Thousands of health care workers in Michigan have become infected with COVID-19 during the height of the pandemic that is still raging on within hospitals and certain pockets of the community.
But for health care workers themselves, hospital policies vary for those who contract COVID-19, as does how they are compensated for being sick and out of work, the Michigan Health & Hospital Association said.
And at some health systems, how they caught the virus or their vaccination status might matter.
"Those policies have continued to change throughout the pandemic to address the different stressors with which hospitals have encountered, including childcare shortages, PPE shortages, infection of health care workers from community spread and more," John Karasinski, MHA's director of communications, said in an email to Crain's Detroit Business, Modern Healthcare's sister publication.
"As the vaccine has become available and these other concerns have continued to evolve, hospitals generally have adjusted their operational policies to reflect these improvements and will likely continue to do so," he said.
While all hospitals follow federal guidelines for COVID-19 exposure and return to work, the Centers for Disease Control and Prevention has recommended that employers actively encourage employees who are exhibiting symptoms to stay home and maintain physical distancing.
In April 2020, the federal COVID-19 response act provided $200 million that allowed eligible workers to claim up to 80 hours of paid leave for a health issue arising from coronavirus. The law expired at the end of 2020 and hospitals have been using their own funds to pay for COVID-19 sick leave.
Beaumont Health and Henry Ford Health System have compensation systems for health care workers with COVID-19 that differ somewhat from Detroit Medical Center and Trinity Health Michigan's policies, which restrict pay based on where the infection was contracted.
The Michigan Department of Health and Human Services does not track the numbers of sick health care workers or the numbers who have died. Overall in Michigan, more than 876,854 people in Michigan have contracted the virus and more than 18,627 have died since May 17.
The World Health Organization has estimated COVID-19 has infected more than 114,000 health workers in the U.S. from March to August 2020 and Kaiser News and The Guardian reported last December 2,900 health worker deaths.
Long-term-care facilities must report to the state, but it is up to hospitals to voluntarily release their numbers to the public. Since late November, total long-term care staff COVID-19 cases were 22,744, or about 12.3 percent of the 185,000 total workforce. Weekly numbers peaked at 1,349 and had dropped to 215 on May 5, the state said.
At the height of the pandemic in April 2020 when PPE was not widely available, more than 2,200 health care workers at Beaumont (1,500) and Henry Ford (734) tested positive for COVID-19, less than 2 percent of the workforces.
At Henry Ford, 8.3 percent of its approximately 30,000 health care workers have tested positive for COVID-19, a spokesperson said. This means about 2,490 total health care workers were infected by the virus. Weekly numbers have declined the past month. For example, only 31 Henry Ford employees tested positive the week ending May 12, or 6 percent of those tested.
Beaumont Health didn't provide a total number, but said the eight-hospital system has averaged 100 employees out on a daily basis with a pending test or COVID-19 in the three hospital surges the past year.
During the second surge last fall, Beaumont peaked at 403 and fell back down to a daily average of around 100. During the third and most recent surge that started in February, employees peaked at 282 and steadily fallen to under 100 per day.
As of March 18, Trinity Health Michigan has had about 3,300 COVID-19 positive health care workers, or about 16.5 percent of its 20,000-employee workforce. The eight-hospital system has been averaging about 70 infected health care workers per week since mid-April, a spokesperson said.
DMC did not respond to several requests for total numbers of COVID-19 infected workers.
Trinity Health Michigan provides up to 10 days of sick pay for COVID-19 illness. In February, the policy was modified to include a qualifier, a spokesperson said. Infected employees would be paid only if the exposure did not result from personal, non-work-related travel to a COVID-19 "hot spot" location.
DMC, which operates six hospitals and employs about 12,000 health care workers, allows employees to claim an excused absence for COVID-19 infection only if they caught the virus during a hospital shift, and only if they followed infection-control guidelines, according to DMC officials.
Those DMC workers who test positive for COVID-19 for an infection they caught outside of work must quarantine for 14 days. If they have accrued paid time off, they can use that for compensation during that period, DMC officials told Crain's.
On the other hand, Henry Ford Health System and Beaumont do not take into account where a health care worker acquired COVID-19. All time off related to the virus is excused and paid.
How health care workers are compensated for time off differs by system and for how long they are compensated also varies, hospital officials said.
Two DMC employees shared with Crain's internal memos they say illustrate how managers applying sick leave policies for COVID-19 to discourage workers to report they are positive by forcing them to take vacation time or other accrued time off if they become sick outside of work, or go unpaid if they are out of that time.
"Not only is this putting our coworkers at risk, it's putting our patients lives at risk as well," said the DMC worker.
Crain's obtained the following April 22 memo sent to DMC workers on which the anonymous health care workers based their comments.
"With proper PPE and vaccinations available, there will no longer be excused absences related to being COVID-positive or COVID exposures," said the DMC manager in the memo.
The DMC manager also noted some health care workers have not been following PPE guidelines and are creating risks for patients and co-workers. "If you are not wearing PPE you can be disciplined."
DMC spokesperson Brian Taylor told Crain's that employees with signs or symptoms consistent with COVID-19 regardless of test results are not to report to work. They should call the DMC occupational health employee COVID-19 hotline.
"The medical team will triage the call and determine based on the reported symptoms if the employee is to be quarantined," Taylor said in an email. "Work time missed while an employee is quarantined is considered to be an excused absence."
Taylor also explained that if it is determined that the exposure was work-related, the employee will be paid by DMC for the entire quarantine. But if it is determined that the exposure was not work-related, the employee can use their accrued time off benefits to be paid, he said.
Both DMC health care workers said of the 10 people they know who have stayed home for work-related COVID-19 illness, all have had to use accrued sick time, personal time off or extended illness benefit (EIB) time during their 14-day quarantine period.
The employees said the policy will discourage workers who have no vacation pay left over from staying at home, even if they are COVID-19 positive.
On April 29, the same DMC manager sent out another email to "clarify" what she had described earlier was policy for workers who contracted COVID-19 outside of work.
"Let me start by stating, safety of my staff and our patients and families is my number 1 priority," said DMC manager.
The DMC manager said contracting COVID-19 in the community is considered an unexcused absence and workers must use their time off pay.
However, the DMC manager added that "work-related exposures will be thoroughly reviewed to determine how they will be addressed, with the main factor being was all proper PPE for your area being used. Please wear your PPE as required by hospital guidelines."
At Beaumont, health care workers testing positive for COVID-19 are given 40 hours of compensation, which does not come out of paid time off, said spokesman Mark Geary in an email. Quarantine time at home amounts to a total of 10 days from the first day of symptoms.
During their second week off, Beaumont employees can receive short-term disability or worker's comp, Geary said. However, if the test is negative, Beaumont follows its standard procedures for any employee who is ill, he said.
"This entire process is followed regardless of where the employee thinks he or she contracted COVID-19," Geary said.
Henry Ford's COVID-19 special pay system has evolved four times since the pandemic began in March 2020, said Derick Adams, Henry Ford's vice president of total rewards.
"Throughout the pandemic, the health and safety of our team members have been at the center of everything we are doing," Adams said
During the first surge in March 2020, Henry Ford gave employees up to 80 hours of paid time off that was added to their existing compensation bank if they contracted COVID-19 or if they needed to care for an ill family member.
Last November, as the second hospital surge was heading up, Henry Ford provided up to 10 days of paid time off for employees who tested positive or had symptoms awaiting a positive test.
"Our policy evolved yet again with the start of our vaccination program in December 2020. We provided up to 80 hours of paid time off for illness caused by a work-related COVID-19 exposure for team members who received the COVID-19 vaccine," Adams said.
The fourth change occurred on May 3, after the COVID-19 vaccine became widely available.
"Currently, team members who missed work due to a workplace COVID-19 exposure since March 23 can retroactively request COVID paid time off if they received at least the first dose of the vaccine or they receive a first dose of the vaccine by May 15," Adams said in an email.
Henry Ford CEO Wright Lassiter III said the health system has tried to be compassionate as possible with the policy changes.
"We did not feel it was fruitful to have employees trying to prove that they got it at work versus in the community, which is very difficult to do and a fairly, fairly significant burden on the on the part of the employee," Lassiter said.
This story first appeared in our sister publication, Crain's Detroit Business.