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.”

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 COVID-19 information from the state government as of 3:30 p.m. on Tuesday, January 19.

Office of the Governor/Vaccination Plan

The state has expanded its categories of individuals eligible to receive the COVID-19 vaccine as part of phase 1A of Pennsylvania’s vaccination plan; this change is incorporated into the Department of Health’s vaccine web page.  To introduce this policy change, the governor’s office also sent the following message to selected stakeholders:

The Pennsylvania Department of Health today will announce two additional categories of eligible individuals to receive the COVID-19 vaccination as part of Phase 1A. Beginning today, all individuals 65 and older, and individuals ages 16-64 with certain medical conditions, as defined by the Centers for Disease Control and Prevention (CDC) that increase the risk of severe illness from the virus, are eligible for the COVID-19 vaccination. The Departments’ Updated Interim Vaccine Plan can be found here.

Those conditions are outlined by the CDC here and include: Cancer; Chronic kidney disease; COPD (chronic obstructive pulmonary disease); Down Syndrome; Heart conditions such as heart failure, coronary artery disease, or cardiomyopathies; Immunocompromised state (weakened immune system) from solid organ transplant, blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines; Obesity; Severe Obesity; Pregnancy; Sickle cell disease; Smoking; and Type 2 diabetes mellitus. 

If you are part of a group that is eligible for vaccination, you can use the Pennsylvania Vaccine Provider Map to find a place to schedule your vaccine. Contact the vaccine provider of your choice directly to schedule an appointment. This map will be updated as more locations receive vaccine. Although a provider may have received vaccine, there is no guarantee that they have open appointments as supply is still very limited. Check back frequently as the map will be updated multiple times per week. 

We’ll be releasing additional information later today, including an FAQ, with more detailed information on how individuals can find a provider to schedule a vaccination. Thank you for your partnership and for all you are doing to serve Pennsylvania. 

Department of Health

President-elect Biden has nominated Pennsylvania Department of Health Secretary Rachel Levine to become assistant secretary of the U.S. Department of Health and Human Services.

Department of Health – by the numbers

• Although the numbers remain very high, the decline in the number of new daily COVID-19 cases has generally continued since late last week.
• The death toll remains very high, with more than 19,000 Pennsylvanians dying from COVID-19 – 18 percent of them since January 1.
• For the week from January 8 through January 14 the state’s overall COVID-19 test positivity rate fell to 12.7 percent; it was 14.4 percent the week before that.  This marked the fourth consecutive week the rate fell.
• Despite these positive signs, all 67 Pennsylvania counties remain in “substantial level of community transmission,” as has been the case the past several weeks, and all counties have positivity rates greater than five percent, which is the level that is considered “concerning.”
• Four of those counties have positivity rates greater than 20 percent, down from 14 counties last week and 27 counties two weeks ago.
• The numbers of Pennsylvanians hospitalized with COVID-19 has fallen below 5000 for the first time since early December.  The number of Pennsylvanians in hospital ICUs has fallen in the past week, as has the number on ventilators.
• More than 21,500 health care workers in the state have contracted COVID-19.
• More than 71,000 long-term-care facility residents and employees have contracted COVID-19 in 1521 facilities in all 67 Pennsylvania counties.
• Currently, 18 percent of adult ICU beds in the state are unoccupied, as are 16 percent of medical/surgical beds, 16 percent of pediatric ICU beds, 32 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 two weeks.
• As of January 19 the state’s vaccine dashboard shows that 340,000 COVID-19 Pennsylvanians have received their first dose of a COVID-19 vaccine and more than 42,000 Pennsylvanians 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 vaccine 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.
• Every week the White House Coronavirus Task Force provides a profile to the administration with data and recommendations for each state.  Go here to see the latest (January 10) report for Pennsylvania.

Department of Human Services

• DHS’s Office of Long-Term Living has issued a transition plan to phase out temporary changes in Pennsylvania’s OBRA 1915(c) waiver.  The Centers for Medicare & Medicaid Services (CMS) approved temporary changes in that waiver beginning March 6, 2020 in response to the COVID-19 pandemic.  These changes addressed potential staffing shortages and the need for service provision not included in approved service descriptions.  OLTL has now obtained another waiver from CMS to extend the effective date of the temporary changes, permitting some flexibilities to continue until March 5, 2021; to provide additional flexibilities for Adult Daily Living Services to be provided remotely; and for waiver services to be provided in alternate settings as approved by OLTL.  OLTL now publishes new guidance that rescinds and replaces its OBRA guidance dated May 8, 2020.  This guidance also clarifies flexibilities that remain available through March 5, 2021 or another date determined by OLTL.  See the revised guidance here and find additional information here, including a list of flexibilities that remain in effect until March 5.
• OLTL has updated its guidance on COVID-19-related temporary changes in the state’s Act 150 program.  The Act 150 program provides assistance to adults 18 through 59 years of age who are mentally alert and have physical disabilities to perform activities of daily living.
• HHS’s Office of Development Programs has issued updated guidance for adult daily living providers delivering services remotely or by telephone during the COVID-19 emergency.
• HHS’s Office of Development Programs has issued guidance to supports coordination organizations, administrative entities, providers, and other interested parties regarding services included in Individual Support Plans that are effective through June 30, 2021 for individuals enrolled in the Consolidated, Community Living, Person/Family Directed Support (P/FDS), or Adult Autism waivers.

Department of State

Pennsylvania’s Department of State has issued a waiver permitting pharmacists who hold a valid Authorization to Administer Injectables to order and administer COVID-19 vaccines without the need for an order from a licensed prescriber or a protocol approved/authorized by a physician or the medical staff of an institution, subject to certain terms and conditions.  The order applies only to administering COVID-19 vaccines and expires 90 days after the termination of the governor’s declaration of the COVID-19 emergency.

Pennsylvania Health Care Cost Containment Council

PHC4 has released its initial “COVID-19 Disaster Emergency Report.”  According to the report, the state’s hospitals and health systems had $4.93 billion in COVID-19-related expenses and lost revenue from January through September 2020; this figure does reflect federal funding provided under the CARES Act and other measures.

Around the State

• Hospitals in western Pennsylvania are struggling not to waste leftover COVID-19 vaccine serum, according to the Pittsburgh Tribune-Review.
• In the face of the challenges they have faced dealing with COVID-19, officials in Westmoreland County wonder whether they should establish their own county health department, according to the Tribune-Review.
• Published reports tell of declining COVID-19 cases in Bucks County, Allegheny County, York County, Lancaster County, and Berks 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

The following is the latest COVID-19 information from the state government as 2:00 p.m. on Friday, January 8.

Department of Health

• The Department of Health has updated the state’s COVID-19 vaccination plan.
• The Department of Health issued an advisory with indications and contraindications for COVID-19 vaccines as well as vaccine adverse events monitoring and reporting.
• The Department of Health issued a health alert with information on the UK variant strain of COVID-19 that was detected in a patient in Dauphin County.  The alert directs laboratories to submit samples fitting the description of the variant to the department.  The department also issued a news release about the new variant.
• The Department of Health issued an FAQ for laboratories reminding them to provide demographic information on the COVID-19 testing submission forms they submit to the state.
• The Department of Health has written to nursing home administrators whose facilities have not yet transitioned to the state’s new electronic death registration system (EDRS) offering the state’s assistance with that transition.  Go here to learn more about EDRS, which is the required platform for reporting deaths attributed to COVID-19.
• The Department of Health reports that Pennsylvania is above the average national testing rate, as noted in the White House Task Force Weekly Report dated January 3.  According to the report, Pennsylvania was at the yellow level for number of tests performed per 100,000 people for the previous week.  The yellow level is 2,000 to 2,999 tests per 100,000 population.

Department of Health – by the numbers

• Pennsylvania’s daily new case count generally remains at the high level it has been since mid-December but today was the state’s worst day since December 12.  Yesterday the state’s total number of COVID-19 cases since the pandemic began surpassed 700,000.
• Yesterday the state’s overall death toll since the pandemic began passed 17,000.
• The numbers of Pennsylvanians hospitalized with COVID-19, in hospital ICUs, and on ventilators remain very high but are at their lowest levels since early December.
• More than 20,000 health care workers in the state have contracted COVID-19.
• More than 66,000 long-term-care facility residents and employees have contracted COVID-19 in 1491 facilities in all 67 Pennsylvania counties.
• Currently, 13 percent of adult ICU beds in the state are unoccupied, as are 13 percent of medical/surgical beds, 16 percent of pediatric ICU beds, 23 percent of pediatric beds, and 30 percent of airborne isolation units.  The proportion of unoccupied medical/surgical beds, pediatric ICU beds, and pediatric beds has declined considerably over the past three 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 has flagged 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 identifies as 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.

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 COVID-19 information from the state government as 2:00 p.m. on Tuesday, January 5.

Secretary Levine’s News Briefing

Department of Health Secretary Rachel Levine briefed the press yesterday about the state of Pennsylvania’s response to the COVID-19 crisis and took questions from reporters.  Among the highlights of her briefing are the following points:

• Secretary Levine discussed the new state policy that hospitals that receive shipments of vaccine doses must set aside 10 percent of their supply to vaccinate non-hospital health care workers, such as EMS personnel.  This policy takes effect on Wednesday, January 6.  Every hospital that has receive doses must designate a contact whom non-hospital health care workers can contact to schedule their vaccinations.
• Within their own organizations, hospitals should give priority to vaccinating frontline health care workers, beginning with those who come into contact with patients who have been diagnosed with or are suspected of having COVID-19.
• Pennsylvania expects 166,000 doses of Pfizer vaccine this week.  99,000 will be for second doses to health care workers who already received the first dose; 32,000 will be for first doses for additional health care workers; and 39,000 will be for vaccinations at skilled nursing facilities.
• The state also will receive 80,000 doses of the Moderna vaccine this week.
• The number of vaccine doses the state receives from the federal government will fluctuate from week to week so the delivery schedule will fluctuate as well.
• CVS and Walgreens have started to visit long-term-care facilities to administer vaccines.  The state is waiting for a report from the companies on which facilities they visited and how many vaccines they gave.
• The slow roll-out of the vaccines nation-wide, Secretary Levine says, is the product of overly optimistic projections for the holiday season.
• It will take months for all Pennsylvanians to be vaccinated.
• Providers and the state will need to hire additional health care professionals to administer vaccines.  The additional funding provided by Congress at the end of last year should help with this.
• When the time comes, the state will have ways for people to sign up for appointments to receive their vaccines.  It does not want people waiting in long lines to get their shots.
• While the state has received reports of health care workers and long-term-care personnel declining to get vaccinated, it has no numbers on how prevalent this has been.

Department of Health

• The Department of Health has ordered all entities that are receiving and providing COVID-19 vaccines  – hospitals, health systems, and federally qualified health centers (FQHCs) – to use at least 10 percent of each vaccine shipment it receives from the federal government to vaccinate Phase 1-A non-hospital health care personnel that fit that definition in the state’s interim COVID-19 vaccine plan.  This includes vaccines received through individual pharmacy providers; the department will post the name and locations of those pharmacy providers on its COVID-19 vaccine web site after January 6.  That website also has been updated to include fact sheets and a COVID-19 vaccine dashboard with data on vaccinations and shipments.  See the department’s news release announcing the order and the order itself.
• The Department of Health revised its frequently asked questions on COVID-19 treatment drugs and biologics.
• In a memo to acute-care hospitals, the Department of Health announced that it has been certified by the U.S. Department of Health and Human Services to submit CORVENA data files to the Teletracking portal on behalf of Pennsylvania hospitals.  The first submission took place on December 31, 2020.  Hospitals may continue uploading to Teletracking but any data submitted before 10:00 a.m. may be overwritten with the submission of CORVENA data.
• The Department of Health issued an advisory to hospitals outlining the recommended response to COVID-19 outbreaks originating in the facility, as identified in the health advisory issued on December 9, 2020.
• The Department of Health issued an advisory reminding laboratory providers that patient date of birth, address, telephone number, race, and ethnicity data fields should be included on all laboratory submission forms.
• The Department of Health updated its guidance to skilled nursing facilities to clarify the requirements when a patient is discharged from a hospital to a skilled nursing facility and to incorporate departmental and CMS guidance issued since the document was last updated in late November.
• On December 30 the Department of Health announced that the federal Pharmacy Partnership for Long-Term Care Program has begun vaccinating residents and staff at 126 Pennsylvania skilled-nursing facilities.
• The departments of Health and Human Services published information on a state-funded program that will replace the Regional Response Health Collaborative program (RRHCP), for which federal funding lapsed on December 31, 2020, with new Regional Congregate Care Assistance Teams (RCAT).  The new groups will provide more limited COVID-19 outbreak support to the same facilities that were eligible for RRHCP assistance, doing so through February 28, 2021.  Learn more from a news release issued jointly by the two departments.

Department of Health – by the numbers

• Pennsylvania continues to experience between 7000 and 9000 new COVID-19 cases a day, as it generally has since mid-December.  The overall total of cases in the state now approaches 675,000 since the pandemic began.
• Daily death toll figures generally have ranged between 200 and 300 a day since mid-December but have declined in recent days.  The total death count rose past 16,500 today.
• The number of Pennsylvanians hospitalized with COVID-19 has been fairly constant since Christmas, as has the number of COVID-19 patients in hospital ICUs.  The number of COVID-19 patients on ventilators has declined modestly from its pre-Christmas high.
• More than 19,700 health care workers in the state have contracted COVID-19.
• Nearly 65,000 long-term-care facility residents and employees have contracted COVID-19 in 1479 facilities in all 67 Pennsylvania counties.
• Currently, 13 percent of adult ICU beds in the state are unoccupied, as are 14 percent of medical/surgical beds, 21 percent of pediatric ICU beds, 34 percent of pediatric beds, and 30 percent of airborne isolation units.
• The weekly Pennsylvania COVID-19 Early Warning Monitoring Dashboard, issued by the Department of Health and Governor Wolf, shows that the state’s positivity rate for COVID-19 tests fell from 15.1 percent two weeks ago to 15 percent last week.  This is the third consecutive week the rate has declined.
• Despite this, all 67 Pennsylvania counties remain, according to Pennsylvania’s criteria, in “substantial transmission status.”
• Every county in the state has a positivity rate greater than five percent, which is generally considered a “concern,” and 21 of the state’s 67 counties have positivity rates of more than 20 percent.
• The state also reports that it has experienced a “…significant decrease” in people willing to cooperate with contract tracing investigations.
• The Department of Health’s “COVID-19 Data for Pennsylvania” web page has several features of potential interest to health care providers and stakeholders.
  • Its “Reduction of Elective Procedures” dashboard tracks the criteria the state is using – staffing, surge percentage, and bed availability – to determine whether it will order hospitals to reduce or eliminate elective procedures to ensure their ability to handle possible influxes of COVID-19 patients.  Organized according to the state’s seven health coalition regions, the latest dashboard shows only one potential problem area:  staffing shortages among southwestern Pennsylvania hospitals.  Despite this, the dashboard shows no need for hospitals in any part of the state to curtail or suspend elective procedures at this time.
  • Another feature on the COVID-19 Data for Pennsylvania page is a “Vaccine Dashboard” that shows the number of vaccines administered in the state on a county-by-county basis.  As of January 4, more than 135,000 vaccines have been administered.  These vaccines are all categorized as “partial” because complete vaccination requires two doses and not the one dose that has been administered so far.

Department of Human Services

• DHS has issued a Medical Assistance bulletin informing pharmacies that the state’s Medicaid program will pay for the administration of COVID-19 vaccines to Medicaid beneficiaries by licensed pharmacists.  The policy, announced December 30, has an effective date of December 1, 2020.  The department elaborated further on the new policy in this provider guidance and also posted further information about additions to the Medicaid fee schedule for vaccinations.
• DHS has issued guidance to local education agencies participating in the state’s School-Based ACCESS Program during the COVID-19 emergency about services that can be provided directly to program participants during the pandemic and how they must be provided.  See that guidance here.
• DHS’s Office of Long-Term Living has begun laying the groundwork for transitioning out of its temporary changes in the Community HealthChoices program by updating two documents:  its “Temporary Changes to the Community HealthChoices 1915(c) Waiver” and its “Transition Plan to Phase Out Temporary Changes to the Community HealthChoices 1915(c) Waiver.”
• DHS’s Office of Long-Term Living has updated its guidance for adult daily living providers delivering telephone or remote services during the COVID-19 emergency.

Department of Revenue

Pennsylvania collected $3.7 billion in General Fund revenue in December, which was $465.8 million, or 14.5 percent, more than anticipated, Revenue Secretary Dan Hassell reported on Monday. Fiscal year-to-date General Fund collections total $18.5 billion, which is $467.1 million, or 2.6 percent, above estimate.

Around the State

• The Carlisle Sentinel reports that more than 50 percent of Cumberland County’s COVID-19 cases and deaths occurred in the month of December.
• The number of new COVID-19 cases in Berks County declined for the third straight week, according to the Reading Eagle.
• Hospitals in the central part of the state are preparing for a possible post-holiday surge in COVID-19 patients, the Harrisburg Patriot-News 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

The following is the latest COVID-19 information from the state government as of 1:00 p.m. on Thursday, December 24.

Department of Health

• The Department of Health has updated its COVID-19 guidance for hospitals with clarification on testing prior to discharge to another facility and information on reporting requirements for COVID-19 outbreaks.
• The Department of Health and Department of Human Services have issued guidance on how the operations of the Regional Response Health Collaborative Program (RRHCP) will wind down as funding for the program expires on December 30, 2020.  They also have posted an updated directory of RRHCP call centers.
• The Department of Health has amended reporting requirements for skilled nursing facilities.  Effective December, 24, 2020, skilled nursing facilities will no longer be required to report capacity data into the CORVENA software.  Daily reports into SURVEY 123 continue to be required by 8 a.m.

Department of Health – by the numbers

• After a three-day lull, Pennsylvania’s daily count of new COVID-19 cases has risen past 9000 for the past few days.
• Death counts remain as high as they have been at any time during the pandemic:  more than 200 deaths a day in eight of past ten days.
• More than 18,300 health care workers in the state have contracted COVID-19.
• Currently, 12 percent of adult ICU beds in the state are unoccupied, as are 17 percent of medical/surgical beds, 20 percent of pediatric ICU beds, 41 percent of pediatric beds, and 32 percent of airborne isolation units.

Department of Human Services

DHS has issued a Medical Assistance Bulletin informing providers that it has added Current Procedural Terminology codes to the Medical Assistance program fee schedule for the administration of COVID-19 vaccines.  The new codes take effect retroactive to December 1, 2020.

Department of State

The Department of State has suspended certain limits on the nursing practice limits of student nurses to permit those who have expertise in the technical details of administering vaccines to serve as technicians, separate and apart from their clinical placements but without being licensed, to administer influenza and COVID-19 vaccines, with supervision by a licensed health care practitioner.  This waiver extends for the duration of the COVID-19 emergency plus an additional 90 days after the emergency ends.

The Department of State has extended an existing waiver that permits licensed professionals whose endeavors are overseen by 22 of the 29 licensing boards and commissions overseen by department’s Bureau of Professional and Occupational Affairs to continue renewing their licenses after January 1, 2021 using continuing education programs through either traditional, in-person courses or distance learning.  As a result, licensees may satisfy up to 100 percent of their continuing education requirements for their next renewal with hours obtained entirely through online courses from providers of distance education that meet the applicable board’s continuing education requirements.

Around the State

• Areas of Pennsylvania that were largely spared from this spring’s COVID-19 outbreak are now feeling the pandemic’s effects, the Philadelphia Inquirer reports.  The story highlights the situation in Blair, Mifflin, and Westmoreland counties.
• Several counties are seeing a leveling off in the number of new COVID-19 but continued increases in COVID-related deaths, according to reports in the Bucks County Courier Times, the Johnstown Tribune-Democrat, and the Harrisburg Patriot-News.
• The Harrisburg area was the scene of the highest number of citations for violations of the state’s latest COVID-19 restrictions last weekend, the Carlisle Sentinel 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

The following is the latest COVID-19 information from the state and federal governments as 5:00 p.m. on Thursday, December 10.

Pennsylvania Update

Governor Wolf

In a news conference held Thursday afternoon from his home in York, where he is under quarantine because he was diagnosed with COVID-19, Governor Wolf announced new state mitigation efforts to attempt to stem the current surge of cases in the state.  Joining Governor Wolf for the news conference was Department of Health Secretary Rachel Levine, who also is under quarantine because she recently was exposed to people who have tested positive for the disease.  (Members of the governor’s staff and security team have tested positive for COVID-19.)

The new mitigation steps take effect at 12:01 a.m. on Saturday morning, December 12, expire on January 4 at 8:00 a.m., and include:

• All in-person indoor dining at restaurants, bars, and other such establishments is prohibited.  Outdoor dining is permitted, as is take-out service.
• Indoor gatherings and events of more than 10 persons are prohibited.  Places of worship are excluded from this limit but urged to find alternative methods of worship.
• Outdoor gatherings of more than 50 people are prohibited.
• All in-person businesses, such as retail, may operate at only 50 percent of capacity.
• Indoor operations at gyms and fitness facilities are prohibited.  Outdoor facilities and classes are permitted but participants must wear masks.
• All in-person businesses in the entertainment industry serving the public within a building or indoor defined area, including but not limited to theaters, concert venues, museums, movie theaters, arcades, casinos, bowling alleys, private clubs, and other such venues, are prohibited from operating.
• Voluntary activities sponsored by or approved by school systems are suspended but may be held virtually.
• All sports at K-12 public schools, non-public schools, private schools, and club, travel, and recreational, intermural, and intramural sports are “paused.”
• Professional and collegiate sports activities may continue, subject to current CDC and Department of Health guidelines, but spectators are prohibited.

The governor said his administration has engaged state and local law enforcement and other state agencies to help enforce these new requirements.  These steps are necessary, he said, because “This virus continues to rage in Pennsylvania.”  He also noted that his latest COVID-19 test was negative.

To learn more, go here to see the governor’s news release about the new mitigation efforts; go here to see the governor’s limited-time mitigation order; and go here to see Department of Health Secretary Levine’s limited-time mitigation order.

Department of Health – by the numbers

• Pennsylvania’s number of new COVID-19 cases was in five figures yesterday for the sixth time in the past eight days.
• The state’s number of COVID-19 cases to date now exceeds 450,000.
• Pennsylvania’s overall COVID-19 death toll surpassed 12,000 on Thursday after one of the highest single-day totals the state has suffered since the pandemic began.

Around the State

• The Pittsburgh Tribune-Review reports that “Allegheny County on Wednesday reported 34 new coronavirus deaths, a record for a single day, and 727 additional coronavirus cases.”
• “Uniontown Hospital has run out of intensive care unit or medical/surgical beds available as it deals with a flood of Covid-19 cases that has hit Fayette County over the last week and forced a significant number of staff to quarantine or isolate due to the virus,” reports the Pittsburgh Business Times.   The report continues that “The 145-bed hospital has about 50 Covid-19 patients, up from 25 or so a week ago and the previous peak, earlier in the pandemic, of about a dozen.  The ICU unit has been completely converted to COVID-19 care and a secondary ICU unit has been set up within the hospital, and there are COVID-19 patients on multiple floors and in multiple areas.  Patients are being held in the emergency department sometimes until a bed opens up.”
• With a 43 percent test positivity rate last week, Lycoming County officials, reports the web site northcentralpa.com, are

…putting tighter restrictions on accessibility to public buildings and services.  To enter any county facility, a person must be masked.  “We are not making exceptions,” said Lycoming County Sheriff Mark Lusk. “We’re going to ask you to go back to your vehicle.  We’ll give you a sheet to make the calls that you need to make to make an arrangement with the particular office in the courthouse, to discuss how you want to transact your business.”

Visitors to the courthouse will have to make appointments before arriving.  No extra family members will be permitted into courtroom proceedings.  Essentially the courthouse will be operating on a “call before you come” basis.

• On Wednesday the New York Times published an interactive map that presented the degree to which hospital intensive care units across the country are occupied largely because of COVID-19 patients (based on a data set made available by the federal government on Monday).  Among the Pennsylvania areas showing especially high occupation rates were:
  • Easton – 104 percent (all ICU beds occupied plus one patient)
  • Allentown – 90 percent of 135 ICU beds occupied
  • Norristown – 95 percent of 27 ICU beds occupied
  • Erie – 94 percent of 111 ICU beds occupied
  • Philadelphia – 84 percent of 1113 ICU beds occupied
  • Pittsburgh – 87 precent of 698 ICU beds occupied
  • Harrisburg – 85 percent of 67 ICU beds occupied
  • Reading – 90 percent of 60 ICU beds occupied
  • Lancaster – 87 percent of 72 ICU beds occupied

Federal Update

Centers for Medicare & Medicaid Services

• CMS has updated its FAQs for Medicare fee-for-service billing with 20 new or updated questions, all marked “12/8/2020,” that address payments for monoclonal antibody treatments and vaccines, including billing and payments for skilled nursing facilities and non-excepted off-campus provider-based departments; requirements for providing antibodies through infusion therapy; and “hospital without walls” flexibilities.  Find the new and updated questions between pages 122 and 135.
• CMS has posted an infographic on coverage of monoclonal antibody products to treat COVID-19.
• In its online publication MLN Matters CMS announced that to support clinicians during the COVID-19 emergency it has extended the 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception application deadline to February 1.  For the 2020 performance year, MIPS-eligible clinicians, groups, and virtual groups may submit an application asking CMS to reweight one or more performance categories to 0 percent due to the current emergency.  For further information, consult the following resources:
• MIPS Extreme and Uncontrollable Circumstances Exception Application user guide and fact sheet
• How to Submit an Extreme and Uncontrollable Circumstances Exception Application video
• Extreme and Uncontrollable Circumstances Exception webpage
• Quality Payment Program Exceptions Application fact sheet
• Contact the Quality Payment Program at QPP@cms.hhs.gov or 866-288-8292; affected parties who are hearing impaired can dial 711 for a TRS Communications Assistant
• In response to the COVID-19 public health emergency, the following new ICD-10 codes take effect on January 1:
• 21 procedure codes (ICD-10-PCS):  CMS will implement new codes to describe the introduction or infusion of therapeutics, including monoclonal antibodies and vaccines for COVID-19 treatment
• 6 diagnosis codes (ICD-10-CM):  CDC National Center for Health Statistics

See the announcement (ZIP) for more information about assignment of these new diagnosis and procedure codes under the ICD-10 Medicare Severity Diagnosis Related Group (MS-DRG).

• CMS has updated the FAQ for its acute-care hospital “Care at Home” program.
• In MLN Matters CMS has revised a past article about new and expanded flexibilities for rural health centers and federally qualified health centers during the COVID-19 public health emergency.  The update includes additional guidance on telehealth services for which there is cost-sharing and for which cost-sharing is waived.
• CMS and the CDC will hold a call on fundamentals of COVID-19 prevention for nursing homes on January 7 at 4:00 p.m. (eastern).  Go here for information on registration and more.

CMS COVID-19 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.

COVID-19 Office Hours Call

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In:  833-614-0820; Access Passcode:  3968359

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 past stakeholder calls, go here.

Department of Health and Human Services

• HHS has updated its COVID-19 guidance for hospital reporting and FAQs for hospitals, hospital laboratory, and acute-care facility data reporting.  Among the requirements, reporting on COVID-19 therapeutics will be required beginning on January 8, 2021.
• HHS’s Office of the Inspector General has issued an advisory opinion about whether providers can offer other providers or suppliers free items and services related to COVID-19 vaccine storage, distribution, redistribution, or administration.
• HHS has posted a brief case study of the establishment of an alternative care site – a field hospital – in response to a surge of COVID-19 patients.

Food and Drug Administration

• The FDA has authorized the first direct-to-consumer COVID-19 test home collection kit that can be used without a prescription.  This product enables consumers to self-collect a nasal swab sample at home and then send that sample to the manufacturer’s lab for analysis.  Positive or invalid test results are delivered to users by phone call from a health care provider.  Negative test results are delivered via email or online portal.  See the FDA’s announcement here.
• The FDA has posted a notice warning health care providers and patients that patients may be injured if they wear face masks (such as surgical or non-surgical masks and respirators) with metal parts and coatings during a magnetic resonance imaging (MRI) exam
• The FDA has approved an abbreviated new drug application for dexmedetomidine hydrochloride in 0.9% sodium chloride injection, indicated for sedation of initially intubated and mechanically ventilated patients – such as those with COVID-19 – during treatment in an intensive-care setting and sedation of non-intubated patients prior to and/or during surgical and other procedures.

Centers for Disease Control and Prevention

• The CDC has updated its clinical guidance for the management of patients with COVID-19.
• The CDC has updated its toolkit for clinicians.
• The CDC has updated its COVID-19 testing guidelines for nursing home residents and personnel.

Congressional Research Service

• The Congressional Research Service has published a list of all of the temporary provisions related to the COVID-19 emergency that have already expired or will expire at the end of calendar year 2020.

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