Webinar | EMS Performance: NEMSQA Quality Measures

EMS Performance: NEMSQA Quality Measures Webinar
December 3, 2020 | 15:00 ET | Register Now►

Performance measures drive practice, protocols, spending, and behaviors across healthcare. The National EMS Quality Alliance (NEMSQA) is leading the charge in development, refinement and dissemination of quality and performance measures for EMS. Working with EMS organizations, stakeholders, partners from government and industry, NEMSQA updated the EMS Compass measures to ensure their evidence-basis and make them readily deployable across the EMS community to drive quality and improvement in patient care. This program will inform you about the work of NEMSQA, how the NEMSQA measures are being implemented already, and how you can employ NEMSQA measures to improve performance in your EMS service or region.

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NEMSQA Mission Statement
NEMSQA will develop and endorse evidence-based quality measures for EMS and healthcare partners that improve the experience and outcomes of patients and care providers.

NEMSQA Vision Statement
Improving patient outcomes through the collaborative development of quality measures for EMS and health systems of care.

CARES Act Reporting Requirements Released

All recipients of payments from the Department of Health and Human Services’ Provider Relief Fund (PRF) are required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary.

Providers that received more than $10,000 in grants will have to report on how they spent funds on coronavirus-related expenses and lost revenue in 2020 by Feb. 15, 2021. If providers do not spend all their grant funds by the end of 2020, they will be required to submit a final report on the remaining funds by July 31, 2021.

Any recipient of PRF payments may be subject to auditing to ensure the accuracy of the data submitted to HHS for payment.  Any recipients identified as having provided inaccurate information to HHS will be subject to payment recoupment and other legal action.

For more details, please refer to the Terms and Conditions associated with each payment distribution and the Reporting Requirements and Auditing FAQs.

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CO | Anesthesiologists want paramedics to stop injecting people with ketamine during arrests

From the Colorado Sun

A group of Colorado anesthesiologists wants paramedics to stop injecting people with a powerful sedative when police believe suspects are out of control until officials finish a review launched nearly a year after the death of Elijah McClain, a Black man put in a stranglehold by officers and injected with ketamine.

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NHTSA: EMS Accessing PPE

The National Highway Traffic Safety Administration has released a memo reinforcing the best methods for EMS agencies to request PPE supplies:

  • The preferred method of EMS agencies to obtain PPE is via ordering through the normal supply distribution chains from which they normally order EMS supplies and equipment. The supply chain distributors are becoming more stable in their access to PPE components. In addition, in the near future, Boundtree will have available a larger supply of N95 NIOSH Tested/Approved respirators for purchase, which EMS can tap into
    purchasing;
  • PPE push at the national level is not possible without a Resource Request from the States. Local EMS agencies should work with their local emergency management agency with requests pushed up to the state emergency management agency or for EMS PPE Resource Requests where there are still elevated (albeit decreasing or stabilizing) COVID-19 cases. Once those formal Resouce Requests are received at the federal level,
    they will be reviewed and acted upon.

Download Memo

NHTSA COVID PPE & Resource Reporting Tool

NHTSA asks EMS agencies across the U.S. to take a few minutes each week to report PPE, personnel status within their agency.

EMS and its public safety colleagues continue to serve at the frontlines in the fight against the COVID-19 pandemic. Resource procurement and distribution of personal protective equipment and staffing shortages continue to challenge EMS leaders. It is vital that local, State and Federal officials have the information they need to help address these issues.

The NHTSA Office of EMS, with support from the team at the NEMSIS Technical Assistance Center, has designed a reporting tool to allow for a consistent, real-time method of reporting PPE supply status and personnel shortages. Your participation in the EMS COVID Resource Reporting Tool provides objective evidence to ensure your local agency’s resource status is understood by State and National EMS leadership, and that your resource needs are being prioritized.

While this information will be available to State and Federal Officials, this reporting tool does not supersede coordination with local and state emergency management, public health, or healthcare coalitions. Organizations should still follow local and state procedures for reporting information and requesting supplies or other additional resource needs.

NHTSA is asking agencies to take a few minutes each week, preferably on Monday mornings, to complete the online form. You can find the form, as well as a video and other information explaining how the information is used and how to complete the form, here.

For questions regarding this process, please contact nemsis@hsc.utah.edu.

EMS COVID Resource Reporting Tool

Tracking the reach of COVID-19 kin loss

From the Proceedings of the National Academy of Sciences

“Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States”

Ashton M. Verdery, Emily Smith-Greenaway, Rachel Margolis, and Jonathan Daw
PNAS July 28, 2020 117 (30) 17695-17701; first published July 10, 2020 https://doi.org/10.1073/pnas.2007476117
Edited by Douglas S. Massey, Princeton University, Princeton, NJ, and approved June 19, 2020 (received for review April 18, 2020)

COVID-19 has created a mortality shock throughout the world, and it may yield a second wave of population health concerns tied to bereavement and social support reductions. We created the COVID-19 bereavement multiplier, an indicator that clarifies one downstream impact of COVID-19 mortality and can be applied to different epidemiological projections of death counts: How many people are at risk for losing a grandparent, parent, sibling, spouse, or child for each COVID-19 death. In the United States, we estimate that on average, under diverse epidemiological circumstances, every death from COVID-19 will leave approximately nine bereaved. Studying how acute mortality crises reverberate through a population in the form of bereavement multipliers expands understandings of the social impacts of health crises.

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Interim Guidance: COVID-19 and Field Trauma Triage Principles.

The Federal Healthcare Resilience Task Force has released interim guidance on COVID-19 and Field Trauma Triage Principles. This document provides a brief overview of how the Coronavirus Disease 2019 (COVID-19) impacts trauma triage for first responders, including Emergency Medical Service (EMS), fire & rescue, and law enforcement. The contents of this guidance document do not have the force and effect of law and are not meant to bind the public in any way. This guidance document is intended only to provide clarity to the public regarding existing requirements under the law or agency policies.

Download Guidance

CMS Releases CY 2021 Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) has released the Physician Fee Schedule Proposed Rule for Calendar Year (CY) 2021 which has traditionally included proposed changes to the Ambulance Fee Schedule for the same year. The American Ambulance Association (AAA) has confirmed with CMS that the reason there are no references to the Ambulance Fee Schedule in the Proposed Rule is because the temporary add-ons were built into the regulations themselves.  Thus, the governing regulations already indicate that the temporary add-on payments for ground ambulance transports are effective for services furnished through December 31, 2022.  The regulations are at 42 CFR §414.610 (c)(1)(ii) and 42 CFR §414.610 (c)(5)(ii).

The Proposed Rule also seeks to extend or make permanent several of the telehealth waivers CMS has implemented during the public health emergency.  Because CMS does not believe it has the authority to reimburse ambulance providers or suppliers for services provided without transportation also occurring, these waivers have not applied to ground ambulance.  However, we will review these provisions of the rule closely to identify potential opportunities to include ground ambulance providers and suppliers in these policies.

NEMSIS | HIPAA and Bidirectional Data Exchange White Paper

Prepared by Page, Wolfberg, and Wirth

Overview

Emergency Medical Service (EMS) agencies nationwide still widely report that hospitals and other healthcare providers refuse to share patient information with them, citing concerns under the Health Insurance Portability and Accountability Act (HIPAA).1 Misconceptions about HIPAA have created an  artificial barrier to legitimate, approved bidirectional data exchange between EMS and other providers. As a result, many healthcare systems are missing a critical opportunity to improve patient outcomes and advance evidence-based practices in prehospital care.

Download White Paper

 

Updated CDC Guidance for EMS

On July 15, 2020 the Centers for Disease Control issued an updated guidance for EMS personnel in response to the ongoing Public Health Emergency.

Summary of Key Changes for the EMS Guidance:

  • Reorganized recommendations into 2 sections:
    • Recommended infection prevention and control (IPC) practices for routine activities during the pandemic.
    • Recommended IPC practices when caring for a patient with suspected or confirmed SARS-CoV-2 infection.
  • Added recommendations that were included in healthcare IPC FAQs addressing:
    • Universal use of PPE for healthcare personnel working in communities with moderate to sustained transmission of SARS-CoV-2, the virus that causes COVID-19
    • Creating a process for responding to SARS-CoV-2 exposures among healthcare personnel and others.

Read the Full Guidance

Colorado Natural Hazards Center Grants

The Colorado Natural Hazards Center is offering three grants of $4000 for original research.

  • 1) Communications, the Pandemic, and Local Transportation Resources: What strategies are being implemented, and how effective are they? What are best practices in communicating and messaging by transportation organizations?
  • 2) Transportation, Vulnerable Populations, and COVID-19: What are best practices in providing useful and safe transportation for various socially and economically vulnerable population groups that are traditionally heavily reliant on public transit such as low-income people and racial and ethnic minorities? What about newly vulnerable populations, such as seniors, transportation workers, bus drivers, and so forth? How can the needs of all be met while assuring health and safety among particularly medically fragile or economically marginalized people?
  • 3) Transportation and Emergency Management Policy: How should transportation leaders and emergency managers work together to deliver community services? Including but also beyond ESF-1, what are innovative ways and best practices within and among communities and transportation services to accomplish community objectives during the pandemic? For example: transit agencies have launched food delivery services for vulnerable populations using their idled vehicles and drivers; state DOT facilities have been used a COVID-19 testing sites; Wi-Fi equipped vehicles have been used as local community hot spots.

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COVID Testing for EMS

This document provides a brief overview of COVID-19 testing to inform decision-making for first responders including emergency medical service (EMS), Fire & Rescue, Law Enforcement and 911 telecommunicators.

Overview of testing for SARS-CoV-2 (the virus that causes the disease COVID-19): The Food and Drug Administration (FDA) is the U.S. government entity responsible for regulating medical devices, including tests and devices like those being used to detect SARS-CoV-2. Because of the public health emergency caused by a novel coronavirus, the FDA has issued multiple Emergency Use Authorizations (EUA) for various types of medical devices, including tests. Final validation of these tests still needs to be completed through all of the normal FDA clearance processes and receive approval by the FDA under the traditional marketing pathways approval processes. A list of tests that have been issued EUAs is available at EUA Information: FDA.gov.

Types of Testing:

  • Molecular: The molecular diagnostic tests look for evidence of an active infection by detecting either the genetic material of the pathogen or a unique marker of it. This type of test detects signs of the virus’s genetic material. One type of molecular testing is called a reverse transcriptase – polymerase chain reaction (RT-PCR). This method requires only a small sample size of the pathogen (ex. from blood or saliva) and amplifies segments of the virus’ genetic code and replicates it in order to show its presence and allow it to be more easily detected. A positive result indicates the presence of actual infectious viral material in the body. However, these results cannot alone determine if the pathogen remains viable (e.g., infective) or is dead and no longer infective. The presence of such material does not necessarily indicate if the patient is infectious (although for provider safety, patients with a positive test should be presumed infectious) but simply that such material is there. Test samples are usually obtained from humans using a special nasal swab designed for this purpose.
  • Antigen: The antigen diagnostic tests quickly detect fragments of pathogen proteins found on or within the virus from human testing samples often from a swab of the nasopharyngeal cavity. However, antigen tests may not detect all active infections. Antigen tests are very specific for the virus but are often not as sensitive as molecular RT-PCR tests because of the certainty of positive samples used to develop the actual test. Positive results from antigen tests are highly accurate but there is also a higher chance of false negatives. As a result, negative results do not rule out infection. Until well-validated antigen testing is available, negative results from this approach may warrant confirmatory testing using a molecular test (i.e. an antigen test may need to be confirmed with a RT-PCR test prior to making treatment decisions to help prevent the possible spread of the virus due to a false negative).
  • Serological: The serology tests look for the presence of antibodies, which are specific proteins made in response to an infection as part of the body’s attempt to fight that infection. It does not specifically indicate current (active) disease. It is important to remember that the development of antibodies takes some time, usually weeks, to develop after exposure to the infection. There are also different types of antibodies that are developed and can be tested for individually (i.e. IgG, IgM). Depending upon when someone was infected and the timing of the test, antibodies may not have developed in sufficient quantities to be detected by the test. We currently don’t know if detection of antibodies, and at what level, indicates immunity, and/or protection from future exposure. Similarly, there is another concern that any detected antibodies may instead reflect other strains of more commonly occurring coronaviruses, such as variations of the common cold.

Testing Limitations: No test is 100% accurate 100% of the time.

a. Specificity: Specificity is a measure of a test’s ability to correctly generate a negative result for people who don’t have the condition that’s being tested for (also known as the “true negative” rate). A high-specificity test will correctly rule out almost everyone who doesn’t have the disease when the test is negative and won’t generate a high percentage of false-positive results. (Example: a test with 90% specificity will correctly return a negative result for 90% of people who don’t have the disease but will return a positive result — a false-positive — for 10% of the people who don’t have the disease and should have tested negative.)

b. Sensitivity: Sensitivity is a measure of how often a test correctly generates a positive result for people who have the condition that’s being tested for (also known as the “true positive” rate). A test that’s highly sensitive will identify almost everyone who has the disease and not generate many false-negative results. (Example: a test with 90% sensitivity will correctly return a positive result for 90% of people who have the disease but will return a negative result — a false-negative — for 10% of the people who have the disease.)

c. There are currently a variety of tests which have not been reviewed by FDA but may be purchased to test for COVID-19. The concern with false negatives relates to the higher potential for future transmissions whereas the concern for a false positive relates to unnecessary diagnostic or medical procedures for the patent and wasted PPE use for the provider. A false negative result could lead to additional exposure to contacts of the patient, including first responders and EMS personnel.

Testing Evaluation Tips:

a. Testing for first responders and EMS clinicians should be coordinated with the EMS Medical Director and other local/state public health agencies.

b. Check the FDA site (COVID-19 Testing EUA Recipients) to determine whether the test you are considering purchasing has received an EUA by the FDA.

c. Work with the EMS Medical Director to identify the test error rate to determine whether the results can be relied upon and if actions should be made based upon the data obtained.

d. Purchase tests only through verified suppliers to ensure authenticity. There have been reports of counterfeit tests being sold to unsuspecting clients.

e. Follow the test instructions exactly to avoid increasing the error rate and to achieve full test performance. Use Clinical Laboratory Improvement Amendments (CLIA)-certified labs for test processing, if required, based on the specific test.

Research References:

CDC Serology Testing: https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html
Emergency Use Authorizations: https://www.fda.gov/medical-devices/emergency-use-authorizations-medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices
FAQs on Diagnostic Testing for SARS-CoV-2: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2
FDA Contact Information on Testing:
• Toll-free line 24 hours a day: 1-888-INFO-FDA option *;
• Email to report shortages: deviceshortages@fda.hhs.gov;
Email applicable diagnostic tests: COVID19DX@FDA.HHS.GOV
FDA Statement Regarding COVID-19 Antigen Testing: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-antigen-test-help-rapid-detection-virus-causes
Serology Test FAQs: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2#serology
CDC recommendations for the Testing of COVID 19: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html
Infectious Disease Society of America (IDSA) primer on serological testing : https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody-testing-primer.pdf*

NYT | The Fullest Look Yet at the Racial Inequity of Coronavirus

From the New York Times on July 5, 2020 by By Richard A. Oppel Jr., Robert Gebeloff, K.K. Rebecca Lai, Will Wright and Mitch Smith

Early numbers had shown that Black and Latino people were being harmed by the virus at higher rates. But the new federal data — made available after The New York Times sued the Centers for Disease Control and Prevention — reveals a clearer and more complete picture: Black and Latino people have been disproportionately affected by the coronavirus in a widespread manner that spans the country, throughout hundreds of counties in urban, suburban and rural areas, and across all age groups.

Continue reading►

COVID-19 Testing for First Responders

From the Federal Healthcare Resilience Task Force’s EMS / Prehospital Team on July  2.

COVID-19 Testing for First Responders

Product (EMS42) Purpose

This document provides a brief overview of COVID-19 testing to inform decision-making for first responders including emergency medical service (EMS), Fire & Rescue, Law Enforcement and 911 telecommunicators.

Developed By

The Federal Healthcare Resilience Task Force (HRTF) is leading the development of a comprehensive strategy for the U.S. healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19. The Task Force’s EMS/Pre-Hospital Team is comprised of public and private-sector EMS and 911 experts from a wide variety of agencies and focuses on responding to the needs of the pre-hospital community. This team is composed of subject matter experts from the National Highway Traffic Safety Administration (NHTSA) Office of Emergency Medical Services (OEMS), National 911 Program, Federal Emergency Management Agency (FEMA), U.S. Fire Administration (USFA), U.S. Army, U.S. Coast Guard (USCG), Department of Homeland Security (DHS) Cybersecurity and Infrastructure Security Agency (CISA) and non-federal partners representing stakeholder groups. Through collaboration with experts in related fields, the team develops practical resources for field providers, supervisors, administrators, medical directors, and associations to better respond to the COVID-19 pandemic.

Intended Audience

State, Local, Tribal, and Territorial Governments (SLTTs), First Responders (Law Enforcement, Fire & Rescue, Emergency Medical Services (EMS) and 911 communication personnel).

Expected Distribution Mechanism

EMS.gov, Stakeholder Calls, EMS stakeholder organization’s membership distribution Email mechanisms, USFA website, Social Media posts. Request assistance distributing to FEMA/HHS RECs

Internal Routing Review

NRCC (for approval), All ESFs and HCRTF Teams & Threads (for SA only)

Primary Point of Contact

NHTSA Office of EMS, nhtsa.ems@dot.gov, 202-366-5440

Date Published: July 2, 2020

COVID-19 Testing for First Responders

Purpose: This document provides a brief overview of COVID-19 testing to inform decision- making for first responders including emergency medical service (EMS), Fire & Rescue, Law Enforcement and 911 telecommunicators.

1. Overview of testing for SARS-CoV-2 (the virus that causes the disease COVID-19):

The Food and Drug Administration (FDA) is the U.S. government entity responsible for regulating medical devices, including tests and devices like those being used to detect SARS-CoV-2. Because of the public health emergency caused by a previously unknown novel coronavirus, the FDA has issued multiple Emergency Use Authorizations (EUA) for various types of medical devices, including tests. Final validation of these tests still need to be completed through all of the normal FDA clearance criteria and received approval or clearance by the FDA under the traditional marketing pathways approval processes at this time. A list of tests which have been issued EUAs is available at EUA Information: gov.

2. Types of Testing:

  • Molecular: The molecular diagnostic tests look for evidence of an active infection by detecting either the genetic material of the pathogen or a unique marker of it. This type of test detects signs of the virus’s genetic material. One type of molecular testing uses is called a reverse transcriptase – polymerase chain reaction (RT-PCR) for pathogen detection. This approach requires only a small sample size of the pathogen (ex. from blood or saliva) and amplifies segments of the virus’ genetic code and replicates it in order to be show it is present more easily detected. A positive result indicates the presence of actual infectious viral material in the body. However, these results cannot alone determine if the pathogen remains viable (e.g., infective) or is dead and no longer infective. The presence of such material does not necessarily indicate if the patient is infectious (although for provider safety, patients with a positive test should be presumed infectious) but simply that such material is there. Test samples are usually obtained from humans using a special nasal swab designed for this
  • Antigen: The antigen diagnostic tests quickly detect fragments of pathogen proteins found on or within the virus from testing samples collected from humans, often from a swab of the nasopharyngeal cavity using swabs. However, antigen tests may not detect all active infections. Antigen tests are very specific for the virus but are often not as sensitive as molecular RT-PCR tests because of the certainty of positive samples used to develop the actual test. This means that while positive results from antigen tests are generally highly quite accurate, but there is also a higher chance of false negatives – which means falsely claiming absence of infection, thus negative results do not rule out infection. Until well-validated antigen testing is available, negative results from this approach may warrant confirmatory testing using a molecular test (i.e. an antigen test may need to be confirmed with a RT-PCR test prior to making treatment decisions or to help prevent the possible spread of the virus due to a false negative).
  • Serological: The serology tests look for the presence of antibodies, which are specific proteins made in response to an infection as part of the body’s attempt to fight that infection. It does not specifically indicate current (active) disease. It is important to remember that development of antibodies takes some time to develop after exposure to the infection, usually weeks. There are also different types of antibodies that are developed and can be tested for individually (ie. IgG, IgM). Depending on when someone was infected and the timing of the test, antibodies may not have developed in sufficient quantities to be detected by the test. We currently don’t know if detection of antibodies, and at what level, indicates immunity, and/or protection, from a future exposure. Similarly, there is also, another concern that any detected antibodies may instead reflect other strains of a more commonly occurring coronaviruses, such as those causing which causes some variations of the common

3. Testing Limitations: No test is 100% accurate 100% of the time.

  • Specificity: Specificity is a measures of a test’s ability to correctly generate a negative result for people who don’t have the condition that’s being tested for (also known as the “true negative” rate). A high-specificity test will correctly rule out almost everyone who doesn’t have the disease when the test is negative and won’t generate a high percentage of false-positive results. (Example: a test with 90% specificity will correctly return a negative result for 90% of people who don’t have the disease but will return a positive result — a false-positive — for 10% of the people who don’t have the disease and should have tested negative – which is termed a false positive )
  • Sensitivity: Sensitivity is a measures of how often a test correctly generates a positive result for people who have the condition that’s being tested for (also known as the “true positive” rate). A test that’s highly sensitive will identify almost everyone who has the disease and not generate many false-negative results. (Example: a test with 90% sensitivity will correctly return a positive result for 90% of people who have the disease but will return a negative result — a false-negative — for 10% of the people who have the disease and should have tested positive, or a false )
  • There are currently a variety of tests which have not been reviewed by FDA but may be purchased to test for COVID-19. The concern with false negatives relates to the higher potential for future transmission whereas the concern for a false positive relates to unnecessary additional diagnostic or medical procedures for the patient and wasted unnecessary PPE use for the provider and a false negative result could lead to additional exposure to contacts of the patient, including first responders and EMS personnel.

4. Testing Evaluation Tips:

Testing for first responders and EMS clinicians should be coordinated with the EMS Medical Director and other local/state public health

Check the FDA site (COVID-19 Testing EUA Recipients ) to determine whether the test you are considering purchasing has received an EUA by the

Work with the EMS Medical Director to identify the test error rate to determine whether the results can be relied upon and if actions can be made with the data

Purchase tests only through verified suppliers to ensure authenticity. There have been reports of counterfeit tests being sold to unsuspecting

Follow the test instructions exactly to avoid increasing the error rate and to achieve full test performance. Use Clinical Laboratory Improvement Amendments (CLIA)-certified labs for test processing, if required based on the specific

5. Research References:

CDC Serology Testing: https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html

Emergency Use Authorizations: https://www.fda.gov/medical-devices/emergency-use- authorizations-medical-devices/coronavirus-disease-2019-covid-19-emergency-use- authorizations-medical-devices

FAQs on Diagnostic Testing for SARS-CoV-2: https://www.fda.gov/medical-devices/emergency- situations-medical-devices/faqs-diagnostic-testing-sars-cov-2

FDA Contact Information on Testing:

FDA Statement Regarding COVID-19 Antigen Testing: https://www.fda.gov/news-events/press- announcements/coronavirus-covid-19-update-fda-authorizes-first-antigen-test-help-rapid- detection-virus-causes

Serology Test FAQs: https://www.fda.gov/medical-devices/emergency-situations-medical- devices/faqs-diagnostic-testing-sars-cov-2#serology

CDC recommendations for the Testing of COVID 19: https://www.cdc.gov/coronavirus/2019- ncov/symptoms-testing/testing.html

Infectious Disease Society of America (IDSA) primer on serological testing : https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody- testing-primer.pdf*

Guidance on Interpreting COVID-19 Test Results: https://www.whitehouse.gov/wp- content/uploads/2020/05/Testing-Guidance.pdf

CDC | Testing Guidelines for Nursing Homes

On June 13, the Centers for Disease Control and Prevention issued updated guidance for COVID-19 testing in nursing homes. Thank you to the many  member organizations  providing this vitally important care to our nation’s vulnerable populations. Changes are summarized below:

  • Reorganized recommendations to address:
    • Viral testing of healthcare personnel (HCP)
    • Viral testing of residents
    • Viral testing in response to an outbreak
  • Changed “baseline” testing to “initial” testing, although these terms are interchangeable
  • Added the following recommendations:
    • Testing the same individual more than once in a 24-hour period is not recommended.
    • Clinicians are encouraged to consider testing symptomatic residents for other causes of respiratory illness, for example influenza, in addition to testing for SARS-CoV-2.

CDC Nursing Home Testing

US DOL Issues Guidance Impacting EMS Offices

U.S. Department of Labor Issues OSHA Guidance As Non-Essential Businesses Reopen and Employees Return to Work

WASHINGTON, DC—The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has issued guidance  to assist employers reopening non-essential businesses and their employees returning to work during the evolving coronavirus pandemic.

The guidance supplements the U.S. Department of Labor and U.S. Department of Health and Human Services’ previously developed  Guidance on Preparing Workplaces for COVID-19 and the White House’s  Guidelines for Opening Up America Again. The guidelines provide general principles for updating restrictions originally put in place to slow the spread of the coronavirus. During each phase of the reopening process, employers should continue to focus on strategies for basic hygiene, social distancing, identification and isolation of sick employees, workplace controls and flexibilities, and employee training.

Non-essential businesses should reopen as state and local governments lift stay-at-home or shelter-in-place orders and follow public health recommendations from the Centers for Disease Control and Prevention and other federal requirements or guidelines. Employers should continue to consider ways to use workplace flexibilities, such as remote work and alternative business operations, to provide goods and services to customers.

OSHA recommends that employers continually monitor federal, state, and local government guidelines for updated information about ongoing community transmission and mitigation measures, as well as for evolving guidance on disinfection and other best practices for worker protection.

Visit OSHA’s  coronavirus webpage  frequently for updates. For further information about the coronavirus, please visit the  Centers for Disease Control and Prevention.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit  www.osha.gov.

The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights.