Combating the Novel Coronavirus (COVID-19): Week of July 13
Posted on July 17, 2020
As the state experiences a steady rise in the number of COVID-19 cases, Gov. Gretchen Whitmer has extended the official state of emergency in Michigan through Aug. 11. The MHA continues to keep members apprised of developments during the pandemic through email updates and the MHA Coronavirus webpage. Important updates on how the pandemic is affecting Michigan hospitals are outlined below.
HHS Announces Next Tranche of Funds for Hospitals with High COVID-19 Caseloads
The U.S. Department of Health and Human Services (HHS) announced July 17 that it will distribute $10 billion to hospitals with high numbers of COVID-19 patients, beginning the week of July 20. This is the second tranche of high-impact funds from the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act.
Using data hospitals submitted on COVID-19-positive inpatient admissions for the period Jan. 1 to June 10, 2020, the HHS based this distribution on a formula for hospitals with over 161 COVID-19 admissions during that period, equating to one admission per day, or that experienced a disproportionate intensity of COVID-19 admissions (exceeding the average ratio of COVID-19 admissions/bed). The HHS also considered previous high-impact payments when determining each hospital’s payment in this distribution. Hospitals will be paid $50,000 per eligible admission.
The MHA and American Hospital Association have been advocating for additional hospital financial relief at every opportunity. This funding comes at a critical time, as cases of COVID-19 in Michigan are again rising. However, since not all hospitals will meet the threshold for receiving high-impact funds, securing additional funds for all hospitals and loan forgiveness for Medicare advance payments remain among the association’s top priorities.
Members with federal advocacy questions may contact Laura Appel at the MHA.
Changes Made in Federal Requirements for COVID-19 Reporting
The U.S. Department of Health and Human Services (HHS) announced July 13 it would discontinue the use of the National Healthcare and Safety Network COVID-19 Module for hospitals starting July 15. Instead, hospitals will be required to enter COVID-19 information daily into the HHS Teletracking portal. The department has updated its guidance and frequently asked questions (FAQs) to reflect the data fields that will be collected and their definitions, including new data elements.
The MHA is currently working with the state of Michigan to modify the state’s EMResource data collection system to allow the state to submit data on behalf of Michigan hospitals and to expedite the state and federal government approval process. Until the state of Michigan receives approval from the federal government, hospitals must enter COVID-19 information daily into both the HHS Teletracking portal and EMResource to be eligible to receive future distribution of resources, including pharmaceuticals and more.
The association will notify members when the state receives approval from the federal government to submit data on behalf of hospitals, which will allow providers to make daily entries into only the EMResource system. Members with questions may contact Jim Lee at the MHA.
State Works with MHA on Ending Relaxation of Scope of Practice, Immunity Provisions
The governor issued Executive Order (EO) 2020-150 to rescind EO 2020-61, which had allowed healthcare practitioners to temporarily practice beyond the scope of their license, with limitations. The governor referenced stable and manageable COVID-19 hospitalization rates and hospital resources as the reason for rescinding the expansion of scope, which also removed certain important immunity provisions that protected healthcare facilities and entities during the pandemic, effective July 13.
The MHA discussed the EO with the Michigan Department of Licensing and Regulatory Affairs (LARA), and the department issued a memo July 17 that outlines flexibility and license requirements that remain in place under EO 2020-150. The memo is available via the July 17 email update to members and also provides a timeline for returning to normal order for scope of practice. LARA is allowing providers an extended compliance deadline of 11:59 p.m. Aug. 31 before enforcing the updated supervision and other requirements. In addition, the EO extends the suspension of certain licensing and certification requirements for healthcare professionals, life support and first aid workers, and 911 operators.
Meanwhile, the MHA is working with the Legislature on Senate Bill 899, which would secure important immunity protections similar to those afforded in EO 2020-61. Members with questions on the memo from LARA may contact Paige Fults at the MHA.
MIOSHA Hospital State Emphasis Program and Requests for Voluntary Inspections
The Michigan Occupational Safety and Health Administration (MIOSHA) recently announced its Hospital State Emphasis Program, which focuses on inspecting hospital facilities for appropriate personal protective equipment and staff safety related to COVID-19.
Since the initial announcement, the MHA has shared a letter with leadership at the Department of Labor and Economic Opportunity suggesting opportunities for achieving good outcomes for patient care and worker safety. The MHA continues to work with MIOSHA to clarify areas of a FAQs document the agency is preparing.
While a limited number of MHA members are expected to be contacted for inspection under the State Emphasis Program, members may use MIOSHA in a consulting manner by request. Michigan employers may request a voluntary MIOSHA inspection of their workplace (full or partial) without the attachment of fines or penalties. These on-site consultations are conducted by occupational safety consultants or industrial hygienists through the Consultation Education and Training Division. Prior to the start of this type of inspection, employers must agree to correct all serious violations found during the voluntary inspection. For more information about the Hospital State Emphasis Program, contact Laura Appel at the MHA.
Governor Updates Mask Requirement
Gov. Gretchen Whitmer July 17 issued an updated executive order (EO 2020-153) requiring masks to be worn in public places and businesses and providing some clarification for how the requirement should be interpreted and enforced. Essentially, the new order provides clarity about law enforcement officers wearing masks, who is not required to wear a mask, and exceptions for removing a mask.
Healthcare settings are not mentioned specifically in the updated order; however, members continue to be advised to make their best effort to comply with the mask requirement enforcement for patients and visitors in their facilities, while prioritizing patients’ individual health and circumstances.
State Discusses Supply Chain Issues with MHA Members
The MHA continues to host calls for hospital supply chain contacts as needed. During a recent call, the state indicated it is working to increase the supply of key personal protective equipment, with a goal of having a 90-day supply on hand. Nitrile gloves will continue to be in short supply, and hospitals should follow conservation recommendations of the Centers for Disease Control and Prevention as much as possible.
MHA member HPS, a group purchasing organization, said that most of its vendors have an ample supply of personal protective equipment and related items available. The organization encourages groups that are not current HPS members to consider partnering with HPS as it adds additional contracts for personal protective equipment during the summer. Members with questions may contact Kevin Crampton at HPS.
Opportunities Available for Pooling Lab Tests for Asymptomatic Individuals
The MHA and the Michigan Department of Health and Human Services (MDHHS) host weekly calls with laboratory directors regarding COVID-19 testing capacity and the increasing demand for screening of asymptomatic populations. Those calls prompted a July 16 call for Michigan laboratories interested in pooled testing strategies for COVID-19, along with leaders from the state Bureau of Laboratories (BOL).
The statewide testing strategy has expanded to include more asymptomatic individuals to protect the safety of employees, students, patients and others. While this is a positive step, it has also placed further strain on an already limited supply of COVID-19 diagnostic tests. Pooling samples of asymptomatic individuals preserves limited testing resources but requires additional validation because the Food and Drug Administration (FDA) has approved the current diagnostic tests only for individuals suspected of having COVID-19.
To streamline additional studies, the FDA released in June template updates regarding the validation of diagnostic tests for developers that intend their analysis to be used for pooling patient samples or for screening asymptomatic individuals not suspected of having COVID-19. In addition, the FDA has made available new testing FAQs with information regarding the screening of asymptomatic individuals.
Labs that plan to begin their own validation studies are encouraged to share the information with the Michigan BOL. Members with questions, or those who wish to join the MHA calls with the laboratory directors, may contact Brittany Bogan at the MHA.
Healthcare Heroes Acknowledged via Social Media
From April through June, the MHA ran a social media campaign recognizing the heroic workers on the front lines of COVID-19 working throughout its member hospitals and health systems. The effort highlighted more than 250 healthcare professionals — nurses, physicians, environmental service workers and others — from communities across the state and thanked them for their dedication to fighting COVID-19 and caring for patients. Using information supplied by member hospitals, the campaign ran on the MHA’s Facebook, Twitter and Instagram accounts, and several video samples of the posts were included in related articles on the MHA Newsroom webpage. More than 431,000 people shared, liked and/or commented on the posts. Members with questions may contact Ruthanne Sudderth at the MHA.
Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members:
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