CMS Office Hours on COVID-19

CMS Office Hours on COVID-19 You are invited to CMS “Office Hours” on COVID-19, today, Thursday, April 16th from 5:00 – 6:00 PM Eastern, the next in a series of opportunities 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:…

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Technical Resources from HHS/ASPR TRACIE to Assist First Responders and Healthcare Providers

Technical Resources from HHS/ASPR TRACIE to Assist First Responders and Healthcare Providers HHS ASPR, the Technical Resources, Assistance Center, and Information Exchange (TRACIE) was created to meet the information and technical assistance needs of regional ASPR staff, healthcare coalitions, healthcare entities, healthcare providers, emergency managers, public health practitioners, and others working in disaster medicine, healthcare…

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EMS1: National associations join forces to tell the story of the front line

AAA Communications Chair Rob Lawrence shared his insights about recent  EMS and fire association joint advocacy efforts in EMS1. Don’t miss the full article!

Last week, the AAA were approached, via EMS1, by U.S. News, a national publication represented by journalist Gaby Galvin, asking about COVID-19 as it affects the front lines, rates of infection and quarantine, and generally life on the street. This opportunity provided the chance to bring together three national organizations who are all working hard to represent their members, lobby Congress and highlight the challenges at the tip of the spear.

Keep reading on EMS1►

Managing Patient and Family Distress Associated with COVID-19 in the Prehospital Care Setting

The following document was developed by the Healthcare Resilience Task Force Behavioral Health Work group and Adapted by the Prehospital [911 and Emergency Medical Services (EMS)] Team This guidance applies to all delivery models including but not limited to; free standing, third-service; fire-based, hospital-based, independent volunteer, and related emergency medical service providers.
Download PDF from FEMA Website

Managing Patient and Family Distress Associated with COVID-19 in the Prehospital care setting

Tips for Emergency Medical Services Personnel

Day to day operations for Emergency Medical Services (EMS) in the prehospital care setting can cause stress and anxiety under normal conditions. During an emerging infectious disease outbreak, such as COVID-19, the number of individuals experiencing distress—and the intensity of that stress and anxiety—may be significantly amplified. This stress and anxiety can contribute to unwanted patient behaviors, increased calls from those who are anxious but not in need of emergency care, and a reluctance to follow guidance from EMS or other healthcare clinicians, which may ultimately contribute to an increase in mortality and morbidity. This document contains strategies that may be helpful in reducing patient and family stress.

The expected surge of healthcare utilization brought on by an infectious disease outbreak may make it necessary for EMS to modify their usual care practices. These modifications may be in direct contrast with the expectations that patients and families have about prehospital care and other health care, and therefore make their experience even more distressing. Listed below are steps that EMS clinicians and their medical directors can take to help patients and their families manage this distress more effectively, EMS clinicians are encouraged to adapt recommended actions based on their agencies’ individual needs and practical considerations (e.g. limited resources and staff) as approved by the medical director.

Communication: Take time to hear patient concerns and worries

Patients may be scared for themselves or others, may feel guilty, stigmatized, or may be worried about not only practical issues (e.g., who will take care of dependents or pets, how will bills get paid, will they lose their job), but also if they may die from the COVID-19.

  • When talking with patients, speak to them directly and talk calmly and
  • Acknowledge the challenges to effective communication presented by personal protective use (PPE) (masks, face shields, and other barriers that limit non-verbal expression).
  • Reassure patients that you want to minimize any discomfort or concerns they may have about the care they are
  • Although there may not be clear answers or solutions, try and display openness and honesty to the best of your ability
  • Have difficult conversations with family members and/or patients as needed (we cannot transport you to the hospital -or – to the hospital of your choice, you are not ill enough to go to the hospital).
  • Reflect back what you have heard the patient say and identify the emotion the patient is communicating.
    • Patient: “I want my family to go to the hospital with ”
    • Provider: “It’s normal to feel scared in this situation and it’s important for you to connect with your family but at this time it is safer for them to stay home while we take you to the hospital”. (if local hospitals have policies in place to not permit family or visitors in the hospital, explain that as well)
  • VitalTalk1provides practical advice about how to have difficult conversations. The site provides tips and scripts specific to COVID-192 and these resources are also all available on an app3.
  • Make sure to take time to speak with family members about care and

Social Support: Help patients stay connected with their social support system

While in-person visits may not be possible, consider ways that patients can stay in contact with their social support system (e.g., family, friends, spiritual support).

  • Consider strategies to promote social support for these populations:
    • If transporting alone to healthcare facility
      • Allow patients to bring their phone or tablet
      • Remind patient to bring necessary
    • If patient assessed and determined not to need transport
      • Do they have access to a phone or tablet to keep in touch with their social support network?
      • Do they have access to telehealth/telemedicine resources?

 

Resources for Patients

1,2,3,4,5 This is a non-federal website. Linking to a non-federal website does not constitute an endorsement by the U.S. government, or any of its employees, of the information and/or products presented on that site.

hippa

NASEMSO 2020 National EMS Assessment Released!

The National Association of State EMS Officials (NASEMSO) has released its 2020 EMS Assessment, updating the 2011 report. This report  provides unparalleled insights into the EMS systems that  provide mobile healthcare across our nation. We highly recommend that you download the full report at  www.nasemso.org/2020-assessment.

(Falls Church, Va.) In the midst of the COVID-19 pandemic and applause for first responders in the United States, the National Association of State Emergency Medical Services Officials (NASEMSO) has released the 2020 National EMS Assessment updating the 2011 assessment. The 2020 assessment provides a comprehensive accounting by state/territory of the numbers and types of all 911 ambulance services and emergency medical services (EMS) professionals.

The 2020 National EMS Assessment is the first set of documentation about these critical emergency medical response personnel and agencies to be published in nearly 20 years. Every year in times of disasters, disease outbreaks and daily medical emergencies, such as heart attacks and car crashes, out-of-hospital emergency medical care systems make life-and-death differences in the lives of millions of Americans. EMS systems are the safety net for hospital emergency departments and public health as the front lines of response to 911 calls. Additionally, responders place themselves in high risk situations on a daily basis, as well as during communicable disease outbreaks and pandemics.

Data collection for this assessment was completed in 2019 by NASEMSO members, who are the staff of the state agencies that license America’s critical EMS personnel and agencies. State EMS offices protect the public by regulating the human and organizational components of EMS systems across the United States, as well as executing their legislative mandates to implement and improve systems of care for time-sensitive emergencies in order to offer every patient an opportunity for survival and optimal outcomes. The assessment provides the following key findings:

  • More than 18,200 local EMS agencies respond to 911 calls for medical emergencies and injuries, utilizing nearly 73,500 ground vehicles such as ambulances and fire engines.

  • Local EMS agencies respond to nearly 28.5 million 911 dispatches every year in 41 states.

  • More than 750 services are licensed by state EMS offices to fly patients, using helicopters and fixed-wing aircraft to provide rapid transportation to critical care.

  • More than 1.03 million personnel are licensed as emergency medical technicians, paramedics, and other levels of EMS patient care capability within all 50 states, the District of Columbia, Puerto Rico and American Samoa.

  • More than 9,300 physicians serve as local EMS Medical Directors, assuring that contemporary and quality care is provided to patients.

  • Sixty percent of 53 state EMS offices participated or expect to participate in mass casualty exercises involving a biological threat during the 18-month evaluation period.

  • The report is available from NASEMSO at www.nasemso.org/2020-assessment.

JEMS: The Ethics of PPE and EMS in the COVID-19 Era

Read the  full piece at JEMS.

By  Brian J Maguire, Dr.PH, MSA, EMT-PKirsty ShearerJohn McKeown, MAScot Phelps, JD, MPHDaniel R. Gerard, MS, RN, NRPKathleen A. Handal, MDPaul Maniscalco, PhD(c), MPA, MS, EMT/P, LP  and Barbara J. O’Neill, PhD, RN

These are trying times for emergency medical services (EMS) personnel on the front lines of the COVID-19 pandemic. In this article we discuss two critical areas of concern. First, we articulate the ethical challenges EMS personnel face in the absence of having proper personal protective equipment (PPE) and offer some guidance on how to frame their decisions.

Second, we give voice to the urgent need for a national dialogue to address the needs of EMS clinicians and leaders. We present key questions that must be answered to improve the future structure of the profession and the safety of all personnel.

These are times that are putting EMS to the test. These are times that will define the future of EMS.

Continue Reading►

HHS Announces Release of Initial Tranche of CARES Act Provider Relief Funding

On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).  As part of that Act, Congress allocated $100 billion to the creation of a “CARES Act Provider Relief Fund,” which will be used to support hospitals and other healthcare providers on the front lines of the…

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CARES Act Provider Relief Fund

President Trump is providing support to healthcare providers fighting the COVID-19 pandemic. On March 27, 2020, the President signed the bipartisan CARES legislation that provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. This funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19.

Immediate infusion of $30 billion into healthcare system

Recognizing the importance of delivering funds in a fast and transparent manner, $30 billion is being distributed immediately – with payments arriving via direct deposit beginning April 10, 2020 – to eligible providers throughout the American healthcare system. These are payments, not loans, to healthcare providers, and will not need to be repaid.

Who is eligible for initial $30 billion

  • All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
  • Payments to practices that are part of larger medical groups will be sent to the group’s central billing office.
    • All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).
  • As a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
  • This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.

How are payment distributions determined

  • Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.
  • A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.
  • As an example: A community hospital billed Medicare FFS $121 million in 2019. To determine how much they would receive, use this equation:
    • $121,000,000/$484,000,000,000 x $30,000,000,000 = $7,500,000

What to do if you are an eligible provider

  • HHS has partnered with UnitedHealth Group (UHG) to provide rapid payment to providers eligible for the distribution of the initial $30 billion in funds.
  • Providers will be paid via Automated Clearing House account information on file with UHG or the Centers for Medicare & Medicaid Services (CMS).
    • The automatic payments will come to providers via Optum Bank with “HHSPAYMENT” as the payment description.
    • Providers who normally receive a paper check for reimbursement from CMS, will receive a paper check in the mail for this payment as well, within the next few weeks.
  • Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open the week of April 13, 2020, and will be linked on this page.
  • HHS’ payment of this initial tranche of funds is conditioned on the healthcare provider’s acceptance of the Terms and Conditions – PDF, which acceptance must occur within 30 days of receipt of payment.  If a provider receives payment and does not wish to comply with these Terms and Conditions, the provider must do the following: contact HHS within 30 days of receipt of payment and then remit the full payment to HHS as instructed.  Appropriate contact information will be provided soon.

Is this different than the CMS Accelerated and Advance Payment Program?

Yes. The CMS Accelerated and Advance Payment Program has delivered billions of dollars to healthcare providers to help ensure providers and suppliers have the resources needed to combat the pandemic. The CMS accelerated and advance payments are a loan that providers must pay back. For more information from CMS, click here.

How this applies to different types of providers

All relief payments are being made to providers and according to their tax identification number (TIN). For example:

  • Large Organizations and Health Systems: Large Organizations will receive relief payments for each of their billing TINs that bill Medicare. Each organization should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.
  • Employed Physicians: Employed physicians should not expect to receive an individual payment directly. The employer organization will receive the relief payment as the billing organization.
  • Physicians in a Group Practice: Individual physicians and providers in a group practice are unlikely to receive individual payments directly, as the group practice will receive the relief fund payment as the billing organization. Providers should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.
  • Solo Practitioners: Solo practitioners who bill Medicare will receive a payment under the TIN used to bill Medicare.

Priorities for the remaining $70 billion

The Administration is working rapidly on targeted distributions that will focus on providers in areas particularly impacted by the COVID-19 outbreak, rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans.

Ensuring Americans are not surprised by bills for COVID-19 medical expenses

The Trump Administration is committed to ensuring that Americans are protected against financial obstacles that might prevent them from getting the testing and treatment they need from COVID-19.

  • As announced in early April, a portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
    • As a condition, providers are obligated to abstain from “balance billing” any patient for COVID-related treatment.
  • The Families First Coronavirus Response Act requires private insurers to cover an insurance plan member’s cost-sharing payments for COVID-19 testing.
  • President Trump has also secured commitments from private insurers, including Humana, Cigna, UnitedHealth Group, and the Blue Cross Blue Shield system to waive cost-sharing payments for treatment related to COVID-19 for plan members.
Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on April 9, 2020

TIME: A Day With a Paramedic Facing the Coronavirus Pandemic

Thank you to TIME for following  Empress EMS in Westchester  to shine a light on the impact of mobile healthcare in the COVID-19 pandemic.

These days, paramedics like Badgley are the first line of defense. On March 3, there was one coronavirus case in Westchester County. By April 6, there were nearly 14,000, including 197 deaths, according to the New York Times. Even though her department is not yet out of personal protective equipment (PPE), Badgley has been wearing the same N95 mask for two weeks, protecting it with a surgical mask during the day and disinfecting it at night.

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FEMA Advisory | Supply Chain Stabilization

The following information was delivered by FEMA via email on April 9.

Coronavirus (COVID-19) Pandemic Supply Chain Stabilization 

The Supply Chain Task Force continues executing a strategy maximizing the availability of critical protective and lifesaving resources through FEMA for a whole-of-America response. Efforts to date have focused on reducing the medical supply chain capacity gap to both satisfy and relieve demand pressure on medical supply capacity. The task force is applying a four-prong approach of Preservation, Acceleration, Expansion and Allocation to rapidly increase supply today and expand domestic production of critical resources to increase supply long-term.

The preservation line of effort focuses on providing federal guidance to responders and the non-medical sector, such as public service (police, fire, EMT), energy distribution and the food industry on how to preserve supplies when possible, to reduce impact on the medical supply chain.

The  acceleration  line of effort provides direct results to help meet the demand for personal protective equipment PPE through the industry to allow responders to get supplies they need as fast as possible.

The  expansion  line of effort is charged with generating capacity with both traditional and non-traditional manufacturers, such as adding machinery or by re-tooling assembly lines to produce new products.

The  allocation  of supplies facilitates the distribution of critically needed PPE to “hot spots” for immediate resupply. States report on supplies and can request assistance when they experience a shortage.

The Supply Chain Task Force is working with the major commercial distributors to facilitate the rapid distribution of critical resources in short supply to locations where they are needed most. This partnership enables FEMA and its federal partners to take a whole-of-America approach to combatting COVID-19. The task force is providing distributors with up-to-date information on the locations across the country hardest hit by COVID-19 or in most need of resources now and in the future. The distributors have agreed to focus portions of their distributions on these areas in order to alleviate the suffering of the American people.

A key example of this partnership in action is Project Airbridge. The airbridge was created to reduce the time it takes for U.S. medical supply distributors to receive PPE and other critical supplies into the country for their respective customers. FEMA covers the cost to fly supplies into the U.S. from overseas factories, reducing shipment time from weeks to days.

Overseas flights arrive at operational hub airports for distribution to hotspots and nationwide locations through regular supply chains. Flight arrivals do not mean supplies will be distributed in the operational hub locations.  Per agreements with distributors, 50 percent of supplies on each plane are for customers within the hotspot areas with most critical needs. The remaining 50 percent is fed into distributors’ normal supply chain to their customers in other areas nationwide.  HHS and FEMA determine hotspot areas based on CDC data.

Working together, we can efficiently distribute these vital resources to hospitals, nursing homes, long-term care facilities, pre-hospital medical services, state and local governments, and other facilities critical to caring for the American people during this pandemic.

FEMA_Adv_SCTF_Supply Chain Stabilization.pdf

EMS.gov | Note from Dr. Krohmer

Read the update from Dr. Jon Krohmer on EMS.gov.

First, let me just say thank you. Thank you to everyone out there who is making a difference during this especially difficult time, by answering 911 calls, responding to emergencies, and staffing operations centers; by performing critical administrative functions that keep our 911 and EMS personnel safe and able to focus on patient care; and by doing what might be the most difficult, especially for us—staying at home when not working.

As people who normally respond to emergencies, locking ourselves inside our homes when asked isn’t easy. But if you’re feeling sick or were asked to quarantine because you were exposed, or you’re watching the kids or helping an elderly family member so others in your family can report to duty, you are performing a critical service. Social distancing can feel like inaction, but it’s one of the most important actions we can take as a community to beat COVID-19 and save lives.

Here in the NHTSA Office of EMS, we are doing everything we can to support state and local EMS systems. I have been asked to serve as the lead of an EMS/prehospital care task force within the national response coordinated by the Federal Emergency Management Agency and working very closely with ASPR. This means that NHTSA’s Office of EMS is representing EMS concerns at FEMA’s National Response Coordination Center seven days a week, sharing information we receive from state and local EMS officials and finding ways to support your efforts.

We are collaborating closely with our federal partners in the Departments of Health and Human Service and Homeland Security and throughout government to ensure that EMS’s needs are considered and understood as we respond to this public health emergency. We are also meeting regularly with national EMS organizations to update the community and learn what we can do for you. Recently we launched a COVID-19 page on EMS.gov, which includes links to important resources, and will be updated regularly.

Our colleagues at the National Association of EMTs and American College of Emergency Physicians recently announced the theme for this year’s National EMS Week: “Ready Today. Preparing for Tomorrow.” Although COVID-19 will likely impact our usual EMS Week celebrations, be assured that our colleagues throughout the federal government appreciate your efforts on the frontlines. We know that no matter what the emergency is, you stand ready to face it and are preparing for tomorrow’s challenges at the same time.

Situations like the one presented by COVID-19 put enormous strain on you, your organizations and your families, but they also bring out the best in our communities—something exemplified by the tens of thousands of EMS clinicians across the nation who are putting others first every day.

CMS Announces Delay to ET3 Start Date

On April 8, 2020, the Centers for Medicare and Medicaid Services (CMS) announced that it will be delaying the start of the Emergency Triage, Treat and Transport (ET3) Model until Fall 2020.  The ET3 Model was previously set to start on May 1, 2020.  CMS cited the national response to the COVID-19 pandemic as the…

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EMS.gov | PPE Challenges Guidance

The following information was posted to the NHTSA EMS.gov site.

We are all aware of the challenges of obtaining personal protective equipment (PPE) during this pandemic. We hope this information will help address concerns and clarify the replenishment request process.

The current shortage applies to all health care disciplines – the challenges you are experiencing are being felt by your peers. As a nation, we are working very hard to address the challenges through ramped up production and distribution as resources become available. First responders are recognized as a high priority component of the nation’s critical infrastructure. Decisions regarding PPE allocation are based on specific and identified need and are being prioritized based on those needs.

It may be helpful to reinforce to the first responder community the process for submitting your requests for resupply. It is critical that requests are submitted through the proper process:

    • 1. Continue to submit your request for replenishment of PPE through your normal distribution supply chain. While the supply remains limited, filling those orders will be challenging and you may not receive your entire requested order.

 

    • 2. To request supplies from state or federal resources (eg: stockpiles or reserves), you must submit those requests through your established local emergency management structure. Based on that structure in your state, your request may be then processed through the emergency management chain or through the public health chain to state level emergency management. From the state level, it will be transmitted to the federal level. Final decisions for health care material are made by HHS which will then order distribution of the material.
    • 3. When submitting that request, indicate the following:

      • a. Agency
      • b. Specific material and quantity request
      • c. Detailed risk / exposure justification for the request

        • i. Current on-hand requested supplies
        • ii. Burn rate of current supplies
      • iii. Other information pertinent to the request
    • d. Alternatives that are available and risks associated with pending gaps

This information will be critical in helping to determine the reallocation plan. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to challenge the COVID-19 response. Following the appropriate process for requesting supplies will be critical to your success.

EMS.gov Webinar 4/10 | EMS Patient Care & Operations

EMS: Patient Care and Operations
Friday, April 10, 2020
12:00 PM EDT / 9:00 AM PDT
Register Now►

Webinar Agenda

Welcome and Introductions

Richard C. Hunt, MD, FACEP, HHS/ASPR National Healthcare Preparedness Programs

Patient Care and Operations

Michael Sayre, MD, University of Washington & Seattle Fire Department
Ed Racht, MD, Global Medical Response

Q & A and Discussion

Register Now►

New CMS Infection Control Guidance for COVID-19

FOR IMMEDIATE RELEASE
April 8, 2020

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

 CMS Issues New Wave of Infection Control Guidance Based on CDC Guidelines to Protect Patients and Healthcare Workers from COVID-19

Guidance will aid clinicians in various healthcare settings to prevent and mitigate the spread

 Under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) has issued a series of updated guidance documents focused on infection control to prevent the spread of the 2019 Novel Coronavirus (COVID-19) in a variety of inpatient and outpatient care settings. The guidance, based on Centers for Disease Control and Prevention (CDC) guidelines, will help ensure infection control in the context of patient triage, screening and treatment, the use of alternate testing and treatment sites and telehealth, drive-through screenings, limiting visitations, cleaning and disinfection guidelines, staffing, and more.

The guidance is designed to empower local hospitals and healthcare systems, helping them to rapidly expand their capacity to isolate and treat patients infected with COVID-19 from those who are not. Critically, the guidance released today includes new instructions for dialysis facilities as they work to protect patients with End-Stage Renal Disease (ESRD), who, because of their immunocompromised state and frequent trips to health care settings, are some of the most vulnerable Americans to complications arising from COVID-19. The guidance is part of the unprecedented array of temporary regulatory waivers and new policies CMS issued on March 30, 2020 that gives the nation’s healthcare system maximum flexibility to respond to the COVID-19 pandemic.

“CMS is helping the healthcare system fight back and keep patients safe by equipping providers and clinicians with clear guidance based on CDC recommendations that reemphasizes and reinforces longstanding infection control requirements,” said CMS Administrator Seema Verma.

The guidance is particularly timely for dialysis facilities. Dialysis facilities care for immunocompromised Americans who require regular dialysis treatments and are therefore particularly susceptible to complications from the virus. Today’s updated guidance has multiple facets, including the option of providing Home Dialysis Training and Support services – to help some dialysis patients stay home during this challenging time – and establishment of Special Purpose Renal Dialysis Facilities (SPRDFs), which can allow dialysis facilities to isolate vulnerable or infected patients. These temporary changes allow for the establishment of facilities to treat those patients who tested positive for COVID-19 to be treated in separate locations.

In addition to dialysis facilities, the infection control guidance affects a broad range of settings including hospitals, Critical Access Hospitals (CAHs), psychiatric hospitals, Ambulatory Surgical Centers (ASCs), Community Mental Health Centers (CMHCs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Outpatient Physical Therapy or Speech Pathology Services (OPTs), Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) and Psychiatric Residential Treatment Facilities (PRTFs).

For hospitals, psychiatric hospitals and CAHs, the revised guidance, for example, provides expanded recommendations on screening and visitation restrictions, discharge to subsequent care locations for patients with COVID-19, recommendations related to staff screening and testing, and return-to-work policies.

Similarly, for hospitals and CAHs, the revised guidance on the Emergency Medical Labor and Treatment Act (EMTALA) includes a detailed discussion of: patient triage, appropriate medical screening and treatment; the use of alternate testing sites; telehealth; and appropriate medical screening examinations performed at alternate screening locations, which are not subject to EMTALA, as long as the national emergency remains in force. This step will allow hospitals and CAHs to screen patients at a location offsite from the hospital’s campus to prevent the spread of COVID-19.

For outpatient clinical settings, such as ASCs, FQHCs, and others, guidance discusses recommendations to mitigate transmission including screening, restricting visitors, cleaning and disinfection, and closures, and addresses issues related to supply scarcity, and Federal Drug Administration (FDA) recommendations. In addition, CMS encourages ASCs and other outpatient settings to partner with others in their community to conserve and share critical resources during this national emergency.

Updated guidance for ICF/IIDs, and PRTFs include practices related to screening of visitors and outside health care service providers, community activities, staffing, and more.

CMS will continue to monitor and review the impact of the COVID-19 pandemic on the clinicians, providers, facilities and programs, and will update regulations and guidance as needed.

To view the latest updates to these CMS guidance documents on infection control, go to: https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page

For information on the COVID-19 waivers and guidance, and the Interim Final Rule, released on March 30, please go to the CMS COVID-19 flexibilities webpage: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers.

These actions, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov.  For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

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Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS@CMSgov, and @CMSgovPress.

4/8: CMS Telehealth Open Door Forum

CMS invites you to a Special Open Door Forum addressing CMS’ actions to increase access to Telehealth in Medicare during the COVID-19 Public Health Emergency.

This Special Open Door Forum is open to everyone, if you are a member of the Press, you may listen in but please refrain from asking questions during the Q & A portion of the call. If you have inquiries, please contact CMS at Press@cms.hhs.gov. Thank you.

This call will begin promptly at 1:30 PM on Wednesday, April 8.

Wednesday, April 8
1:30-2:30 PM ET

Dial-in Information
1-888-455-1397
Participant passcode: 3535324

Please dial in 15 minutes ahead of time

Additional Information

CMS has also released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.

Video

You can access recordings of this call along with transcripts on the following link: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts. We will continue to host calls and share information through our list serves and media.

US News: AAA, NAEMT, IAFC Urge PPE for First Responders

Webinar April 7 | EMS.gov & ASPRCOVID-19 Clinical Rounds

Please see below for a message from EMS.gov and ASPR about another COVID-19 Clinical Rounds webinar being held tomorrow entitled “Lifesaving Treatment and Clinical Operations: Critical Care.” Speakers will provide updates on clinical care for people with COVID-19, followed by Q+A and discussion.

COVID-19 CLINICAL ROUNDS
Lifesaving Treatment and Clinical Operations: Critical Care
A Peer to Peer Virtual Community of Practice
Tuesday, April 7, 2020
12:00 PM EDT / 9:00 AM PDT

Register Now►

COVID-19: Clinical Rounds Agenda

  1. Welcome and Introductions – Richard C. Hunt, MD, FACEP; HHS/ASPR National Healthcare Preparedness Programs
  2. Update: Lifesaving Treatment and Clinical Operations [5 min] – Mark Caridi-Scheible, MD; Emory University School of Medicine
  3. Q&A [10 min]
  4. Update: Lifesaving Treatment and Clinical Operations [5 min] – Melissa Brunsvold, MD; University of Minnesota
  5. Q&A [10 min]
  6. General Q&A and Discussion [20 min]
  7. Closing – Richard C. Hunt, MD, FACEP

Visit the COVID-19 Resources page on EMS.gov for links to important information for EMS leaders and click here to watch the most recent NHTSA EMS Focus webinar, “Crisis Standards of Care and COVID-19: What EMS Needs to Know.”

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