Regional Response Health Collaboratives in Pennsylvania Strengthen Support for Long-Term Care Facilities

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.”