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COVID-19 Update: Monday, January 25

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

PA Safety Net Admin2021-01-26T09:42:38+00:00January 26th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Tuesday, January 19

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

PA Safety Net Admin2021-01-20T06:00:14+00:00January 20th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Wednesday, January 13

The following is the latest COVID-19 information from the state and federal governments as of 4:30 p.m. on Wednesday, January 13.

Pennsylvania Update

The Wolf Administration

The Wolf administration has announced that the state is transitioning from the Regional Response Health Care Collaboration program (RRHC) created last year to a Long-Term Care Task Force that includes Regional Congregate Care Assistance Teams (RCATs) to continue supporting those facilities. The ten health systems that participated in the RRHC will continue to work with the RCATs, with some previous RRHC functions to be performed by separate contractors. The program has been allocated $12 million for January and February. Learn more about the transition, the new program, and the contractors in this Wolf administration news release.

Governor Wolf and Secretary Levine

On Monday, January 11 Department of Health Secretary Rachel Levine held a news briefing and the following day she participated in a separate briefing led by Governor Wolf. Highlights from the January 11 briefing:

As of January 11, when this briefing was held, the state has received 827,000 doses of vaccine and 285,000 of them have been administered. This latter total may not include some administered by CVS and Walgreens, which are serving long-term-care facilities. They take as long as 72 hours to report on how many vaccines have administered.
Operation Warp Speed says Pennsylvania will receive 138,000 new doses this week.
It will take several months before there is enough vaccine for everyone, Secretary Levine said.
Doses are going directly from federal sources to hospitals and other providers and those providers are often receiving them with very little advance notice. Notification comes from Operation Warp Speed, not the state.
The state expects more than $100 million to help administer vaccines; this money comes from the end-of-the-year COVID-19 relief/stimulus bill.
The perception that the state has been slow to administer vaccines is largely a function of unrealistic projections from the federal government, especially during the holiday season, Secretary Levine said.
Pennsylvania is considering expanding access to vaccines to Phase 1-B individuals (seniors).
In response to concerns about people choosing not to be vaccinated, Secretary Levine said that the federal government needs a better plan for communicating the importance and effectiveness of the vaccines and the state will be doing the same.
Pennsylvanians should not expect to see the impact of vaccinations on new COVID-19 case levels for several months.
Secretary Levine said she has received no reports of hospitals discarding unused vaccines.
In response to questions about new guidance from Washington about vaccination priorities, Secretary Levine said that she and the Department of Health have not yet seen that guidance and will review it before making any changes in the state’s current approach, although she supports vaccinating additional elderly individuals when programs are in progress and there is serum available.

Highlights of the joint January 12 news briefing:

311,000 vaccines have now been administered, including to more than 52,000 skilled nursing facility residents and staff.
Special testing is needed for the new (UK) strain of COVID-19. Based on the genetic content of current test results, the state is directing that some samples be sent to the CDC or CDC-designated labs for further analysis to ascertain whether they are the UK strain. The state hopes to develop the capacity to do these tests itself at its Exton lab sometime next month.
About two percent of Pennsylvanians have received the vaccine, Secretary Levine said. That roughly tracks the current vaccination rate nation-wide, she said.
There have been no reports of people trying to jump the line to get vaccines, Secretary Levine said.
In response to a question, Secretary Levine said that while rural areas did not receive doses of the Pfizer vaccine because they lack facilities to store it, those areas have received, and will continue to receive, the Moderna vaccine and others as they become available.
The state’s partnership with rural pharmacies to administer vaccines should begin the next few weeks.

Department of Health – by the numbers

After several days of its highest new case counts in several weeks, the number of new COVID-19 cases reported in Pennsylvania has declined significantly in recent days.
The death toll remains high, however, and yesterday the state surpassed 18,000 deaths since the pandemic began.
For the week from January 1 through January 7 the state’s overall COVID-19 test positivity rate fell to 14.4 percent; it was 15 percent the week before that. This marked the third consecutive week the rate fell slightly.
Despite this modest decline, all 67 Pennsylvania counties remain in “substantial level of community transmission,” as has been the case the past several weeks.
Fourteen of those counties have positivity rates greater than 20 percent, down from 27 such counties the previous week.
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.
Nearly 21,000 health care workers in the state have contracted COVID-19.
More than 68,000 long-term-care facility residents and employees have contracted COVID-19 in 1500 facilities in all 67 Pennsylvania counties.
Currently, 16 percent of adult ICU beds in the state are unoccupied, as are 14 percent of medical/surgical beds, 14 percent of pediatric ICU beds 28 percent of pediatric beds, and 32 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.
As of January 13 the state’s vaccine dashboard shows that 300,000 COVID-19 vaccines have been administered so far 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.
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 3) report for Pennsylvania.

Department of Human Services

DHS’s Office of Long-Term Living has issued vaccination information for its home and community-based providers.

General Assembly

House Bill 55 was favorably reported from the State Government Committee earlier today. This legislation would amend Pennsylvania’s constitution to limit gubernatorial emergency declarations to no more than 21 days unless the General Assembly agrees to extend it in whole or part. In addition, once a disaster emergency expires, the governor would not be able to declare a new one based on “the same or substantially similar facts” without approval from the General Assembly. Further, the bill would clarify that the General Assembly, through a concurrent resolution, could vote to terminate a disaster declaration without having to present it to the governor. Similar legislation was passed by both chambers in the previous legislative session. If it is passed by both chambers this session, it could be placed on the ballot as early as this spring for voter approval.

Around the State

Various jurisdictions are beginning to plan, or to establish, mass vaccination sites across the state. The Lehigh Valley Health Network will build a mass vaccine site at Dorney Park; the city of Philadelphia will open one at its convention center; Montgomery County at its Montgomery County Community College’s Blue Bell campus; and Delaware County in Yeadon. Allegheny County is still reviewing potential sites for mass vaccination facilities.
Reading Hospital has opened a tent outside its ER to handle a recent surge of COVID-19 cases, according to WFMZ.
The Lehigh Valley Live web site has posted an interactive map that shows COVID-19 case and death counts for every county in the state.
The mayor of Harrisburg has mandated that all city employees receive COVID-19 vaccines, the Harrisburg Patriot-News reports.

Federal Update

Provider Relief Fund

HHS has updated its Provider Relief Fund FAQ with nine new or modified questions on pages 12-13, 13, 15 (three questions), 40-41, 41, and 56. The new and modified questions address
- how changes of ownership affect providers’ ability to receive Provider Relief Fund grants and nursing home quality incentive payments;
- answer questions about audit deadlines and extensions;
- and describe the methodology for calculating Phase 3 distributions and the timing and size of those distributions.

Providers that have received past distributions and that believe they are eligible for Phase 3 distributions should review the updated FAQ carefully.

Department of Defense

The Department of Defense, which is playing a leading role in the distribution of COVID-19 vaccines, has posted a brief document titled “Officials Discuss COVID-19 Vaccine Deliveries and Prioritization Criteria.” The document outlines the status of vaccine distribution efforts to date, offers data on the number of vaccines that have been distributed and administered, and notes the expansion of vaccine administration to individuals beyond those considered to be the highest priority for receiving vaccines.

Department of Health and Human Services

HHS has updated its guidance for hospitals on the reporting of COVID-19 data. Hospitals now are asked to report data weekly on their administration of COVID-19 vaccines to health care personnel. This request is optional at this time, and the relevant portions of this document begin on page 13.
HHS has launched a web-based locator for sites that provide outpatient monoclonal antibody treatment for COVID-19. Go here to read HHS’s announcement about the new initiative and go here for the locator site itself.
HHS has established a “Vaccine Adverse Event Reporting” web site for individuals to report adverse reactions to COVID-19 vaccines. The site also offers data on adverse events that have been reported.

Centers for Medicare & Medicaid Services

CMS has issued a letter to state Medicaid agencies presenting Clinical Laboratory Improvement Amendments of 1988 (CLIA) Laboratories surveyor guidance for new and modified CLIA requirements related to COVID-19 test result reporting.

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.

CMS COVID-19 Office Hours Calls

Tuesday, February 2 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4956655

Audio Webcast link: go here.

Tuesday, February 23 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2528725

Audio Webcast link: go here.

Centers for Disease Control and Prevention

The CDC has updated its FAQs for laboratories about COVID-19.
The CDC has established a web page to track COVID-19 vaccinations. It includes data on vaccine dose distribution and administration, an interactive map for the individual states, and other data.
The CDC has updated its guidance on the importance of COVID-19 vaccinations for residents of long-term-care facilities.
The CDC has published research on the incidence of COVID-19 among people ages 0 to 24 in the U.S. between March 1 and December 12, 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

PA Safety Net Admin2021-01-14T09:52:50+00:00January 14th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Friday, January 8

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

PA Safety Net Admin2021-01-11T06:00:05+00:00January 11th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Tuesday, January 5, 2021

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

PA Safety Net Admin2021-01-06T06:00:47+00:00January 6th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Thursday, December 24

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

PA Safety Net Admin2020-12-28T06:00:22+00:00December 28th, 2020|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Tuesday, December 22

The following is the latest COVID-19 information from the state government as 2:00 p.m. on Tuesday, December 22.

Governor Wolf

Last week the Governor’s Budget Office released a mid-year budget report. The report noted that the state ended the 2019-2020 fiscal year with a $2.7 billion deficit largely due to the COVID-19 pandemic. For the second half of the fiscal year the administration projects that economic growth will rebound slightly due to low interest rates, short-term fiscal policies, and a declining unemployment rate. The mid-year budget report also highlighted areas of concern moving forward, including the uncertainty of the impact of COVID-19 on state revenue, the replacement of one-time funding sources, and the unknown potential of additional federal stimulus funding. The administration will deliver its fiscal year 2021-2022 budget proposal on February 2^nd.

Department of Health

The Department of Health has published guidance for responding to signs and symptoms among health care workers after they receive COVID-19 vaccinations.
The Department of Health issued an order calling for vaccine providers to report data related to each administration of an immunization for COVID-19 through the Pennsylvania Statewide Immunization Information System.
The Department of Health has posted infection prevention and control considerations for residents of long-term-care facilities who show signs and symptoms following COVID-19 vaccination.

Department of Health – by the numbers

Pennsylvania’s number of new daily COVID-19 cases remains exceptionally high but has declined during the past three days.
The state’s total number of COVID-19 cases today surpassed 560,000. Thirty-seven percent of those cases have been diagnosed this month alone.
The number of new daily COVID-19 deaths remains exceptionally high and is not declining. Today the state surpassed 14,000 deaths since the beginning of the pandemic and more than 25 percent of those deaths have been this month.
Nearly 6200 Pennsylvanians are currently hospitalized with COVID-19. That is more than twice the number of people hospitalized during the peak of the crisis in the spring.
The state’s positivity rate on COVID-19 tests fell from 16.2 percent two weeks ago to 15.8 percent last week.
More than 57,000 residents and employees of long-term-care facilities have contracted COVID-19. That encompasses 1433 facilities in all 67 counties.
Nearly 18,000 health care workers have now contracted the virus.
According to the state’s COVID-19 early warning monitoring dashboard, every county in the state except Sullivan County now has a positivity rate greater than five percent. In the past, Department of Health Secretary Levine has referred to anything greater than five percent as “concerning.”
All 67 Pennsylvania counties are now, according to the Department of Health, in “substantial levels of community transmission.”
Among young people from the ages of five through 18, there have been more than 44,000 cases of COVID-19 since the start of the pandemic. Twenty-seven percent of those cases have occurred in the past two weeks.

Department of Human Services

DHS’s Office of Developmental Programs has released temporary closure guidance to Older Adult Daily Living Centers, Structured Day Programs, LIFE Day Centers, Adult Training Facilities and Vocational Facilities related to the community spread of COVID-19 or when an individual or staff member is diagnosed with COVID-19 and spent 15 minutes or more in the facility within a 24-hour period starting from two days before illness onset (or, for asymptomatic patients, two days prior to test specimen collection) until the time the person is isolated. This announcement also describes the process for re-opening facilities using DHS’s Community Participation Support and Older Adult Facility Reopening Tool. Find the announcement here.

DHS’s Office of Developmental Programs policy states that staff members can administer medications to individuals if the staff person successfully completes an ODP-approved medication administration course. Due to the COVID-19 pandemic, ODP permitted staff who are required to take the Standard Medication Administration Training Course to take the Modified Medication Training Course until December 31, 2020. Because the pandemic continues, staff may still take the modified course in place of the standard course until June 30, 2021. Go here to see the policy statement and learn more about certain conditions under which it applies.

Department of State

The Department of State has authorized chiropractors, dentists, optometrists, pharmacists, and podiatrists to order and administer COVID-19 tests if they have been issued a clinical lab permit from the Pennsylvania Department of Health to conduct diagnostic lab testing. See the department’s announcement of this policy, which will remain in effect for the duration of the governor’s emergency declaration and an additional 90 days.
The Department of State has extended its March 2020 waiver temporarily suspending the requirement that pharmacists with active Authorizations to Administer Injectables maintain active certifications in cardiopulmonary resuscitation. Pursuant to that waiver, if a pharmacist held a valid CPR certificate on March 17, 2020, the State Board of Pharmacy has treated that certification as valid through December 31, 2020. As long as a pharmacist held a CPR certificate that was valid on March 17, 2020, such certification will be accepted by the board as valid through March 31, 2021. Pharmacists who fall within this group may take an online CPR training class in lieu of in-person training to enable them to renew their CPR certification prior to the new, extended deadline of March 31, 2021. This does not affect the current biennial renewals for pharmacists and for authorizations to administer injectables. Those renewals are still due by December 29, 2020.
The Department of State has issued a 90-day extension of the December 31, 2020 renewal deadline for licensees under the State Board of Medicine. These licenses will remain active until March 31, 2021. In addition, emergency temporary licenses granted to licensed practitioners in other states and jurisdictions have been extended from their current expiration date of December 31, 2020 to June 30, 2021. If an individual already holds an emergency temporary license but is unable to meet all requirements for full licensure by December 31, 2020, that individual may continue to practice in Pennsylvania after December 31, 2020 until the next expiration date of June 30, 2021.

Around the State

The Harrisburg Patriot-News has published an interactive map with a county-by-county breakdown of COVID-19 cases in Pennsylvania since the start of the pandemic.
The Johnstown Tribune-Democrat, citing data collected by the New York Times, reported that Pennsylvania’s Cambria County “…led the nation in new cases per capita over the past two weeks – among counties with populations of 100,000 or more people.”
COVID-19 is posing increasing staffing challenges for nursing homes in southwestern Pennsylvania according to a Pittsburgh Tribune-Review report that tells of one nursing home company where the situation “…is so dire that roughly a dozen corporate office workers have been trained as temporary nurse aides. Employees who were formerly nurses have jumped in to help, picking up overnight and back-to-back shifts when spates of employees got sick or quarantined at home,” adding that “…at least 372 of the chain’s roughly 1,500 staffers – or nearly 1 in 4 – have contracted covid-19.” The article also tells of facilities’ extensive use of staffing agencies to fill positions.
Westmoreland County Commissioner Gina Cerilli has tested positive for COVID-19, according to the Latrobe Bulletin. This means all three of the county’s commissioners have contracted the virus; two remain under quarantine.
The Philadelphia Business Journal reported on the city of Philadelphia’s plans for distributing and administering COVID-19 vaccines.

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

PA Safety Net Admin2020-12-23T06:00:57+00:00December 23rd, 2020|COVID-19, DSH hospitals|Comments Off

COVID-19 Update: Thursday, December 10

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

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

PA Safety Net Admin2020-12-11T06:00:23+00:00December 11th, 2020|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Wednesday, December 9

The following is the latest COVID-19 information from the state government as 3:00 p.m. on Wednesday, December 9.

Governor Wolf

Governor Wolf has tested positive for COVID-19. It was diagnosed in a routine test and he is quarantining at home. See a news release from the governor’s office with further information.

Department of Health

The Department of Health has issued guidance to hospitals on how to identify and report COVID-19 outbreaks originating within the facility. The department wants this guidance to be used to supplement other relevant guidance documents and to guide the implementation of public health expectations for hospitals.

Key messages included in the guidance:

COVID-19 surveillance procedures must be outlined via written policy and implemented in a way that can systematically identify clusters.
Outbreak Definition:
- ≥2 cases of confirmed COVID-19 in a patient seven or more days after admission for a non-COVID condition, with epi-linkage; or
- ≥3 cases of confirmed COVID-19 in HCP with epi-linkage AND no other more likely sources of exposure for at least two of the cases.
Outbreaks fitting the definition outlined in this advisory must be reported through the Pennsylvania Patient Safety Reporting System (PA-PSRS) as an infrastructure failure. This does not replace reporting of COVID-19 cases or capacity data in other state or federal systems.

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

PA Safety Net Admin2020-12-10T06:00:42+00:00December 10th, 2020|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Tuesday, December 8

The following is the latest COVID-19 information from the state and federal governments as 2:30 p.m. on Tuesday, December 8.

Pennsylvania Update

Governor Wolf

At a press briefing on Monday, Governor Wolf expressed concern about the alarming rate at which new COVID-19 cases are being diagnosed in Pennsylvania, asked Pennsylvanians to wear masks, engage in recommended social distancing, and avoid mass gatherings, and warned that while he was not calling for any new mitigation requirements at this time, he and other state officials are reviewing their options and may recommend new measures later this week.

Department of Health

The Department of Health announced that beginning on Thursday, December 10, regional drive-through and indoor walk-in COVID-19 testing clinics will be held in Clinton, Delaware, Greene, Warren, and Wyoming counties. Counties with new, temporary state-sponsored testing sites will change each week over the next 11 weeks so that 61 counties will eventually be reached by these pop-up testing sites. Go here to learn more, including the testing schedule and site addresses.

Department of Health – by the numbers

Pennsylvania’s number of COVID-19 cases today surpassed 345,000.
In three of the past six days Pennsylvania has set a new single-day high for the number of new cases.
More than 11,500 Pennsylvanians have now died from COVID-19.
More than 40,000 residents of long-term-care facilities and more than 7000 people who work in those facilities have contracted COVID-19. Those figures encompass 1349 facilities in 66 of Pennsylvania’s 67 counties.
More than 18,000 health care workers in the state have contracted COVID-19.
The number of people currently hospitalized with COVID-19 has doubled in the past two weeks.
The number of COVID-19 patients currently breathing with the help of a ventilator has risen 50 percent in the past two weeks.
More than 1000 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19; that is a 40 percent increase in the past two weeks.
14 percent of hospital adult ICU beds are currently unoccupied, as are 14 percent of medical/surgical beds, 37 percent of pediatric beds, 16 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.
The state-wide positivity rate on COVID-19 tests rose from 11.7 percent two weeks ago to 14.4 percent last week, according to the early warning dashboard released weekly by the governor and Department of Health.
A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.

Around the State

The web site northcentralpa.com reported late last week that “The 15-day average test positivity rate in Lycoming County is 43%, Pa. Department of Health data show. By comparison, the statewide 7-day average is 11%. A percent positivity rate of 5% is considered ‘too high’ by some experts.”
Westmoreland County has experienced an especially high rate of new COVID-19 cases in recent weeks. The Pittsburgh Tribune-Review reports that in response to increases in the number of hospitalized patients, Excela Health will convert a procedure room into a new space for about 12 new, temporary beds in one of its Westmoreland County hospitals. The newspaper notes that “On Monday, there were 133 patients hospitalized in the county with covid-19 – a 24% increase in a week and more than 138% since Nov. 1, according to state data. On Sunday, there were 137 patients — the highest since the pandemic started in March.”
One of that county’s commissioners has tested positive for COVID-19, the Tribune-Review reports.
And after being exposed to someone who tested positive for COVID-19, Philadelphia’s mayor has just entered into a quarantine period – for the second time, according to the Philadelphia Inquirer.
The Inquirer also reports that according to Philadelphia’s health commissioner, the city’s recent spike in COVID-19 cases was “likely caused by social gatherings that happened over Thanksgiving on top of already high case counts.” The Inquirer added that “The city on Tuesday reported 1,408 newly confirmed cases, for a total of 75,458 since the pandemic began. During the week that ended Saturday, the city reported about 910 new cases per day, with a positive rate of 12.7%.”

Department of State

To provide a greater number of people with convenient, limited-contact access to flu shots, the Department of State has suspended the age restriction that limits intern-administered flu shots to those ages nine and older. Instead, pharmacy interns may temporarily administer any age-appropriate influenza vaccination to children three years of age and older. Also, to increase access to COVID-19 vaccines as they become available, this waiver authorizes pharmacy interns to administer COVID-19 vaccinations to persons who are at least 18 years of age but only under the direct, immediate, and personal supervision of a licensed pharmacist who holds an active authorization to administer injectable medications. See the notice of this new, temporary policy.
The Department of State has extended previous waivers related to CPR training for massage therapists and CPR and basic life support training for dentists, dental hygienists, and expanded function dental assistants. See the notice of this new, temporary policy.
The Department of State has extended a waiver of the periodontal portion of the dental clinical exam because that exam involves a live patient. It also has extended the current waiver of the live patient aspect of the restorative exam and for its temporary replacement by a non-patient-based restorative dentistry examination administered by the Commission on Dental Competency Assessments and the Council of Interstate Testing Agencies Inc. See the notice describing these waivers.

Federal Update

Provider Relief Fund

HHS announced that the Provider Relief Fund will distribute $523 million in second-round performance payments to 9248 nursing homes as rewards for successfully reducing COVID-19-related infections and deaths between September and October. HHS concluded that between September and October, 69 percent of 13,251 eligible nursing homes met the incentive program’s infection control criteria. See HHS’s announcement of the nursing home distribution and a list of how much of this money HHS distributed to nursing homes in individual states.
HHS has updated its CARES Act Provider Relief Fund FAQ with nine new or modified questions and answers. Find the new items, all labeled “12/4/2020,” on pages 2, 6, 14, 15, 16-17, 25, 34, 47, and 55. Fund recipients should review this new information carefully, and in particular, the question on page 6 about erroneous payments, which reverses previous policy, and questions on audit terms and extensions on pages 14 and 15.

Centers for Medicare & Medicaid Services

CMS has posted information about how providers should code monoclonal antibody treatments and vaccine administration for Medicare beneficiaries and how much Medicare will pay for those activities.
CMS has sent a letter to the nation’s governors about steps they can take to ensure that their hospitals have sufficient capacity to handle the current surge in COVID-19 cases and their other patients as well. The letter stresses three steps states can take to maximize hospital capacity: ensure that no state-level licensure or scope of practice restrictions would impede health systems from leveraging flexibilities already granted by the federal government; ensure that state Medicaid agencies adapt payment and coverage policies appropriately; and foster coordination within their health care systems to create the partnerships necessary for effective community surge plans. See CMS’s letter to state governors.
CMS has updated its statement on how it will exercise its enforcement discretion for laboratories that perform COVID-19 molecular and antigen point-of-care tests.
CMS has posted new nursing home COVID-19 testing FAQs.

CMS COVID-19 Stakeholder Calls

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.

Hospitals Without Walls Call

On November 25, CMS announced the expansion of its Hospitals Without Walls program by introducing its Acute Hospital Care At Home program, giving eligible hospitals unprecedented regulatory flexibilities to treat eligible patients in their homes. This program was developed to support models of at-home hospital care that have succeeded in several hospitals and networks. A CMS Hospitals Without Walls stakeholder call will feature two organizations walking through their programs and a question and answer session. Slides/resources will be posted on CMS.gov prior to the call.

Wednesday, December 9 at 4:00-5:00 PM (eastern)

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1235939

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 released new hospital COVID-19 capacity data at the facility level. Previously released data about hospital capacity that had been released was aggregated at the state level but this new, more granular data release aggregates daily hospital reports into a “week at a time” picture while providing a view of how COVID-19 is affecting hospitals and communities. See HHS’s announcement about the new data and an FAQ about the data and go here for access to the data itself.

Food and Drug Administration