Coronavirus update for Tuesday, May 26 as of 2:30 p.m.

Pennsylvania Update

The Wolf Administration

Last Friday Governor Wolf announced that eight more counties would move to the yellow phase of reopening on May 29; 17 counties that were already in the yellow phase would move to green that same day; and the remaining counties still in the red phase would move to yellow on June 5.  That latter group includes Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Department of Health

• Late last Friday the department announced that on the previous day it shipped 8928 doses of remdesivir to 81 Pennsylvania hospitals. This news release is the announcement and it includes a link to a list of the recipient hospitals.
• The department updated its guidance for hospitals to clarify that the requirement to test patients for COVID-19 infection prior to discharge to a long-term-care facility applies only to inpatients of the hospital. In addition, hospitals’ visitor policies cannot deny access to an attendant, caregiver, or family member of a patient who has an intellectual, developmental, or cognitive disability, communication barrier, or behavioral concerns.
• The department updated its guidance for ambulatory surgical facilities to reflect the requirement that ambulatory surgical facilities with their own COVID-19 laboratory testing report those test results, whether positive or negative, through PA-NEDSS.

Department of Health – by the numbers

• The department reported that the number of new COVID-19 cases over the holiday weekend remained modest by the standard of recent weeks and fell under 500 a day for the past two days.
• The new daily death totals fell significantly over the holiday weekend, from more than 100 a day for several days last week to just 56 over the last three days combined.
• 551 Pennsylvanians have now tested positive on serology tests.
• More than 17,000 residents and employees of 594 long-term-care facilities have now tested positive for COVID-19.
• As have more than 5100 health care workers.
• As of today, 1628 Pennsylvanians are hospitalized for COVID-19.
• 320 of them are on ventilators and 16 are undergoing extracorporeal membrane oxygenation (ECMO).
• 45 percent of state hospitals’ acute-care beds, 38 percent of its adult ICU beds, and 24 percent of its pediatric ICU beds are currently unoccupied, as are 53 percent of their isolation rooms.

Department of Human Services

DHS’s Office of Children, Youth and Families has issued guidance regarding the suspension of regulatory requirements for its licensees during the COVID-19 pandemic.  Recipients of the guidance include county children and youth agencies, private children and youth social services agencies, family foster care agencies, adoption services agencies, child residential and day treatment facilities, and child welfare service providers.

Federal Update

Department of Health and Human Services

• HHS has submitted its required report to Congress detailing its COVID-19 strategic testing plan.
• HHS announced a 45-day extension for providers that are receiving grants from the CARES Act’s Provider Relief Fund to accept the terms and conditions for those payments. This means providers have now been granted 90 days from the date they received a payment to accept the terms and conditions or return the money.
• ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, has announced that a presentation from and a recording of its webcast on “Funding Sources for the Establishment and Operationalization of Alternate Care Sites” are now available. Find them here.
• HHS announced $400 million in payments from the CARES Act’s Provider Relief Fund to Indian Health Services and tribal hospitals, clinics, and urban health centers to support the tribal response to COVID-19.

Department of Health and Human Services/Office of the Inspector General

HHS’s Office of the Inspector General has announced the release of its strategic plan for oversight of the COVID-19 response and recovery. Go here for the announcement and here to see the plan itself.

Centers for Disease Control and Prevention

• The CDC has updated its COVID-19 transmission web page to clarify information about the different types of spread of the virus.
• The CDC has updated its web page on evaluating and reporting persons under investigation for COVID-19.
• The CDC has posted information about a new laboratory test kit it has developed for use in testing patients for COVID-19.
• The CDC has updated its FAQ on COVID-19 and children.
• The CDC has updated its web page about serology testing for COVID-19.
• The CDC has updated its interim guidelines for COVID-19 antibody testing in clinical and public health settings.
• The CDC has posted information about steps health care facilities can take now to prepare for COVID-19.

Food and Drug Administration

• The FDA has updated its FAQ on testing for COVID-19.
• The FDA has approved emergency use authorizations for three new commercial diagnostic tests for COVID-19. Find them here, here, and here.
• The FDA has posted a notice to manufacturers of gowns and other apparel, health care personnel, hospital purchasing departments and distributors, and other stakeholders listing currently authorized equipment, requirements it is waiving when considering issuing emergency use authorizations, and outlining the standards it considers when determining whether to issue such authorizations for new gowns and apparel.

National Institutes of Health

The NIH has issued a media advisory sharing the preliminary results of peer-reviewed data from clinical trials to test the effectiveness of remdesivir for treating COVID-19. A more detailed preliminary report also can be found in the New England Journal of Medicine.

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.)

Coronavirus update for Friday, May 22 as of 3:30 p.m.

Pennsylvania Update

Budget Update

The House and Senate will return next Tuesday to begin the FY 2020-2021 budget process.  Their current plan is to enact a budget that funds the first five months of the fiscal year and then return in the fall after the November elections to fund the remainder of the fiscal year.  SNAP understands that the General Assembly will use the current fiscal year funding amounts as a baseline and fund most line-items at 42 percent of their current levels (a 58 percent cut).  Some areas, such as education, will be funded at or close to 100 percent.  We will provide updates as developments warrant when they reconvene next week.

The Wolf Administration

Twelve more counties moved from the red to the yellow phase today.  See the governor’s executive order on this change here.

The Wolf administration announced that it will close its COVID-19 drive-through public testing site in Wilkes-Barre next Friday, May 29.  Since April 20 it tested more than 2000 people, seven percent of whom tested positive for COVID-19.  The state plans to shift these resources elsewhere.

Department of Health

On Friday the Department of Health reported:

• A new case count in line with recent days and more than 100 new deaths.
• More than 16,600 residents and employees of 578 long-term-care facilities in 44 counties have contracted COVID-19 to date.
• As have nearly 5000 health care workers.
• 1602 Pennsylvanians are currently hospitalized with COVID-19.
• 350 of them are on ventilators.
• 14 are undergoing extracorporeal membrane oxygenation (ECMO).
• 45 percent of the state’s acute-care beds, 38 percent of its adult ICU beds, 24 percent of its pediatric ICU beds, and 53 percent of its isolation beds are currently unoccupied.

Federal Update

Department of Health and Human Services

• HHS has updated its CARES Act Provider Relief Fund page, adding a new section on allocations for skilled nursing facilities.
• That new section is the foundation for HHS’s announcement that it has begun distributing nearly $4.9 billion in relief funds to skilled nursing facilities to help them respond to the effects of COVID-19. Each SNF will receive a fixed distribution of $50,000 plus $2500 per bed.  All certified SNFs with six or more certified beds are eligible for this targeted distribution.
• HHS has updated its CARES Act Provider Relief Fund FAQ, adding several new questions and answers about reporting for related entities (see pages 11 and 12).

Centers for Medicare & Medicaid Services

In the past week CMS issued seven section 1135 waivers to give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued three such waivers to Rhode Island, two to Texas, and one each to North Dakota and Virginia.

CMS Weekly Stakeholder Calls

COVID-19: Lessons from the Front Lines Calls — May 29

Friday, May 29 from 12:30 to 2 pm ET

These weekly calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration (FDA) Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians share their experiences, ideas, strategies, and insights related to their COVID-19 responses.  There is an opportunity to ask questions.

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 877-251-0301; Access Code: 6350189

COVID-19: Home Health and Hospice Call — May 26

3 to 3:30 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 4666966

COVID-19: Office Hours Call — May 26

Tuesdays from 5 to 6 pm ET

Hospitals, health systems, and providers: Ask CMS questions about its temporary actions that enable providers to increase hospital capacity, expand the health care workforce, and promote telehealth.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 8977438

Target Audience: Hospitals, health systems, and providers.

COVID-19: Nursing Home Call — May 27

Wednesdays from 4:30 to 5 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or, call 833-614-0820; Access Passcode: 1243649

Target Audience: Nursing home providers.

COVID-19: Dialysis Organization Call — May 27

Wednesdays from 5:30 to 6 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 6152699

Target Audience: Dialysis organizations.

COVID-19: Nurses Call — May 28

Thursdays from 3 to 3:30 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 2988422

Target Audience: Nurses.

Prior Authorization Process and Requirements for Certain Outpatient Hospital Department Services Special Open Door Forum — May 28

Thursday, May 28 from 1:30 to 3 pm ET

CMS invites hospitals, physicians, practitioners, and other Medicare stakeholders to discuss the prior authorization of certain outpatient hospital department services from the following categories: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation.

For More Information:

• Final rule
• Prior Authorization webpage: Presentation materials posted prior to the call
• Find more information here

Participation Instructions:

• Participant Dial-In Number: 888-455-1397
• Conference ID #: 9375124

COVID-19: Lessons from the Front Lines Calls — May 29

Friday, May 29 from 12:30 to 2 pm ET

These weekly calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration (FDA) Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians share their experiences, ideas, strategies, and insights related to their COVID-19 responses.  There is an opportunity to ask questions.

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 877-251-0301; Access Code: 6350189

Centers for Disease Control and Prevention

• The CDC has updated its guidance about the diagnosis, evaluation, infection prevention and control practices, and disposition of neonates with confirmed or suspected COVID-19 or known COVID-19 exposure, including birth to a mother with confirmed or suspected COVID-19.
• The CDC has updated its web page on serology testing.

Food and Drug Administration

• The FDA has updated its temporary policy for the compounding of certain drugs for hospitalized patients by outsourcing facilities during the COVID-19 emergency.
• The FDA has approved the use of dexmedetomidine hydrochloride for treating initially intubated and mechanically ventilated patients during treatment in an intensive care setting and sedation of non-intubated patients prior to and/or during surgical and other procedures.
• The FDA has issued an emergency use authorization (EUA) for the use of a sterilizer to decontaminate compatible N95 respirators for single-user reuse by health care personnel.
• The FDA has issued EUAs for four additional commercial diagnostic tests for COVID-19. Find those EUAs here, here, here, and here.

Congressional Research Service

The Congressional Research Service has published a brief paper on COVID-19 and federal employment protections for work refusals.

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.)

Coronavirus update for Thursday, May 21 as of 3:30 p.m.

Pennsylvania Update

Department of Health

The Department of Health has issued revised guidance for home care agencies, home health agencies, and hospices during the COVID-19 emergency.

Department of Health – Daily Briefing

• Pennsylvania’s new COVID-19 case count remains under 1000 a day but its death count remains more than 100 a day.
• More than 14,000 residents of long-term-care facilities and more than 2300 employees of such facilities have contracted COVID-19 and such facilities account for two-thirds of all COVID-19 deaths in the state.
• Nearly 5000 health care workers have been diagnosed with COVID-19.
• Secretary Levine reported that the state now has about 300 testing sites that performed more than 13,000 tests yesterday. Testing capacity continues to improve.
• The state now has two confirmed cases of multisystem inflammatory syndrome in children (MIS-C) and several other unconfirmed cases. The one pediatric COVID-19 death the state has experienced did not involve MIS-C.
• Secretary Levine reported that the counties in southwestern Pennsylvania that are now in the yellow phase are doing well.

Federal Update

Department of Health and Human Services

• HHS has again updated its CARES Act Provider Relief Fund FAQ.
• HHS has announced that it is collaborating with Astra Zeneca to make available at least 300 million doses of a COVID-19 vaccine called AZD1222, with the first doses delivered as early as October of this year.
• HHS has notified skilled nursing facilities of its intent to distribute additional Provider Relief Fund grants to them.  According to email communication directly from HHS to those providers, “Each SNF will receive a fixed distribution of $50,000, plus a variable distribution ranging between $2,000 per bed for the smallest SNFs (between 5 and 25 beds) and $1,800 per bed for the largest SNFs (more than 200 beds).”
• HHS has issued an advisory opinion stating that the Public Readiness and Emergency Preparedness Act preempts state licensing laws that restrict the ability of pharmacists to order and administer COVID-19 diagnostic tests where HHS has authorized pharmacists to order and administer such tests.
• HHS’s Office of the Assistant Secretary for Preparedness and Response has established a new web page featuring its portfolio of COVID-19 medical countermeasures under investigation.
• HHS’s Office of the Assistant Secretary for Preparedness and Response also has created a new web page that specifically addresses remdesivir.
• ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, will hold a webinar on ensuring health care safety throughout the COVID-19 pandemic on June 2.
• ASPR TRACIE has posted a health care facility onboarding checklist to help hospitals and other faculties streamline staff acquisition and onboarding in times of need.
• ASPR TRACIE has introduced behavioral health guidance and resources for preventing and addressing moral injury affecting health care workers during the COVID-19 pandemic.

Centers for Disease Control and Prevention

• The CDC updated its instructions to laboratories on how to report their COVID-19 lab data.
• The CDC updated its FAQ for laboratories on COVID-19.
• The CDC updated its web page with resources for laboratories working on COVID-19.
• The CDC has updated its interim clinical guidance for management of patients with confirmed COVID-19.
• The CDC has updated its FAQ on COVID-19 infection and prevention control in health care settings.
• The CDC has updated its interim considerations for infection prevention and control of COVID-19 in inpatient obstetric care settings.
• The CDC has updated its COVID-19 contact tracing training guidance and resources.
• The CDC has updated its web page with strategies for long-term-care facilities.

Food and Drug Administration

• The FDA issued an emergency use authorization (EUA) for an airway management isolation chamber to be used by military health care providers as an extra layer of barrier protection to prevent exposure to pathogenic biological airborne particulates during transport of patients at the time of definitive airway management or when performing medical procedures on such patients during the COVID-19 pandemic.
• The FDA has issued an EUA for use of a continuous renal replacement therapy to treat patients with renal failure, fluid overload, or both in an acute-care environment during the COVID-19 pandemic.
• The FDA issued an EUA for a specific commercial COVID-19 diagnostic test.
• The FDA has removed from its list of available serology tests 27 individual tests because their sponsors did not meet additional filing requirements or problems arose with the tests.  (Scroll down to the question about removed serology 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.)

Coronavirus update for Wednesday, May 20 as of 3:00 p.m.

Pennsylvania Update

Department of Human Services

DHS has published a Medical Assistance Bulletin advising providers of the diagnosis coding guidance issued by the CDC for health care encounters related to COVID-19.

DHS has updated its FAQ on CHIP program coverage of COVID-19 testing and related services.

Department of Health

The Department of Health has published an FAQ on its strategy for universal COVID-19 testing in long-term-care facilities.

As of 4:15 on Wednesday afternoon the department had not published its usual news release with a summary of new case and death statistics and other matters and did not provide a daily briefing.

Federal Update

Department of Health and Human Services

• HHS has updated its FAQ for the distribution of CARES Act money through the Provider Relief Fund on four occasions in the past two weeks, including new updates dated yesterday.  Updates from yesterday include instructions on attestation and questions about change in ownership.  Go here to see the changes, which are identified within the document.
• HHS announced that its Health Resources and Services Administration provided $225 million to rural health clinics for COVID-19 testing and shared a state-by-state breakdown of the funding.

Centers for Medicare & Medicaid Services

• For COVID-19 tests that do not use high throughput technology, CMS has announced that Medicare Administrative Contractors have developed payment amounts for claims in their jurisdictions that will be used until CMS establishes national payment rates though the annual laboratory meeting process. The same notice includes reminders about other payment policies implemented in response to the COVID-19 crisis.
• CMS has published a therapy codes update that includes the addition of codes related to the COVID-19 emergency.
• CMS has posted information for hospitals requesting Medicare approval for swing beds as a hospital service to provide skilled nursing care for hospitalized patients who do not need acute care but cannot find nursing home placement during the COVID-19 crisis.
• During the COVID-19 emergency, CMS is relaxing billing requirements for a limited number of laboratory tests required for a COVID-19 diagnosis. Any health care professional authorized under state law may order these tests and Medicare will pay for these tests without a written order from the treating physician or other practitioner.
• During the COVID-19 crisis, Medicare will cover medically necessary emergency and non-emergency ground ambulance transportation from any point of origin to a destination that is equipped to treat the condition of the patient consistent with state and local emergency medical services protocols where the services will be furnished.
• CMS’s Office of Minority Health has compiled federal resources on COVID-19 to assist those who work with vulnerable patients, such as older adults, those with underlying medical conditions, racial and ethnic minorities, rural communities, and people with disabilities.

Centers for Disease Control and Prevention

• The CDC has posted its original plan for guiding the reopening of the country. This is the detailed, 60-page plan that was not released publicly but was instead revised into a series of shorter advisory documents.
• The CDC has updated its information for pediatric providers about multi-system inflammatory syndrome in children (MIS-C).

Food and Drug Administration

• The FDA approved the use of succinylcholine chloride injection to facilitate tracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.
• The FDA has issued emergency use authorization for a specific commercial diagnostic test for COVID-19.

Congressional Research Service

The CRS has published a new report titled “FCC COVID-19 Telehealth Program and Connected Care Pilot Program: Funding to Assist Health Care Providers and Patients.”

Department of Labor

The department’s Occupational Safety and Health Administration has adopted revised policies for enforcing OSHA’s requirements involving COVID-19 as economies reopen in states throughout the country.

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.)

Coronavirus update for Tuesday, May 19 as of 2:30 p.m.

Pennsylvania Update

Governor Wolf

Governor Wolf has vetoed three COVID-19-related bills.

• Senate Bill 317 would have authorized counties to develop and implement their own mitigation plans and decide when businesses within their county could reopen and would have prohibited state agencies from promulgating regulations until 90 days after the COVID-19 emergency declaration is terminated except with permission from the legislation
• House Bills 2388 and 2412 would have permitted various industries to reopen in red phase counties.

See the governor’s news release announcing the vetoes and also find links to his veto messages for each of the bills.

Department of Health

The department announced that the CDC has sent three teams to Pennsylvania to help with the state’s response to COVID-19.  The teams arrived last week and will stay for two weeks, with two teams assisting with long-term-care facilities and one team helping to address food facility outbreaks.  They will teach infection control practices, provide training on the use of personal protective equipment and outbreak response, and assist with developing the state’s testing strategy for nursing homes.

Department of Health Daily Briefing

• The state continues to report high death figures as the number of new cases continues to decline. Secretary Levine explained that this results from a combination of the continued reconciliation of past case data and deaths resulting from times when the case counts were higher.  The death figures should eventually reflect the declining case counts, she said.
• The state has seen its first pediatric death from COVID-19.
• More than 16,000 residents and employees in 557 long-term-care facilities in 44 counties have been diagnosed with COVID-19. More than 3100 of those residents have passed away from the disease.
• Secretary Levine discussed the work of the three teams from the CDC (described above) and said the teams working with long-term-care facilities would be developing facility-specific testing plans for nursing homes.
• The department’s web site now has case and death data for all long-term-care facilities regulated by the Department of Health and Department of Human Services.
• Secretary Levine said the state is ahead of its schedule for increasing testing in Pennsylvania.
• Contact tracing is under way in all of the yellow counties with adequate staffing but the state is also working to increase that staffing.

Department of Human Services/Office of Long-Term Living

Noting that federal guidance directs nursing homes to restrict visitors and non-essential personnel to protect residents, OLTL announced that Pennsylvania has received approval to use funds from civil money penalties for the purchase of technology that enables residents to engage in virtual social and telehealth visits in the absence of visitors.  Facilities interested in pursuing such resources can learn more from this FAQ for state Medicaid agencies and use this application template.

Federal Update

Department of Health and Human Services

• HHS has updated its FAQ for the distribution of CARES Act money through the Provider Relief Fund on three occasions in the past two weeks. Go here to see the changes, which are identified within the document.
• HHS is providing $11 billion in new funding to support COVID-19 testing to states, territories, and tribes. States must submit to HHS their projected month-to-month testing plans and capabilities for the rest of calendar year 2020.

Centers for Medicare & Medicaid Services

• CMS issued recommendations on the safe reopening of nursing homes. See CMS’s announcement, the recommendations, and an FAQ.

Centers for Disease Control and Prevention

• The CDC updated its interim infection prevention and control recommendations for patients with suspected or confirmed COVID-19.
• The CDC has updated its advice on strategies for optimizing the supply of personal protective equipment.

Food and Drug Administration

• The FDA published guidance on the implementation of acceptable full-length and abbreviated donor history questionnaires and accompanying materials for use in screening donors of source plasma.
• On Wednesday, May 20, the FDA will hold a virtual town hall meeting for clinical laboratories and commercial manufacturers that are developing or have developed COVID-19 diagnostic tests to answer technical questions about the development and validation of such tests. The FDA will hold another such town hall next Wednesday, May 27.

National Institutes of Health

The NIH has launched a multi-pronged study to understand the effects of the COVID-19 pandemic during and after pregnancy. The study will be conducted by researchers in the Maternal-Fetal Medicine Units Network, a group of 12 U.S. clinical centers funded in part by the NIH.

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.)

COVID-19 update for Monday, May 18 as of 2:30 p.m.

Pennsylvania Update

Department of Health

The Department of Health issued revised guidance for health care providers that have not already received guidance on how to reopen elective procedures.  The guidance would not apply to hospitals, ambulatory surgical facilities, dental practices, and any others operating under separate department guidance.

The department issued additional clarification late Friday about Secretary Levine’s order for nursing homes to report information about COVID-19 patients to the Department of Health.

Because of the serious implications that COVID-19 has had and is having for the residents and staff of nursing homes, and the surrounding communities, and because of the need for the most timely and accurate data the Department of Health is able to obtain, the Secretary of Health has chosen to exercise her public health authority and issue an Order requiring the reporting in question. The Department of Health has provided instructions today to all skilled nursing facilities regarding how to report into its system for this purpose. The Department is requiring facilities to report daily, even over weekends and holidays, precisely because of the serious consequences that spread of the virus has for nursing home residents, its ability to spread asymptomatically, and the need for the most current, timely and accurate data to inform the Commonwealth’s response.

Information provided to skilled nursing facilities by the Department today did also include a letter reminding them of their obligations under CMS’ new regulations. This letter, while intended to be a timely reminder of those federal regulatory obligations, was not intended to define their obligations under the Secretary’s public health Order. The Secretary’s Order stands separate and apart from requirements mandated by CMS and is authorized by her authority to protect the health of the people of this Commonwealth, and to determine and employ the most efficient and practical means for the prevention and suppression of disease. Therefore, the letter detailing federal requirements relating to CMS should be disregarded for purposes of complying with the Secretary’s Order. The Department is not taking the issuance of this Order as a regulatory step, but as a public health imperative.

Department of Health Daily Briefing

• More than 13,600 residents of long-term-care facilities and more than 2000 people who work at such facilities have tested positive for COVID-19.  Those cases are spread over 561 facilities in 44 counties.
• Nearly 69 percent of all COVID-19-related deaths in Pennsylvania have been people who resided in long-term-care facilities.
• Nearly 4500 health care workers have tested positive for COVID-19, as have more than 2400 people employed in the food industry in 159 different facilities.
• Secretary Levine explained that the state is now using a new death reporting system.  When publicly reporting long-term care deaths, they will be reported based on the county of the facility.  When reporting overall deaths, patients who passed away in long-term-care facilities – and those who do so in hospitals as well – will be reported based on their county of residence, not the county where the long-term-care facility or hospital was located.
• More testing at long-term-care facilities will be introduced this week but it will not necessarily be weekly testing.  The frequency of testing will be based on the situations of the individual facilities.
• Case and mortality data for individual long-term-care facilities will be publicly reported beginning tomorrow.
• Secretary Levine reported that the state is still seeking to acquire COVID-19 antibody testing for state labs and hopes to have it by the end of the month but some hospitals, as well as LabCorp and Quest, already have this capacity.  She warned that the value of such tests is still not entirely clear.

Federal Update

Centers for Medicare & Medicaid Services

• CMS has posted a compendium of COVID-19-related flexibilities it has authorized for ambulance services during the COVID-19 crisis.
• CMS has updated its collections of COVID-19-related waiver flexibilities for several types of health care providers.
  • For health care providers, a new section on ambulance services and the Medicare ground ambulance data collection system (p. 29).
  • For hospitals, new provisions addressing specific life safety code matters for hospitals (p. 3); expanded ability for hospitals to offer long-term-care services (swing beds) (p. 6); hospitals classified as sole-community hospitals (p. 7); and hospitals classified as Medicare-dependent small rural hospitals (p. 7).
  • For teaching hospitals, teaching physicians, and medical residents, new sections on the expanded ability of hospitals to offer long-term-care services (swing beds) for patients who do not require acute care but do meet the skilled nursing facility level-of-care criteria (p. 5) and its waiving of certain physical requirements under the Medicare conditions of participation to allow for increased flexibilities for surge capacity and patient quarantine at hospitals, psychiatric hospitals, and critical hospitals as a result of COVID-19 (p. 6).
  • For long-term-care facilities (skilled nursing facilities or nursing facilities), a new section on the training required for paid feeding assistants (p. 11).
  • For home health agencies, a new provision that permits occupational therapists, physical therapists, and speech language pathologists to perform initial and comprehensive assessments for all patients and not only for patients for whom physical therapy has been ordered (see page 4).
  • For end-stage renal disease facilities, new information about the requirement that facilities furnish dialysis services on the main premises (p. 5).

CMS Weekly Stakeholder Calls

COVID-19: Office Hours Call — May 19

Tuesdays and Thursdays from 5 to 6 pm ET

Hospitals, health systems, and providers: Ask CMS questions about its temporary actions.

To Participate on May 19:

• Conference lines are limited but you also can join via audio webcast
• Or, call 833-614-0820; Access Passcode: 9984433

Target Audience: Physicians and other clinicians

COVID-19: Home Health and Hospice Call — May 19

Tuesdays from 3 to 3:30 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance. Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate on May 19:

• Conference lines are limited but you also can join via audio webcast
• Or, call 833-614-0820; Access Passcode: 6477704

COVID-19: Nursing Home Call — May 20

Wednesdays from 4:30 to 5 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate on May 20:

• Conference lines are limited but you also can join via audio webcast
• Or, call 833-614-0820; Access Passcode: 4879622

COVID-19: Dialysis Organization Call — May 20

Wednesdays from 5:30 to 6 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate on May 20:

• Conference lines are limited but you also can join via audio webcast
• Or, call 833-614-0820; Access Passcode: 3287645

COVID-19: Nurses Call — May 21

Thursdays from 3 to 3:30 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate on May 21:

• Conference lines are limited but you also can join  via audio webcast
• Or, call 833-614-0820; Access Passcode: 2874976

COVID-19: Office Hours Call — May 21

Tuesdays and Thursdays from 5 to 6 pm ET

Hospitals, health systems, and providers: Ask CMS questions about its temporary actions.

To Participate on May 21:

• Conference lines are limited but you also can join via audio webcast
• Or, call 833-614-0820; Access Passcode: 9984433

Target Audience: Physicians and other clinicians

COVID-19: Lessons from the Front Lines Call — May 22

Fridays from 12:30 to 2 pm ET

These weekly calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians: Share your experience, ideas, strategies, and insights related to your COVID-19 response. There is an opportunity to ask questions.

To Participate on May 22:

• Conference lines are limited but you also can join via audio webcast
• Or, call 877-251-0301; Access Code: 6086125

To catch up on past calls, go here for transcripts and podcasts.

Department of Health and Human Services

• ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, has published a summary on funding for alternative care sites for helping to increase hospital surge capacity in communities overwhelmed by patients diagnosed with COVID-19.  In particular, see the charts on pages 3 and 4.
• HHS will be distributing another large quantity of the drug remdesivir to state health departments later this week.  Those state health departments, in turn, will distribute the drug to their states’ hospitals as they believe appropriate.  This distribution is about the same size as last week’s.  Another, smaller distribution is expected next week.

Neither this week’s nor next week’s distributions require any action by hospitals; they do not have to provide any data through the COVID-19 teletracking portal.

Gilead, manufacturer of remdesivir, is expected to donate more than 300,000 additional vials to the federal government in early June.  Hospitals will be asked to input their COVID-19 data through the teletracking portal in early June as that next donation draws closer.

Centers for Disease Control and Prevention

The CDC updated its information for pediatric health care providers on multi-system inflammatory syndrome in children (MIS-C).

Food and Drug Administration

The FDA has issued an emergency use authorization (EUA) for an at-home sample collection kit that can then be sent to specified laboratories for COVID-19 diagnostic testing.

• The FDA has issued an EUA for a commercial device to be used for remote monitoring of cardiograms among COVID-19 patients whose hearts may be susceptible to cardiac arrhythmias when taking certain prescription drugs.
• The FDA has updated its guidance document on conducting clinical trials of medical products during the COVID-19 emergency.

• The FDA has issued EUAs for four new commercial diagnostic tests for COVID-19.  Find them here, here, here, and here.

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.)

COVID-19 update for Friday, May 15 as of 2:30 p.m.

Pennsylvania Update

Governor Wolf

Governor Wolf announced that 12 more counties will move to the yellow phase and begin reopening next Friday, May 22.  This will bring 49 of Pennsylvania’s 67 counties into the yellow phase of partial reopening.

Department of Health

The Department of Health has issued an order requiring nursing homes to report to the department daily beginning on May 16 the same information CMS requires these facilities to report to the CDC under the interim final rule issued on May 8.  Click here for a letter from CMS to states explaining these requirements.

Department of Health Daily Briefing

• Nearly 1000 new cases of COVID-19 brings Pennsylvania’s total to more than 60,000.
• Nearly 13,000 residents of long-term-care facilities and more than 2000 who work in 550 such facilities in 44 counties have tested positive for COVID-19.
• As have more than 4300 health care workers and nearly 2400 people who work in 150 food facilities.
• Pennsylvania has cut its case count in half in recent weeks.
• But the state is still seeing pockets of outbreaks and some parts of the state are only now beginning to show signs of declining cases.
• Secretary Levine said testing and contact tracing are working well in yellow counties.
• Secretary Levine confirmed that the state now has cases of multi-system inflammatory syndrome in children (MIS-C) associated with COVID-19. She said she has no information about how many such cases there are and where in the state these children live.

General Assembly

The House is scheduled to reconvene next Monday and the Senate canceled its session for next week.

Federal Update

Centers for Medicare & Medicaid Services

• CMS released a bulletin that gives guidance to states on how to temporarily modify provider payment methodologies and capitation rates under their Medicaid managed care contracts to address the impact of the COVID-19 emergency while preserving systems of care and access to services for Medicaid beneficiaries.  See CMS’s announcement of the bulletin here and find the bulletin itself here.
• CMS updated its COVID-19 FAQ on Medicare fee-for-serving billing with new information about accountable care organizations that terminate their Shared Savings Program agreement (p. 40).
• HHS’s Office of the Inspector General updated its FAQ addressing how it will apply its administrative enforcement authorities to arrangements directly connected to the COVID-19 public health emergency.  The new information makes clear the circumstances under which a physician group that contracts with a nursing home to provide care to its residents could furnish protective face masks to the nursing home at no or reduced cost during the COVID-19 crisis.
• HHS’s Office of Civil Rights published a notice of enforcement discretion informing interested parties that it will not impose penalties for non-compliance with regulatory requirements under the HIPAA rules against covered health care providers and their business associates in connection with their good-faith participation in the operation of a community-based testing site during the public health emergency.
• In the past week CMS issued 13 section 1135 waivers to give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  The states receiving waivers this week are Alabama, Alaska, California, Connecticut, Georgia, Indiana, Louisiana, Massachusetts, Minnesota, Missouri, Nebraska, and Oregon and the District of Columbia.
• CMS posted a message announcing temporary changes in its Medicare Diabetes Prevention Program as a result of the COVID-19 crisis.
• CMS issued a call for nominations for individuals to serve on its Coronavirus Commission on Safety and Quality in Nursing Homes.  The commission process will be led by a contractor that will, among other things, manage the nomination and selection of commission members.

Department of Health and Human Services

HHS and its Agency for Healthcare Research and Quality (AHRQ) will award $5 million in fiscal year 2020 to support novel, high-impact studies that evaluate the responsiveness of health care delivery systems, health care professionals, and the overall U.S. health care system to the COVID-19 pandemic.   See HHS’s announcement of the grant program here and find the full funding announcement here.

Centers for Disease Control and Prevention

The CDC issued a health advisory through its health alert network with background information on several cases of a recently reported multi-system inflammatory syndrome in children (MIS-C) associated with COVID-19.  The advisory includes a case definition for this syndrome and the CDC’s recommendation that providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.

Food and Drug Administration

• The FDA issued a news release alerting the public to early data that suggests potentially inaccurate results from using the Abbott ID NOW point-of-care test to diagnose COVID-19.  Specifically, the test may return false negative results.

• The FDA issued an update to its guidance for pharmacy compounders that experience shortages of the personal protective equipment they typically use to compound human drugs that are intended or expected to be sterile.  In the update, FDA clarifies that drugs can be compounded under the policy in a segregated compounding area that is not in a cleanroom when specific beyond-use dates are used.

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.)

COVID-19 update for Thursday, May 14as of 2:30 p.m.

Pennsylvania Update

Governor Wolf

The Wolf administration released an updated Carnegie Mellon University Risk-Based Decision Support Tool report for May 12.  The support tool is used when making decisions about which Pennsylvania counties to reopen.

Department of Health

On its message board for licensed entities (go here and click “message board”), the Department of Health sent the following reminder to skilled nursing facilities:

As the COVID-19 pandemic unfolds, the Department is aware that some skilled nursing care facilities may struggle with adequate staffing.  Despite this challenge, the facility remains responsible for providing adequate care and maintaining a safe environment for residents.  The Department will continue to uphold its regulatory responsibilities but will not cite a facility based solely on a request for assistance from federal, state, and local resources such as the National Guard, the Department’s consultant, ECRI, Inc., or others. The Department expects facilities to reach out for assistance during this unprecedented time.

Department of Health Daily Briefing

• With 275 new deaths to report, most of which are the result of reconciling past case data, Pennsylvania’s COVID-19 death toll now exceeds 4000 people. All were adults.
• More than 12,600 residents of long-term-care facilities and nearly 2000 employees in those facilities have tested positive for COVID-19, as have more than 4000 health care workers.
• Secretary Levine discussed strategies for pediatricians to provide well-child visits and ensure that children stay current with their immunizations.
• Department of Health officials are contacting the state’s six children’s hospitals about whether they have seen any cases of a COVID-19-related inflammatory syndrome that shows similar symptoms to Kawasaki disease, which is a childhood illness. Despite published reports, Secretary Levine said she is unaware of any such cases in the state.
• Secretary Levine announced that CVS will begin performing drive-through testing at some of its locations using self-swabs. She does not know the criteria CVS will employ for whom it tests.  Rite Aid testing locations will test anyone.
• Secretary Levine said there have been no troubling spikes in case counts in counties that have moved from red to yellow but warned that only five days have passed since those reopenings.
• Next week the state will begin considering criteria for moving counties and regions from yellow to green.
• Secretary Levine expressed no opinion when asked about HAP’s complaints about the governor’s veto of telehealth legislation, the state helping hospitals with loans instead of grants, and other matters.
• The state has no plans to reopen any areas on anything less than a county-wide area.

Department of Human Services

• DHS reissued its comprehensive guidance document for hospitals to reflect a requirement to test patients for COVID-19 prior to discharge to a nursing care facility, personal care home, or assisted living residence.
• DHS issued new guidance documents for nursing homes summarizing several recent health alerts on topics such as testing protocols for residents returning from a hospital, cohorting patients, and periodic screening of residents and staff. Find those documents here and here.

• DHS has posted a notice about the reprocessing of Medicaid fee-for-service claims with COVID-19-related diagnosis code and co-pay collection.

Federal Update

Department of Health and Human Services

HHS is sending out its largest distribution of remdesivir this week. As of this week, HHS will have sent out 40 percent of its current supply.  The drug is being sent to state health departments, which will distribute it to hospitals.   Hospitals are being asked to update their data on COVID and suspected COVID inpatients and ICU patients on a weekly basis via the teletracking portal.  The next deadline is Monday, May 18 at midnight.  Once the federal supply is exhausted the federal government will not receive any additional donated doses of the drug.

Federal Emergency Management Agency

FEMA has updated its policy on COVID-19 medical costs eligible for public assistance under the agency’s FEMA Public Assistance Program. Eligible recipients for these funds include state, local, tribal, and territorial entities and certain private, non-profit organization-owned and/or operated medical facilities.

Department of Homeland Security/U.S. Citizenship and Immigration Services

The U.S. Citizenship and Immigration Services has issued a policy memorandum describing temporary policy changes for certain foreign medical graduates during the COVID-19 emergency.  The temporary policy addresses situations in which H-1B foreign medical graduates are temporarily unable to work full-time due to quarantine, illness, travel restrictions, or other consequences of the pandemic during the COVID-19 emergency.

Centers for Medicare & Medicaid Services

CMS has issued a new toolkit on state actions and best practices to mitigate the prevalence of COVID-19 in nursing homes.

Occupational Safety and Health Administration

OSHA has issued an alert with information to keep nursing home and long-term care facility workers safe during the COVID-19 pandemic.

Substance Abuse and Mental Health Services Administration

SAMHSA is inviting applications for $40 million in grants to support states and communities during the COVID-19 pandemic in advancing efforts to prevent suicide and suicide attempts among adults 25 and older in order to reduce the overall suicide rate and number of suicides in the United States.

National Institutes of Health

The NIH announced that a clinical trial has begun to evaluate whether hydroxychloroquine, given together with the antibiotic azithromycin, can prevent hospitalization and death from COVID-19.

Food and Drug Administration

• The FDA has posted information about thermal imaging systems and their uses, and limits, in serving confirmed and suspected COVID-19 patients. This information supplements the agency’s enforcement policy for telethermographic systems during the COVID-19 emergency, which was issued last month.

• On Friday, May 15, the FDA will hold a virtual town hall for researchers, clinical laboratories, and commercial manufacturers to discuss the production and use of 3D-printed swabs during the COVID-19 crisis. Learn more here.

• In light of an insufficient supply of infusion pumps and infusion pump accessories needed to treat COVID-19 patients, the FDA has written to the manufacturers of such equipment, health care providers, distributors, and other stakeholders outlining the conditions under which it will issue emergency use authorizations (EUA) for infusion pumps and infusion pump accessories.

• The FDA has issued EUAs for four specific commercial diagnostic tests for COVID-19; find them here, here, here, and here.

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.)

COVID-19 update for Wednesday, May 13 as of 2:30 p.m.

Pennsylvania Update

Governor Wolf

Governor Wolf announced that gender identity, sexual orientation, and expression will be included in the state’s COVID-19 data collection.

Department of Health

The Department of Health announced its plans for distributing 1200 doses of remdesivir that it has received from the federal government.  See its announcement, including links to the department’s distribution formula and a list of the 51 recipient hospitals.

Department of Health Daily Briefing

• The state’s new COVID-19 case count was down over the past 24 hours but the death count climbed as a result of continued reconciliation of past data.
• More than 12,400 residents of long-term-care facilities and 1800 employees of those facilities have been diagnosed with COVID-19.
• As have more than 4000 health care workers across the state.
• Secretary Levine announced that the state has distributed more than 1200 doses of remdesivir, a drug that preliminary clinical trials suggest can help people recover from COVID-19 (see link above for the department’s formal announcement). The federal Department of Health and Human Services is managing distribution of the drug among the states and has assured that Pennsylvania will receive more in the future.
• Pennsylvania now has the laboratory capacity to do much more testing.
• The state is now able to test those who in the past were considered likely cases of COVID-19 but were not tested because of the scarcity of testing supplies.
• But while the state’s goal is broad surveillance testing, that is not yet possible.

Department of Human Services

• DHS has posted a notice that nurse aide testing is suspended until May 16, 2020 or until conditions are deemed safe to reopen.
• DHS’s Bureau of Human Services Licensing has published an FAQ on how economic impact payments made under the federal CARES Act might affect the Medicaid eligibility of residents of personal care homes and assisted living facilities who participate in programs operated by the department’s Office of Long-Term Living. The FAQ also addresses how such facilities must handle those payments on their residents’ behalf.

State Board of Medicine

The State Board of Medicine has suspended a regulation requiring physicians to provide paper prescriptions within 72 hours of issuing emergency prescriptions by telephone during the COVID-19 emergency.

Attorney General

State Attorney General Josh Shapiro has announced that his office has opened criminal investigations into “several” nursing homes for possible criminal neglect of patients and residents.

General Assembly

• Yesterday the Senate unanimously passed SB 1122, which would appropriate $507 million in federal CARES Act money to state long-term care budget lines. This was added as an amendment to a bill that directed $34 million in CARES Act money to firefighters and EMS service.  Find further information in the fiscal note on the bill.
• Senate leaders said that in light of the unpredictability of the COVID-19 pandemic and state revenues, they are working on a five-month state budget that would run from July through November and would therefore require additional budget legislation to cover state spending as of December 1, 2020.
• House Speaker Mike Turzai has introduced HB 2510, the Senior Protection Act, which would spend $500 million in federal CARES Act money to address the spread of COVID-19 in long-term-care facilities. Unveiled earlier this week, the bill focuses on three areas: enhancing testing capabilities, infection control, and advancing clinical practices including the use of telemedicine.  According to the Speaker, this would be accomplished by utilizing Pennsylvania’s academic medical centers (AMC) to ensure greater protection of seniors.
• The House is expected to return to session on Thursday, May 14.

Federal Update

Centers for Medicare & Medicaid Services

• CMS has posted an FAQ on price transparency and requirements for providers to make public their cash prices for COVID-19 diagnostic testing.

Centers for Disease Control and Prevention

• The CDC has updated its FAQs for health care personnel working among and around patients who have or are suspected of having COVID-19.
• The CDC has updated its resources for hospitals and health care professionals preparing for patients with suspected or confirmed COVID-19.
• The CDC has published information providing a framework for health systems providing non-COVID-19-related services during the COVID-19 pandemic.
• The CDC has updated its FAQ for laboratories that perform or wish to perform COVID-19 tests.
• The CDC has updated its information for pediatric providers.
• The CDC has posted information about COVID-19 and patients on home dialysis.
• The CDC has published guidance on serving patients in memory care units of long-term-care facilities and dealing with COVID-19 in this context.

Food and Drug Administration

• The FDA has updated its information for blood establishments regarding the COVID-19 emergency.

• The FDA has issued emergency use authorization (EUA) for a commercial nurse call system for use by providers for remotely monitoring and communicating with patients on ventilators.

• The FDA has issued an EUA for a commercial cardiogram system to be used as a diagnostic aid for identifying potential cardiac complications associated with COVID-19 or underlying conditions that may affect the clinical management of patients who have or are suspected of having COVID-19.

• The FDA has issued an EUA for a specific commercial diagnostic test for COVID-19.

Government Accountability Office

• The GAO has published a brief review of the science underlying social distancing.

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.)

COVID-19 update for Tuesday, May 12 as of 3:00 p.m.

Pennsylvania Update

Department of Health

The Department of Health has issued an advisory calling on skilled nursing facilities to develop and implement plans to perform COVID-19 tests on their residents and employees.

Department of Health Daily Briefing

• Nearly 14,000 residents of long-term-care facilities and people who work at those facilities have now tested positive for COVID-19.
• As have nearly 4000 other health care workers.
• The state is introducing a new testing strategy for the residents and employees of skilled nursing facilities that calls for testing every resident of every such facility. All patients who are returning to such facilities from hospitals must be tested and then accommodated appropriately.  The Department of Health issued guidance on its new approach today.  This guidance, linked above, calls for different levels and frequency of testing for different facilities based on how many COVID-19 cases they have had and how recently they have had them.
• Secretary Levine said the state is introducing this strategy now because it is the first time it has had sufficient access to testing supplies and equipment and laboratory resources to undertake such an effort.
• She said the department also has directed skilled nursing facilities to report daily, starting May 17, on their testing activity and case counts. This information will be reported publicly.

Department of Human Services/Office of Long-Term Living

OLTL has issued a reminder to OLTL-regulated programs operating in counties that are moving from red to yellow that previous guidance that applied to those programs remains in effect.  Specifically:

• For programs involving home and community-based services, this DHS memo to Community HealthChoices managed care plans addressing temporary changes in the Community HealthChoices program and this notice to OBRA waiver service coordinators and providers describing temporary changes of the OBRA waiver.
• For nursing facilities, this DHS clarification guidance for pre-admission screening resident review (PASRR); Department of Health interim guidance on visitation in nursing facilities during the COVID-19 emergency; and CMS guidance for infection control and prevention.
• For Living Independence for the Elderly (LIFE) programs, OLTL’s LIFE provider guidance related to COVID-19.
• For assisted living residents and personal care homes, the Department of Health’s interim guidance on visitation to nursing facilities during the COVID-19 pandemic; CMS’s guidance for infection control and prevention; OLTL’s guidance suspending and restricting license requirements for personal care homes and assisted living residences; and DHS’s visitation restrictions in personal care homes and assisted living residences.

Federal Update

Congress

House Democrats have unveiled their newest pandemic relief bill.  The overall bill is estimated to cost around $3 trillion.  A few of the health care provisions included in this bill are:

• $100 billion for eligible health care providers to be distributed through the Health Care Provider Relief Fund. This is in addition to the $175 billion Congress has already appropriated for providers.  This bill would include a prescriptive and structured methodology for distribution of the Health Care Provider Relief Fund that would include, among other things:
• quarterly relief funds based on hospital cost reports, with aid providers already received from the relief fund subtracted from the quarterly amount
• eligibility to receive up to 60 percent of revenue lost in comparison to the previous year, to help compensate for pandemic-related expenses
• a requirement that recipients not charge COVID-19 patients and not engage in balance billing
• Reduces interests rates and lengthens the payback period for Part A and Part B advance payments.
• $75 billion for testing, contact-tracing, and other activities.
• Prohibits the administration from finalizing the Medicaid Fiscal Accountability Rule (MFAR) during the current public health emergency.
• $7.6 billion to health centers.
• $4.5 billion to NIH to expand COVID-10-related research.
• $3 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA).
• Increases federal medical assistance percentage (FMAP) 14 percentage points from July 1, 2020 through June 30, 2021.
• Temporarily increases Medicaid DSH allotments to states by 2.5 percent.
• Eliminates cost-sharing for most patients for COVID-19 treatment.

These are only a few of the health care provisions included in this sprawling bill.  You can find a summary of the bill here and the text of the bill here.

The House is expected to vote on the bill this Friday but the Senate is working on its own plan and is not expected to take up any new pandemic relief legislation until after Memorial Day.

Centers for Disease Control and Prevention

• The CDC has published information about factors to consider when purchasing ventilators from another country.
• The CDC has updated its FAQ on infection prevention and control in health care settings.
• The CDC has updates its interim laboratory biosafety guidelines for handling and processing specimens associated with COVID-19.

Food and Drug Administration

• The FDA has published guidance for industry and investigators addressing pre-investigational new drug application (IND) meeting requests for COVID-19-related drugs and biological products.

• The FDA has published guidance on developing drugs and biological products for the treatment or prevention of COVID-19.

• The FDA has issued an emergency use authorization for a specific commercial laboratory test to diagnose COVID-19.

Occupational Safety and Health Administration

OSHA issued an alert with information about helping to keep dental industry practitioners safe during the COVID-19 emergency. See the announcement here and the alert itself here.

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.)