We’re coming out of the most harrowing months since the earliest days of this pandemic. In January, there were more new COVID-19 patients than the previous 10 months combined. A spike in hospitalizations—2,603 COVID inpatients per day on average—strained your hospitals and already overburdened workforce. Fifteen Maryland hospitals—35% of the acute care hospitals in the state—declared crisis standards of care in this time, indicating severe overload.

It’s some relief to see the drop in COVID-19 hospitalizations in Maryland in recent weeks. Yet, we aren’t out of the woods.

Maryland’s 444th legislative session of the General Assembly has just begun, and already we can see that our top priorities are on the minds of legislators. As you know, each year we come together at the start of session to review the hospital and health system fieldwide priorities.

As Maryland’s 2022 legislative session gets underway, MHA is shining the spotlight on your achievements and the severe challenges you face in the seemingly never-ending pandemic. You’re treating more COVID-19 patients than ever before. You’re imploring the public to vaccinate, boost, mask, and more.

Last Wednesday, 30 MHA members and staff came together for an event with Senate President Bill Ferguson. We shared a clear message: Hospitals need unprecedented levels of support to meet this moment. Operations have shifted drastically over the course of the pandemic due to meteoric staffing costs, volatile vacancy rates, and ever-fluctuating community needs.

As 2021 ends, there’s no room at the inn. COVID patients have more than doubled in the past month and hospital beds are full.

This week your hospitals hit a historic, unprecedented, and unwanted milestone—less than 500 available staffed beds across the state. This is the lowest number since the beginning of the pandemic.

There’s power in numbers—and impact. For the coming session of the General Assembly, MHA will expand its grassroots advocacy pilot program to include all Maryland hospitals. MHA asks all hospital leaders to commit to engage fully, so we can prove the strength of Maryland hospitals and your workforce.

The arrival of the holiday season—our second under the cloud of COVID-19—is an opportunity to reflect on all we are thankful for.

MHA contacted the Commission immediately to stress that real-time hospital finances show a very different picture. It’s important they acknowledge the 2020-2021 period reflects one-time federal relief and HSCRC support, and that they understand the unsustainable workforce pressures you face.

Dr. Michael Zollicoffer, a pediatrician with Sinai Hospital, captured the immense relief and excitement in Maryland—and nationwide—as we received much-anticipated news that the Centers for Disease Control and Prevention and Food and Drug Administration approved the Pfizer COVID-19 vaccine for children ages 5 to 11.

With two months to go before the next regular session of the Maryland General Assembly, there are many uncertainties. There is movement on the major players, key priorities, and even the format.

On Thursday, several hospital leaders joined state officials and others from across the Maryland health care field to meet with Center for Medicare and Medicaid Innovation (CMMI) Director Elizabeth Fowler and her team to hear their views of the Maryland Total Cost of Care Model.

The Health Services Cost Review Commission (HSCRC) began strategic planning efforts over the summer to define the ideal future position for HSCRC and the Maryland Model over the next decade. Last week HSCRC revealed a new aspirational vision statement for Maryland’s Total Cost of Care Model: “The Maryland Model, stabilized and embracing a population health approach for all providers, will serve as the nation’s leader in health equity, quality, access, total cost, and consumer experience by leveraging value-based payment methodologies across all payers.”

For 20 months, hospitals have grappled with COVID-19 patient surges. And we now feel additional pressures due to the unprecedented workforce shortages and financial strains. Last week, during an appearance at the Health Facilities Association of Maryland’s annual conference, I reflected on another persistent challenge—transitioning people out of hospitals and into post-acute care (PAC) facilities to make space for acute patients.

Included in a slew of new Maryland laws that took effect Friday were several priority bills championed by MHA and your hospitals to advance health equity. These necessary laws—delivering proper training, data, and collaboration to close long-standing inequities—rounded out our bold health equity agenda in the 2021 legislative session.

Last week MHA’s principal governing body, the Executive Committee, met to explore ways to secure the future of the Total Cost of Care Model. At the start, they heard from Maryland Health Secretary Dennis Schrader and Health Services Cost Review Commission Chair Adam Kane that the Centers for Medicare and Medicaid Services wants more value: more cost savings, more care transformation, more health care quality improvement and disparities reduction, and more work to advance population health.

Maryland hospitals have faced staffing challenges for as long as many of us can remember. Now, more than 560 days into the COVID-19 pandemic, these problems have become much more acute. The American Nurses Association earlier this month urged the U.S. Department of Health and Human Services to declare the current and unsustainable nurse staffing shortage a national crisis.

Maryland hospitals and health systems have battled together against COVID-19 from the start. You’ve shared your expertise, your beds, and other precious resources. You’ve also jointly advocated in the best interests of your patients, communities, and state to lead our way out of this crisis.

This Labor Day weekend, our second under the cloud of the COVID-19, we are thankful for your strength, talent, and resilience. You and your teams have worked more than 500 days and saved the lives of almost 46,000 Marylanders. Now, you are being tested again as the Delta variant once again fills your hospitals with COVID patients.