The following is the latest COVID-19 information from Pennsylvania’s state government as of 4:00 p.m. on Tuesday, August 25.

Governor Wolf

• Governor Wolf has presented his fall legislative agenda.  Among his proposals, he called for $225 million for hazard pay for frontline workers; $10 million for a personal protective equipment reimbursement program for small businesses; and $250 million for child care for families with school-age children in need of care because of blended or remote in-person instruction models.  Learn more about these and other aspects of the governor’s proposal here.
• Senate and House Republican leaders responded to the governor’s accusation that they have ignored the public health crisis and thwarted Democratic legislators’ efforts to fight for progress to protect families and business.  Senate majority leader Corman  R (Centre, Huntingdon, Mifflin, and Juniata) called the governor’s fall agenda a “political document” and stated that Governor Wolf, a Democrat, is more interested in providing political cover for Senate and House Democrats in the upcoming election than he is in governing and working with the legislature.  House majority leader Benninghoff (R-Centre and Mifflin) labeled the governor’s agenda disingenuous and unaffordable.
• Governor Wolf announced that Pennsylvania will apply to participate in the federal Lost Wages Assistance program to gain funding for an additional $300 a week in supplemental payments for some Pennsylvanians receiving unemployment benefits.
• The governor’s office posted his weekly COVID-19 status update.  Highlights include:
  • A decline in the state’s positivity rate for COVID-19 tests, from 4.0 percent to 3.4 percent, marking the fourth consecutive week that rate has declined.
  • A 20 percent decline in new COVID-19 cases from the previous week.

The weekly report also includes information about the state’s contact tracing efforts.  Learn more here, in the governor’s news release.  A separate Department of Health news release also addresses the state’s contact tracing work.

Department of Health

• The Department of Health has unveiled “CATE” (Community-Accessible Testing and Education”), a recreational vehicle that has been equipped as a mobile COVID-19 testing and education unit that will travel the state offering free COVID-19 tests and education in medically underserved communities in 16 counties.  Established and operated by the organization Latino Connection, staffed by the Welsh Mountain Health Centers, and funded in part by the state, Highmark, and Independence Blue Cross, CATE has more than 30 stops scheduled during September, the first half of them in the Philadelphia area and then moving westward across the state.  Appointments are not needed and CATE’s tests will be performed by the state’s lab in Exton, which is producing results in 24 to 48 hours.  Learn more about CATE, its origins, and its scheduled stops in this Department of Health news release and by visiting the CATE web site.

• At a news conference Secretary Levine reported that the major backlog of COVID-19 test results has eased.  LabCorp and Quest are now reporting results in two to three days and hospitals and smaller labs are now generally turning around tests in 24 to 48 hours, as is the state’s own lab.  The biggest challenge to access to testing, she said, continues to be access to the reagents used for testing.

Department of Health – by the numbers

• The number of new COVID-19 cases has been declining for the past two weeks.  As noted above, the total of new cases declined 20 percent last week in comparison to the previous week.
• The state’s total number of COVID-19 cases just surpassed 130,000.
• COVID-19 death totals fluctuate considerably from day to day, with the total number of deaths now surpassing 7600.
• Nearly 9400 health care workers in the state have contracted COVID-19.
• The number of Pennsylvanians hospitalized with COVID-19 has declined slowly but steadily over the past month but has spiked modestly in recent days.
• The number of Pennsylvanians on ventilators also has been declining, although more slowly than the number of people hospitalized with COVID-19.
• More than 25,000 residents and staff of 922 long-term-care facilities in 61 of the state’s 67 counties have now contracted COVID-19.
• 22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  26 percent of adult ICU beds, 23 of pediatric ICU beds, 38 percent of pediatric beds, and 43 percent of airborne isolation rooms.

Department of Human Services

• DHS’s Office of Developmental Programs (ODP) has posted an announcement that provides direction on the use of its health risk screening web portal for staff working at ODP-contracted facilities and programs who are suspected of having COVID-19 or have confirmed cases of COVID-19.

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

The following is the latest coronavirus information from Pennsylvania’s state government as of 3:30 p.m. on Tuesday, August 18.

Wolf Administration

The Wolf Administration has awarded $50 million in hazard pay grants for front-line workers in life-sustaining industries.  The program, funded through CARES Act money appropriated to the Department of Community and Economic Development, was announced in mid-July in an effort to keep front-line workers working across the commonwealth.  Click here to read the full press release and here to view a list of grant recipients.

 Department of Health 

• The Secretary of the Department of Health has ordered all skilled nursing facilities, personal care homes, assisted living residences, and private intermediate care facilities to develop, implement, and adhere to policies and procedures that provide for the procurement and distribution of personal protective equipment to all staff by August 27, 2020.  The policies and procedures must at a minimum include distribution of respirators to staff providing direct patient care to COVID-19 positive and suspected cases and staff assigned to provide direct patient care in COVID-19 units.  The respirators distributed by each facility must be National Institute for Occupational Safety and Health-approved or FDA-approved.  Respirator distribution must occur prior to the beginning of the staff member’s shift and the respirator must be replaced as soon as practical if the facility is notified by a staff member that a mask has become soiled, damaged, or otherwise ineffective.
• The administration provided an update on its efforts to improve and expand COVID-19 contact tracing efforts through the Department of Health.

Department of Health – by the numbers 

• The number of new COVID-19 cases has remained relatively steady for the past two weeks:  fewer than late July and more like the beginning of last month.
• The department continues to report that the number of cases among people between the ages of 19 and 24 exceeds those among people between the ages of 50 and 64 and those 65 years of age and older.  The number of cases among those between 19 and 24 is rising in every part of the state.
• More than 8,997 health care workers in the state have contracted COVID-19.
• The number of COVID-19-caused deaths in Pennsylvania is nearing 7,500.
• The number of long-term-care facility residents and staff who have contracted COVID-19 now exceeds 24,700.  These cases have occurred in 899 such facilities in 61 of the state’s 67 counties. 

Department of Human Services 

The Department of Human Services has temporarily suspended certain regulatory requirements for the continued and uninterrupted delivery of behavioral health services during the COVID-19 pandemic. Go here for a complete list of the regulatory suspensions issued by the Office of Mental Health and Substance Abuse Services to date.

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

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Tuesday, August 11.

Pennsylvania Update

Wolf Administration

In a message to families in anticipation of a new school year, the Wolf administration stressed the importance of children receiving their required childhood vaccinations but reminded Pennsylvanians that the Department of Health has temporarily suspended its requirements for children’s immunizations for two months after the beginning of the school year or the beginning of enrollment in an early childhood education program.  See the Wolf administration’s news release on this subject here and Department of Health notice about the temporary policy suspension here.

Department of Health

• The Department of Health addressed a provider question about direct care worker exposure to a COVID-19-positive patient in last week’s weekly wrap-up document, stating that anyone who has had prolonged close contact (within six feet for at least 15 minutes) with an individual who tests positive should be considered potentially exposed regardless of the personal protective equipment worn by either the worker or the patient.
• A posting on the department’s message board provided guidance for hospitals on how to comply with the requirement for an annual public meeting of the governing body in 28 Pa. Code §103.3(10)(iii) during the public health emergency.  That posting explained that

For purposes of a compliance with 28 Pa. Code §103.3(10)(iii), the Department has interpreted the term “attend” to include virtual attendance by the general public and the governing body through the use of audio-video technology.  A hospital choosing to conduct its annual public meeting virtually must still publicize the meeting information well in advance of the meeting and establish a mechanism to document attendance at the meeting.  A hospital does not need approval from the Department to conduct a virtual meeting under 28 Pa. Code §103.3(10)(iii) but must be able to provide documentation of the advance notice and attendance upon request.

Department of Health – by the numbers

• The number of new COVID-19 cases has remained relatively steady for the past week:  fewer than late July and more like the beginning of last month.  Today’s new cases brought the state-wide count to more than 120,000 since the beginning of the pandemic.
• The number of COVID-19-caused deaths has generally been down except for two days in the past week that had the highest death totals since July 1.  Yesterday the state’s total death count from COVID-19 surpassed 7300.
• A report issued jointly by Governor Wolf and the Department of Health late last week noted that the state-wide positive COVID-19 test rate declined to 4.1 percent from 4.6 percent last week.  Counties with concerning positive test rates include Union (11.8 percent), Indiana (7.9 percent), Fayette (7.7 percent), Fulton (7.4 percent), Huntingdon (6.7 percent), Erie (6.2 percent), Mercer (6.2 percent), Lawrence (6.0 percent), Northumberland (6.0 percent), York (5.8 percent), Clearfield (5.7 percent), Luzerne (5.4 percent), Juniata (5.3 percent), Lancaster (5.3 percent), Beaver (5.2 percent), Delaware (5.2 percent), and Mifflin (5.0 percent).
• The number of long-term-care facility residents and staff who have contracted COVID-19 recently rose past the 24,000 mark.
• As has been the case for more than two months, 68 percent of the state’s COVID-19 deaths have been among elderly residents of long-term-care facilities.
• The number of Pennsylvanians hospitalized with COVID-19 and breathing with the help of mechanical assistance continues to decline slowly.
• 22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  24 percent of adult ICU beds, 15 percent of pediatric ICU beds, 41 percent of pediatric beds, and 43 percent of airborne isolation rooms.

Federal Update

Provider Relief Fund

• Eligible providers may now apply for Provider Relief Fund phase 2 general distributions. These are providers that are being given another opportunity to receive Provider Relief Fund payments after missing the June 3, 2020 deadline to apply for funding equal to two percent of their total patient care revenue from the $20 billion portion of the $50 billion phase 1 general distribution; this group also includes Medicaid, Children’s Health Insurance Program (CHIP), dental providers with low Medicare revenues, and hospitals that received payments in the phase 1 distribution but returned them.  In addition, providers that experienced a change in ownership, making them ineligible for phase 1 funding, also may apply.
  • Providers can go here to learn more about this phase 2 distribution and eligibility.
  • Providers can submit the required financial data on the Provider Relief Fund application and attestation portal. The deadline for submitting data is August 28.
  • Providers can go here to register for a webinar on this distribution to be held on Thursday, August 13 at 3:00 (eastern).
• HHS has shared information about its next CARES Act-authorized nursing home Provider Relief Fund distribution. This $5 billion distribution will include approximately $2.5 billion to support increased testing, staffing, and personal protective equipment needs and to establish COVID-19 isolation facilities, with the balance to be linked to nursing home performance.  HHS expects to make the first $2.5 billion distribution in mid-August and the performance-based distributions throughout the fall.  Learn more from this HHS news release.
• HHS has updated its Provider Relief Fund FAQ with 16 new questions, 15 of which address eligibility for phase 2 general distributions from the Provider Relief Fund and how to apply for those distributions. These questions can be found on pages 22, 23, 24, 29, and 31 of the FAQ; these and other new questions are all dated 8/10/2020.  Another question about eligibility, dated 8/7/2020, can be found on page 2.

Department of Health and Human Services

• HHS has posted the July through December COVID-19 testing plans of all states, territories, and localities. Find those testing plans here.

Centers for Medicare & Medicaid Services

• CMS announced a new Community Health Access and Rural Transformation Model (CHART) that will seek to improve the quality, accessibility, and value of care in rural areas. The agency intends to invest up to $75 million in seed money to enable up to 15 rural communities to participate in the program, which will involve tools such as an accountable care organization (AC) transformational track, the extension of COVID-19-inspired telemedicine waivers after the pandemic is over, a reduction of the minimum required supervision level for hospital outpatient therapeutic services, and an increase in wage indexes for low-wage hospitals, including many rural hospitals.  Learn more here.
• CMS has updated its “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing” document with a new question about the broader impact of its waiving of certain Medicare and Medicaid utilization review requirements. See page 22, question 23 for further details.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its 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 attendees an opportunity to ask questions of CMS and other subject matter experts.

Lessons from the Front Lines: COVID-19

Friday, August 21 at 12:30 – 2:00 PM eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5956858

Audio Webcast Link:  go here.

CMS COVID-19 Office Hours Call

Tuesday, August 25 at 5:00 – 6:00 PM eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 8579003

Audio Webcast link:  go here.

Home Health and Hospice Call

Tuesday, August 25 at 3:00 – 3:30 PM eastern

Toll Free Attendee Dial-In: 833-614-0820 Access Passcode: 6782346
Audio Webcast Link:  go here.

Nursing Homes Call

Wednesday, August 12 at 4:30 – 5:00 PM eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7857618

Audio Webcast Link:  go here.

Wednesday, August 26 at 4:30 – 5:00 PM eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5718509
Audio Webcast Link:  go here.

Dialysis Organizations Call

Wednesday, August 12 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1027088

Audio Webcast Link:  go here.

Wednesday, August 26 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1834329
Audio Webcast Link:  go here.

Nurses Call

Thursday, August 13 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7844289

Audio Webcast Link: go here.

Thursday, August 27 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1556623
Audio Webcast Link:  go here.

Conference lines are limited, so CMS encourages interested parties to join via audio webcast.  To listen to the audio files and read the transcripts for these and past COVID-19 Stakeholder calls, visit CMS’s Podcast and Transcripts page.

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

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Friday, August 7.

Pennsylvania Update

News Conference

Governor Wolf and Health Secretary Levine held a joint news conference on Thursday, August 6.  Among the issues they highlighted:

• Pennsylvania now has 445 testing sites.
• The state’s testing capacity, about 8000 tests a day in April, is now more than 22,000 tests a day.
• The state is now testing about four percent of its population a month.  It would like to exceed five percent.
• The positivity rate on those tests is less than five percent.  More than five percent is considered a problem.
• One of the biggest challenges is the turnaround time for test results.  Hospital and small commercial labs are often turning tests around in 24-48 hours but the major labs are struggling under their workload.  With many cases and often lacking reagents needed for testing, they are averaging a turnaround time of seven days.  State officials have spoken to them about this and to the federal Department of Health and Human Services about the lack of testing reagents that is a major part of the problem.
• The national labs also often need to focus on states in the midst of serious outbreaks.
• The number of Pennsylvanians hospitalized daily for COVID-19 has fallen from an average of 1028 in June to 700 at the end of July and the number of patients on ventilators daily has fallen from an average of 222 in June to 94 at the end of July.
• With mandatory nursing home testing now completed, the state will turn its attention to continued testing at nursing homes based on what the first round of testing revealed and testing at the more than 1200 assisted living and personal care facilities.
• At this point, everyone who needs a test can get one.  The challenge remains getting the results of such tests in a timely manner.
• The state laboratory has expanded its testing capacity.  In addition, it can prioritize tests taken in areas where there appear to be outbreaks, to ensure more timely results.
• The state lab and the county labs have enough reagents and testing materials for their own use but they do not have any to share.
• Governor Wolf expressed a desire for a simpler point-of-care test that is less uncomfortable to administer.  He revealed that he has not yet been tested.

Department of Health

The Department of Health has revised a previous health alert on infection prevention and control in health care settings to reorganize the information and add new recommendations about protective eye wear.  This advises personnel working in health care facilities located in areas with moderate to substantial community transmission to wear eye protection in addition to a face mask for all patient care encounters.

Department of Health – by the numbers

• The number of new COVID-19 cases has declined from the higher totals of late July.  With occasional exceptions, daily death totals also are generally down.
• 22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  26 percent of adult ICU beds, six percent of pediatric ICU beds, 38 percent of pediatric beds, and 44 percent of airborne isolation rooms.
• The number of health care workers who have contracted COVID-19 now exceeds 8500.
• Pennsylvania has seen 40 confirmed cases of multisystem inflammatory syndrome in children (MIS-C).  twelve suspected cases were found not to be MIS-C and another 16 are currently being investigated.

Department of Human Services

• DHS has updated its interim guidance for personal care homes, assisted living residences, and private intermediate-care facilities during the COVID-19 emergency.
• DHS has developed a suggested tool for personal care homes, assisted living residences, and private intermediate-care facilities to use when developing their implementation plan for reopening.  It is designed not as a tool to submit to DHS but as a means of facilitating compliance with the interim guidance noted above.  Find it here.

State Legislature

The Senate Republican Policy Committee held an informational meeting to discuss the challenges facing the state’s rural hospitals, and in particular, the challenges those hospitals have faced during the COVID-19 emergency.  Go here to see a video of what the committee billed as a “workshop.”

Federal Update

White House:  Executive Order

The White House issued an executive order directing the Department of Health and Human Services to extend permanently some of the Medicare telehealth waivers initiated during the COVID-19 public health emergency; to simplify Medicare billing codes and propose a payment model to improve health care in rural areas; and to encourage the Department of Agriculture and Federal Communications Commission to invest in technology that enhances access to telehealth services.

The administration’s plans for following through on this executive order are described in an HHS news release that summarizes the policy changes the administration seeks and a CMS news release that addresses several proposed regulations that would facilitate achieving these objectives.

Department of Health and Human Services

• HHS’s Office of the Assistant Secretary for Preparedness and Response held a webinar in late July on the use of telemedicine in alternative care sites.  Now available from that webinar are the presentation around which that webinar was conducted and an FAQ about the use of telemedicine in alternative sites.
• The Office of the Assistant Secretary for Preparedness has created a new rural health information hub web page with current and key resources for rural health care systems preparing for and responding to a COVID-19 surge.  The page includes links to resources by audience and topic.
• HHS’s Office of the Inspector General has updated its guidance on the application of its administrative enforcement authorities to arrangements directly connected to the COVID-19 public health emergency with new guidance on the ability of clinical laboratories to offer free COVID-19 antibody testing to federal health care program beneficiaries who are contemporaneously receiving other medically necessary blood tests.

Centers for Medicare & Medicaid Services

• CMS has posted three-year average hourly wages used for 2022 Medicare area wage index reclassifications.  CMS usually publishes this data with its final inpatient prospective payment system regulation but is posting it separately this year.
• CMS has updated its FAQs about COVID-19 testing in skilled nursing facilities.
• CMS has posted a database detailing which nursing homes will receive point-of-care tests in its first wave of such shipments.

Food and Drug Administration

• The FDA has issued guidance on the use of drugs frequently used to treat COVID-19 patients when those drugs go beyond their labeled “in-use time” limits.
• The FDA has issued emergency use authorization (EUA) for a commercial device intended to provide temporary left ventricular support when treating critically ill COVID-19 patients who are undergoing ECMO treatment and suffer complications during that treatment.
• The FDA has issued an EUA for a commercial device that is a patient interface intended for helmet-based non-invasive positive pressure ventilation used to treat acute respiratory distress symptoms among COVID-19 patients being treated in hospital intensive care units.
• The FDA has issued an EUA for a commercial device that is a valve intended for use to deliver emergency, short term, constant-flow pressure-cycled ventilator support for COVID-19 with patients who weigh 10kg or more.
• The FDA has issued an EUA for a commercial device that provides bi-level positive air pressure to support respiratory therapy of spontaneously breathing adults who weigh more than 30kg and who suffer from COVID-19.
• The FDA has issued a surgical masks umbrella EUA in response to concerns about insufficient supply and availability of disposable, single-use surgical masks.  Under this EUA, surgical masks that meet specific performance requirements are authorized for use in health care settings by health care personnel as personal protective equipment during surgical mask shortages resulting from the COVID-19 pandemic.
• The FDA will host a virtual town hall for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for COVID-19.  The purpose of this town hall is to help answer technical questions about the development and validation of tests for COVID-19.  This event will be held on Wednesday, August 12 at 12:15 p.m. (eastern).  Go here for call-in information.  Similar town hall meetings will be held on August 19 and August 26.

Centers for Disease Control and Prevention

• The CDC has updated its FAQs on COVID-19 clinical issues.
• The CDC has updated its guidance for shared and congregate housing.
• The CDC has updated information about its own two COVID-19 diagnostic tests.

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

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)