, which nursing homes struggled to obtain early in the pandemic. Gordon acknowledged that he had not.
“I mean we're certainly willing to work with you on that, I mean, you just got to come and ask … Is that your strategy to not work with the Legislature on a lot of these things you're trying to do?” Hall asked.
Rep. Vanessa Guerra, D-Saginaw, stepped in to defend Gordon, accusing Hall of “badgering” the health director. Her microphone was then switched off.
“I think gross mischaracterization. I'll leave it at that,” Gordon said as Guerra continued to speak.
State Sen. Kim LaSata, R-Bainbridge Township, pressed Gordon about why the state didn’t secure personal protection equipment in March, when a major nursing home outbreak in Washington state made national news.
“Why weren't we prepared?” she repeatedly asked.
But Gordon replied that no state had been able to adequately prepare. In fact, the entire nation was scrambling for PPE in the early days of the pandemic, and he laid the blame squarely on the Trump administration.
“The federal government did not raise alarms of PPE because the president and the White House concealed information about the level of risk posed by coronavirus, among other things,” Gordon said.
“I don't rely on the federal government, I rely on my state, on my governor to protect me,” LaSata retorted. “I feel we should have had our own stockpile in case something happened.”
“We should have been prepared, period,” she said, a short time later.
“Senator, 20/20 hindsight is a wonderful thing,” Gordon said.
Sen. Curtis Hertel, D-East Lansing, returned to the PPE shortage later in the hearing, noting there was no stockpile in the state before Gordon arrived in office nearly two years ago.
“Do you know who was governor and control of the legislature for the last eight years before that?” Hertel asked Gordon, referring to Republican Gov. Rick Snyder and both legislative chambers, which were under GOP control through Snyder’s eight years in office.
“I do,” Gordon said simply.
“Okay, I think that people do too,” Hertel said. “And there was no actual investment in that [stockpile of PPE.]”
He, too, accused Republicans of badgering Gordon and ignoring the facts.
“This committee should be working in a bipartisan manner to solve problems together,” Hertel said. “What I have seen over and over again is a lack of respect for those that are in front of the committee and, quite frankly, a refusal to look at the actual facts that have been presented over and over again.”
Republicans also grilled Gordon on why the state did not adopt a recommendation from the Health Care Association of Michigan, which represents hundreds of Michigan nursing homes. In March, an HCAM email had suggested the state open COVID-only facilities for nursing home residents.
That email was made public through a Freedom of Information Act request, and Hall questioned whether the department was hiding internal emails the panel requested in June.
“When are you going to turn them over, or do we have to issue a subpoena?” the committee chair asked Gordon.
Gordon called the panel’s initial request overly broad, saying it sought every department email with the phrase “nursing home,” which would include “thousands and thousands” of documents that would need to be retrieved and prepared for release.
But Hall said the committee narrowed its request in July at the request of the department, limiting it to emails from six health officials.
“You still won’t provide the documents, and so I want to know, why are you stonewalling us?” Hall asked.
The health department has been “extremely busy” but is working to respond to the request, Gordon responded.
“You will forgive me if in our focus on actually protecting the well-being of people, we are not able to meet your request with the haste that you would like,” he said.
Legislators also grilled Gordon on decisions to ban visitors from nursing homes. An order from Gordon Thursday now allows nursing homes to begin outdoor visits and permit ancillary staff, such as podiatrists, dentists and clergy, to enter facilities.
“I know you're concerned about numbers, and you feel like you're coming under fire because lives have been lost, what are the lives like that we’ve maintained? We all deserve better,” said Rep. Julie Calley, R-Portland.
Gordon noted a powerpoint slide showing the declining death rate since June 1.
Not seeing loved ones is a “terrible thing,” Gordon agreed.
He again pointed to drop in deaths since June 1.
“I think that is a reflection of difficult decisions that the governor has made, and that the department has made, and hard work by folks at nursing homes,” he said.
Without that work, he said, “there would be more funerals of people in nursing homes. There would be more people grieving the loss of their loved ones. I personally think erring on the side of protection of life is a reasonable thing,” he said.
“I appreciate that,” Calley said, adding “There are a number of residents who would happily take on that risk, just to hug their loved one again.”