The Pandemic Operational Recovery Guide for Health Centers and Free Clinics was written to assist health centers and free clinics in identifying and minimizing risks as they recover from operational disruptions related to a pandemic. The handbook contains links to tools as well as links to additional resources for a more comprehensive discussion of individual topics. Readers can refer to descriptive “Strategy” headings in each section, and consult the recommendations, tools, and resources that follow for more detailed information. Although some tools and resources focus on the COVID-19 pandemic, they can be adapted to respond to other public health emergencies.

The Pennsylvania Department of Health is providing additional guidance through Health Alert 545 – 01-06-ADV for providers on COVID-19 vaccination. The information in this HAN should be used to supplement other relevant guidance documents and guide the implementation of public health expectations for vaccine providers. Key messages included in the guidance:

• There are two mRNA vaccines with 90-95% efficacy in preventing clinical COVID-19 currently available through an Emergency Use Authorization (EUA) by the FDA in the United States.
• The only absolute contraindication to COVID-19 vaccination is history of an immediate allergic reaction to either COVID-19 vaccine or any of their components.
• Severe adverse reactions are uncommon, but vaccine providers should be prepared for this rare event.
• Vaccine providers should report all adverse events following vaccination to Vaccine Adverse Event Recording System (VAERS).
• All COVID-19 mitigation measures should continue to be followed after vaccination.

Click here to access all the Pennsylvania health alerts, advisories and updates.

The U.S. Equal Employment Opportunity Commission (EEOC) has posted an updated and expanded technical assistance publication addressing questions arising under the Federal Equal Employment Opportunity Laws related to the COVID-19 pandemic. The publication, “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws,” now includes a new section providing information to employers and employees about how a COVID-19 vaccination interacts with the legal requirements of the Americans with Disabilities Act (ADA), Title VII of the Civil Rights Act of 1964 and the Genetic Information Nondiscrimination Act (GINA). This includes issues pertaining to medical pre-screening questions and employer accommodations for those unable to receive a vaccination.

Of nearly 2 million people who were vaccinated against COVID-19 during a 10-day period in December, only 21 people experienced severe allergic reactions, officials with the Centers for Disease Control and Prevention (CDC) reported this week. Read more.

The Food and Drug Administration issued a safety alert about the potential for false results from a rapid COVID-19 test made by Curative Inc. False negative results, in particular, have been a concern. To reduce the risk of false negatives, the FDA emphasized the importance of following the test’s guidelines. Swabs should be limited to patients who have COVID-19 symptoms and who test within 14 days of when their symptoms start, and trained healthcare workers should oversee the sample collection. Also, a negative result doesn’t rule out COVID-19 and shouldn’t be used as the sole basis for treatment or patient management, the FDA wrote. The FDA also encouraged healthcare providers and patients to report problems with the Curative test, including suspected inaccurate results.

HRSA recently added a vaccines category to its COVID-19 FAQs webpage, which includes information on:

• Where health centers can find information about Medicare and Medicaid enrollment and reimbursement related to the administration of COVID-19 vaccines
• Considerations regarding the providers who can administer COVID-19 vaccines
• Liability protections when an individual who receives a vaccine has an adverse reaction

The Pennsylvania Department of Human Services, Office of Medical Assistance Programs has issued a new bulletin to inform pharmacies that the Medical Assistance (MA) Program will make payment to licensed pharmacists for the administration of the novel coronavirus (SARS-CoV-2) vaccines to MA Program beneficiaries.

As Pennsylvania and the nation continue to ramp up to get individuals vaccinated to control the pandemic and help us return to some sense of normalcy, new implementation questions arise each week and the Department of Health modifies its Pennsylvania COVID-19 Vaccination Plan. Some of the points DOH has repeatedly emphasized include:

• Focus should be on vaccination of Phase 1A eligible individuals (healthcare workers and elderly in long-term care facilities) at the present time
• That said, when confronted with the option of wasting dosages in a vial because no eligible Phase 1A candidates are available or giving to someone in a different phase, DOH urges NOT to waste any vaccine
• FQHCs and Hospitals were the first to receive vaccine supply—DOH is requiring these vaccine administrators to use at least 10% of supply received to vaccinate “non-affiliated” Phase 1A eligible individuals
• Administer vaccines you receive, DO NOT reserve or hoard them—failure to do so will limit additional supplies both to you and the state and hamper vaccination progress (to date, only 26.31% of vaccines supplied to Pennsylvania are in arms rather than storage)
• Do NOT order or reserve vaccine for second doses—DOH will automatically send second doses at the appropriate time

PACHC participates in DOH’s weekly Vaccine Open Forum and provides a summary of the questions asked and answers given along with our weekly summary of information shared during our regular Wednesday All FQHC CEO Call. If you have questions on vaccine administration, please let us know by contacting Eric Kiehl, PACHC Director of Policy and Partnerships.

Gov. Wolf noted that the new Department of Health COVID-19 Vaccine Dashboard launched last week. The dashboard provides the number of vaccinations administered by county and demographic information about the people being vaccinated. The data on the dashboard comes from vaccine providers that are reporting information relating to the individuals to whom they administer the COVID-19 vaccine. That information is reported into the Pennsylvania Statewide Immunization Information System (PA-SIIS).

The appropriations portion of this large package was largely in-line with what had been introduced in the House and Senate earlier last year. The legislation included $329 million for carrying out rural health programs within HHS, $120 million allocated for the National Health Service Corps, $43 million allocated for Area Health Education Centers, and $975 million for Maternal and Child Health Programs. For the fiscal year (FY) 2022 appropriations process, NRHA will continue to advocate for the inclusion of the creation of an Office of Rural Health within the Centers for Disease Control and Prevention (CDC) and specified funding for the Rural Maternal and Obstetric Management Strategies (RMOMS) program during the FY 2022 appropriations process.

Included in the text was $69 billion for the Public Health and Social Services Emergency Fund (PHSSEF). Within the PHSSEF, $9 billion is directed to the CDC for vaccine distribution, $22 billion for testing, tracing, and mitigation programs – including a $2.5 billion set aside for rural health providers – and $3 billion for the Provider Relief Fund. The language also included $250 million for the FCC COVID-19 Telehealth Program, the extension of Medicare sequestration relief until March 31, 2021, a moratorium on Disproportionate Share Hospital (DSH) reductions through FY 2023, a moratorium on recent cuts in the most recent Physician Fee Schedule final rule until 2024, a three-year extension for important public health provisions, a five-year extension of the rural community hospital demonstration program, an extension of the Frontier Community Health Integration Program (FCHIP) Demonstration, and the injection of $3 billion into the current Physician Fee Schedule for enhanced reimbursement until the funding runs out.

The legislation also includes an agreement as to how to handle ‘surprise’ medical and air ambulance bills using the independent dispute resolution (IDR) methodology, the creation of the Rural Emergency Hospital (REH) model, and changes to the payment model for rural health clinics (RHC). The legislation also makes rural friendly changes to the Medicare Graduate Medical Education (GME) rural training tracks (RTT) programs providing greater flexibility urban and rural hospitals to partner, expands Medicare telehealth to allow mental health services to be furnished, and allows for the direct payment under Medicare to physician services furnished to beneficiaries beginning in 2022.