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COVID-19 Update: Wednesday, February 17

The following is the latest COVID-19 information from the state government as of 4:30 p.m. on Wednesday, February 17.

Department of Health

The Department of Health announced that some vaccine providers have inadvertently been administering second-dose Moderna vaccines as first doses. As a result, the requests the state has received for second-dose Moderna vaccines this week significantly exceeded the state’s allocation; 200,000 such Moderna second doses were requested. To address this issue and ensure that patients receive a second dose within the time frame recommended by CDC guidelines (minimum of 21 to 28 days and maximum of 42 days), the Department of Health is adjusting the timing of the second dose. In addition, it will decrease first-dose allocations to meet the increased second-dose demand. According to Acting Secretary Alison Beam, the administration of approximately 100,000 doses may be delayed. This only applies to the Moderna vaccine and does not apply to Philadelphia County. The situation and the state’s response to it are described in greater detail in this news release.
To help providers adjust to this problem, The Department of Health has updated formal guidance on the timing interval between COVID-19 vaccines, including instructions for vaccine providers to document instances when two doses of different vaccines are administered for any reason.
The Department of Health has issued an order that seeks to increase the rate of COVID-19 vaccinations in the state. Among other things, the order requires vaccine providers to administer 80 percent of the vaccine first doses they receive within seven days of receipt and to report regularly on their progress in administering those vaccines; to report to the state on their receipt of additional vaccines; and to establish online and telephone systems through which Pennsylvanians can make appointments to receive vaccines. Learn more from the Department of Health’s news release on the action, its order on vaccine administration, and its FAQ on the order.
Pharmacy partners are hosting three on-site clinics at all long-term-care facilities enrolled in the federal Pharmacy Partnership for Long-Term Care Program. The Department of Health has posted an FAQ to help facility administrators and providers prepare for residents and staff who may get their first COVID-19 vaccine dose at the third and final clinic.
The Department of Health has issued quarantine recommendations for individuals exposed to COVID-19 after receiving a vaccination.
The Department of Health has terminated its March 26, 2020 order requiring ambulatory surgical facilities to make daily reports of specific data on supplies and equipment.
The Department of Health is temporarily suspending the requirement for new employees of long-term-care facilities to have a two-step tuberculosis skin test prior to beginning employment so that the skin test will not interfere with planning for the employee’s COVID-19 vaccination or delay employment. See the additional information posted on the Department of Health message board.

Department of Health – by the numbers

The number of new daily cases has continued to decline in recent days but today the state passed the 900,000 mark for total COVID-19 cases.
The daily death toll remains high but shows clear signs of declining. More than 23,000 Pennsylvanians have now died from the virus.
More than 24,000 health care workers in Pennsylvania have contracted COVID-19, as have more than 78,000 residents and employees of long-term-care facilities across the state.
For the week from February 5 through February 11 the state’s overall COVID-19 test positivity rate fell to 8.0 percent; it was 8.6 percent the week before that. This marked the eighth consecutive week the rate fell.
51 counties are currently in “substantial levels of community transmissions,” the lowest number this winter and down from 59 a week ago. Three counties are now in low levels of community transmission, up from just one a week ago, and 15 are in moderate levels of community transmission, up from seven a week ago. Allegheny and Philadelphia counties, the two largest in the state, continue to experience high levels of community transmission.
The number of Pennsylvanians hospitalized with COVID-19 is just 40 percent of what it was at the beginning of the year; the number in hospital ICUs is 40 percent of what it was at the beginning of the year; and the number on ventilators is 39 percent.Currently, 21 percent of adult ICU beds in the state are unoccupied, as are 17 percent of medical/surgical beds, nine percent of pediatric ICU beds, 26 percent of pediatric beds, and 35 percent of airborne isolation units.
As of February 17 the state’s vaccine dashboard shows that 877,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 436,000 have received both doses of vaccine. These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
The vaccine dashboard shows vaccine totals by county.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2021-02-18T06:00:47+00:00February 18th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Thursday, February 11

The following is the latest COVID-19 information from the state and federal governments as of 3:15 p.m. on Thursday, February 11.

Pennsylvania Update

The Wolf Administration

Governor Wolf has created a COVID-19 Vaccine Joint Task Force with administration representatives and “…members from each legislative caucus who can share vaccine information and communicate issues and solutions expediently on behalf of and to the broader General Assembly.” According to a news release from the governor’s office, “Task force members will represent their caucus’s point-of-view and work to streamline conversations to focus and drive issues of importance. Wolf Administration members will serve as task force members with the subject matter expertise to listen, collaborate and provide information, answers and suggestions to solve problems in a timely manner.” Members of the task force are co-chairs Acting Secretary of Health Alison Beam and director of the Pennsylvania Emergency Management Agency Randy Padfield; for the Senate Democratic caucus, Senator Art Haywood; for the House Democratic caucus, Representative Bridget Kosierowski; for the Senate Republican caucus, Senator Ryan Aument; and for the House Republican caucus, Representative Tim O’Neal.

Department of Health

The Department of Health has updated its guide to getting the COVID-19 vaccine, which now includes a “Your Turn” feature to help Pennsylvanians learn when they will be eligible to receive a vaccine.

Department of Health – by the numbers

The number of new daily cases has continued to decline in recent days.
The daily death toll remains very high although it, too, is generally declining.
The numbers of Pennsylvanians hospitalized with COVID-19, in ICU beds because of the virus, and on ventilators are all about 60 percent of what they were three weeks ago.
Currently, 21 percent of adult ICU beds in the state are unoccupied, as are 16 percent of medical/surgical beds, 11 percent of pediatric ICU beds, 26 percent of pediatric beds, and 34 percent of airborne isolation units. As is usually the case, these numbers tend to decline later in the week.
As of February 11 the state’s vaccine dashboard shows that 791,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 335,000 have received both doses of vaccine. These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
The vaccine dashboard shows vaccine totals by county.

Department of State

To expand the number of health care professionals who can administer COVID-19 vaccines, the Department of State has temporarily suspended certain licensure requirements to enable practitioners from other states to administer COVID-19 vaccines without licensure in Pennsylvania provided that they hold a license in good standing in their home jurisdiction and meet the requirements of the federal Public Readiness and Emergency Preparedness (PREP) Act

Around the State

Despite the declining number of new COVID-19 cases in Pennsylvania, on Tuesday Allegheny County reported more new cases – 405 – than it had on any day during the previous two weeks, according to the Pittsburgh Tribune-Review.
More the norm is the situation in Westmoreland County, which has been a COVID-19 hotspot in recent months but is now averaging only about 30 percent of the new cases it was a month ago, the Tribune-Review adds.
During the week of February 3, Montour County led Pennsylvania in COVID-19 vaccines administered per 1000 population with 79, followed by Cameron County (56 per 1000 population), Lackawanna (50), Northumberland (45), and Columbia (45). Pulling up the rear in the state were Pike County (14), Bradford County (13), Fulton County (10), and Potter County (6). The information, from Lancaster Online, does not include Philadelphia, which operates its own vaccination and data collection program. The following is a complete list:

County	Shots per 1,000 people Feb. 3-9
Montour	79
Cameron	56
Lackawanna	50
Northumberland	46
Columbia	45
Centre	42
Luzerne	41
Forest	41
Butler	38
Clarion	38
Mercer	37
Lehigh	37
Northampton	36
Sullivan	36
Armstrong	35
Mifflin	34
Union	34
Juniata	32
Huntingdon	31
Jefferson	31
Schuylkill	31
Lycoming	31
Clinton	30
Wayne	30
Blair	29
Clearfield	29
Westmoreland	29
Allegheny	28
Crawford	28
Wyoming	28
Carbon	27
Cambria	27
Snyder	27
Elk	26
Delaware	26
Montgomery	26
Franklin	26
Lancaster	25
Susquehanna	25
Lawrence	25
Greene	25
Cumberland	23
Erie	23
Bucks	23
Fayette	22
Chester	22
Washington	21
Indiana	21
York	21
Tioga	21
Warren	21
Somerset	19
McKean	19
Berks	19
Monroe	18
Lebanon	17
Venango	17
Dauphin	16
Beaver	16
Bedford	16
Adams	15
Perry	15
Pike	14
Bradford	13
Fulton	10
Potter	6

The National Football League has offered the stadiums of all of its teams to serve as mass vaccination sites. This idea has been received with limited enthusiasm in Philadelphia, the Philadelphia Inquirer reports.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

Federal Update

The White House

The White House has announced the membership of its COVID-19 Health Equity Task Force. See this White House fact sheet to learn more about the task force, its objectives, and its members.
The White House has announced the introduction of a community health center vaccination program next week, with doses of vaccines to be sent directly to such facilities, and an increase in the supply of vaccines to be shared with states, tribes, and territories. Learn more from a White House fact sheet.

Centers for Medicare & Medicaid Services

The Families First Coronavirus Response Act requires Medicare Part B to cover beneficiary cost-sharing for provider visits when a COVID-19 diagnostic test is administered or ordered. CMS has updated the list of codes (note: this link leads to a zip file that can be downloaded) that physicians and non-physician practitioners can use with the Cost-Sharing (CS) modifier. Go here to learn more.
CMS has revised the MLN Matters article “Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)” to clarify billing instructions in the skilled nursing facility benefit period waiver – provider information section.
CMS has modified the previously extended deadline for third quarter 2020 submission of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data and extended the submission deadline for electronic clinical quality measures for acute-care hospitals and prospective payment system-exempt cancer hospitals. Learn more about how this affects specific reporting requirements and their changing deadlines.

HHS and CMS COVID-19 Stakeholder Calls

HHS Clinical Rounds Peer-to-Peer Virtual Communities of Practice

HHS’s Office of the Assistant Secretary for Preparedness and Response sponsors COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice that are interactive virtual learning sessions that seek to create a peer-to-peer learning network in which clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes. These webinar topics are covered every week:

EMS: Patient Care and Operations (Mondays, 12:00-1:00 PM eastern)
Critical Care: Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM eastern)
Emergency Department: Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM eastern)

Go here for information about signing up to participate in the sessions and go here for access to materials and video recordings of past sessions.

CMS Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Calls

Tuesday, February 23 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2528725

Audio Webcast link: go here

Tuesday, March 16 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4177586

Audio Webcast link: go here

Tuesday, April 6 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2769397

Audio Webcast link: go here

Food and Drug Administration

The FDA has issued an emergency use authorization (EUA) for bamlanivimab and etesevimab administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older weighing at least 40 kilograms [about 88 pounds]) who test positive for COVID-19 and who are at high risk for progressing to severe COVID-19. The authorized use includes treatment for those who are 65 years of age or older or who have certain chronic medical conditions. Learn more from:
- the emergency use authorization letter issued by the FDA to the manufacturer of the two monoclonal antibodies
- an FDA fact sheet for providers
- an FDA FAQ on use of the two drugs in combination
- an FDA fact sheet for patients, providers, and caregivers

The FDA has issued a final guidance document presenting its policy for temporary compounding of certain alcohol-based hand sanitizer products during the COVID-19 pandemic.

Centers for Disease Control and Prevention

The CDC has published a checklist with steps health care workers should take in preparation for the transport and arrival of patients with confirmed or possible COVID-19.
The CDC has updated its interim infection prevention and control guidance for health care workers during the COVID-19 emergency.
The CDC has again updated its recommended strategies for optimizing supplies of N95 respirators.
The CDC has introduced several documents that seek to encourage the use of masks to protect against COVID-19 and to use masks more effectively. Those documents are:
- an updated summary of why and how to wear masks
- information about the results of new research on how to improve the fit of cloth and medical procedures masks to improve their ability to reduce exposure to COVID-19
- a consumer-oriented document that offers updated information about using masks more effectively. This is the document that suggests wearing two masks as an option for greater protection.
- Another consumer-oriented, updated guidance document on wearing masks.

PA Safety Net Admin2021-02-12T06:00:08+00:00February 12th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Monday, February 9

The following is the latest COVID-19 information from Pennsylvania’s state government as of 4:30 P.M. on Monday, February 8, 2021.

Department of Health

The Department of Health has issued a health advisory with updates on the current COVID-19 variants and public health measures to take when a variant case is suspected or identified.
The Department of Health has published an update on COVID-19 vaccinations in Pennsylvania.
The Department of Health has published a summary of its contact tracing activity during the last week of January.
Last April the state legislature passed a COVID-19 bill that included a provision permitting direct support professionals who support individuals with intellectual disabilities/autism to accompany those individuals when they are hospitalized. On one of its message boards the Department of Health explains that “It has come to the Department’s attention that some facilities may not be adhering to this guidance… We appreciate your prompt attention to this matter.” The department posted a brief description of the issue and the results of a survey documenting the extent of the problem.
Last April the state legislature passed a COVID-19 bill that included a provision permitting direct support professionals who support individuals with intellectual disabilities/autism to accompany those individuals when they are hospitalized. On one of its message boards the Department of Health explains that “It has come to the Department’s attention that some facilities may not be adhering to this guidance… We appreciate your prompt attention to this matter.” The department posted a brief description of the issue and the results of a survey documenting the extent of the problem.

Department of Health – by the numbers

The number of new daily cases has continued to decline in the past week but remains more than twice the daily highs recorded in the spring.
The daily death toll remains very high, although not as high as three weeks ago.
For the week from January 29 through February 4 the state’s overall COVID-19 test positivity rate fell to 8.6 percent; it was 9.3 percent the week before that. This marked the seventh consecutive week the rate fell.
For the first time in several months, three counties have positivity rates less than five percent and no counties have positivity rates greater than 20 percent.
59 counties are currently in “substantial levels of community transmissions,” the smallest number this winter. One county – Cameron – is in a low level of community transmission and seven are in moderate levels of community transmission: Armstrong, Bedford, Cambria, Elk, Indiana, Westmoreland, and Wyoming.
The number of Pennsylvanians hospitalized with COVID-19 is just 60 percent of what it was in mid-January; the number in hospital ICUs, 63 percent; and the number on ventilators, 59 percent.
Currently, 23 percent of adult ICU beds in the state are unoccupied, as are 19 percent of medical/surgical beds, 16 percent of pediatric ICU beds, 31 percent of pediatric beds, and 35 percent of airborne isolation units.
As of February 8 the state’s vaccine dashboard shows that 726,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 287,000 have received both doses of vaccine. These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
The vaccine dashboard shows vaccine totals by county.

Department of State

The Department of State has issued a waiver that permits licensed volunteers under the State Board of Medicine, the State Board of Osteopathic Medicine, and the State Board of Nursing to administer vaccinations in settings that fall outside the definition of “approved clinic,” including community-based primary-care clinics and clinics in medically underserved areas and state and federally qualified health centers. See the waiver announcement here.
The Department of State has suspended certain state licensing requirements to enable physicians and nurses whose Pennsylvania licenses lapsed, expired, or were inactive within the last five years to administer COVID-19 vaccines. They will be permitted to do so without reactivating or renewing their licenses provided that they meet the specific qualification requirements and that, at the time of their licenses’ expiration, they were active and in good standing.
The Department of State has issued a waiver so that medical students, functioning as “clinical clerks” and not necessarily in hospitals to which they have been assigned, may “…assist in administering COVID-19 vaccinations…” when doing so under carefully defined supervision.
The Department of State has expanded a previous, temporary measure permitting licensed pharmacists and registered pharmacy interns to administer COVID-19 vaccines to persons younger than 18 years of age to enable those individuals to administer COVID-19 vaccines to individuals who are 16 and 17 years old as well. See the department’s notice here.
The Department of State’s Board of Dentistry announced that it will continue to temporarily waive the live-patient aspect of the dental hygienist clinical examination and accept instead the results of an alternative, the ADEX Manikin (non-patient) Examination.

Around the State

Elderly residents of rural Pennsylvania counties face challenges in getting COVID-19 vaccines. Spotlight PA reports.
A bill in the state legislature proposes engaging the Pennsylvania National Guard in the effort to advance the rollout of COVID-19 vaccines in the state. The Allentown Morning Call tells the story.
Alison Beam, nominated by Governor Wolf to be the state’s next Secretary of Health, met last week with the editorial board of the Harrisburg Patriot-News to discuss the state of Pennsylvania’s effort to administer COVID-19 vaccines. Watch a video of that meeting.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2021-02-09T09:44:34+00:00February 9th, 2021|Coronavirus, COVID-19|Comments Off

SNAP Asks PA Delegation for Help From COVID-19 Relief Bill

The next federal COVID-19 relief bill should include more resources for the Provider Relief Fund, SNAP has told members of Pennsylvania’s congressional delegation.

Safety-Net Association of Pennsylvania logo The bill also should include additional targeted funding for safety-net hospitals, help with staffing, an extension of the current moratorium on the Medicare sequestration, and forgiveness for safety-net hospitals for loans they received under the Medicare Accelerated and Advance Payment Program.

This was the message the Safety-Net Association of Pennsylvania conveyed last week in a letter to members of Pennsylvania’s congressional delegation. See that letter here.

PA Safety Net Admin2021-02-05T17:20:29+00:00February 5th, 2021|Coronavirus, COVID-19, Federal Medicaid issues, Medicare|Comments Off

SNAP Asks PA Delegation for Help in Next COVID-19 Relief Bill (Letter)

SNAP has asked members of Pennsylvania’s congressional delegation to pursue more resources for the Provider Relief Fund, additional targeted funding for safety-net hospitals, help with staffing, an extension of the moratorium on the Medicare sequestration, and forgiveness for safety-net hospitals for loans they received under the Medicare Accelerated and Advance Payment Program in the COVID-19 relief bill Congress is currently pursuing.

PA Safety Net Admin2021-05-27T15:08:15+00:00February 5th, 2021|Advocacy|Comments Off

COVID-19 Update: Thursday, February 4

The following is the latest COVID-19 information from the state government as of 3:30 p.m. on Thursday, February 4, 2021.

Commonwealth of Pennsylvania

The state has posted a guide to getting a COVID-19 vaccine. The guide describes the vaccine phases and tells readers how to check on their eligibility, find a vaccine provider, and schedule an appointment.

Department of Health – news briefing

The Department of Health gave a news briefing on the state’s COVID-19 efforts on Wednesday, February 3. It was conducted by Lindsey Mauldin, a department senior advisor.
The Biden administration announced this week that it will be distributing vaccines to 60 Rite Aid and 100 TopCo pharmacies in Pennsylvania. This is part of a new federal distribution. TopCo is a company that operates its own pharmacies as well as pharmacies in retail establishments, including supermarkets – including, in Pennsylvania, Wegman’s, Shop Rite, Weis Markets, Redner’s, and others.
This new allocation of vaccines is in addition to what the state is already receiving from the federal government.
The federal government will begin giving states three weeks’ notice of incoming vaccine shipments, which should facilitate planning, transparency, and the scheduling of vaccines.
The state does not operate a central state registry for people to sign up for COVID-19 vaccinations and does not plan to do so at this time. Instead, its web site offers a map people can use to identify local vaccine providers.
The number of reported vaccines administered in Pennsylvania lags behind the number actually administered because regular vaccine providers have 24 hours to report their activity and retail pharmacy partners have 72 hours to report on their efforts.

Department of Health – by the numbers

The number of new daily cases has declined significantly in the past week – well below November and December highs but still more than twice the daily highs recorded in the spring. On Tuesday the state passed the 850,000 mark for total COVID-19 cases.
The daily death toll remains very high, although not as high as two weeks ago, and the state-wide total now exceeds 22,000.
For the week from January 22 through January 28 the state’s overall COVID-19 test positivity rate fell to 9.3 percent; it was 10.5 percent the week before that. This marked the sixth consecutive week the rate fell.
The numbers of Pennsylvanians hospitalized with COVID-19, in hospital ICUs, and on ventilators have all fallen to about two-thirds of what they were in mid-January.
More than 23,000 health care workers in the state have contracted COVID-19.
More than 76,000 long-term-care facility residents and employees have contracted COVID-19 in 1548 facilities in all 67 Pennsylvania counties.
Currently, 20 percent of adult ICU beds in the state are unoccupied, as are 16 percent of medical/surgical beds, 16 percent of pediatric ICU beds, 30 percent of pediatric beds, and 33 percent of airborne isolation units.
In its “Reduction of Elective Procedures” dashboard that tracks the criteria the state is using to determine whether to order hospitals to reduce or eliminate elective procedures to ensure their ability to handle possible influxes of COVID-19 patients, the state continues to flag a growing staffing shortage in hospitals in the state’s Keystone health care coalition region (Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties). In that region, 41 percent of the region’s hospitals anticipate a staffing shortage in the coming week – more than the 33 percent level that the state believes poses a potential problem. The overall situation in the Keystone region, however, has not reached a point where the state would direct hospitals in this region to reduce or eliminate their elective surgeries. This situation has remained the same for the past month.
As of February 4 the state’s vaccine dashboard shows that 651,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 230,000 have received both doses of vaccine. These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
The vaccine dashboard shows vaccine totals by county.
As ordered by the Department of Health in late 2020, health care institutions – hospitals, FQHCs, and others – must reserve 10 percent of the doses of COVID-19 vaccines they received for non-hospital health care providers. The vaccine page on the department’s web site features a map of locations where non-hospital providers can obtain vaccines. The map includes contact information for non-hospital providers identifying whom they can contact to schedule their vaccines. State officials say more sites will be added to this map as more doses of COVID-19 vaccine become available.

Department of Human Services

DHS’s Office of Developmental Programs has updated its guidance for stakeholders on face coverings, close contact, screening protocols, and handwashing procedures.
DHS’s Office of Long-Term Living and Office of Developmental Programs have updated their COVID-19 guidance for personal care homes, assisted living residences, and private intermediate-care facilities.

General Assembly

The House and Senate both held hearings this week examining Pennsylvania’s vaccine distribution to date. Acting Secretary of Health Alison Beam testified, as did long-term-care providers and representatives of hospitals and pharmacies. Members of the House and Senate expressed frustration and concern with the state’s implementation of its vaccination plan. Their concerns included prioritization of target populations; vaccine allocation across counties; distribution logistics; transparency and accountability; scheduling and registration; and communication. View the House Health Committee hearing here and the Senate Health and Human Services Committee hearing here.

Around the State

The Allegheny County Health Department has begun canceling COVID-19 vaccination appointments scheduled by people who do not meet the criteria for receiving vaccines at this time. As CBS Pittsburgh explains, those finding their appointments canceled are not very happy about it.
The city of Philadelphia has opened its first mass vaccination site and plans five more by the end of the month, the Philadelphia Inquirer reports.
The number of new COVID-19 cases in Allegheny fell nearly 40 percent in January, according to the Pittsburgh Tribune-Review.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2021-02-05T06:00:39+00:00February 5th, 2021|Coronavirus, COVID-19|Comments Off

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

MACPAC kicked off its January meeting with a review of a draft chapter for the March 2021 report to Congress and recommendations on a mandatory extension of Medicaid coverage for 12 months postpartum. The Commission received extensive public comment on the recommendations. On Friday, the Commission approved three recommendations as drafted related to postpartum coverage. The Commission recommended that Congress should:

extend the postpartum coverage period for individuals who were eligible and enrolled in Medicaid while pregnant to a full year of coverage, regardless of changes in income. Services provided to individuals during the extended postpartum coverage period will receive an enhanced 100 percent federal matching rate;
extend the postpartum coverage period for individuals who were eligible and enrolled in the State Children’s Health Insurance Program (CHIP) while pregnant (if the state provides such coverage) to a full year of coverage, regardless of changes in income; and
require states to provide full Medicaid benefits to individuals enrolled in all pregnancy-related pathways.

Commissioners then turned their attention to Medicaid estate recovery policies that affect beneficiaries using long-term services and supports (LTSS). Commissioners on Friday approved recommendations to:

make estate recovery optional rather than required;
allow states with managed long-term services and supports to pursue recovery based on the cost of services where it is less than the capitation payment paid to a managed care plan; and
direct the Secretary of the U.S. Department of Health and Human Services (HHS) to establish minimum hardship waiver standards, including a minimum estate value threshold for estate recovery.

Next, the Commission considered recommendations for countercyclical financing adjustments in Medicaid. This would allow federal financial stimulus to be directed to states more quickly during economic downturns and provide states with greater budget predictability. The Commission approved a recommendation that Congress should adopt a statutory mechanism to amend the Social Security Act to provide an automatic Medicaid countercyclical financing model, using the prototype developed by the U.S. Government Accountability Office as the basis. The Commission also recommended this policy change should include:

an eligibility maintenance of effort requirement for the period covered by an automatic countercyclical financing adjustment;
an upper bound of 100 percent on countercyclical adjusted matching rates; and
exclusion of countercyclical adjusted federal matching rate from services and populations that receive special matching rates (e.g., for the new adult group) or are otherwise capped or have allotments (e.g., disproportionate share hospital payments, territories).

After a break on Thursday, Commissioners discussed a draft chapter for the March 2021 report on design considerations for creating a new program for dually eligible beneficiaries and reviewed a report to Congress by the U.S. Secretary of Health and Human Services (HHS) on Medicaid housing supports for individuals with substance use disorder (SUD). The Commission plans to send a letter to HHS and leadership of relevant congressional committees commenting on the Secretary’s report to Congress on Medicaid housing supports for people with SUD who are experiencing or at risk of homelessness.

Next, Commissioners heard a panel discussion on the outlook for state budgets and the implications for Medicaid with Emily Blanford, program principal at the National Conference of State Legislatures; Shelby Kerns, executive director for the National Association of State Budget Officers; and Susie Perez Quinn, government affairs director for the National Governors Association. * The day ended with a presentation on value-based payment for maternity services.

On Friday, Commissioners heard a panel discussion on how Medicaid serves people with intellectual or developmental disabilities with Sharon Lewis, a principal at Health Management Associates; Melissa Stone, director of Arkansas’ Division of Developmental Disabilities Services; and Elizabeth Weintraub, a senior advocacy specialist at the Association of University Centers on Disabilities. * Additional sessions focused on a congressionally mandated MACPAC study of non-emergency medical transportation (NEMT), which will be included in the June 2021 report to Congress. In addition, Commissioners heard a new analyses of care integration for dually eligible beneficiaries, and a discussion of potential new models for payment and coverage of high-cost specialty drugs. The meeting concluded with a discussion of mental health parity in Medicaid.

Supporting the discussion were the following briefing papers:

Because they serve so many Medicaid and CHIP patients – more than the typical hospital – MACPAC’s deliberations are especially important to Pennsylvania safety-net hospitals.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program. Find its web site here.

PA Safety Net Admin2021-02-02T06:00:35+00:00February 2nd, 2021|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

Wolf Agenda Addresses Health Care Both Directly, Indirectly

In advance of introducing his proposed FY 2022 budget next week, Pennsylvania Governor Tom Wolf has issued a statement outlining his policy priorities for the coming year.

In this statement he addresses health care both indirectly, with references to health equity and opportunity, and directly as well.

Highlights include:

The COVID-19 pandemic has caused major disruptions and layoffs to Pennsylvania’s workforce, disproportionately impacting low-wage workers, people of color, people with disabilities, and certain industries. Our economic recovery requires a strategic investment in workforce development that addresses these inequities, supports workers most significantly impacted by the pandemic, and focuses on high-quality, well-paying jobs and careers. Building on the bipartisan Keystone Economic Development and Workforce Command Center, the governor is proposing a multi-billion-dollar injection into the workforce development system to provide rapid re-employment assistance to workers impacted by the pandemic and address barriers to employment.

Also,

Building on the overwhelming bipartisan support to establish the state-based health insurance exchange in Pennsylvania, increasing access to affordable care and saving money for both the state and taxpayers, Governor Wolf offers a plan that addresses comprehensive health reforms focusing on both physical and behavioral health and promoting affordability, accessibility and value in health care. The Health Value Commission, a key component to the health reform package, would be charged with keeping all payors and providers accountable for health care cost growth, to provide for the long-term affordability and sustainability of our health care system, and to promote whole-person care.

Next Tuesday Governor Wolf will unveil his proposed FY 2022 budget, which is expected to proposed specific programs and investments in pursuit of these objectives.

PA Safety Net Admin2021-01-29T06:00:48+00:00January 29th, 2021|Pennsylvania proposed FY 2022 budget|Comments Off

COVID-19 Update: Wednesday, January 27

The following is the latest COVID-19 information from the state government as of 3:30 p.m. on Wednesday, January 27.

Department of Health

The Department of Health has amended its hospital reporting order effective on January 27, 2021 to require daily reporting to the CORVENA system by 10:00 a.m. instead of the previous 8:00 a.m. deadline. The order also was amended to include as a required data field “Other categories or data fields required by the federal data reporting system (TeleTracking)” to ensure that facilities are completing all necessary information for the Health Department’s upload from CORVENA into the Teletracking system. Go here for the amendments to the order and here for a memo about these changes.
The Department of Health has posted slides that were presented during a recent meeting of the Health Care Coalition containing information about vaccine strategies for long-term-care facilities.
The Department and Health and Department of Human Services has posted a COVID-19 vaccine toolkit for long-term and congregate care facilities.

Department of Health – by the numbers

The number of new daily COVID-19 cases has remained steady in recent days – well below November and December highs but more than twice the daily highs recorded in the spring.
The daily death toll remains very high and the state-wide total rose past 21,000 today.
For the week from January 15 through January 21 the state’s overall COVID-19 test positivity rate fell to 10.5 percent; it was 12.7 percent the week before that. This marked the fifth consecutive week the rate fell.
The numbers of Pennsylvanians hospitalized with COVID-19, in hospital ICUs, and on ventilators has remained steady in recent days.
More than 22,000 health care workers in the state have contracted COVID-19.
More than 74,000 long-term-care facility residents and employees have contracted COVID-19 in 1533 facilities in all 67 Pennsylvania counties.
Currently, 18 percent of adult ICU beds in the state are unoccupied, as are 15 percent of medical/surgical beds, 14 percent of pediatric ICU beds, 27 percent of pediatric beds, and 33 percent of airborne isolation units. All of these numbers are down in recent days.
In its “Reduction of Elective Procedures” dashboard that tracks the criteria the state is using to determine whether to order hospitals to reduce or eliminate elective procedures to ensure their ability to handle possible influxes of COVID-19 patients, the state continues to flag a growing staffing shortage in hospitals in the state’s Keystone health care coalition region (Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties). In that region, 41 percent of the region’s hospitals anticipate a staffing shortage in the coming week – more than the 33 percent level that the state believes poses a potential problem. The overall situation in the Keystone region, however, has not reached a point where the state would direct hospitals in this region to reduce or eliminate their elective surgeries. This situation has remained the same for the past three weeks.
As of January 27 the state’s vaccine dashboard shows that 491,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and nearly 140,000 have received both doses of vaccine.
The vaccine dashboard shows vaccine totals by county both on a map and in lists.
A spreadsheet of facilities that have received vaccines can be found here.
As ordered by the Department of Health in late 2020, health care institutions – hospitals, FQHCs, and others – must reserve 10 percent of the doses of COVID-19 vaccines they received for non-hospital health care providers. The vaccine page on the department’s web site features a map of locations where non-hospital providers can obtain vaccines. The map includes contact information for non-hospital providers identifying whom they can contact to schedule their vaccines. State officials say more sites will be added to this map as more doses of COVID-19 vaccine become available.

Department of Human Services

DHS has issued a new Medical Assistance Bulletin explaining its decision to increase the Medical Assistance program fee schedule rate for the administration of the COVID-19 vaccine from its current rate to the rate paid by Medicare. This change is effective December 1, 2020 and DHS will reprocess claims submitted between December 1, 2020 and the issuance of this bulletin. Providers do not need to resubmit the claims.

Department of State

Under current waivers, pharmacy interns may administer vaccinations, including COVID-19 vaccinations, under the direct supervision of a licensed pharmacist. In anticipation of the possibility that some pharmacies may have more pharmacy interns capable of administering COVID-19 vaccinations than they have licensed pharmacists capable of providing the requisite direct supervision, the Department of State has temporarily broadened the scope of “eligible supervisors” to include other licensed and trained health care professionals whose current scope of practice permits them to immunize, thereby making it possible for pharmacy interns to administer COVID-19 vaccinations under the direct, immediate, and personal supervision of a pharmacist or certain other health care practitioners. Specifically, appropriate supervisors pursuant to this waiver include other licensed health care professionals who are trained in the administration of immunizations and emergency care of patients: physicians, physician assistants, and nurse-midwives licensed by the State Boards of Medicine and Osteopathic Medicine, registered nurses, and certified registered nurse practitioners licensed by the State Board of Nursing. This waiver applies solely to COVID-19 vaccines and shall be valid for the duration of the governor’s disaster emergency declaration plus an additional 90 days thereafter, unless terminated sooner. Learn more about the waiver here.

General Assembly

House Bill 55 was approved by the House of Representatives on Wednesday by a vote of 116-86. This legislation would amend Pennsylvania’s constitution to limit gubernatorial emergency declarations to no more than 21 days unless the General Assembly agrees to extend it in whole or part. In addition, once a disaster emergency expires, the governor would not be able to declare a new one based on “the same or substantially similar facts” without approval from the General Assembly. Further, the bill would clarify that the General Assembly, through a concurrent resolution, could vote to terminate a disaster declaration without having to present it to the governor. The bill will now go to the Senate for concurrence. If the Senate approves the bill before mid-February, it will be able to be placed on the May 18 primary ballot for voter consideration.
Senate Bill 109 was approved by the Senate Wednesday afternoon by a vote of 48-0 and sent to the House of Representatives for consideration. SB 109, a $912 million COVID-19 relief package, provides funding to support restaurants, schools, employers, tenants, and landlords as they continue to confront the financial challenges caused by COVID-19. The measure provides $569.8 million for rental and utility assistance; $197 million for education programs; and $145 million to support the hospitality industry. The funds appropriated by the bill are provided through federal COVID-19 stimulus money. The legislation does not designate any funds for health care. It could be approved by the House as early as next week.

Around the State

Forest County, Pennsylvania has experienced more COVID-19 cases in the past two weeks than it had since the start of the pandemic until that point, according to the Philadelphia Inquirer.
The Inquirer also reports that the city of Philadelphia has terminated its relationship with Philly Fighting COVID, which ran the city’s largest mass vaccination site and operated a vaccine preregistration website.
Westmoreland County, a major COVID-19 hotspot in recent months, has seen its new case numbers fall to their lowest level since October, according to the Pittsburgh Tribune-Review.
Philadelphia hospitals have begun giving COVID-19 vaccines to their patients, WHYY radio reports.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2021-01-28T09:07:25+00:00January 28th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Monday, January 25

The following is the latest COVID-19 information from Pennsylvania’s state government as of 3:30 p.m. on Monday, January 25.

Department of Health

The Department of Health has updated it guidance on the use and interpretation of point-of-care antigen test results.

The Department of Health has issued an updated health alert for long-term-care facilities on the use of point-of-care antigen tests, recommending a follow-up molecular test within 48 hours for any asymptomatic person with a positive antigen test result or symptomatic person with a negative result.

Department of Health – by the numbers

Over the weekend Pennsylvania’s total number of COVID-19 cases surpassed 800,000. That means that more than six percent of the state’s population has had the virus.
Although the daily numbers remain very high, the decline in the number of new cases reported every day has fallen significantly in the past week.
The daily death toll remains very high and the state-wide total rose past 20,000 in recent days.
For the week from January 15 through January 21 the state’s overall COVID-19 test positivity rate fell to 10.5 percent; it was 12.7 percent the week before that. This marked the fifth consecutive week the rate fell.
Despite these positive signs, 66 of Pennsylvania’s 67 counties remain in “substantial level of community transmission.” This week, Cameron County fell out of this group. Even so, all counties have positivity rates greater than five percent, which is the level that is considered “concerning.”
The numbers of Pennsylvanians hospitalized with COVID-19 has fallen below 4000 for the first time since the week of Thanksgiving. The number of Pennsylvanians in hospital ICUs has fallen again for the second consecutive week, as has the number on ventilators.
More than 22,000 health care workers in the state have contracted COVID-19.
More than 73,000 long-term-care facility residents and employees have contracted COVID-19 in 1529 facilities in all 67 Pennsylvania counties.
Currently, 22 percent of adult ICU beds in the state are unoccupied, as are 19 percent of medical/surgical beds, 17 percent of pediatric ICU beds, 34 percent of pediatric beds, and 34 percent of airborne isolation units.
In its “Reduction of Elective Procedures” dashboard that tracks the criteria the state is using to determine whether to order hospitals to reduce or eliminate elective procedures to ensure their ability to handle possible influxes of COVID-19 patients, the state continues to flag a growing staffing shortage in hospitals in the state’s Keystone health care coalition region (Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties). In that region, 41 percent of the region’s hospitals anticipate a staffing shortage in the coming week – more than the 33 percent level that the state believes poses a potential problem. The overall situation in the Keystone region, however, has not reached a point where the state would direct hospitals in this region to reduce or eliminate their elective surgeries. This situation has remained the same for the past three weeks.
As of January 25 the state’s vaccine dashboard shows that 451,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and more than 114,000 have received both doses of vaccine.
The vaccine dashboard shows vaccine totals by county both on a map and in lists.
A spreadsheet of facilities that have received vaccines can be found here.
As ordered by the Department of Health in late 2020, health care institutions – hospitals, FQHCs, and others – must reserve 10 percent of the doses of COVID-19 vaccines they received for non-hospital health care providers. Now, the vaccine page on the department’s web site features a map of locations where non-hospital providers can obtain vaccines. The map includes contact information for non-hospital providers identifying whom they can contact to schedule their vaccines. State officials say more sites will be added to this map as more doses of COVID-19 vaccine become available.

Department of Human Services

DHS’s Office of Children, Youth, and Families has updated its general guidance reflecting the state’s COVID mitigation orders affecting services to children, youth, and families served by counties and providers licensed by the office. The guidance covers safety precautions and visitation requirements.

Around the State

Spotlight PA has posted an interactive map that shows every COVID-19 vaccination site in 66 of the state’s 67 counties (Philadelphia is not included).
Appointments to receive COVID-19 vaccines are being filled almost as soon as they are being made available in some parts of the state. Lehigh Valley Live reports that two weeks’ worth of appointments in Allentown were filled in just three hours, while according to WESA-FM, “Less than an hour after the Allegheny County Health Department opened up vaccination appointments to people age 65 and older all the slots were reportedly filled.” The Allegheny Health Network has stopped making vaccination appointments because of a shortage of vaccines, according to the Pittsburgh Tribune-Review.
The Philadelphia Inquirer writes that “After nearly a year of dealing with the effects of COVID-19 with the assistance of neighboring Chester County, Delaware County has taken a series of concrete steps toward forming a health department of its own.”