COVID-19 Update: Thursday, October 15
The following is the latest COVID-19 information from the state and federal governments as of 3:00 p.m. on Thursday, October 15.
Pennsylvania Update
Department of Human Services
DHS’s Office of Developmental Programs has issued an FAQ on modifications to medication administration course requirements as a result of the COVID-19 emergency. The audience for this FAQ is Office of Developmental Programs providers whose staff, contractors, or consultants are required by state law to take medication administration training. Due to the COVID-19 pandemic, the Office of Developmental Programs has temporarily permitted staff required to undergo such training to take a modified medication administration course. The FAQ addresses the current state of the training requirement.
Department of Health
- The Department of Health has issued new guidance for skilled nursing facilities that replaces guidance issued on September 3 and brings the agency’s guidance in line with recent CMS memoranda. This document is a compendium of all COVID-19-related guidance and recommendations in areas such as testing, visitation, cohorting, and reporting.
- The Department of Health announced that the state has begun distributing the first allotment of 250,000 COVID-19 rapid antigen test cards provided by the federal government.
- Distribution is beginning with Bradford, Centre, Lebanon, Montour, Northumberland, Schuylkill, and Snyder counties because of the recent high COVID-19 incidence rates in those areas.
- The tests are being distributed to Clinical Laboratory Improvement Amendments (CLIA)-certified organizations, including long-term-care facilities, personal care homes and assisted living/intermediate-care facilities, higher education institutions, drug and alcohol and behavioral health treatment centers, state and county correctional facilities, and health care providers such as FQHCs, urgent care centers, pharmacies, and primary care doctors.
- Populations targeted for testing with these materials include individuals in congregate care settings, day care workers and clients, K-12 students and adults who work in K-12 settings, college and university students, individuals without permanent housing, food distribution facility employees, food workers, and first responders.
- These test kits are separate from and in addition to the tests being provided by the federal government directly to skilled nursing facilities, personal care homes, and historically black colleges and universities.
- The Secretary of Health issued an order to laboratories, health care practitioners, health care providers, and facilities reinforcing that all antigen test results, both positive and negative, must be reported to the Department of Health via its reporting system, PA-NEDSS.
Department of Health – by the numbers
The weekly news release from the office of the governor and the Department of Health cited 14 counties as concerns because of their high rate of positive test results: Northumberland (8.6 percent), Centre (7.6 percent), Bradford (7.4 percent), Lebanon (7.4 percent), Lawrence (6.9 percent), Potter (6.3 percent), Westmoreland (6.3 percent), Fulton (6.2 percent), Montour (6.0 percent), Berks (5.9 percent), Indiana (5.9 percent), Huntingdon (5.8 percent), Lackawanna (5.4 percent), and Schuylkill (5.0 percent). It also noted that “Each of these counties bears watching as the state continues to monitor all available data.”- With the increase in cases in Northumberland County, the Department of Health has arranged for an outdoor testing site from October 16-20. The tests are free and appointments are not needed.
- The number of new COVID-19 cases has been in four digits in 14 of the 15 days of October – the first time that has happened in more than four months. Today’s new case count is the highest single day figure since at least May.
- The number of people currently hospitalized with COVID-19 is up 43 percent since October 1.
- The number of COVID-19 patients currently breathing with the help of a ventilator is up 57 percent since October 1 and is at its highest level since August 20.
- 22 percent of hospital adult ICU beds are currently unoccupied, as are 18 percent of medical/surgical beds, 33 percent of pediatric beds, 13 percent of pediatric ICU beds, and 38 percent of airborne isolation unit beds. These figures are almost identical to what they were a week ago.
- More than 11,500 health care workers in the state have contracted COVID-19.
Federal Update
Provider Relief Fund
Yesterday HHS held a webinar to provide more detailed information to health care providers about its planned $20 billion CARES Act Provider Relief Fund Phase 3 general distribution. It used this toolkit during the webinar. The deadline for applying for a Phase 3 general distribution is November 6.- During the webinar, providers that have received Provider Relief Fund general distributions in the past were advised that they need to submit an entirely new application to participate in Phase 3 and be eligible to receive any add-on payment that HHS distributes from the funding pool that remains after all applicants have received payments equal to two percent of patient care revenue. There are no details available on how these potential add-on payments might be calculated.
- During the webinar HHS offered a point of contact for stakeholders with questions about the Provider Relief Fund and payments for testing and treatment for the uninsured: its Provider Support Line at 866-569-3522 (for TYY, dial 711).
Centers for Medicare & Medicaid Services
CMS has expanded the list of telehealth services that Medicare fee-for-service will pay for during the COVID-19 public health emergency, adding 11 new services to the Medicare telehealth services list. Medicare will begin paying for these services immediately and for the duration of the COVID-19 emergency. These new telehealth services include certain neurostimulator analysis and programming services and cardiac and pulmonary rehabilitation services. Go here to see CMS’s announcement of the newly authorized telehealth services and here for a link to the list of the new services and their billing codes.- CMS has published the document “State Medicaid and CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth” and subtitled it “COVID-19 Version.” The document explains that “This guide is intended to help states identify which aspects of their statutory and regulatory infrastructure may impede the rapid deployment of telehealth capabilities in their Medicaid program. As such, this guide will describe each of these policy areas and the challenges they present below. The toolkit concludes with a list of questions state policymakers can use to ensure they have explored and/or addressed potential obstacles.” It also notes that “CMS encourages states to consider telehealth options as a flexibility in combatting the COVID-19 pandemic and increasing access to care. States are encouraged to facilitate clinically appropriate care within the Medicaid program using telehealth technology to deliver services covered by the state.” CMS also has published a supplement to this guide, “State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth,” and subtitled it “COVID-19 Version: Supplement #1.” This document is dated October 14, 2020.
Centers for Disease Control and Prevention
Resources to Consult
Pennsylvania Department of Human Services
Pennsylvania Department of Health
Centers for Disease Control and Prevention
That’s according to a new study from the Center for Children and Families at Georgetown University’s Health Policy Institute.
The letter refers to changes in how the federal Department of Health and Human Services wants hospitals to calculate the revenue they lost as a result of COVID-19 – the justification in part for the Provider Relief Fund payments hospitals have received through the CARES Act. In June, HHS told hospitals how to make that calculation but late last month it changed those directions in ways that could force many Pennsylvania safety-net hospitals to return some or even much of the federal aid they received.
Provider Relief Fund
Food and Drug Administration
Included in this month’s edition are articles about:
An Interagency Health Reform Council charged with developing recommendations on how to identify and capitalize on efficiencies in the existing health care system.
Department of State 
HHS Secretary Azar has renewed the COVID-19 public health emergency declaration, which was set to expire on October 23. With this renewal, the CMS waivers made possible by the declaration will remain in effect until January 21 unless the emergency is renewed again. View the renewal notice 
The enrollment increase can be traced to rising unemployment, with many people losing their employer-sponsored health insurance. The new figures cover five months, from February through June, the latter four of which marked the beginning of the COVID-19 pandemic.