COVID-19 Update: Friday, December 4

The following is the latest COVID-19 information from the state and federal governments as of 2:45 p.m. on Friday, December 4.

SNAP Advocacy

Safety-Net Association of Pennsylvania logo SNAP has written to Congress to request additional COVID-19 legislation between now and the end of the year. SNAP asked Congress for additional funding for the Provider Relief Fund; extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states. Read SNAP’s message to Congress.

Pennsylvania Update

Department of Health

The Department of Health has posted a fact sheet on the CDC’s arrangement with pharmacies to provide on-site COVID-19 vaccination services for residents of nursing homes and assisted living facilities once vaccination is recommended for them.
The Department of Health has compiled answers to frequently asked questions about the Secretary’s order for the reduction of elective procedures in regions that meet certain COVID-19-related metrics. The department also updated its COVID-19 guidance to hospitals to incorporate changes made by the elective procedures order.
The Department of Health shared clarification it received from CMS explaining that personnel providing non-emergency medical transportation under arrangements with nursing facilities should be tested for COVID-19 or required to prove that testing was completed elsewhere during the time frame that corresponds with the facility’s testing frequency. This requirement does not apply to individuals providing emergency services.
The Department of Health issued a health alert with updated quarantine recommendations for persons in the community exposed to COVID-19. This alert does not apply to staff working in health care settings who are exposed to COVID-19, who should follow guidance outlined in PA-HAN-510, or to patients and residents in health care settings, who should follow PA-HAN-526.
The Department of Health shared on its message board the following information to clarify that surveyors visiting licensed facilities are required to follow the department’s own testing and visitation protocols:

The Department of Health recognizes the need to protect the patients and residents in healthcare facilities by ensuring that visitors (including Department of Health employees) follow guidance and requirements issued by the Department of Health and CMS regarding visitation to healthcare facilities. Surveyors from the Department of Health are required to follow these requirements and guidance. The Department of Health also has its own testing program for our surveyors. Because of HIPPA we cannot share medical results of our employees, but again we can assure you that all employees who are on site at facilities are compliant with all Department of Health and CMS guidance and requirements.

Department of Health – by the numbers

For the second consecutive day, Pennsylvania set a new high for new COVID-19 cases in a single day.
More than 11,000 Pennsylvanians have now died from COVID-19. Daily death figures are now the highest they have been since the pandemic began.
Nearly 38,000 residents of long-term-care facilities and more than 7100 people who work in those facilities have contracted COVID-19. Those figures encompass 1316 facilities in 65 of Pennsylvania’s 67 counties.
More than 15,000 health care workers in the state have contracted COVID-19.
More than 1000 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
Nearly 600 Pennsylvanians are currently breathing with the help of a ventilator because they have COVID-19.
16 percent of hospital adult ICU beds are currently unoccupied, as are 15 percent of medical/surgical beds, 40 percent of pediatric beds, 17 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.

Around the State

The Pittsburgh Tribune-Review reports that “More than one-third of hospitals in Southwestern Pennsylvania anticipate staffing shortages in the coming week.”
It also notes that “In Allegheny County, just over 11% of adult ICU beds in the county remain available – about 91 beds in total.”
ICU beds are a major concern, the Tribune-Review adds, explaining that “Intensive care units already are at capacity in two Western Pennsylvania hospitals. Officials with Butler Health System said in a release Wednesday units at Butler Memorial and Clarion hospitals are full, and the health system has activated phase one of its surge plan.”
That plan “…includes converting Butler Memorial’s post-anesthesia care unit into an intensive care unit, which will add 15 more critical care beds in the hospital.”
In addition, the Tribune-Review adds, “The health system will suspend all nonemergency elective surgeries and procedures that would require an in-patient stay, a move officials hope will free up as many beds as possible.”
In addition, the Pittsburgh Business Times reports that the state’s Keystone region also is expected to see staffing shortages in the coming week. That region consists of Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties.
The Harrisburg Patriot-News explains that “WellSpan York Hospital has put up a tent outside its emergency room and plans to add trailers. A spokesman said the space is for isolating ER patients awaiting results of COVID-19 tests. It’s not being used to house hospitalized patients, nor is the ER housing hospitalized patients.”
The Philadelphia Business Journal notes that on Wednesday, Philadelphia’s Health Department “…reported 859 patients with Covid are now being treated in city hospitals, nearing the 1,000 Covid admissions level Philadelphia medical centers experienced during the spring.”
Finally, the Philadelphia Inquirer reported that “The counties whose hospital ICUs were completely filled with coronavirus patients, according to state data, included Lycoming, Schuylkill, and Washington. Most have small capacities, with some having fewer than five or 10 ICU beds in total, according to state data.”

Department of Human Services

DHS’s Office of Developmental Programs has posted guidance to community and life-sharing home providers about how to apply updated COVID-19 testing guidance and infection control procedure guidance issued by the state’s Department of Health.

Federal Update

Centers for Medicare & Medicaid Services

CMS has updated its FAQs on Medicare fee-for-service billing with 14 new questions that address administration and billing for monoclonal antibody therapy. The new questions can be found on pages 33-34, p. 34, pp. 120-121, p. 121, pp. 121-124, pp. 124-125, p. 125 (four questions), p. 126, pp. 126-127, p. 127, and pp. 127-128.
CMS covers much the same ground in an updated version of its document “Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction.”
CMS has published a statement on its intended use of its enforcement discretion on skilled nursing facility consolidated billing for COVID-19 vaccines and monoclonal antibody infusions. Through the exercise of this discretion, CMS will permit Medicare-enrolled immunizers to bill directly and receive direct reimbursement from the Medicare program. Go here to see the complete statement.

Coronavirus (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 8 at 5:00 (eastern)

Toll Free Dial-In: 833-614-0820; Access Passcode: 3129517

Audio Webcast link: go here.

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 issued a fourth amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to increase access to critical countermeasures against COVID-19, including greater use of telehealth. Go here for a more detailed description of what the amendment authorizes.

Food and Drug Administration

On Tuesday, December 8 at noon (eastern) the FDA will host a webinar on its enforcement policy for sterilizers, disinfectant devices, and air purifiers during the COVID-19 pandemic as part of its series on respirators and other personal protective equipment for health care personnel use during the pandemic. Go here for further information about the webinar and how to participate.
The FDA has issued emergency use authorization for a bioburden-reduced N95 respirator. See the FDA’s letter of authorization and its fact sheet for health care providers.