Pennsylvania Releases Resources for Those in Substance Use Recovery

Posted on by lad3

The Pennsylvania Department of Human Services (DHS) has provided the following information for supporting vulnerable friends and families in substance use recovery:

ACOs Seek Flexibility from CMS to Mitigate Losses Due to Coronavirus

Posted on by lad3

FierceHealthCare, Robert King, March

Accountable care organizations (ACOs) are seeking flexibility from the Trump administration on mitigating any financial losses that could arise from treating the burgeoning coronavirus outbreak.

The concerns come as the coronavirus has spread to more than 1,200 people across the country and has healthcare facilities worried about being overwhelmed. ACOs are in a particularly difficult situation as they are on the hook for paying back Medicare if healthcare costs skyrocket.

ACOs participating in either the Medicare Shared Savings Program (MSSP) or the Next-Gen ACO program agree to take on some form of financial risk. If they meet spending targets, they get a share of the savings, but if that spending accelerates they must pay back the Centers for Medicare & Medicaid Services (CMS) for a share of the losses.

Read more.

States’ Oral Health Providers Scope of Practice

Posted on by lad3

Supported through HRSA’s cooperative agreement with National Organizations of State and Local Officials, the Scope of Practice Policy website now includes information on dental hygienists with direct access to initiate treatment without the specific authorization of a dentist. The site also features interactive maps that highlight which states allow dental therapists to practice and which states allow the practice of teledentistry services.

See the maps.

HRSA Takes on Rural Substance Misuse

Posted on by lad3

After somberly recounting overdose deaths in his own family, HHS Deputy Secretary Eric Hargan delivered a moving appreciation of local community leaders and clinicians for quickly responding to a set of HRSA initiatives that have brought care and treatment to small town rural America where once there was none.

Starting in 2015 with fewer than 20 grantees distributing Narcan overdose-reversal kits in remote towns, HRSA’s Federal Office of Rural Health Policy (FORHP) has grown its recovery effort into the Rural Communities Opioid Response Program. It now involves nearly 250 grantees with counselors and outreach workers in 1,000 communities in 47 states.

Read more about HRSA’s efforts to take on rural substance misuse.

HHS Takes New Action to Cut Red Tape to Support COVID-19 Response

Posted on by lad3

On March 18, 2020, the Health Resources and Services Administration (HRSA) launched an information collection effort to support the Trump Administration’s response to the COVID-19 pandemic, surveying HRSA-funded health centers on their involvement in the COVID-19 response, including whether they are offering diagnostic tests. This effort was made possible by a Paperwork Reduction Act waiver issued pursuant to statutory authorities that became available as a result of the public health emergency declared by HHS Secretary Alex Azar in late January.

Read the news release.

Tyrone Hospital Signs Letter of Intent for Affiliation With Penn Highlands Healthcare

Posted on by lad3

March 19, 2020

 TYRONE/DUBOIS, PA – The Boards of Directors of both Tyrone Hospital and Penn Highlands Healthcare have signed a Letter of Intent to negotiate an affiliation agreement between the two entities that would integrate Tyrone Hospital into Penn Highlands Healthcare system.

The Tyrone Hospital Board of Directors led an extensive Request for Proposal process and determined that Penn Highlands Healthcare would be a perfect long-term partner to meet the healthcare needs of the area.

The mission of Penn Highlands Healthcare is to provide exceptional care through its community-based health system while maintaining a reverence for life.  “The Penn Highlands mission resonated with our organization,” said Kelly Wike, Board President of Tyrone Hospital Board of Directors.  “Tyrone Hospital has always been committed to serving our patients with the highest quality of care, and we believe that affiliating with Penn Highlands will continue to honor that longtime commitment.”

The affiliation with Penn Highlands Healthcare, anticipated to take effect in late 2020, is designed to strengthen the delivery of healthcare services by the Blair County-based health care provider.  The board’s key objectives that guided the search for a new partner included:

  • Continue the spirit of the mission, vision and values of Tyrone Hospital
  • Maintain and expand key programs and services
  • Attract and retain high-quality physicians and advanced practice providers in a wide range of specialties
  • Preserve jobs in Blair County and provide competitive wages, benefits and retirement plans
  • Provide the necessary capital investment to support quality and growth
  • Maintain a meaningful role in local governance of the hospital

“Penn Highlands Healthcare is expanding our footprint across the region with the launch of our Master Facility Plan project in 2018,” according to Dick Pfingstler, Chairman of Penn Highlands Healthcare Board of Directors, “The affiliation with Tyrone Hospital broadens our reach while also supporting their history of offering quality health care.”

Anna Marie Anna, Acting CEO agreed.  “Penn Highlands Healthcare is an ideal partner for our hospital and our community given that they operate other like-sized hospitals in the area.  Penn Highlands understands the needs of communities like ours, and is committed to building on our past success.”

“We are thrilled with this opportunity to partner with Tyrone Hospital,” said Steve Fontaine, CEO of Penn Highlands Healthcare.  “We believe that Tyrone Hospital shares our vision to be the integrated health system of choice and will enable us to serve more patients with the highest quality care.”

The signing of the letter of intent means that Tyrone Hospital and Penn Highlands Healthcare have agreed to general terms and conditions of a prospective affiliation.  Throughout the next several months, both parties will engage in additional due diligence, research and discussions to work toward a definitive agreement.  This process is subject to customary regulatory review.

About Tyrone Regional Health Network

Tyrone Hospital was founded by the community in 1954.  In June 2014, Tyrone Regional Health Network (TRHN) was announced to better reflect the entities and variety of services that are part of Tyrone Hospital.

TRHN consists of Tyrone Hospital, a twenty-five bed community hospital that provides general medical and surgical care, three primary care physician offices which include Tyrone Rural Health Center, Pinecroft Medical Center and Houtzdale Rural Health Center. Its services include the Breast Cancer & Women’s Health Institute, an orthopedic clinic, a cardiology clinic, Company Healthcare and the Tyrone Fitness & Wellness Center.  The Tyrone Regional Health Network Foundation and the Tyrone Hospital Auxiliary conduct fund raising activities to support Tyrone Hospital and other entities within the network.  For more information visit www.tyroneregionalhealthnetwork.org.

About Penn Highlands Healthcare

Penn Highlands Healthcare was officially formed on September 30, 2011, and is comprised of five hospitals – Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois, Penn Highlands Elk and Penn Highlands Huntingdon that have served area communities for the past 100 years. Its business continuum also includes a home care agency, Penn Highlands Community Nurses; two long-term care facilities, Pinecrest Manor and Penn Highlands Jefferson Manor; and a senior residential living facility, Elco Glen.

Through this partnership, Penn Highlands Healthcare has evolved into an organization with approximately 4,400 workers in 120+ locations throughout 13 counties in North Central/Western Pennsylvania that include community medical buildings, outpatient facilities, surgery centers and physician practices.

Providing exceptional quality care to the region, it has 499 physicians and 273 advanced practice providers on staff. The facilities have a total of 705 inpatient and skilled nursing beds. The system offers a wide range of care and treatments with specialty units that care for cancer, cardiovascular/thoracic, neurosurgery, pulmonology, neonatal and high-risk pregnancy patients.

Being focused on what is important – patients and families – makes Penn Highlands Healthcare the best choice in the region. For more information, visit www.phhealthcare.org.

Pennsylvania Releases COVID-19 Operational Recommendations, Telehealth Guidelines for Behavioral Health Services

Posted on by lad3

March 17, 2020

Harrisburg, PA – The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) today released operational recommendations and telehealth guidelines for providers of behavioral health services.

“The Wolf administration is committed to serving vulnerable populations every day, and that commitment will not waiver in the face of an emergency,” said DHS Secretary Teresa Miller. “We are working with county mental health programs and behavioral health service providers to be sure that behavioral health services for Pennsylvanians continue uninterrupted.”

OMHSAS has developed the following operational recommendations, which will be updated and re-released on a recurring basis as new information becomes available. Recommendations include:

  • Exercise and promote hygienic practices;
  • Review agency emergency preparedness plan and infection control procedures;
  • Report all suspected cases of COVID-19 to OMHSAS;
  • Contact OMHSAS before making any changes to your business practice whenever possible. Examples of changes in business practices include, but are not limited to;
    • Suspending services at a service location or temporarily closing programs.
    • Closing county offices.
  • Document what actions were taken and maintain evidence for why actions were taken.
  • Stay Informed via the Pennsylvania Department of Health and the Centers for Disease Control and Prevention.

OMHSAS has also temporarily suspended certain requirements for providing behavioral health services via telehealth. Changes to existing telehealth regulations include:

  • Staff may deliver telehealth services via telephonic and video communication applications such as FaceTime or Skype available on smart phones, and through telephonic only devices when video technology is not available;
  • Telehealth services may be provided in the home and without provider staff being physically present with the individual receiving services;
  • Practitioner types who can provide telehealth services is expanded beyond what is typically permitted;
  • Both Behavioral HealthChoices and fee-for-service providers may bill for telehealth;
  • Typical face-to-face contact percentages may be met with use of telehealth;
  • Programmatic limits for the amount of service that may be provided through telehealth are temporarily suspended.

For more information on existing telehealth behavioral health guidance in Pennsylvania, refer to this bulletin.

DHS has already released operational recommendations for providers of child welfare services, intellectual disability and autism services, and long-term services and supports in Pennsylvania in response to COVID-19. DHS program offices are continuing to formulate recommendations for other provider communities and will publish guidance as it becomes available.

Visit the PA Department of Health’s dedicated Coronavirus webpage for the most up-to-date information regarding COVID-19.

If you are experiencing anxiety or stress related to COVID-19, advice on how to manage this is available from the Centers for Disease Control and Prevention here.

Guidance to DHS providers related to COVID-19 is available here.

CONTACT: Erin James, 717-425-7606

Pennsylvania Releases COVID-19 BLS Protocol Update

Posted on by lad3

March 17, 2020

From Dylan Ferguson, Director, Bureau of Emergency Medical Services, PA Department of Health and Dr. Douglas Kupas, Commonwealth EMS Medical Director, Bureau of Emergency Medical Services, PA Department of Health

In response to the COVID-19 pandemic, the Bureau of EMS (Bureau) is issuing an update to BLS Protocol # 931 Suspected Influenza-Like Illness (ILI). Primary additions to the protocol include additional emphasis on deferring aerosol generating procedures unless absolutely necessary. Furthermore, the protocol authorizes EMS providers to carry albuterol meter dosed inhalers (MDI) and spacers to be used in place of nebulizers when required. Please note that these MDI’s should only be utilized one per patient and not reused for subsequent patients. EMS providers of all levels are encouraged to review this updated protocol in its entirety. This updated protocol is effective immediately.

The Bureau is also issuing the following guidance as it relates to the potential need for EMS to transport to alternate destinations.

Section 8128 of the EMS Act sets forth requirements for a facility to be considered a receiving facility for EMS emergency patients. Those requirements include but are not limited to:

(b) Requirements. –A receiving facility shall include, but need not be limited to, a fixed location having an organized emergency department, including a physician trained to manage cardiac, trauma, pediatric, medical, behavioral and all-hazards emergencies, who is present in the facility and available to the emergency department 24 hours per day and seven days per week.

By regulation, the department may authorize other types of facilities to serve as receiving facilities for purposes of serving patients who have special medical needs.

(c) Patient transports. –Unless directed otherwise by a medical command physician, the initial transport of a patient following an ambulance response to a reported emergency shall be to a receiving facility pursuant to a protocol under section 8105(c).

As a result, EMS providers may transport a patient to an alternate destination, other than a receiving facility as defined above, when ordered by a medical command physician. It is the Bureaus desire to give EMS agencies, medical facilities, and patients the flexibility needed to be able to respond to the current public health emergency.

Despite this ability, it must be reiterated that at this time patients must consent to the alternative destination. If the patient does not consent to the alternate destination, they must be transported to an appropriate receiving facility following the guidance outlined in BLS protocol 170 Patient Destination – Ground Transport.

It should be noted that the Bureau cannot guarantee that EMS agencies will be reimbursed by insurers for transports to alternate destinations as each insurer has different policies, coverages and criteria.

Furthermore, if based on a patient’s presentation of an influenza like illness and the approval of a medical command physician the EMS provider and/or medical command physician may recommend to the patient the option to not be transported and instead provide instructions for care or isolation at home. However, as above if the patient still desires transport then at this time, they must be transported to an appropriate receiving facility following the guidance outlined in BLS protocol 170 Patient Destination – Ground Transport.

The Department of Health’s Bureau of EMS website will always contain the most current version of the EMS protocols, the scope of practice for each level of provider, important EMS Information Bulletins, and many other helpful resources. This information can be accessed online at www.health.pa.gov.

Pennsylvania EMS Protocols can be found here.

Any questions regarding to this information should be directed to your Regional EMS Council.

Families First Coronavirus Response Act Summary

Posted on by lad3

On Wednesday, March 18, the President signed the “Families First Coronavirus Response Act” shortly after the Senate approved the legislation with a 90-8 vote. Last week, the House of Representatives approved a version of the bill which incorporated bipartisan technical changes, including paid sick leave and changes to the temporary increase of federal medical assistance percentages for Medicaid.  The bill text can be found here. A high-level analysis of key public health provisions in the legislation is provided below.

Public Health Provisions

  • Requires private health plans to provide coverage for COVID-19 diagnostic testing at no cost to the consumer.
  • Mandates that personal respiratory protective devices be treated as covered countermeasures under the PREP Act declaration.
  • Provides a temporary increase to the federal medical assistance percentage (FMAP) of 6.2% to each state, including the District of Columbia, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, Puerto Rico, and the United States Virgin Islands. The increase will remain in effect until the close of the fiscal quarter during which the public health emergency ends.

Domestic Nutrition Assistance Programs

  • Provides an additional $500 million for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
  • Grants an additional $400 million to the Emergency Food Assistance Program (TEFAP).
  • Permits the Department of Agriculture to approve new state SNAP plans in response to the COVID-19 outbreak.
  • Provides $100 million in nutrition assistance grants for the U.S. territories of Puerto Rico, America Samoa, and the Commonwealth of the Northern Mariana Islands.
  • Releases $250 million for the senior nutrition program in the Administration for Community Living. Funding will provide meals to low-income seniors who:
    • Are home-bound
    • Have disabilities
    • Have multiple chronic illnesses
  • Permits the Secretary of Agriculture to issue new nationwide school meal waivers.

Paid Sick Leave

  • Grants $5 million to the Department of Labor to administer emergency paid sick leave.
  • Requires employers with fewer than 500 employees and government employers to provide employees with two weeks of paid sick leave.
  • Amends the Family and Medical Leave Act to grant the aforementioned groups the right to take up to 12 weeks of job-protected leave.

Other Provisions

  • Requires OSHA to issue an emergency temporary standard within 30 days requiring healthcare employers to develop and implement a comprehensive infectious disease exposure control plan to protect healthcare workers from COVID-19.
  • Releases an additional $1 billion in FY2020 emergency grants to states to process and pay unemployment insurance benefits.

Mandates that state emergency operations centers receive real-time reporting on aggregated COVID-19 testing data as well as results from state and local public health departments. This data is also required to be shared with the CDC.