By Bill Bishop
September’s employment numbers show the pandemic is hurting rural areas less than metropolitan ones.
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As Pennsylvania Governor Wolf’s administration continues to focus on keeping Pennsylvanians safe, programs have been put in place to protect those most vulnerable including the Regional Response Health Collaborative (RRHC) program. RRHC is a statewide program providing clinical, operational, and educational support to long-term care facilities preparing for or facing outbreaks of COVID-19 at their facility.

COVID-19 can be dangerous in congregate care settings, particularly in settings that serve people who are medically fragile or have other health vulnerabilities that make them more likely to experience additional complications from COVID-19, as often is the case for residents of long-term care facilities. The RRHC Program is a crucial part of catching and responding to outbreaks when they occur, saving lives.

The RRHCs work to assist in ensuring facilities have the resources they need to respond to COVID-19 in these vulnerable settings. As we are in the midst of a fall resurgence, the RRHCs will become even more important.

Pennsylvania’s long-term care system serves more than 127,000 people living in nursing homes, personal care homes, assisted living residences, and private intermediate care facilities. Due to the congregate nature and because they often serve individuals who are older or have co-occurring medical conditions that make them more vulnerable to an acute case of or complications from COVID-19, constant vigilance is necessary to avoid a serious outbreak at these facilities.

RRHC Program Structure

Launched in late July, the RRHC program was established to provide clinical support, technical assistance, and education to long-term care facilities as they work to prevent and mitigate spread of COVID-19. The RRHCs are available 24/7 to support the nearly 2,000 nursing facilities, personal care homes, assisted living residences, and private intermediate care facilities in Pennsylvania and the residents they serve. Eleven health systems were selected to serve six regions across Pennsylvania. Southcentral Pennsylvania’s RRHC is Penn State Health.

Each RRHC is required to make a minimum of two on-site visits to each facility in their region, including an initial on-site assessment that will help the RRHC evaluate a facility’s COVID-19 prevention and mitigation strategies and their preparedness to respond to an outbreak if that were to occur. Based on this assessment, the RRHCs will help those facilities implement best practices in infection control, implement contact tracing programs in facilities, support clinical care through on-site and telemedicine services, and provide remote monitoring and consultation with physicians. RRHCs are in regular communication with DHS, the Department of Health (DOH), and the Pennsylvania Emergency Management Agency (PEMA)to report on experiences interacting with facilities, trends experienced by facilities, and potential challenges.

When a RRHC engages with a facility or is called in to help with a concern identified from collaboration between DHS, DOH and PEMA daily calls, these efforts are classified as missions. A mission could be anything from assistance with testing, assessing a facility’s preparedness, staffing support, rapid response deployment to facilities, PPE support, testing to ensure PPE is properly fitted, and questions or concerns requiring consultation. Since launching, the RRHCs have been assigned more than 6,200 missions, primarily covering testing, consultations, facility assessments, and support with PPE. The RRHCs are also working with the Jewish Healthcare Foundation to operate a statewide learning network available to all long-term care facilities. This network holds regular webinars on topics related to infection control and the latest guidance for responding to and mitigating spread of COVID-19. These webinars have reached more than 1,800 participants since the start of the RRHC program.

The administration can also deploy rapid response teams staffed by the RRHCs when an outbreak is suspected or confirmed at a long-term care facility. These rapid response teams consist of clinical and infection control professionals from the RRHCs to evaluate the situation, ensure proper cohorting of patients based off COVID status, facilitate resident transfers and additional staffing if necessary, and coordinate safe continued care for residents who are not COVID-positive. The rapid response teams can also provide emotional support to both residents or staff to help with the stress and fear associated with an outbreak. Rapid response teams are designed to stabilize potential or confirmed outbreaks, and assistance from RRHCs is not withdrawn until the situation is stabilized and there is no immediate risk to staff and residents.

The RRHC is funded through Pennsylvania’s Coronavirus Aid, Relief, and Economic Security (CARES) Act award, the program is currently scheduled to end on December 1. The Wolf administration recently sent a letter to President Trump requesting funding to extend the program so it may continue to be a resource throughout the winter. Governor Wolf urged President Trump to work with Congress on a new stimulus package that would support the RRHC program and other resources crucial to protecting the lives, health and safety of Pennsylvanians.

“The last eight months have been a period of great learning. We’re now at a point where we have a system that is working and helping to stabilize and prevent outbreaks. As the country works to get a vaccine that is effective in market and available, we need to do all we can to protect people who are most vulnerable to this virus,” said Secretary Miller. “The RRHC program cannot stop COVID altogether, but it is undoubtedly making us better at fighting it. We cannot lose this resource.”

Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin and Agriculture Secretary Russell Redding reminded Pennsylvania restaurant, bar and club owners that they may increase indoor capacity from 25 percent to 50 percent through self-certification, which will increase consumer confidence but will not lead to additional inspections or penalties.

“Contrary to what business owners may have heard, the self-certification process will not create any negative impacts, lead to increased inspections, or pose threats or penalties,” said Sec. Davin. “Rather, this process is a win-win for both restaurants and consumers, as it will inspire consumer confidence and lead to increased patronage and sales.”

As of November 2, nearly 8,300 restaurants—or approximately 32 percent of all restaurants—have self-certified. The self-certification process is still open for restaurants that wish to self-certify. There is no cost to self-certification.

Restaurants can access the online self-certification form on PA.GOV/COVID. Self-certification enables restaurants, private social clubs and ​food service businesses that serve dine-in, sit down food in a regular, non-event capacity to increase indoor occupancy to 50 percent while adhering to mitigation efforts that will keep employees and customers safe.

The occurrence of regularly scheduled or complaint-based inspections from enforcement agencies will not be affected by certification status. In fact, certifying proves that a business is committed to protecting employees and providing patrons a safe dining experience.

“We encourage all Pennsylvania restaurants to take advantage of this opportunity to both increase capacity and improve visibility of your business,” said Sec. Redding. “Now more than ever, Pennsylvanians want to make educated dining decisions to keep their families safe. Self-certification gives restaurant owners a tool to reassure customers that they are working to keep them, and the staff who serve them, safe.”

The Wolf Administration has released Frequently Asked Questions as a reference for restaurant owners and the public, along with updated restaurant guidance.

Business owners with additional questions about the self-certification program can contact covidselfcert@pa.gov.

Signup for the Coronavirus Food Assistance Program 2 (CFAP 2) began on Sept. 21, 2020 and will continue through Dec. 11, 2020. CFAP 2 provides eligible producers with direct financial assistance due to market disruptions and associated costs because of COVID-19.

Many more commodities are eligible for CFAP 2 than CFAP 1. Our new, easy-to-use CFAP 2 Eligible Commodities Finder makes finding payment rates specific to your operation simple.

Try it out here.

On October 30, CMS launched a new online platform – the Nursing Home Resource Center – to serve as a centralized hub bringing together the latest information, guidance, and data on nursing homes that is important to facilities, frontline providers, residents, and their families, especially as the fight against COVID-19 continues.

The Resource Center consolidates all nursing home information, guidance, and resources into a user-friendly, one-stop-shop that is easily navigable so providers and caregivers can spend less time searching for critical answers and more time caring for residents. Moreover, the new platform contains features specific to residents and their families, ensuring they have the information needed to make empowered decisions about their health care.

With the new page, people can efficiently navigate all facility inspection reports and data – including COVID-19 pandemic and Public Health Emergency (PHE) information. This tool will remain active through and beyond the COVID-19 PHE.

Full text of News Alert.

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

 Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

Next Office Hours:

Tuesday, November 3^rd at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2394789

Audio Webcast link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2612

For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.

The Centers for Disease Control and Prevention (CDC) has added vaccine-specific content to their extensive Coronavirus Disease 2019 (COVID-19): Vaccines gateway page. These new resources include information on vaccination planning, how vaccine safety will be monitored, and FAQs. These resources are intended to clarify how COVID-19 vaccine recommendations will be made and how the vaccines will be monitored for safety, to build trust and confidence in future COVID-19 vaccines. As more information becomes available and as vaccines become authorized or approved and recommended for use in the U.S. updates will be added.