The Health Services Cost Review Commission’s (HSCRC) move Wednesday to raise per capita revenue by 3.38% is welcome news as Maryland hospitals reset from the pandemic and cope with workforce challenges and cost inflation.

A children’s mental health crisis was building before the COVID-19 pandemic. It has now reached emergency proportions—a “tsunami,” according to Brad Schlaggar, CEO of Kennedy Krieger Institute.

In the summer of 2020, each of your hospitals and health systems signed on to MHA’s fieldwide commitment to racial equity. Since that time, your organizations have been hard at work improving diversity, equity, and inclusion. You have built-in new ways to address social determinants of health and improve the health of your patients, communities, and employees.

This year, for the first time in a century, contests for Maryland’s four statewide constitutional offices—governor, lieutenant governor, attorney general, and comptroller—will not have any incumbents on the ballot. Plus, 15% of state senators and 20% of delegates will not run for re-election.

As COVID-19 seems to have lost a bit of steam, the concerns left in its wake are real and need to be addressed – particularly financial matters and the workforce shortage. The reality is that one out of every four nursing positions in the state is open. At the same time, 57% of hospitals in Maryland had negative margins to date in rate year 2022. If you take out the one-time federal pandemic funding, we are looking at significant losses at every hospital in the state.

Last Wednesday, 30 hospital and health system presidents joined together at the first member meeting held at MHA’s office in Elkridge in more than two years. We joined together to talk about Maryland Model design innovations, financial policies, legislative successes, and the ongoing review of Association governance.

If you’ve filled up your gas tank lately or bought groceries for your family, it’s clear inflation has driven up costs significantly. The steep and sudden rise in inflation—an estimated 8.5% according to the Consumer Price Index—takes a toll on your hospitals as well. Everything you use to care for your patients is more costly now.

Maryland’s legislature packed scores of high-profile bills into the 90-day session that ended April 11—from climate change and paid family leave to redistricting and other election-year priorities. Together with your government affairs leaders, we made sure legislators treated health care as a key priority, too.

Last week, our nation made history, confirming the first Black woman justice of the Supreme Court: Ketanji Brown Jackson. We hope that having the nation’s highest court better reflect the U.S. population will, over the long haul, improve the odds of achieving one of our own aims—health equity.

For much of the past two years, hasn’t it felt as if we’ve been running just ahead of a steamroller? Unpacking the latest science, reacting to ever-changing guidance and rules, and living with constant uncertainty in operational, clinical, and financial domains?

For the first time since 2019, MHA is excited to invite hospital and health system leaders to our Annual Member Meeting. When hospitals in Maryland saw their first cases of COVID-19, around this time two years ago, we canceled in-person experiences, including our annual meeting. We considered offering you a virtual experience but determined your time was better spent focusing on protecting staff and meeting patients’ needs. Plus, part of the annual meeting experience is the opportunity to socialize with peers from across the state.

Violence should not be part of the job for your hospital employees. You go to great lengths to make facilities safer for your staff, patients, and visitors. That includes major investments in security teams, cameras, panic buttons, and security alerts. You provide special training and track triggers for early intervention.

Earlier this month I attended the American Hospital Association’s Regional Policy Board meeting along with two Maryland hospital leaders who serve as delegates to that body. It was no surprise to hear intense discussion on workforce challenges—burnout, violence, attrition, and costs.

With two weeks until the crossover deadline, MHA is making good and substantial progress on the hospital field’s legislative priorities. Well before the Maryland General Assembly began the 90-day session, we knew that efforts to strengthen your workforce would be our top priority. We have held true to that commitment, seeking more resources and state support, including a dedicated loan repayment program for nurses and nursing assistants.

It was two years ago this week that the first COVID-19 inpatients were admitted to Maryland hospitals. As we enter this new phase in the pandemic, we reflect on the incredible strength and bravery of your hospital workforce. Cases and hospitalizations are reaching more manageable levels, and public attention on COVID has begun to wane. Yet, the state’s nurses, doctors, and other caregivers are still on the front lines fighting this pandemic, keeping us safe, and recovering from a 730-day campaign. They are still heroes.

Maryland hospitals are places of health and healing for your patients. Your organizations may also be the largest institutions in your communities. As such, you are often asked to speak up when social justice concerns arise, whether in your neighborhood or around the world.

A more diverse and inclusive health care workforce makes all our organizations stronger and improves health care for all Marylanders. Yet, data show we have a long way to go.

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.