Updated ODH testing guidance prioritizes congregate settings. The Health Department (ODH) issued revised COVID-19 testing guidance that breaks from the Centers for Disease Control and Prevention standard by prioritizing asymptomatic residents and staff in congregate living settings, along with symptomatic residents and health care workers. ODH defines a congregate living setting as including "assisted living or nursing facilities, substance use residential facilities, facilities serving individuals with developmental disabilities, homeless shelters and other residential treatment facilities." The guidance specifies that testing must be available to these priority groups and that providers should work with their regional hospital leads to secure testing, primarily from hospital or private laboratories. On a conference call this morning, Dr. Mary Applegate, the Department of Medicaid (ODM) Medical Director, explained that from a clinical perspective, everyone should be tested, not just enough people to support an epidemiological conclusion that COVID-19 is present in the setting. OHCA views this guidance as a breakthrough in our effort to obtain more widespread testing for long-term services and supports.
COVID-19-positive facility list updated. ODH updated their online list of facilities with confirmed or probable positive COVID-19 cases today, adding many more centers to the partial set they posted yesterday. The table now shows 1,199 residents and 477 staff members at 172 facilities throughout the state.
Latest stimulus package passes Congress. With a House of Representatives vote today, the Paycheck Protection Program and Health Care Enhancement Act (colloquially known as Stimulus 3.5) is on its way to President Trump for signature. Of most importance to health care providers, the act replenishes the Provider Relief fund with $75 billion on top of the nearly $30 billion remaining in the fund before the legislation. It also adds another $321 billion to the Paycheck Protection Program for small business loans/grants and provides $25 billion for COVID-19 testing.
New PPE options. The following are two possible options for members who need to obtain personal protective equipment (PPE) from other than typical supply channels. OHCA believes that both of these are trustworthy. We nonetheless are concerned with the high prices for PPE in the non-traditional market and are hopeful, from talking with our large traditional medical suppliers, that disposable surgical masks and gowns will be more prevalent in the supply chain over the next couple of weeks. However, members continue to contact OHCA seeking assistance, so notwithstanding the high prices, we feel compelled to share purchasing options for product that is available immediately.
Ohio Private Sector PPE Exchange. The PPE Exchange is a group of Ohio manufacturers that re-purposed their production capacity to make PPE. It is a collaboration of the Ohio Manufacturers' Association, the Ohio Hospital Association, the Ohio Manufacturing Extension Program, and JobsOhio.
Local Columbus company has stock of 3-ply disposable masks. Flow, a Columbus-based company known for feminine hygiene Aunt Flow products, re-purposed their manufacturing plant in China to produce 3-ply disposable masks. See Flow’s price sheet and available PPE-related product. For information and ordering, please contact Jen Severns at jen@goauntflow.com.
CMS grants parts of Ohio's 1135 waiver request. The Centers for Medicare and Medicaid Services (CMS) approved several items in ODM's request for an 1135 waiver, while continuing to review others. The approved items are standard provisions that CMS has granted to numerous other states and are included in their waiver template. They address prior authorizations, state plan amendment procedures, provider enrollment, provision of services in alternate settings, and compliance with the home and community-based services settings requirements. The waivers are back-dated to March 1.
Ombudsman admission direction. Beverley Laubert, the State Long-Term Care Ombudsman, expressed concern with facilities having blanket policies against re-admission of residents discharged from the hospital without two negative COVID-19 tests. Ms. Laubert said SNFs should not have blanket policies, but instead should look at each admission on a case-by-case basis. If the facility is unable to re-admit because of personal protective equipment (PPE) shortages, inability to quarantine, or other reasons they cannot meet the specific residents needs, Ms. Laubert agreed that the center should not re-admit.
DODD confirms adult day services to remain limited. Today, the Department of Developmental Disabilities (DODD) issued a reminder that the order issued by ODH Director Dr. Amy Acton limiting adult day service group sizes to 10 people remains in effect until rescinded. DODD will work with stakeholders to develop a plan to re-open day services, but until the plan is completed, day service providers must continue to operate in compliance with the ODH order.
Free post-acute care panel discussion: "Caring for Patients after Hospital Discharge During a Pandemic". The Leonard Davis Institute of Health Economics at the University of Pennsylvania will host a complimentary, one-hour panel discussion tomorrow, April 24, 2020, beginning at 12:00 noon. The panel will explain potential solutions to the challenges COVID-19 poses for post-acute care, including minimizing risk of transmission from new admissions to facility residents and supporting families caring for patients at home. The panel also will take audience questions. Interested providers can join here: https://ldi.upenn.edu/event/virtual-seminar-caring-patients-after-hospital-discharge-during-pandemic. No registration is required. A recap and full recording of the seminar will be available next week if you are unable to attend.