provider relief fund Archives - Safety-Net Association of Pennsylvania

COVID-19 Update: Friday, February 26

The following is the latest COVID-19 information from the state and federal governments as of 3:30 p.m. on Friday, February 26.

Pennsylvania Update

Department of Health

The Department of Health updated its guidance on hospitals’ responses to COVID-19 with information on how hospitals that have been approved by the Centers for Medicare & Medicaid Services to participate in the Acute Hospital Care at Home program may provide acute care inpatient services to patients in their homes.

The Department of Health has updated its guidance for return-to-work criteria for health care personnel and its transmission-based precautions used by health care facilities to care for patients with confirmed or probable COVID-19. Both updates reflect recent changes from the CDC.

Department of Health – by the numbers

Although today’s new COVID-19 case count is the highest in the past week, the daily numbers continue their general decline.
The daily death toll has only been in double digits for the past eight days – the first time that has happened since the fall.
More than 24,000 health care workers in Pennsylvania have contracted COVID-19, as have nearly 80,000 residents and employees of 1566 long-term-care facilities across the state. The continual increase in these numbers since the start of the pandemic has slowed considerably.
For the week from February 12 through February 18 the state’s overall COVID-19 test positivity rate fell to 6.5 percent; it was 8.0 percent the week before that. This marked the ninth consecutive week the rate fell.
40 Pennsylvania counties – down from 51 a week ago – remain in substantial levels of community transmission of COVID-19: Adams, Beaver, Berks, Bradford, Bucks, Carbon, Centre, Chester, Clinton, Columbia, Cumberland, Dauphin, Delaware, Erie, Forest, Franklin, Greene, Huntingdon, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, McKean, Mifflin, Monroe, Montour, Northampton, Northumberland, Perry, Philadelphia, Pike, Schuylkill, Snyder, Union, Wayne, and York. Three counties have low levels of community transmission: Cameron, Fulton, and Sullivan; this figure is the same as it was last week. The remaining Pennsylvania counties, including Allegheny County, are experiencing moderate levels of community transmission.
The number of Pennsylvanians hospitalized with COVID-19, in hospital ICU units because of COVID-19, and on ventilators because of COVID-19 continues to decline.
Currently, 21 percent of adult ICU beds in the state are unoccupied, as are 16 percent of medical/surgical beds, 11 percent of pediatric ICU beds, 28 percent of pediatric beds, and 36 percent of airborne isolation units.
As of February 28 the state’s vaccine dashboard shows that 928,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 649,000 have received both doses of a vaccine. These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
The vaccine dashboard shows vaccine totals by county.

General Assembly

The Senate has unanimously passed House Bill 326, which would authorize the National Guard to assist with COVID-19 vaccine distribution. Within 45 days of the bill becoming law, the National Guard would be able to work with the Pennsylvania Department of Health and Pennsylvania Emergency Management Agency to establish and operate COVID-19 vaccination sites across the state. The governor’s office has indicated support for the bill.

Around the State

After having its vaccine call center overwhelmed with calls from people seeking COVID-19 vaccines, Delaware County awarded a $700,000 contract to a customer service vendor to expand its call capacity. The Delaware County Daily Times reports.
A number of organizations around the state are opening vaccination sites, including Penn State Health, in Reading, State College, Camp Hill, and Hershey; Wellspan Health, in York; the city of Philadelphia; FEMA, also in Philadelphia; and Giant Eagle and the Pittsburgh Steelers, in Pittsburgh.
Philadelphia’s health commissioner has urged the city’s hospitals to launch mass vaccination sites, according to the Philadelphia Inquirer.

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

Federal Update

Congress

The House Budget Committee has passed a COVID-19 relief bill. The following is a summary of the bill’s major spending, how it differs from the previous proposals submitted to the Budget Committee by other House committees, and what the bill does not do.

Major Spending Categories

The bill, which calls for $1.9 trillion in federal spending and tax credits, proposes:

$350 billion for emergency aid to states, local, and tribal governments.
$195 billion for state governments, with most of it distributed based on states’ share of unemployed workers.
$130 billion for local governments.

Proposed Health Care-Related COVID-19 Response Spending

The bill proposes:

$46 billion for a national strategy for COVID-19 testing, mitigation, and surveillance.
$10 billion for producing emergency medical equipment and supplies, including testing materials, personal protective equipment, and drugs and devices.
$7.6 billion for a public health workforce that includes epidemiologists, investigators, and contract-tracers.
$7.6 billion for community health centers.
$17 billion for the Department of Veterans Affairs.
$6.1 billion for the Indian Health Service.
$7.5 billion for the promoting, distributing, administering, and tracking COVID-19 vaccines.
$5.2 billion for COVID-19 vaccine research, manufacturing, and purchase and for the purchase of therapeutics and other products needed to treat COVID-19 and its variants.
$1.75 billion for community mental health block grants.
$1.75 billion for substance abuse prevention and treatment block grants.

Medicaid Provisions

The House bill includes several specific Medicaid provisions, including:

An increase of the federal medical assistance percentage – FMAP, the rate at which the federal government matches state Medicaid spending – to 95 percent for Medicaid expansion states.
A 100 percent federal match for Medicaid’s COVID-19 vaccine costs.
An increase of FMAP to 85 percent for Medicaid programs that employ community-based mobile crisis intervention services.
Extension of the 100 percent FMAP for two years for Medicaid services provided by urban Native American health organizations and native Hawaiian health care systems.
A requirement that Medicaid cover COVID-19 vaccines and treatment without cost-sharing until one year has passed after the end of the public health emergency.
Inclusion of outpatient drugs used to treat COVID-19 patients in Medicaid’s drug rebate program.

Changes From Previous Draft Legislation

The House bill includes several changes from legislation proposed last week:

The original draft legislation proposed giving states an option for five years to expand Medicaid eligibility to pregnant women postpartum for 12 months. The length of time of this option has been extended to seven years.
A provision that would have made prison inmates eligible for Medicaid 30 days prior to their release was eliminated.
A proposed $1.8 billion for testing, contact-tracing, and monitoring of COVID-19 in congregate living settings has been eliminated.

Key Issues Not Addressed in the House Bill

The House bill does not:

Add any money to the Provider Relief Fund.
Extend the current moratorium on Medicare sequestration.
Address forgiveness for money provided to hospitals under the Medicare Accelerated and Advance Payment Program.

What’s Next?

The House is expected to begin deliberating on this bill this afternoon and to vote on it late tonight. It is expected to pass with no Republican votes, after which it will go to the Senate.

The bill is not expected to survive in its current form in the Senate, where it will surely be modified. The bill the House passes will include an increase of the minimum wage to $15 an hour but the Senate parliamentarian has already advised that such a measure is inappropriate in reconciliation, so that provision will be removed in the Senate. It is not yet clear when the Senate might vote on the bill, what changes it might make, or what its prospects ultimately are in that chamber. We should have a better idea about that next week.

Provider Relief Fund

HHS has made four additions and modifications in its Provider Relief Fund FAQ. New questions on rural health clinics and Medicare cost reporting can be found on pp. 14 and 16 and a modified question on Medicare cost reporting can be found on page 17; all are marked “2/24/2021.”

A fourth change, a new question also marked 2/24/2021, can be found on page 16 and addresses Medicaid DSH payments and Provider Relief Fund money.

Question:

Are there any restrictions on how hospitals that receive Medicaid disproportionate share hospital (DSH) payments can use Provider Relief Fund General and Targeted Distribution payments?

Answer:

Yes. Providers may not use PRF payments to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Therefore, if a hospital has received Medicaid DSH payments for the uncompensated costs of furnishing inpatient and/or outpatient hospital services to Medicaid beneficiaries and to individuals with no source of third party coverage for the services, these expenses would be considered reimbursed by the Medicaid program and would not be eligible to be covered by money received from a General or Targeted Distribution payment. For more information on the calculation of the Medicaid hospital-specific DSH limit, see https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf.

Department of Health and Human Services

HHS’s Office of the Inspector General has posted a message to stakeholders discussing its role and continuing work in overseeing the integrity of the delivery of telehealth services.

HHS and CMS COVID-19 Stakeholder Calls

HHS Clinical Rounds Peer-to-Peer Virtual Communities of Practice

HHS’s Office of the Assistant Secretary for Preparedness and Response sponsors COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice that are interactive virtual learning sessions that seek to create a peer-to-peer learning network in which clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes. These webinar topics are covered every week:

EMS: Patient Care and Operations (Mondays, 12:00-1:00 PM eastern)
Critical Care: Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM eastern)
Emergency Department: Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM eastern)

Go here for information about signing up to participate in the sessions and go here for access to materials and video recordings of past sessions.

CMS 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, March 16 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:833-614-0820; Access Passcode: 4177586

Audio Webcast link: go here

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

Toll Free Attendee Dial In:833-614-0820; Access Passcode: 2769397

Audio Webcast link: go here

Centers for Disease Control and Prevention

The CDC has updated its guidance on operational considerations for COVID-19 community isolation centers: facilities for COVID-19 patients who do not need hospitalization but may not be able to isolate safely at home.
The CDC has updated its guidelines for collecting, handling, and testing clinical specimens for COVID-19 with new information about capillary fingerstick specimen collection.

Food and Drug Administration

The FDA announced that it is permitting undiluted frozen vials of the Pfizer-BioNTech COVID-19 vaccine to be transported and stored at conventional temperatures commonly found in pharmaceutical freezers for a period of up to two weeks. This reflects an alternative to the preferred storage of the undiluted vials in an ultra-low temperature freezer between -80ºC to -60ºC (-112ºF to -76ºF). Learn more from the FDA’s announcement of this new guidance and from its revised fact sheet for providers.

PA Safety Net Admin2021-03-01T06:00:17+00:00March 1st, 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 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