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AzHHA Member Advisory - COVID-19: March 31

State and Federal Regulatory Waivers Update

AzHHA last week submitted a blanket waiver request to the Centers for Medicare & Medicaid Services (CMS) in collaboration with 16 other state hospital associations. The request was submitted on behalf of all hospitals and health systems in Arizona. CMS granted expedited review and approved the waivers retroactively to March 1, 2020. Click here to view AzHHA’s letter and list of approved waivers.

In addition, CMS Monday released a substantial number of new waivers related to COVID-19. The waivers apply nationwide and are retroactive to March 1, 2020. Among other areas, the waivers include:

  • allowing hospitals to establish additional treatment locations,
  • expanding access to telehealth,
  • removing self-referral barriers to responding to COVID-19,
  • allowing for additional workforce capacity and
  • eliminating certain administrative requirements.

Read the AzHHA letter to the Arizona Department of Health Services (ADHS) listing the need for waivers of state regulations governing hospitals here. This request was also sent on behalf of all hospitals and health systems in Arizona.

Read the AzHHA letter to the Arizona Medical Board calling for an emergency application to provide temporary licensure of physicians seeking to provide COVID-19 services in Arizona here.

ADHS, DEMA and Hospital CEOs Discuss Surge Plans

AzHHA convened a call Tuesday with Arizona hospital CEOs, Dr. Cara Christ and her team from ADHS and Major General Michael T. McGuire from the Arizona Department of Emergency and Military Affairs to discuss a comprehensive plan to address a hospital patient surge related to COVID-19. As hospital CEOs continue to adapt to the latest Executive Orders and implement their emergency management plans, they were able to get valuable input on modeling for various patient surge models, plans for locating additional high and low acuity beds, personal protective equipment and ventilator supply. AzHHA will continue to facilitate discussions and action for Arizona hospitals during our COVID-19 response. If you are a hospital CEO and would like to participate, please contact Communications@azhha.org.

Stay home, stay healthy, stay connected

Governor Doug Ducey announced his latest public health executive order Monday asking Arizonans to “Stay home, stay healthy and stay connected.”

Effective 5 p.m. Tuesday, March 31, 2020, Governor Ducey’s executive order tells Arizonans to eliminate time away from home except for time obtaining essential services. Details on what the order determines as acceptable time away from home and essential services are listed in Executive Order 2020-18: Stay Home, Stay Healthy, Stay Connected, Physical Distancing to Mitigate COVID-19 Transmission.

AHA urges HHS and CMS to 'directly and expediently' distribute funds to hospitals and health systems as designated by CARES Act

The AHA Tuesday asked the Department of Health and Human Services and Centers for Medicare & Medicaid Services to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security Act.

The CARES Act increased funding for the Public Health and Social Services Emergency Fund by $100 billion to reimburse eligible healthcare providers for healthcare-related expenses or lost revenues that are attributable to COVID-19. AHA said that in the past, relatively similar situations, Medicare Administrative Contractors have been used to pay claims and distribute monies directly to providers for purposes other than Medicare payment.

Read the full letter for more details on how AHA proposed that HHS and CMS distribute the funds to hospitals and health systems, as well as the types of costs and lost revenue that should be eligible for funds.

FEMA, HHS task force targets supply chain needs

The Federal Emergency Management Agency and the Department of Health and Human Services have created a Supply Chain Stabilization Task Force to address the need for personal protective equipment, ventilators and other life-saving equipment. The task force will support COVID-19 hot spots with a four-pronged approach: preserve PPE and supplies; accelerate the manufacturing of equipment; expand the industry and allocate resources to the needed areas.

CDC report estimates underlying condition prevalence in U.S. COVID-19 patients

Preliminary U.S. data suggests Americans with health conditions such as diabetes, lung disease and cardiovascular disease are at higher risk for severe COVID-19, the Centers for Disease Control and Prevention reported Tuesday. The study found the percentage of COVID-19 positive patients needing hospitalization or intensive care unit admission was higher for those with at least one underlying health condition or risk factor compared with those without underlying conditions.

The White House Switches Gears on Data Collection

Vice President Mike Pence sent a letter to the nation's hospitals requesting all hospitals report certain data on COVID-19 testing results, bed and ventilator capacity. In the letter, hospitals were asked to report the following two streams of data daily:

COVID-19 results from in-house laboratories - results should be reported to the Federal Emergency Management Agency (FEMA) using a standardized template by 5 p.m. ET each dayand reflect the results through midnight of the previous day. Download the template here and email it to fema-hhs-covid-diagnostics-tf@fema.dhs.gov. Note: hospitals who send all the COVID-19 reporting to select commercial labs do not need to submit data.Those selected commercial labs are LabCorp, BioReference Laboratories, Quest Diagnostics, Mayo Clinic Laboratories and ARUP Laboratories.

This new reporting will replace the data collection the White House had asked AHA to launch last week.

Bed and Ventilator Capacityreport bed and ventilator capacity using the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) COVID-19 module. Among other data elements, hospitals would report the number of confirmed/suspected COVID-19 patients who are in the emergency department and inpatient beds. Hospitals also are asked to report how many patients are being mechanically ventilated, the total number of ventilators available and the number of ventilators in use. Additional details are available on the CDC NHSN website.

#StayHomeAZ

Arizona hospitals are focused on providing care to those who need it. In turn, we ask Arizonans to stay home to protect the health of our healthcare workforce. Find #StayHomeAz social media messages and graphics here.

Informational Resources/Graphics

The Arizona Department of Health Services posts helpful communication resources for sharing at azhealth.gov/covid19:

  • View an up-to-date dashboard on the COVID homepage
  • Download video PSAs and graphics for public awareness on the Communication Materials page
  • Visit the COVID-19 page in Spanish

COVID-19 Updates

Ensure your hospital response team is on AzHHA’s COVID-19 member advisory distribution list. Visit our website https://www.azhha.org/covid19 and sign up to receive future member advisories and COVID-19 updates.

Questions? Contact us at Communications@AzHHA.org.