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AzHHA Member Advisory - COVID-19: July 22

Action Alert: Senate considering COVID-19 relief package

Before Congress leaves for its August recess, we are hopeful the Senate will take up an additional COVID-19 relief package in-line with the HEROES Act previously passed by the House. A new report from the American Hospital Association (AHA) finds the immense financial strain facing hospitals and health systems due to COVID-19 will continue through at least 2020, with total losses estimated to be at least $323 billion by the end of the year. Without further government support, margins could sink to -7% in the second half of 2020, according to the analysis, with half of all hospitals operating in the red.

Now is the time to urge your U.S. senators to include necessary provisions in this legislative package. Click here to take action.

Hospital data reporting updates

The Arizona Department of Health Services (ADHS) has developed a new webpage to assist all licensed hospitals to fulfill the data reporting requirements of Executive Order 2020-48. Under this executive order, hospitals are required to report a line list of all COVID-19 patients every 24 hours. The line list must include patient name, date of birth, gender, race/ethnicity, and hospital admission date. Patients need to be reported only once, regardless of the duration of their hospital stay. Hospitals may select from the following reporting options, and can submit questions through the question/comment form

  1. MEDSIS entry 
  2. Standardized Excel File submission 

Any patient hospitalized subsequent to being reported to ADHS should have their hospital admission date submitted separately. This update should be emailed to idreporting@azdhs.gov. More information on file specifications for reporting hospitalization status for previously reported patients will be forthcoming. Please see the ADHS Guidance and Specifications Document for additional information. 

As previously reported, the federal government is no longer collecting hospital data through Center for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), but rather through the Department of Health and Human Services’ (HHS) Tele Tracking portal.  While HHS will permit state health departments to report data on behalf of their hospitals, similar to the previous agreement with NHSN, such health departments must first be approved by HHS. ADHS this week indicated it continues to work on this approval process. Until further notice Arizona hospitals should report federally required data directly to Teletracker unless they have an HHS approved arrangement with a third-party vendor. 

HHS noted in follow-up communication to hospitals that it was initially prioritizing the reporting of seven data fields to inform distribution of remdesivir, but that all of the requested data will be used for various resource allocations moving forward. To that end, HHS states that hospitals should begin reporting all the data fields requested no later than Wednesday, July 22, 2020.

Remdesivir update from AmerisourceBergen

“The RDV team at AmerisourceBergen is working to get state templates matched to accounts, orders confirmed with the sites and remdesivir shipped to hospitals. While we are in the initial setup phase of the new allocation cycle, AmerisourceBergen apologizes for the 1-2 day lag between states providing files to the distributor and actually shipping the product as sites are added in the new system. AmerisourceBergen expects next week's cycle to be much more smooth as we transition to the new allocation schedule (please see attached for new weekly schedule),” states AmerisourceBergen.

Key Weekly Allocation Timeline (starting for week 3 allocation)

  • States will be notified of their updated allocation for the week by Thursday, July 23, and will be required to submit an allocation plan by Friday, July 24. (For week 2 Arizona was allocated 135 cases and provided AmerisourceBergen a pro rata allocation plan based on the number of COVID positive inpatients reported by each facility in EMResource. Moving forward ADHS expects to submit an updated allocation plan every Friday by COB--the allocation plan will be based on the average number of COVID positive inpatients reported by each facility in EMResource over the last week.)
  • AmerisourceBergen will reach out to all Hospitals (via phone or email) based off of prioritized states and hospitals.
  • Hospitals will have 1 day to confirm quantities once contacted or forfeit their allocation; they DO NOT need to accept all their quantities.
  • AmerisourceBergen will deliver product as early as Monday AM and through the end of the week.
  • We also are moving to email notifications vs. phone calls as well with the hospitals so we can improve the cycle time as well for accepting quantities.
  • Given the new compressed 1 week cycle, AmerisourceBergen is attempting to minimize re-allocation of declined quantities with the exception of emergencies. AmerisourceBergen will communicate to ASPR the weekly declined amount so they can take into consideration for the next allocation cycle and only accept emergency re-allocations. 

AmerisourceBergen states it is working on process improvement to allow states to indicate HIGH PRIORITY (Immediate patient need) hospitals to address them first. 

For urgent requests, hospitals are encouraged to complete this survey form to indicate the estimated quantity of remdesivir needed with any relevant comments by Thursday COB:
https://docs.google.com/forms/d/e/1FAIpQLSdw7ilylOfnIlTKsaozhzyzI4deIcDB7uhEiHTWuAFN7BlJ2A/viewform  

For additional questions or comments, please contact RDV@AmerisourceBergen.com. More information including the weekly allocation of remdesivir is being published on ASPR’s website here.

HHS releases preliminary information on CARES Act reporting requirements

The HHS this week shared additional information on reporting requirements for recipients of provider relief funds authorized under the Coronavirus Aid, Relief, and Economic Security (CARES) Act and Paycheck Protection Program and Health Care Enhancement Act. Recipients who received one or more payments exceeding $10,000 in the aggregate from the Provider Relief Fund will be required to submit reports to HHS on how the funds have been expended using a portal that HHS will open on Oct. 1, 2020. Detailed instructions regarding these reports will be released by Aug. 17, 2020.
 
HHS OCR issues important guidance for healthcare providers

The HHS Office of Civil Rights issued guidance this week for recipients of federal financial assistance, including hospitals, on civil rights protections prohibiting discrimination on the basis of race, color and national origin during COVID-19.

Find more communication and social media resources on our website here: https://www.azhha.org/communications_resources

Updates from CDC