Pennsylvania Department of Human Services (DHS) Secretary Teresa Miller visited Philabundance to assist with on-going volunteer efforts to ensure food is available for people and families experiencing challenges from the COVID-19 pandemic and current economic insecurity. Secretary Miller and Philabundance Chief Executive Officer Loree D. Jones reminded Pennsylvanians of food assistance resources available even and especially amidst COVID-19 mitigation efforts.

“Difficult circumstances created by the pandemic have not subsided, and many people around Pennsylvania still must endure challenges that come from COVID-19’s effect on the state’s and nation’s economies,” said Secretary Miller. “Food banks like Philabundance mobilized quickly to serve individuals and families in their communities so people affected by job or income loss would not have to go hungry, and the Wolf Administration is incredibly grateful for their unending commitment to communities they serve. If you are able, I encourage all Pennsylvanians to support their local food bank so the charitable food network can continue to be there to meet the need of people affected by this pandemic in the uncertain weeks and months to come.”

“The COVID-19 pandemic has impacted food banks on so many levels,” explained Philabundance CEO Loree D. Jones. “From seeing up to a 60% increase in need across the Delaware Valley to volunteers and donations dwindling and food prices sky rocketing, Philabundance needs your generosity to continue providing our neighbors with healthy food during this crisis and beyond.”

Pennsylvanians who need help feeding themselves or their family should find and contact their local food bank or pantry through Feeding Pennsylvania and Hunger-Free Pennsylvania.

Help with buying food is also available through the Supplemental Nutrition Assistance Program (SNAP). SNAP helps more than 1.9 million Pennsylvanians expand purchasing power by providing money each month to spend on groceries, helping households have resources to purchase enough food to avoid going hungry. Inadequate food and chronic nutrient deficiencies have profound effects on a person’s life and health, including increased risks for chronic diseases, higher chances of hospitalization, poorer overall health, and increased health care costs. As the nation faces the COVID-19 pandemic, access to essential needs like food is more important than ever to help keep vulnerable populations healthy and mitigate co-occurring health risks.

Applications for SNAP and other public assistance programs can be submitted online at www.compass.state.pa.us. Those who prefer to submit paper documentation can print from the website or request an application by phone at 1-800-692-7462 and mail it to their local County Assistance Office (CAO) or place it in a CAO’s secure drop box, if available. While CAOs remain closed, work processing applications, determining eligibility, and issuing benefits continues. Clients should use COMPASS or the MyCOMPASS PA mobile app to submit necessary updates to their case files while CAOs are closed.

All applications for SNAP are screened the day they are received for expedited services criteria. For households with minimal income and resources, the SNAP application can be expedited and processed within five days, and all Pennsylvanians who are in a difficult financial situation due to the economic challenges of this pandemic should apply to see if they are eligible for assistance.

Secretary Miller and CEO Jones also encouraged anyone who is healthy and able to please consider taking some time to support their food bank or pantry through volunteer time or monetary donations, as this time is creating an incredible strain on charitable organizations’ volunteer efforts and resources.

Anyone interested in volunteering can find organizations in need of volunteer support on the United Way of Pennsylvania’s 211 website.

For more information about food assistance resources for people around Pennsylvania impacted by COVID-19 and the accompanying economic insecurity, visit https://www.agriculture.pa.gov/Food_Security/Pages/default.aspx.

Pennsylvania Governor Tom Wolf announced the availability of $50 million in grant funding to help employers provide hazard pay to employees in life-sustaining occupations during the COVID-19 pandemic. Hazard pay is intended to keep front-line employees working in vital industry sectors across Pennsylvania.

“In the fight against COVID-19, our front-line workers have put themselves at risk every day in order to continue to provide life-sustaining services to their fellow Pennsylvanians, and this funding will increase their pay in recognition of those sacrifices,” said Gov. Wolf. “These grants will help businesses retain employees, ensure that Pennsylvanians keep working and avoid disruption of critical goods and services.”

Created through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, this reimbursement-based grant is available to employers offering hazard pay during the eligible program period and will be administered by the Department of Community and Economic Development (DCED). Businesses may apply for grants up to a maximum of $3 million.

The following applicants are eligible to apply:

• Businesses
• Healthcare Non-profits
• Public Transportation Agencies
• Certified Economic Development Organizations (CEDO)

Eligible Pennsylvania-based industries include:

• Healthcare and Social Assistance
• Ambulatory Health Care Services
• Hospitals
• Nursing and Residential Care Facilities
• Transit and Ground Passenger Transportation
• Food Manufacturing
• Food Retail Facilities
• Security Services for eligible industries listed above and commercial industries that were not closed as a result of the Governor’s Business Closure Order
• Janitorial Services to Buildings and Dwellings

Grant funds may be used for hazard pay for direct, full-time and part-time employees earning less than $20/hour, excluding fringe benefits and overtime for the 10-week period from August 16, 2020, to October 24, 2020. Applicants may apply for up to $1,200 per eligible full-time equivalent (FTE) employee. Employers may apply for a grant to provide hazard pay for up to 500 eligible full-time equivalent employees per location.

Eligible applicants may apply for grants using the online DCED Electronic Single Application for Assistance located at www.esa.dced.state.pa.us from July 16, 2020, to July 31, 2020. Program inquiries may be directed to (717) 787-6245 or ra-dcedcbf@pa.gov.

Save-the-Date: 2020 NTP Virtual Workshops

Registration for the 2020 Centers for Medicare & Medicaid Services (CMS) National Training Program (NTP) virtual workshops will open in mid-July. To help you plan, the dates for the sessions are on our website. You’ll receive an email with the registration information so you can sign up for the session(s) that meet your schedule and learning needs. Sessions will open at 12pm, with the live presentations starting at 1pm and conclude no later than 3:30pm (ET). Session materials will be available for download during the events. All sessions will be recorded for later viewing.

Please send questions to: cms@seiservices.com

New / Updated Training Materials

Medicare Prescription Drug Coverage training module

Medicare Rights and Protections training module

Medicare for People with End-Stage Renal Disease (ESRD) training module

Medicare and Other Programs for People with Disabilities training module

Medicare Advantage and Other Health Plans training module

Getting Started with Medicare training module

To check all of our materials, go to CMSnationaltrainingprogram.cms.gov

New / Updated CMS Products

Get Help With Your Medicare Costs: Getting Started

Medicare Coverage of Therapy Services

How Medicare Covers Self-Administered Drugs Given in Outpatient Settings

NTP Webinar Recordings

CMS NTP Update and Education Webinar (Recorded June 2020)

Did You Know?

Americans with Disabilities Act (ADA) Day is July 26^th. For more information go to adata.org. For information about getting Medicare if you have a disability, go to Medicare.gov/getting-medicare-if-you-have-a-disability.

You can find personalized Medicare information online. Register at MyMedicare.gov.

• Manage your personal information (like medical conditions, allergies, and implanted devices).
• Sign up to get your “Medicare Summary Notices” (eMSNs) and the Medicare & You handbook electronically.
• Manage your personal drug list and pharmacy information.
• Search for, add to, and manage a list of your favorite providers and get quality information about them.
• Select or change your primary doctor.
• Track Original Medicare claims and your Part B deductible status.
• Print an official copy of your Medicare card.

Visit the CMS Newsroom to get the latest news about Medicare.

On July 15, 2020, Pennsylvania Governor Tom Wolf and Pennsylvania Sec. of Health Dr. Rachel Levine signed new orders for targeted mitigation efforts in response to the recent rise in COVID cases, primarily in southwest Pennsylvania, but also in other counties in the state, influencing the decision for statewide mitigation efforts for bars and restaurants, gatherings and telework. The new orders take effect at 12:01 a.m., Thursday, July 16, 2020.

“During the past week, we have seen an unsettling climb in new COVID-19 cases,” Gov. Wolf said. “When we hit our peak on April 9, we had nearly two thousand new cases that day with other days’ cases hovering around 1,000. Medical experts looking at the trajectory we are on now are projecting that this new surge could soon eclipse the April peak. With our rapid case increases we need to act again now.”

The mitigation efforts included in the new orders from Gov. Wolf and Dr. Levine include:

Bars and Restaurants

All businesses in the retail food services industry, including restaurants, wineries, breweries, private clubs, and bars, are permitted to provide take-out and delivery sales of food, as well as dine-in service in both indoor and outdoor seating areas so long as they strictly adhere to the requirements of the guidance, as required by the order, including:

• Prohibition from conducting operations unless the facility offers sit-down, dine-in meals or is serving take-out sales of alcoholic beverages. All service must be at a table or booth; bar service is prohibited.
• Alcohol only can be served for on-premises consumption when in the same transaction as a meal.
• Take-out sales of alcohol for the purposes of off-site consumption are permitted subject to any limitations or restrictions imposed by Pennsylvania law.
• Non-bar seating in outdoor areas (i.e. tables or counter seats that do not line up to a bar or food service area) may be used for customer seating.
• Social distancing, masking, and other mitigation measures must be employed to protect workers and patrons.
• Occupancy is limited to 25 percent of stated fire-code maximum occupancy for indoor dining, or 25 persons for a discrete indoor event or gathering in a restaurant. The maximum occupancy limit includes staff.

Nightclubs

• All nightclubs, as defined by the Clean Indoor Air Act, 35 P.S. § 637.2, are prohibited from conducting operations.

Other events and gatherings

Events and gatherings must adhere to these gathering limitations:

• Indoor events and gatherings of more than 25 persons are prohibited.
• Outdoor events and gatherings of more than 250 persons are prohibited.
• The maximum occupancy limit includes staff.

Teleworking

• Unless not possible, all businesses are required to conduct their operations in whole or in part remotely through individual teleworking of their employees in the jurisdiction or jurisdictions in which they do business.
• Where telework is not possible, employees may conduct in-person business operations, provided that the businesses fully comply with all substantive aspects of the business safety order, the worker safety order, and the masking order.

Gyms and fitness facilities

• All gyms and fitness facilities, while permitted to continue indoor operations, are directed to prioritize outdoor physical fitness activities. All activities must follow masking requirements as provided by the July 1 order, and must provide for social distancing requirements of persons being at least 6 feet apart, as well as being limited by any limitations related to gatherings.

Enforcement

Businesses and individuals in violation of these orders, issued pursuant to the authority granted to the Governor and the Secretary of Health under the law, including the Pennsylvania Disease Control and Prevention Law, could be subject to fines, business closure or other applicable enforcement measures.

Beginning with a spike in cases in Allegheny County in late June, Pennsylvania has seen cases continue to rise there and in other southwest counties, along with additional select counties in the state.

The state has identified three catalysts for case increases:

• First, some Pennsylvanians have been ignoring mask-wearing requirements and social distancing when they are visiting Pennsylvania bars and restaurants. There they are unknowingly spreading or picking up the virus.
• Second is out-of-state travel. Both by Pennsylvanians returning from travel to hotspot states, and travelers visiting our commonwealth from those hotspots.
• And third, a lack of national coordination has resulted in states in the south and west not committing to social distancing.

“The actions the governor and I are taking today are designed to be surgical and thus precise to prevent from repeating the cycle we saw in the spring,” said Dr. Levine. “We have gained a great deal of experience since the start of this outbreak and have learned from best practices from other states as well as counties right here in Pennsylvania.”

Gov. Wolf and Dr. Levine were joined via Skype by Dr. David Rubin, a general pediatrician and director of PolicyLab at Children’s Hospital of Philadelphia. Dr. Rubin and his colleagues developed a unique model, which tracks and projects COVID-19 transmission in real-time across more than 500 U.S. counties with active outbreaks. The model was built to observe how social distancing, population density, daily temperatures and humidity affect the number and spread of COVID-19 infections over time across a given county.

“Over the last few weeks, public health reporting and our team’s modeling work have uncovered incontrovertible evidence that the virus is sweeping quickly into the northeast region of the United States from the west and south—where there has been a failure in some states to practice vigilance in masking and social distancing—and that it has already begun its resurgence in Pennsylvania,” said Dr. David Rubin, a general pediatrician and director of PolicyLab at Children’s Hospital of Philadelphia. “We can halt this momentum in its tracks. Governor Wolf’s measures will help stop the continued spread of the virus into Pennsylvania and its surrounding states, which would threaten the reopening of schools and our economy in the coming months.”

Pennsylvanians should consider that even with indoor dining limited and bars closed for on-premises alcohol consumption, cocktails to-go are still permitted and there is no shortage of outdoor dining options.

Small gatherings of friends in the backyard or at a local park are permitted and children and families are encouraged to responsibility take advantage of one or more of Pennsylvania’s 121 state parks or other local outdoor fitness options, including at local gyms that are following social distancing protocols.

“Children can visit local playgrounds, community pools, and enjoy outdoor activities with family,” Gov. Wolf said. “We want people to spend time together, but to do so while practicing social distancing and wearing masks when required, such as any time you leave your home and are not participating in outdoor fitness.

“We have seen these efforts work during the first wave in the spring, and they will work again if we all do our part. Thank you to every Pennsylvanian for your continued patience and support. I know you are eager for life to get back to normal, and I am, too.”

View the Governor’s order

View the Secretary of Health’s order

The Trump Administration announced HHS would embark on a one-time procurement of rapid point-of-care testing devices and tests to be distributed to nursing homes in COVID-19 hotspot areas of the United States.

Each nursing home will receive one diagnostic instrument – either the Quidel Sofia 2 Instrument or the BD Veritor Plus system – along with the associated tests. Following the initial distribution, nursing homes can procure additional tests directly from the respective manufacturer. All nursing homes must have the capability to screen and test residents at baseline, and test staff on a weekly basis or according to specific guidance by the state and local health departments. This procurement will also enable testing of visitors if appropriate for that facility.

Distribution will begin with nursing homes prioritized by CMS. The prioritization is based on CDC epidemiological hotspot data, as well as nursing homes that have reported the following information to the CDC by July 5th:

• Three or more confirmed or suspected new cases of COVID-19 within the last 7 days.
• At least one new COVID-19 case in the last 7 days after having zero previous COVID-19 cases.
• Inadequate access to testing within the last 7 days.
• At least one new resident death due to COVID-19 within the last 7 days.
• At least one new confirmed or suspected COVID-19 case among staff within the last 7 days.

Both the Quidel Sofia 2 and BD Veritor Plus analyzers use antigen tests that can quickly detect fragments of proteins found on or within the virus by testing samples collected from the nasal cavity using swabs, providing results in minutes. These unique tools adds to the spectrum of diagnostic test types available for COVID-19 response, and will assist the federal government in scaling up to test millions of Americans per day.

Facilities that do not have a Clinical Laboratory Improvement Amendment (CLIA) Certificate of Waiver to administer the tests will not receive a testing instrument.  Each state has facilities that do not have a waiver, and the following states did not have any facilities that met the criteria for receiving an instrument while also having a CLIA waiver: Alaska, Hawaii, Washington and West Virginia. Facilities in these states will receive allocations when HHS sends the remaining nursing homes instruments and tests, and they obtain a CLIA waiver. Nursing homes can follow the CMS guidance to obtain a CLIA Certificate of Waiver.

It is critically important we all do our part to raise awareness about how to use point-of-care diagnostic technology and we implore you to join HHS and device manufacturers in getting nursing home staff trained to operate devices and tests so utilization will be maximized. Help us to protect the elderly by sharing this message and the effort to ensure awareness and access to training.

Please see the full press release here.

This guidance is intended for state and local emergency medical planners and all healthcare facilities, especially facilities in rural areas. The guidance outlines considerations around the transfer of patients, staff, and supplies between healthcare facilities to optimize patient care, balance resources, and to minimize use of crisis care standards. One strategy is to identify relief healthcare facilities and either establish a federal, state, or regional Medical Operation Coordination Cell (MOCC) or coordinate with an existing MOCC. This guidance offers considerations for jurisdictions around patient safety and relief healthcare facility operations.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/relief-healthcare-facilities.html

The National Academy of Medicine released “Resources on Health Equity in the Context of COVID-19 & Disproportionate Outcomes for Marginalized Groups.” The National Academy of Medicine’s Culture of Health Program works in partnership with national and local stakeholders on behalf of the fundamental changes needed to eliminate inequities for populations across the United States.

Click here to view the resources.

U.S. Secretary of Agriculture Sonny Perdue announced an initial list of additional commodities that have been added to the Coronavirus Food Assistance Program (CFAP), and that the U.S. Department of Agriculture (USDA) made other adjustments to the program based on comments received from agricultural producers and organizations and review of market data. Producers will be able to submit applications that include these commodities on Monday, July 13, 2020. USDA’s Farm Service Agency (FSA) is accepting through Aug. 28, 2020, applications for CFAP, which helps offset price declines and additional marketing costs because of the coronavirus pandemic. USDA expects additional eligible commodities to be announced in the coming weeks.

Changes to CFAP include:

• Adding the following commodities: alfalfa sprouts, anise, arugula, basil, bean sprouts, beets, blackberries, Brussels sprouts, celeriac (celery root), chives, cilantro, coconuts, collard greens, dandelion greens, greens (others not listed separately), guava, kale greens, lettuce – including Boston, green leaf, Lolla Rossa, oak leaf green, oak leaf red and red leaf – marjoram, mint, mustard, okra, oregano, parsnips, passion fruit, peas (green), pineapple, pistachios, radicchio, rosemary, sage, savory, sorrel, fresh sugarcane, Swiss chard, thyme and turnip top greens.
• Expanding for seven currently eligible commodities – apples, blueberries, garlic, potatoes, raspberries, tangerines and taro – CARES Act funding for sales losses because USDA found these commodities had a 5 percent or greater price decline between mid-January and mid-April as a result of the COVID-19 pandemic. Originally, these commodities were only eligible for marketing adjustments.
• Determining that peaches and rhubarb no longer qualify for payment under the CARES Act sales loss category.
• Correcting payment rates for apples, artichokes, asparagus, blueberries, cantaloupes, cucumbers, garlic, kiwifruit, mushrooms, papaya, peaches, potatoes, raspberries, rhubarb, tangerines and taro.

Additional details can be found in the Federal Register in the Notice of Funding Availability (NOFA) and Final Rule Correction and at www.farmers.gov/cfap.

Pennsylvania Governor Tom Wolf released a weekly status update detailing the state’s mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard comparing the seven-day period of July 3 – July 9 to the previous seven days, June 26 – July 2.

The dashboard is designed to provide early warning signs of factors that affect the state’s mitigation efforts. The data available on the dashboard includes week-over-week case differences, incidence rates, test percent-positive rates, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19.

“By looking at both statewide status and individual county status, we can take steps to stop increases before they become critical,” Gov. Wolf said. “One thing we know for certain is that we must continue to wear masks and practice social distancing. Risky behavior such as going out without a mask and congregating at a bar or in a crowded setting where social distancing isn’t being practiced are leading to spikes in cases and higher percent-positive rates.”

As of Thursday, July 9, the state has seen a seven-day case increase of 4,914; the previous seven-day increase was 4,359.

While the statewide percent-positivity rate is at 4.4%, counties with concerning percent-positivity rates include Allegheny (7.9%), Beaver (6.3%), Butler (5.5%), Clarion (14.6%), Fayette (5.2%), Greene (5.4%), Lawrence (5.8%), Lebanon (5.6%), Philadelphia (5.1%), Washington (7.2%), Westmoreland (5.4%) and York (6.3%). Each of these counties bears watching as the state continues to monitor all available data.

The Pennsylvania Department of Health updated its travel recommendations and frequently asked questions, originally announced on July 2, to include Delaware, Iowa, Kansas and Oklahoma on the list of states recommended for domestic travelers returning from to quarantine for 14 days upon return to Pennsylvania.

Gov. Wolf continues to prioritize the health and safety of Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of the status of their county. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic.

Fierce Healthcare, by Robert King |July 6, 2020